Therapy as a service…
Therapy is a very unique type of service, and is often misunderstood in our current cultural landscape. In a world where we simply “change the channel” or, swipe on something we no longer want to engage in, therapy invites us to sit and to consider; to wonder; and to work in a thoughtful manner to design a better outcome for our life.
If you aren’t already familiar with the process of therapy, you may not be accustomed to the idea of paying someone for this special service. Alternatively, perhaps you’ve tried therapy before, but didn’t feel you had positive results. This is where it can be helpful to understand further the value exchange since therapy services can range greatly in terms of cost and quality. If you’ve tried therapy but didn’t feel you had positive results, this may be due to many factors. Reasons for unsuccessful treatment can vary, but might include that the therapist of choice didn’t have the right level of experience or training to help. Or, that for some reason, the client was struggling to actively engage or commit to the effort required to yield more desirable results.
As a therapist who has been trained to help others sit with emotion and to help emotionally strengthen others in a profound way, “the swipe left/ right culture” is in direct opposition to how I operate as both a human being and a provider. It has been sad to see large-scale telehealth companies using the line ‘change therapists at any time, no questions asked’ as a type of marketing point as if that’s some sort of indication of an overall positive thing. This is not to say choice isn’t a good thing, but it is to say: perhaps we are rushing through and running from something instead of facing the thing and committing to the work.
The current “anything goes/ instant results” landscape seems to go against the true essence of good and effective therapy and its purpose. I believe therapy is most useful and effective when the therapist is responsibly holding the frame and facilitating the course of treatment which includes clear communication, clear expectations, and a commitment to the work on both sides.
Why therapy?
Having doubts or concerns about starting therapy is completely normal. Most of us are not used to investing in therapy–meaning it might not be a part of our typical monthly or annual routine/ budget–and so as a result, we don’t have any context in which to place the investment in our mind’s eye…
There’s no denying that therapy is an investment of time, energy, and money, and so it’s important that you choose a therapist wisely. It also requires a willingness to explore the self and a commitment to the process which can feel challenging at times. Especially since it requires you to carve out time to show up each week.
As a therapist, I believe ‘the goal of therapy is to end therapy.’
While each situation is a little different and there are circumstances and situations that may require more long term support and care; generally speaking–therapy is most often a time-limited pursuit. I think of therapy as a course of treatment designed to help you make important improvements to your life (whatever form that may take). Therapy can help you heal from unresolved traumas, family of origin wounds, and gain awareness into any vulnerabilities that are keeping you stuck or struggling in some way.
Through a caring, individualized therapeutic alliance, that is designed to provide both a comforting and challenging environment, your therapist helps you to see yourself from a more authentic and compassionate stance while helping you to take meaningful action toward your desired outcome(s).
Therapy is an investment in your relational and emotional well-being designed to have a lasting positive impact.
While experience isn’t the only factor that goes into making the therapist effective, it can certainly make a big difference in the treatment and helping you work toward your goals. An experienced therapist who is fully licensed and who has been practicing for several years will have a breadth and depth of clinical experience and knowledge that newer therapists would not yet have been able to cultivate given their lack of experience. This is not to say that newer therapists are not helpful, however, you may find the lack of experience to inhibit progress in some important ways depending on your situation and presenting issues.
Understanding the landscape of mental health treatment in general…
The mental health system is a broken one. While there can be many positive aspects to our healthcare system in a broad strokes sense, there are also many challenges. Meaning that as a system, it isn’t functioning all that well and a lot of people struggle to get the right care they need when they need it. Providers do their part to create more accessibility in general and offer services on a sliding scale basis as well as group work. Companies are beginning to tune in more deeply to the importance of mental health overall and offer resources and stipends to their employees. And in general, there’s less overall stigma and people are more educated on the many benefits of therapy and the ways it can significantly improve their quality of life. In addition, there are also many helpful resources that have been developed to help improve access to high quality mental health services, which I will share at the end of this article. While the landscape has significantly shifted over the last ten years, there is still much work to be done. By truly valuing the service of therapy, we continue to move in the direction of truly valuing our peace, well-being and our relational health.
Another factor impacting the overall landscape of therapy services is the low in-network insurance reimbursement rates for providers. As a result, many experienced therapists opt not to take insurance directly (in-network) because they simply wouldn’t be able to sustain themselves. Licensed therapists, similar to doctors and attorneys have spent many years training to become competent in their chosen field often taking out loans to complete their studies. Once a therapist completes graduate school, there are several more years of training required in order to become fully and independently licensed. This failure to acknowledge and respond to the realities of the cost associated with becoming an experienced and highly trained professional therapist contributes to the discord and disjointedness of how services are seen and utilized.
But I’ve never considered therapy to be an important investment…
Lots of folks don’t, and that’s part of the issue. We tend to value therapy only when we are in crisis, but not so much during regular times. Think for a moment what you spent time and money on over these last three months…as you reflect, how did your spending serve you? Do you have any regrets? Do you feel positive about what you seem to deem valuable? What might you change moving forward?
Therapy is the type of service often not thought about until you are feeling “in need of it,” which can impact how we think about investing in it. It can be helpful to contextualize therapy as a unique service and view it as a more time-limited expense rather than a long-term one. It can also be helpful to view therapy as a co-constructed course of treatment with a beginning, middle, and end. The therapist, who is trained to help with the specific issues you are facing, serves as a helpful guide on your unique journey.
Isn’t it like going to the doctor?
Similar but different. As the field of therapy moved over to primarily being controlled by managed care (insurance companies), the way psychotherapy services were offered drastically shifted as the insurance companies moved in to take ownership over the entire experience. As a result, the insurance companies deem how much services should cost and how long a person should be treated for–which can be limiting for many seeking the right care. For this reason, many therapists opt not to contract with insurance companies directly.
In addition, psychotherapy involves the development of an ongoing therapeutic relationship which involves the client sharing personal details about their life that is unique to the service when compared with other types of treatment providers.
Can I afford it?
This is a unique question because it also invites the question what are you willing to spend time and money on and why? Therapy might not be where you want to skimp and here’s why…
- it’s temporary (in most cases, though not all)
- it’s an important investment
- it can significantly improve the quality of your life
- cost is often influenced by therapist’s level of experience and training
Will insurance help pay for it?
In many cases, if you have insurance that covers out-of-network coverage, the answer is likely yes. You will want to contact the number on the back of your insurance card to find out if your contract covers out of network mental health services. You can also ask about the specific codes: 90791 (initial psychiatric assessment), 90847 (family/ couple work), and 90834 (individual psychotherapy) to learn more about the specific coverage of each. This can help you to make informed decisions regarding your care. In most cases, an experienced and highly trained therapist may be a more costly option, but you may find the work is more succinct and helpful overall—resulting in less time, energy and money spent in the long run. Ultimately, it’s important to consider your own specific needs and resources and make an informed decision from there.
What if I can’t afford it?
If you’re finding that the cost is out of reach after considering your personal situation in the context of the landscape of therapy, don’t lose hope. There are many wonderful resources that provide high quality care at low or no cost. You may have to do some research and provide some details about your income, but there are great options out there which I have outlined below. While the most important qualities to look for in a therapist are training and experience, the next most important quality is how comfortable you feel with them. (Studies show the effectiveness of therapy depends on a high quality therapeutic relationship!)
Ackerman Institute for the Family (NY- based)
Institute for Contemporary Psychotherapy (NY- based)
Loveland Foundation -provides assistance for Black women and girls seeking therapy services.
While the initial efforts involved in starting therapy can feel a bit cumbersome at first, therapy is work worth doing. Taking the time to address struggles and tend to our personal barriers helps us grow stronger in the long run. Taking active steps toward the life we desire to live is a powerful form of self-love!