Finding affordable psychotherapy can sometimes seem like an oxymoron. Experienced and highly trained mental health professionals, such as psychologists, psychiatrists or marriage and family therapists in practice for decades, can garner fees well over $100/hour for their services.
While managed care in the 1990s and continued cost cutting by health insurance companies have placed downward pressure on most clinicians' salaries, these fees still seem high and out of reach for most middle-class Americans. While private health insurance will pick up the majority of this cost if you're covered (generally requiring a co-pay of between $10-30 per session), if you're not covered or used up your allotment of visits for the year, you may be looking for alternative ways to pay for psychotherapy.
Alternative Forms of Psychotherapy
Psychotherapy isn't just delivered face-to-face any long. You can now get psychotherapy over the telephone, online, and even on your iPhone! Some forms of these alternatives put you in touch with a licensed mental health professional, just like face-to-face. The only difference is that you're interacting with them by telephone, or via email or chat sessions online. Other forms of online therapy techniques are more like self-help programs -- step-by-step guides and tutorials that walk you through common things you might learn in regular cognitive-behavioral therapy.
The benefit of these methods, besides convenience, is usually lower costs than seeing someone face-to-face. And don't worry about whether these techniques are effective or not -- research has demonstrated their effectiveness for a variety of mental health concerns, including depression.
Discounted Fee Schedules – Sliding Scales
The first place to check is with your current therapist. Many, but not all, therapists offer a fee service schedule for cash-only clients that may "slide" – that is, the fee goes down based upon your income. If you're making a middle-class salary, the discount offered by such sliding scales may not be much. But if you're in the lower socio-economic class, this discounted fee schedule can cut a regular therapist's fee in half or more.
Such discounted fee schedules are entirely up to individual therapists to set. For their own economic well-being, many therapists can't offer them. Don't blame the therapist – they are in a competitive business. Many therapists in solo or small private practices are firmly in the middle-class themselves, and rely on whatever their fees are to make ends meet.
Community Mental Health Centers
Less expensive than private practitioners are public resources setup during the 1960s to try and help move the mentally ill confined to hospitals back in to the community. These community clinics, typically referred to as community mental health centers, are available in hundreds of communities across the country. They are often funded and run by the local government, such as a county or city.
Community mental health centers rarely offer free psychotherapy, however. Like the sliding scale model in private practice, these clinics charge fees to people seeking therapy, but the fees tend to be much less than what is found in the private sector. Psychotherapy is subsidized in these centers by government funding, but they still try and recover some costs directly through the people using the services.
Community mental health centers are often training grounds for budding therapists. Therapists learn most of what they eventually practice by doing and being supervised by trained psychotherapists. So while the quality of the psychotherapy may leave a little something to be desired than that of an experienced therapist, it is often better than no care at all.
Community mental health centers generally don't see people experiencing life problems such as career changes or marital problems (unless they result in the person getting a serious mental disorder). Because their resources are limited, these public clinics tend to focus on more serious mental disorders, such as depression, bipolar disorder and schizophrenia.
These mental health centers often have long waiting lists to get an appointment, so be prepared for a wait to obtain treatment (sometimes it could be a month or longer). Complain to your local politician to try and get more resources allocated to the center, as usually such centers are always in need of more funding.
Working with What You Have
Life often doesn't present us with the luxury of choosing what we most need when we most need it. Although many people feel like they can't afford psychotherapy when they are at a low point in their life and have few financial resources, sometimes psychotherapy may be what's most needed.
Don't give up if finding low-cost psychotherapy in your community is your goal. It can sometimes be frustrating to call around from therapist to therapist, from group practice to community mental health center, to find a therapist that can meet your price and is available for an appointment. Helping prepare yourself for the process can help you set your expectations accordingly.