Paying for Therapy
Figuring out how to afford therapy can be as daunting as actually locating a mental health professional. In most areas of the country, an individual can expect to pay between $100 and $200 per session. There are more affordable options, however.
If you have health insurance, explore your coverage before you find a therapist. Staying in-network, when possible, will reduce the cost. Your insurance company should have a list of professionals who accept your plan. Further questions to ask include:
- What is my co-pay for therapy visits?;
- Do I need pre-approval and/or a referral?;
- Do you cover some types of mental health professionals but not others? (For example, plans that do not include therapists may pay for licensed clinical social workers.); and
- Is there any coverage for out-of-network clinicians? If so, how much and what is the process for being reimbursed? (You then need to verify that the mental health professional you choose is willing to give you the necessary paperwork for submitting a claim, typically a billing statement with a diagnosis code and dates and descriptions for services.)
When you first speak with a clinician, it is appropriate to inquire what his/her rate is and if he/she has a sliding scale. (You should be prepared to tell him/her your income and the amount you can pay per session.) If you truly cannot afford therapy, many mental health professionals see a small number of clients for free so do not be afraid to ask if he or she has a pro bono slot available. The Substance Abuse and Mental Health Services Administration has a treatment locator that allows you to search for providers in your area who accept sliding scale fees. Similarly, NeedyMeds, a nonprofit which provides information on affordable healthcare, also has a list of free, low-cost and sliding scale mental health clinics.
The Fairfax-Falls Church Community Services Board has agreements with a variety of health plans and provides basic subsidies for its fees based on an Ability to Pay Scale. As another low-cost option, the nonprofit Open Path Psychotherapy Collective offers a nationwide network of mental health professionals who provide in-office and online mental health care at steeply reduced rates (often $30 to $50 per hour) to individuals and families in need. Clinicians-in-training pursuing degrees at local universities are closely supervised by licensed professionals and typically charge lower rates for appointments. Consider the George Mason University Center for Psychological Services or the George Washington University Meltzer Center. Many of these facilities have long wait times or lists so it is important to plan accordingly.
If you work full-time and are comfortable talking to your employer, check with your human resources (HR) office to see if there is an Employee Assistance Program (EAP). Workers often qualify for a limited number of free counseling sessions through EAPs (with therapists who are bound by client confidentiality regulations) and many employers have discounted out-of-pocket rates that you can pay to receive continuing care from the mental healthcare professionals, who provide EAP services. (If you are concerned that the therapy appointments will be recorded in your personnel file, ask your HR representative about the EAP’s confidentiality policies.) College and graduate students typically can access free mental health resources, including a set number of therapy sessions, on campus through their universities’ Counseling and Psychological Services.
For a short-term solution, consider warmlines, which are gratis and staffed by individuals who are trained to listen and provide support and who typically have personal experience with mental health issues. To locate a warmline, use the National Directory or call/contact 211, a free, confidential national hotline that connects individuals to resources and support in their local areas. Therapy apps, like BetterHelp, 7 Cups of Tea, Talkspace and Teen Counseling, can be less expensive than traditional mental health services; and if you are comfortable talking in front of others, many practitioners offer group therapy at a lower price than individual sessions. You can locate certified group therapists at https://member.agpa.org//imis/agpa/cgpdirectory/cgpdirectory.aspx.
Crisis hotlines are always available free of charge if you need to talk to someone immediately. The Boys Town National Hotline (https://www.boystown.org/hotline/Pages/default.aspx; 800-448-3000) is confidential and open 24 hours a day, 365 days a year for both boys and girls. It is staffed by trained counselors, who provide help with abuse, anger, bullying, depression, school issues and more. Many places of worship have imams, ministers, priests and rabbis who are trained pastoral counselors. (If not, your church, mosque or temple could maintain funds that help members pay for outside therapy.) Support and recovery groups are often gratis and provide an opportunity to discuss your feelings and learn from others with the same condition. The Depression and Bipolar Support Alliance allows you to search for local support groups and chapters.
Just because alternate payment options do not appear to be listed on a website does not mean they are unavailable. In addition, many individuals have unhealthy spending habits (such as impulsive shopping, regularly buying fast food or expensive coffee and energy drinks, and other types of “retail therapy”) that only make them feel better in the short-term and the price of which can be saved and redirected toward mental health treatment. Do not decide that therapy is “too expensive” without determining what it actually will cost.