How to Pay for Therapy
When I ask people why they aren't in therapy, here's the most common answer I receive, over and over again:
"Therapy is way too expensive - I can't afford it!"
In some of these cases, this response is absolutely accurate. Your life, time, responsibilities, and financial circumstances truly are stretched to the breaking point. Every single day you're hustling like mad just to survive. I see you.
This message is for those who don't fall into the hustle-to-survive category.
This message is for those of you arranging your finances in such a way that promotes temporary gratification over long-term growth. I see you, too. Heck, I've BEEN you - and still continue to be some days! So no judgement here!
I'm not offering judgement or launching an attack against you. What I AM offering is a suggestion, and encouragement - for you to get curious. For you to get curious about your relationship to money, specifically.
Here are some reflection questions to help you think about and clarify your relationship with money:
What's the first word that comes to your mind when you think about money?
What's the first emotion that comes up for you when you think about managing your money?
When you were growing up, what lessons were you taught from your authority figures and culture about money and money management?
How would you describe your overall relationship with money? Do you feel calm and confident? Or do you feel fearful, resentful, and like money is controlling you - rather than you managing your money?
Do you avoid checking your bank account balance because of that sense of dread you get every time you open your and app to check your balance - because that balance is always less than you hope?
Do you struggle to save money because you often make "impulse buys" that in the moment feel good - but later on, you feel guilty or ashamed?
I encourage you to think about your relationship with money because money is a symbol of freedom. In so many ways, it dictates the terms of how we are able to invest in our lives and our selves. So often we are making financial decisions that are driven by our subconscious without even realizing it. Focusing on momentary gratification and coping rather than investments that will truly help us build the life we truly desire.
I say this because so often I find that once I have deeper conversations with folks about therapy and the cost of it - it's rare that the truth of why they're not attending therapy is only because of finances. Instead, once we dig in a little, I usually hear a variation of the following reasons for why folks REALLY aren't going for therapy:
They're not ready for therapy or the painful work that accompanies addressing wounds, healing, and growing.
They don't believe that therapy is worth the financial investment.
They have a fearful and tumultuous relationship with money, and struggle with creating a budget that's in line with their values.
Which, in essence, boils down to the following: therapy is not a priority at the moment (or maybe ever).
Because remember - we invest in our priorities.
(And again - this message is NOT for folks who are truly tapped in terms of resources! This message is for the folks who DO have disposable income but are choosing to spend it on other things).
If therapy isn't a priority for you - that's ok! It doesn't have to be!
Therapy isn't for everyone, or for every season of life.
I'm not telling you that everyone should be in therapy all the time.
What I AM saying is that self-reflection, awareness, and being honest with yourself will go a long way. So even if therapy isn't a priority for you - be honest with yourself about that truth. Acknowledge it, own it - and then keep it movin'.
So, all that being said - if you've realized that perhaps the financial barriers you had previously conceptualized are maybe not as large as you once thought...I AM offering some options to consider for different ways to pay for therapy. And options for low-cost therapy - because therapy SHOULD be affordable and accessible to everyone.
Employee Assistance Programs (EAP) - EAP's are something that an employer pays for so that employees can utilize the EAP services free of charge. They offer services like initial consults, short-term counseling, referrals, and follow up services. This is not traditional longer-term therapy, but it's a great option for folks who are struggling financially and need immediate assistance. Most EAP's offer on average 3-5 counseling sessions for free, during which time you can speak with a trained mental health professional and get assistance getting linked with longer-term therapy options that work for you and fall within your budget. Plus sometimes it's nice just to have someone to talk to, especially when you're going through a hard time.
Flex Spending Account (FSA) / Health Spending Account (HSA) - FSA's and HSA's are great. They're special accounts that you contribute a portion of each paycheck into. These funds are pre-taxed (yay, savings!) and can only be used on healthcare-associated costs - including therapy. You'll receive a card (similar to a debit or credit card) where the funds live, and every time you use your FSA or HSA card, you basically get a discount on whatever you're purchasing - because you won't get taxes taken out on it later on. That's money back in your pocket, and I honestly can't think of a reason why you wouldn't want that!
Health Insurance: In-network-providers - Ask your health insurance company to provide a list of their in-network providers. If your therapist is in-network, this means that you'll likely only need to pay a co-pay at the time of your therapy session. It's then up to your therapist to reach out directly to the insurance company and provide appropriate documentation. The insurance company will then decide whether to reimburse the therapist for the remaining cost of the session or sessions.
Health Insurance: Out-of-network benefits - A lot of therapists don't accept insurance because the process can be quite finicky - sometimes insurance takes forever to pay out, or they don't pay out a livable wage, or they decide not to pay at all. So if the therapist you're interested in doesn't take your insurance, don't count them out just yet! Ask your insurance company if they have "out of network benefits" when it comes to therapy. This often means that they'll cover part of the therapy session cost; the percentage they cover ranges based on insurance company and plan. You'll show up to session and pay the full fee up front, and then submit documentation (your therapist will provide you with a specific type of bill that's insurance appropriate) to your insurance company, and they'll reimburse you for the percentage of the cost they cover. Here's a great article that goes more in depth on out of network benefits.
Sliding Scale - Many therapists offer something called a "sliding scale" when it comes to their fees. This means they offer a range of fees they're willing to take, and they'll match the cost of session based on your income level.
Low-cost options - Check your local universities and therapy institutes. These academic training grounds often have therapists-in-training who are acquiring experience as they're working toward a degree or specialized certification. Because it's a learning experience for them, they often offer their services at steeply discounted rates. It's still a great option for therapy, as many folks in training offer great services. And don't worry, they're being directly supervised and guided by more experienced clinicians the whole time!
Open Path Collective - A nonprofit that prioritizes affordable and accessible care for those who need it most, you pay a one-time fee of $50 to get a "lifetime membership" to a database of therapists who offer their services for $30-$60 per session. Open Path is currently offering both in-person and online therapy. Just know that in order to qualify, you do have to show proof of financial need.
Bi-weekly or monthly sessions - Not sure if folks are aware of this fact, but - you don't have to shell out money *every single week* for therapy! If the financial component is too steep, it may create so much stress that the stress itself outweighs the benefits of therapy. I usually recommend to new clients that we begin with weekly sessions, simply because the process of getting to know each other and build rapport is quite crucial. But if you're not able to do so, most therapists will coordinate with you to create a therapy plan that works for you. That may look like starting off with weekly sessions for the first month, and then decreasing to every other week from the second month on, with the therapist providing interim assignments to work on in between sessions. It may look like once you reach a certain point in therapy, you agree to go down to just monthly sessions as "mental health check ins." Point being, your therapist should be willing to work with you on a therapy treatment plan that really works for you, rather than pressuring you into a time commitment that creates more stress and pressure. And if they're not willing to do so, that's likely a red flag - and I recommend looking for a different therapist!
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