Where do you start when you’ve decided to see a therapist. People often turn to their health insurance for lists of providers. But, is that the best way to go?
It’s generally true that a session with an insurance therapist may be the cheaper option. Often you’ll pay just a co-pay, approximately $10 to $40 for each meeting (check your specific policy for your costs). Paying for therapy without insurance can cost anywhere from $150 to $300 per session. So it might seem like a no-brainer to choose an in-network therapist. However, there are some additional things to consider.
Your Insurance Might Actually Pay For A Therapist Who’s Not On Their List
Some insurance plans will partially pay for any licensed therapist, even if they are not directly contracted with the insurance company. If yours does, your cost may be a lot less than you think. Be sure to check out whether you have coverage for out-of-network providers. At open enrollment time with your employer, you may also want to explore your options to see if there is a plan that has this type of coverage.
Find The Right Therapist For You
If you’ve ever tried to find a therapist, you may know how difficult it can be to find the right one. It can be a little like dating. You may have to talk to more than one before you find that “just right” person. The most important factor in psychotherapy is the relationship between the client and the therapist. If the values or vibes are a mismatch, it’s probably not going to work out very well, regardless of their skill set or years of experience.
Not to mention, you may be looking for something specific. Maybe you want to see someone in-person, or see an African-American therapist, for example. In my case, I am a queer-identified therapist, who focuses primarily on serving the LGBTQ+ community. I also have a focus on survivors who have left religion and may have experienced religious harm or trauma. People seek me out for these reasons. However, if you need help with something like an eating disorder, or OCD, I am probably not the right therapist for you. The good news is that there are plenty of therapists who have these specialties.
Mediocre Therapy Has A Cost
Some therapists are doing mediocre therapy out there, and while some may actually be incompetent, many are simply overloaded. Why? They are seeing too many clients just to make ends meet. Clinics are understaffed. Insurance contracts don’t pay enough. The only way to adequately support themselves and their families is to see high numbers of clients. But they’re fried.
Here’s the thing. Doing therapy (well) is a very taxing endeavor. It is not something one does 40 times in a week. It’s sometimes difficult for a non-therapist to understand what it’s like, but here is a translation of the therapist experience for others (partially paraphrased from user sassybleu on Reddit):
Imagine you’re running an important meeting and have to pay close attention to literally everything that happens, both what’s being said and what’s not being said. You cannot zone out AT ALL. During the entire meeting, you’re mentally accessing and applying anything you know, which includes knowledge about the person(s) in front of you, and as well as deciding in the moment how and when to apply various skills and interventions, and what to say or not say. You’re also sometimes hearing about very painful or difficult human experiences. Through all of this, you must keep all of your own emotions in check. And keep track of time. Then you have to quickly summarize it all in a note that justifies your services. Now, repeat that X number of times per day, 5 days a week.
Would you want to see a therapist who is doing this 7 times before you see them that day? Or would you prefer to see someone who isn’t running on fumes? Broadly speaking, your experience in therapy will be better with someone who isn’t totally burnt out and stretched thin.
(As someone who worked for years in those overloaded situations, I can assure you that I was not doing my best work when I was living with chronic burnout. I was miserable, and my clients weren’t getting what they truly needed.)
Seeing The Wrong Therapist Costs You Time
It’s also good to consider the literal cost of your struggle with mental health. Is your condition preventing you from getting a promotion at work, finishing school, changing jobs, or getting your business to the next level? With a suboptimal therapist you may end up spending longer in therapy. This could mean paying for many more sessions over time, but it also costs that time. If you could feel better in six months or a year, instead of spending 2-3 years in therapy, might that time saved be worth something? It’s something to consider. That’s not to say that higher per-session prices equate to fast healing. Change is often slow, even under the best circumstances. But seeing a therapist who is overworked, underqualified, the wrong fit, and/or can’t see you very often will slow down the process even further.
Protect Your Confidentiality
Therapy is confidential, with few exceptions. But did you know that when you use insurance to pay for therapy, the insurance company receives information about you and your mental health? It might be as little as a diagnosis (yes, you’re being “diagnosed”), or as much as the actual content of the notes that your therapist keeps about you. Some people don’t mind this, but some, especially in the queer and trans community, do. Those folks prefer not to take the chance that it might negatively impact them later.
Not only are the contents of your discussions private, but so is the fact that you’re even attending therapy. For example, I had a client who referred their cousin to me. When the cousin contacted me, she said, “My cousin ___ referred me to you, they’ve been seeing you for a while and spoke highly of you!” To which I answered, “Oh, okay! Well, how can I help you?” I did NOT say, “Oh cool, I enjoy working with ___, I’m glad they referred you!” as one might do in a standard business setting. I can’t say anything that would confirm my client relationship.
Utilizing insurance also increases the risk that other people in your life will know you’re in therapy, if that matters to you. It’s nothing to be ashamed of, but you still might not want others to know. So how would they find out? If you are on your partner’s or parent’s insurance, the primary insured may receive documents that indicate you’re in therapy. Insurance companies send statements (commonly known as an EOB, or explanation of benefits) with a list of the services they have covered. This includes therapy visits.
BONUS TIP: You May Save Money Through An FSA/HSA
As a benefit through your employer, you may also have the option of using a Flexible Spending Account or Health Spending Account, and then use those funds to pay for therapy (as well as other health expenses). These accounts may help you save money by avoiding income taxes on the cash that you put in them. So you end up with extra money to spend on therapy, which can help you pay for the therapist that’s just right for you. Check with your employer/HR to see if this is an option for you.
Where do you start when you’ve decided to see a therapist. People often turn to their health insurance for lists of providers. But, is that the best way to go?
It’s generally true that a session with an insurance therapist may be the cheaper option. Often you’ll pay just a co-pay, approximately $10 to $40 for each meeting (check your specific policy for your costs). Paying for therapy without insurance can cost anywhere from $150 to $300 per session. So it might seem like a no-brainer to choose an in-network therapist. However, there are some additional things to consider.
Your Insurance Might Actually Pay For A Therapist Who’s Not On Their List
Some insurance plans will partially pay for any licensed therapist, even if they are not directly contracted with the insurance company. If yours does, your cost may be a lot less than you think. Be sure to check out whether you have coverage for out-of-network providers. At open enrollment time with your employer, you may also want to explore your options to see if there is a plan that has this type of coverage.
Find The Right Therapist For You
If you’ve ever tried to find a therapist, you may know how difficult it can be to find the right one. It can be a little like dating. You may have to talk to more than one before you find that “just right” person. The most important factor in psychotherapy is the relationship between the client and the therapist. If the values or vibes are a mismatch, it’s probably not going to work out very well, regardless of their skill set or years of experience.
Not to mention, you may be looking for something specific. Maybe you want to see someone in-person, or see an African-American therapist, for example. In my case, I am a queer-identified therapist, who focuses primarily on serving the LGBTQ+ community. I also have a focus on survivors who have left religion and may have experienced religious harm or trauma. People seek me out for these reasons. However, if you need help with something like an eating disorder, or OCD, I am probably not the right therapist for you. The good news is that there are plenty of therapists who have these specialties.
Mediocre Therapy Has A Cost
Some therapists are doing mediocre therapy out there, and while some may actually be incompetent, many are simply overloaded. Why? They are seeing too many clients just to make ends meet. Clinics are understaffed. Insurance contracts don’t pay enough. The only way to adequately support themselves and their families is to see high numbers of clients. But they’re fried.
Here’s the thing. Doing therapy (well) is a very taxing endeavor. It is not something one does 40 times in a week. It’s sometimes difficult for a non-therapist to understand what it’s like, but here is a translation of the therapist experience for others (partially paraphrased from user sassybleu on Reddit):
Imagine you’re running an important meeting and have to pay close attention to literally everything that happens, both what’s being said and what’s not being said. You cannot zone out AT ALL. During the entire meeting, you’re mentally accessing and applying anything you know, which includes knowledge about the person(s) in front of you, and as well as deciding in the moment how and when to apply various skills and interventions, and what to say or not say. You’re also sometimes hearing about very painful or difficult human experiences. Through all of this, you must keep all of your own emotions in check. And keep track of time. Then you have to quickly summarize it all in a note that justifies your services. Now, repeat that X number of times per day, 5 days a week.
Would you want to see a therapist who is doing this 7 times before you see them that day? Or would you prefer to see someone who isn’t running on fumes? Broadly speaking, your experience in therapy will be better with someone who isn’t totally burnt out and stretched thin.
(As someone who worked for years in those overloaded situations, I can assure you that I was not doing my best work when I was living with chronic burnout. I was miserable, and my clients weren’t getting what they truly needed.)
Seeing The Wrong Therapist Costs You Time
It’s also good to consider the literal cost of your struggle with mental health. Is your condition preventing you from getting a promotion at work, finishing school, changing jobs, or getting your business to the next level? With a suboptimal therapist you may end up spending longer in therapy. This could mean paying for many more sessions over time, but it also costs that time. If you could feel better in six months or a year, instead of spending 2-3 years in therapy, might that time saved be worth something? It’s something to consider. That’s not to say that higher per-session prices equate to fast healing. Change is often slow, even under the best circumstances. But seeing a therapist who is overworked, underqualified, the wrong fit, and/or can’t see you very often will slow down the process even further.
Protect Your Confidentiality
Therapy is confidential, with few exceptions. But did you know that when you use insurance to pay for therapy, the insurance company receives information about you and your mental health? It might be as little as a diagnosis (yes, you’re being “diagnosed”), or as much as the actual content of the notes that your therapist keeps about you. Some people don’t mind this, but some, especially in the queer and trans community, do. Those folks prefer not to take the chance that it might negatively impact them later.
Not only are the contents of your discussions private, but so is the fact that you’re even attending therapy. For example, I had a client who referred their cousin to me. When the cousin contacted me, she said, “My cousin ___ referred me to you, they’ve been seeing you for a while and spoke highly of you!” To which I answered, “Oh, okay! Well, how can I help you?” I did NOT say, “Oh cool, I enjoy working with ___, I’m glad they referred you!” as one might do in a standard business setting. I can’t say anything that would confirm my client relationship.
Utilizing insurance also increases the risk that other people in your life will know you’re in therapy, if that matters to you. It’s nothing to be ashamed of, but you still might not want others to know. So how would they find out? If you are on your partner’s or parent’s insurance, the primary insured may receive documents that indicate you’re in therapy. Insurance companies send statements (commonly known as an EOB, or explanation of benefits) with a list of the services they have covered. This includes therapy visits.
BONUS TIP: You May Save Money Through An FSA/HSA
As a benefit through your employer, you may also have the option of using a Flexible Spending Account or Health Spending Account, and then use those funds to pay for therapy (as well as other health expenses). These accounts may help you save money by avoiding income taxes on the cash that you put in them. So you end up with extra money to spend on therapy, which can help you pay for the therapist that’s just right for you. Check with your employer/HR to see if this is an option for you.