Therapy as an Investment
The cost of therapy is among the barriers to receiving quality treatment. Approaching therapy as an investment and recognizing its worth shifts the narrative of what we can afford. Therapy might seem like an expensive endeavor, but probably not compared to maintaining your physical health or letting your symptoms get the better of you. It’s also true that good mental health still tends to be undervalued as a necessity.
The Cost of Therapy Broken Down
Waiting Last Minute to Address Mental Health
There continues to be stigma around seeking treatment and it is sometimes perceived as a luxury compared to a debilitating physical illness such as cancer or heart disease. It’s probably easier to dismiss mental health symptoms such as anxiety or depression than it is a protruding tumor or persistent cough. How long did you wait before pursuing treatment and what were the true costs in doing so? Sometimes we are not aware of the impact of not tending to our mental health until healing is well underway and we become aware of the consequences of living life in the margins, off the radar and underwater.
Cost of Therapy: What are the Variables?
The average cost of a therapy session is typically about $100 to $200. Cost will vary depending on your location, the clinician’s expertise and experience and, to some degree, your financial need. Therapists with more experience and specialized training tend to charge more than recent graduates or those without specialized training. The location can make a difference too. If your therapist has an office location or is located in a metropolitan area, the cost is typically higher. New York City psychiatrists can charge about $400 a session, psychologists around $250 and social workers $200. When you pay for a session, you are often also paying for rent, training, education, license fees and administrative costs. It’s not just that fifty-minute hour. (In some practices, insurance only covers a forty-five-minute hour).
The Differences Between Mental Health Practitioners
Are all Therapists Equal?
Since we just mentioned an assortment of practitioners who all provide therapy, let’s take a moment to comment on how they might differ in the therapy they provide. Practitioners may vary depending on scope of practice, training as well as cost. The best therapist for you won’t necessarily be determined by the depth of training or cost. This is why it’s important to do a little research before making your investment. Bear in mind that there’s some degree of overlap. Psychologists, psychiatrists, social workers, licensed professional clinical counselors, licensed marriage and family therapists, pastoral counselors and psychiatric nurse practitioners all provide psychotherapy.
Here’s a brief breakdown on different types of practitioners:
- Social workers (BSW, MSW, LMSW, LCSW) tend towards a broader context than many other therapists in treating mental health that incorporates social, cultural, economic and other environmental factors with a degree of focus towards social justice, advocacy and self-empowerment. They can diagnose mental health disorders, but do not provide medication. A clinical social worker has at least a master’s degree in social work and training to evaluate and treat mental illnesses.
- A psychiatrist (M.D.) has a medical background and can diagnose and prescribe medication to treat mental health symptoms. Psychiatrists that provide therapy tend towards talk therapy.
- Psychologists (Ph.D. in Psychology or Master’s Level) also provide mental health care, but tend to focus on evaluations and diagnostic test administration. A psychologist is a great start for someone needing very specific diagnosis for a severe mental illness or learning disability. Historically, psychology focuses on pathology, that is, identifying what might be wrong with a client as an individual.
- Marriage and Family Therapists (LMFT) evaluate symptoms, diagnoses, and issues in the context of the client’s relationships typically within the family system.
- Licensed professional clinical counselors (LPC) focus primarily on the needs of patients as individuals from a developmental perspective looking at current functioning.
The Deal With Insurance
One of the factors affecting the cost of therapy has to do with insurance. Your therapist may or may not accept insurance. Many private practitioners do not accept insurance for a variety of reasons that include wanting more autonomy over the session and determination of clinical need. Many practitioners have grown weary of spending countless hours debating the type and length of treatment especially with a bureaucrat who doesn’t see patients and didn’t see your patient. Therapists don’t treat line items. They treat people.
Another closely related issue concerns the loss of privacy and future repercussions if you have a mental health diagnosis. Insurance companies require a diagnosis in order to pay for treatment. They can request access to your written records that document your symptoms, progress and treatment. This can be used to deny or reduce other benefits in the future. Some diagnoses e.g. bipolar disorder can affect promotions and access in certain careers.
In and Out of Network
Even if a practitioner accepts insurance, they don’t typically accept all insurance. Different insurance companies have various requirements and payout schedules. There’s also the issue of deductibles and whether your particular insurance covers mental health.
Just because your therapist does not accept insurance, there are still options to keep therapy an affordable option. Many clients can still seek reimbursement from their insurance company if mental health benefits are provided for out of network providers. Therapy is such a personalized experience, it’s worth emphasizing the right fit and training than selecting a practitioner based on a zip code or some other factor evaluated by insurance.
Need help with filing out of network benefits?
There are handy tools for out of network billing that make the process fairly simple. For about $3 a claim, you can pay a service such as Reimbursify to file the claim for you if you don’t want to call your insurance company.
By selecting your own therapist, you increase your likelihood of successful engagement. Therapy is unlikely to work if you don’t have rapport with your therapist. Now that telehealth is so widespread, your location need not keep you from the right therapist for you. Gender, race, experience, age and other factors play an important role for many individuals in their selection of health professional. You don’t want to stop and start therapy. Once you start, it’s best to follow it through.
“Therapy is unlikely to work if you don’t have good rapport with your therapist. Does your insurance company know your preferences in terms of gender, age, race, cultural background or expertise? Increase your autonomy by being active in the therapist selection process.”
Your Investment Starts Before Your First Session
Be an Active Participant in Your Care
Here are some things to consider and discuss with a prospective therapist and before starting treatment:
- Goals. Think about what you want out of therapy ahead of time. Even better, come up with a few goals that reflect what you want out of treatment. What would a better day look like? Thinking ahead of time will help you stay focused in your sessions. When you feel awful, it’s easy to drift into aimless venting, lose track of time and work on issues that don’t really reflect any meaningful change.
- Scheduling. Consider appointments at “off peak hours.” Many people want evening hours, but just how many of those are available? There’s currently a shortage of mental health providers relative to the demand. You increase your chances of getting an appointment or negotiating a discount if you are willing to be flexible.
- Training, expertise & credentials. Interview your therapist and make sure you are aware of their expertise and credentials. Find out how that experience might work for you specifically. You don’t need to pay for what you don’t need and you don’t need to pay and not use what you need. A surprising number of clients remain closed to offerings and trainings that might be outside their awareness or comfort zone, but can greatly facilitate their healing process. Some situations are more complicated than you might realize. Specialized training is often beyond the scope of practitioners only a few years out from school. Many experienced practitioners in private practice are trained in modalities that not only advance the healing process but accommodate different comfort zones. For example, for those with trauma-based symptoms who cannot recall or are reluctant to discuss the details of their trauma, there are some interventions that don’t require detailed narrative. Insufficiently trained therapists may offer fewer options, derail or prolong therapy because of their inexperience. Saving a dollar today might cost you more in the long run.
- Not every issue is a mental health issue. Do you need therapy or coaching? If you do not have a mental health disorder or diagnosis, sometimes you can benefit from specialized knowledge, consultation or problem-solving assistance from an experienced coach. Many therapists offer their expertise as coaches and may also have workshops available to help you cope with your issues in a more affordable manner. For instance, parents needing guidance or skills to cope with co-parenting, families living with addicted loved-ones, those in interracial relationships or couples needing pre-marital guidance might benefit from affordable coaching.
- Think ahead. Schedule a consultation or reach out to your therapist ahead of your appointment to ask what you need to know to move ahead with therapy. It’s important not to turn the consult into a therapy session. Think ahead of time what you need most to determine the fit that is right for you.
- Flexibility. Stay open to any therapist suggestions that might make your treatment more affordable. Ask about in-between session support and consider small group work in which you can practice key skills. Group sessions are typically longer and much more affordable than individual sessions. Contrary to popular belief, you can maintain privacy in your small group work and still benefit tremendously. Research the benefits that can be provided by a clinician with specialized training in group work. Group should be much, much more than an audience for your concerns and group talk.
- Commitment. Keep cancellations to a minimum so you keep momentum going in your work. Therapists love motivated clients.
- Accountability. Come to sessions prepared and review your treatment plan objectives/goals to help you stay focused.
- Penny wise and pound foolish? Explore options such as EMDR intensives which are more cost-effective in the long run. (1-4 weeks). Our relationship intensives allow you to include family members and schedule 2.5 hour intensives.
- Reimbursement. Contact your insurance company before you start therapy to find out if they will reimburse you for coverage. If therapy seems beyond your reach, ask your therapist to work with you on a payment plan that allows you to pace a large deductible. Easier still, companies such as Reimbursify can demystify out of network benefits and do the legwork for you. The process may be as simple as taking a picture of the superbill supplied by your therapist and sending it to Reimbursify.
- Let technology work for you. Since telehealth has become a fairly permanent way of providing mental health services, make sure you’re savvy with respect to any technology you might be using and have a good internet connection. Not only is it frustrating to not have a good connection, you eat up valuable session time trying to connect. Find out if your therapist will be using any applications that you might have to download ahead of time.
- Sliding scale. Find out if your therapist offers a sliding scale particularly if your finances change during your time in therapy. Many therapists are willing to work with motivated clients who respect therapy practices and policies. Make sure you understand the terms and limits governing your discount.
“Many therapists are willing to work with motivated clients who respect therapy practices and policies.”
Here’s some additional information to help you get the most out of your therapy:
You can find other soundbites related to preparation for therapy here . Stay in tune with issues related to your well-being and mental health right here in the Urim Recovery Journal updated 2x a week.