Therapy is for the elite

amother

Pearl

Yesterday at 9:23 am

You don’t need a top notch therapist. Just because they charge a lot and have tons of certifications doesn’t make them better.
It’s a lot of trial and error but you can find an amazing competent therapist who takes insurance.
I see one now trained in EMDR, took many trials she is brilliant and pushes me but takes insurance too

amother

Seafoam ↓

Yesterday at 9:58 am

Many therapists in private practice who charge 200-300 a session also work in clinics part time for various reasons. For me I do it for benefits like insurance, having a peer group etc. not all clinic people are inexperienced or trying to leave! I love my clinic work and wouldn’t give it up for lots of reasons (sitting in my own office with no colleagues is isolating and I don’t want that experience full time). Do research and find somebody good that takes insurance or is clinic based. It exists. But private practice therapy is expensive. Also, there are clinics and insurance that pays more than you think so it’s not necessarily like we are sacrificing so much. Therapy has become way too expensive. Problem is if you charge 150 in pp which I think is reasonable, people assume you are lousy and not in demand and don’t want to use you!!

ectomorph

Yesterday at 9:58 am

amother OP wrote:

This is a rant. Please don't bash.
I wish it were different. How so many people can afford thousands of dollars for a top notch therapist when there are many who desperately need therapy and can barely pay their rent/mortgage. The therapists who take lower tier insurance are either just starting out or working at a clinic and hoping to go private, and are therefore not that "top notch" quality that many really desperately need! And the fact that so many therapists can go private and make a living makes me wonder how many of us are struggling just to pay for a top notch therapist, how many of us have that extra income to spare, or how many of us prioritize therapy over other things that would be lovely to have, like cleaning help and new clothes.

With that said, is it possible to get high quality therapy without the big bill?

I agree with you 💯

amother

Daisy ↓

Yesterday at 10:39 am

I'm sorry but you sound uninformed.

BH I have an in network therapist through my insurance. She is not in a 'clinic'. She is private practitioner with 25 years of experience. Why do you think that all therapists who take insurance are sub par or inexperienced? That's just not true. Did you actually go through the list of in network providers from your insurance and research each one?

amother

↑ Daisy ↓

Yesterday at 10:44 am

amother Springgreen wrote:

Not everyone has Medicaid. We don’t qualify for but don’t have a high income . We live simply and can not afford desperately needed therapy.

One problem is that it’s hit or miss. I spent $600-800 on several sessions only to realize this lady is not going to be the right person to help me.

BH I don't have Medicaid. My insurance is not Medicaid, and my therapist is fully covered. Are you certain that mental health is a policy exclusion for your insurance?

amother

Olive

Yesterday at 10:44 am

amother Daisy wrote:

You are very lucky that it worked out for you. My husband and I needed therapy a few years ago but we had to stop because it was costing us 450$ a week.
We desperately need therapy but we just can't afford it.

amother

↑ Snowflake

Yesterday at 10:51 am

The problem is that even on insurance or clinics can be expensive.
Many people have significant deductibles of $2000-$3000 a year.
That means I'm still paying $150 a week for a total of $3000. And then I have to pay a $50 a week copay.
Last year, I paid my $3000 deductible towards therapy and then an additional $1200 as copays.
And next week we start again.
And that's with paying $1000 a month for insurance.

amother

↑ Mintgreen ↓

Yesterday at 10:55 am

amother Yarrow wrote:

Irene lyon keeps getting recommended on imamother. Is it mostly one person who keeps recommending her over and over?

Ive signed up for her 21 day course and its probably worth the about $200, but I would not say jump to say its a replacement for therapy.

If your dealing with trauma /mental health issues its good to utilize multiple tools. Therapy, journaling, courses, books, support groups... I'm not saying you should do them all at once, (don't) but to say this one method was so amazing that you don't need to do anything else and that therapy wasn't necessary anymore, isn't something I believe can be true in 99% of cases.

Childhood trauma is basically always relational trauma and relational trauma needs to be healed within relationship. So while you utilizing many tools is important, please don't believe you can fully heal alone. Your desire to deal with struggles alone probably started in childhood, because you had to. It's a coping mechanism. People need people.

(I'm talking to those of you with serious issues/childhood trauma. Which is probably anyone who would consider Irene Lyons course)

Hi. Yes. It's probably always me recommending her. But on this thread I see that both you and someone else have taken her course. So that's really exciting to see.

For some ppl the course is all they need and for others they need therapy or medication or both. Irene and Seth are very open about other things they have done in adjunct, including body work, supplements and marriage counseling. I myself have gone back to doing weekly therapy sessions because life got difficult and I saw I needed more support. That doesn't take away from the amazing shifts I have seen and especially in my ability to trust other ppl including my therapist.

The 21 day course is great but obviously the longer course gives you more so keep that in mind.

In regards to needing other ppl to support you one of the things you learn in the course is how to feel safe in connection with yourself and others and how to turn to yourself as a resource. You could check out Irenes YouTube video on sparking up social connection. Often when we have early trauma we don't connect will with others.

This course definitely addresses trauma, the SBSM course more than the 21 day course. The 21 day course is better suited to handling stress of modern life.

Also the reason I want to spread awareness of this course is just because I don't think the Frum world is aware of it and I just think it's an amazing resource. Honestly, for myself I would prefer it to be a safe space where I don't know anybody but I feel that it's the right thing to share it so others can benefit too.

amother

↑ Dimgray

Yesterday at 10:56 am

amother Snowflake wrote:

Obviously this is going to be very individual. But I buy insurance through the marketplace and I specifically choose a plan that costs me very little out of pocket for therapy. Therapy is currently my biggest medical expense so I prioritize a plan that reduces the cost for me, taking into account my family's total medical needs.

amother

↑ Springgreen

Yesterday at 11:31 am

amother Daisy wrote:

BH I don't have Medicaid. My insurance is not Medicaid, and my therapist is fully covered. Are you certain that mental health is a policy exclusion for your insurance?

We can’t afford good insurance so our plan doesn’t offer very good coverage for therapy.

amother

↑ Daisy

Yesterday at 11:35 am

amother Springgreen wrote:

We can’t afford good insurance so our plan doesn’t offer very good coverage for therapy.

I understand. I am by no means wealthy. My insurance is through my employer. I take home a lower salary in exchange for comprehensive insurance.

amother

↑ Seafoam

Yesterday at 11:37 am

To add.. as has been said before— the cost of therapy has skyrocketed and gotten out of control. It used to be people went into the field to help others with the expectation they wouldn’t get Rich. Now people go into the field specifically to make a lot of money. Clinics got more expensive and private therapists raised rates a ton. It’s a problem.

amother

Black ↓

Yesterday at 11:59 am

I’m a therapist (currently at an clinic) and have been a therapy client and I think there are two separate issues here.

One is an uninformed consumer. What is therapy? What is an experienced therapist? What makes a therapist more or less qualified?

Admittedly this is hard to evaluate or know without doing some research, and often you have nothing to go on but hearsay and a list of certifications. I would encourage therapy clients to think about what they want out of therapy and how they hope to achieve that, then look for therapists who provide that. Do you want someone more gentle or more direct in their approach? Someone who will be very nurturing and laid back about progress, or someone who will remind you of your goals? How long do they expect the process to take, how will they assess change? There’s nothing wrong with any one approach, but if you’re looking for one thing and getting the other, you won’t be satisfied. You can discuss this in your first few sessions with a therapist.

A big part of the success of therapy is the relationship - the trust and rapport with the therapist, and sometimes you need to try out different therapists for the right fit.

It’s helpful to know whether you are looking for specific skills (DBT, CBT), greater insight (humanistic, relational, psychodynamic), a very specific modality that worked for your friend or relative that has conflicting evidence of efficacy (EMDR, IFS, somatic). Sometimes you will want a combination of these or an eclectic therapist who knows a little or a lot about each of these.

But it’s absolutely untrue that effective therapists all charge $450+ an hour. Those are therapists who have built a name for themselves for whatever reason and whether they are worth the money is subjective. Unfortunately we have a habit of assigning value to those who assign themselves value. Just like there is often a negligible difference between a 10K sheitel and a 5K sheitel but the 10K is the “best” because they have priced themselves as most exclusive.

The second issue is where does one find a therapist charging an affordable rate?

Some suggestions: at training institutes or programs for specific modalities where supervision is excellent. Psychoanalytic/psychodynamic and gestalt modalities have institutes. People training in something like EFT or family therapy might be looking for lower pay clients as well.

Asking private pay therapists if they have sliding scale spots: many private pay therapists will save several spots for clients who can’t afford more, but won’t advertise this. It’s always worth asking.

Clinics: yes the clinicians working at clinics are hit or miss. Some will be fresh interns with little experience, others will be working part time at a clinic for years. All will be receiving supervision and have more resources at their disposal. It’s worth trying a few, asking for a clinician that specializes in something, or for someone who has been there a few years if that’s important to you.

Therapists covered under insurance: just like some clinicians save sliding spots, others will take some insurances even at a reduced reimbursement rate so that therapy is more accessible to people.

That said: I get why you feel therapy is for the elite. It is easier to find someone worth your time if you have the money to pay for it, unfortunately.

ETA: I also understand that the whole world of therapy is confusing to many. Ideally you wouldn’t need to know that much about therapy to get good therapy. However at this point there are so many disparate approaches and so many differently types of diagnoses that going in without some understanding of what you want just puts you at a loss of time and money. If you have a particular diagnosis or presenting issue that can give you a direction. Certain conditions are commonly treated in specific ways, for example for borderline personality disorder either DBT or a psychodynamic/transference focused approach.

amother

Thistle

Yesterday at 2:12 pm

I have a fantastic therapist who takes insurance. Yes, she's on the newer side. Who cares? She's good and she helps me.

amother

Brown

Yesterday at 2:16 pm

Agree. I need a therapist desperately but I don’t even have health insurance right now so it’s not even an option. Too expensive

amother

Currant

Yesterday at 2:32 pm

As a therapist who works in a program (not clinic but similar)- just because we work here doesn't mean we are inexperienced. I am fully licensed, do speciality work like EMDR (and not from some quick 6 hour CEU course but actually trained), and have years of experience.
I stay here because of convenience and scheduling. Life is too busy for me to figure out renting an office, furnishing it, advertising... I have an ill family member so don't have extra time.

Don't knock clinics until you have tried them. People stay for all sorts of reasons. My private therapist had to change my time on me because of her personal needs. So private doesn't Mean you are guaranteed long term time slots either!

Don't knock people who take insurance- they may do that to help you.

Price - more expensive ones aren't necessarily better. Many just are good at advertising, social media and getting their name in articles (sometimes because of who they are related to!). I know someone who is "full" but only because their relative is a Rav and teaches so sends a lot of people to her practice. Ethics aside, packed schedule and price doesn't mean they are talented.

amother

Maize

Yesterday at 3:05 pm

I agree. I'm seeing a very caring therapist in a clinic, who started being a therapist, when I started being her client, at advanced age, she is also a professor and gives DBT classes at clinic. Covered by my Medicaid insurance, and costs me nothing, plus I take the class, covered by ins.
Otoh, I just terminated, a pp marriage counselor that we shelled out 4-5000 thousand dollars for the last half a year, who didn't help us in the least bit, and was a bad fit, and wasn't doing her job well as a professional, we ended up paying money just for her and me to fight, and she didn't give us any tools or skills for our marriage.

So price is not related.

amother

↑ Nutmeg

Yesterday at 4:41 pm

amother DarkGray wrote:

How did you get to this therapist. This actually sounds great.

I would love to send you the number of the program director. I called him, answered some questions and then a few weeks later he matched me with a therapist. I did tel him I needed someone who isn't anti zionistic/anti jewish. Can I message you?

amother

Chartreuse

Yesterday at 4:47 pm

amother Snowflake wrote:

Or they change their scheduling.

A few years ago, I was in a situation in which I needed to work and couldn't take off a minute and also needed therapy..

Think a scenario where a husband left the wife and now she needs to work 12 hours minimum wage just to feed the kids.
Or husband was depressed. Or whatever.

Point was, I called the clinic and said I needed someone available nights or Sundays. They gave me someone, we clicked and then after 4 months, she stopped working nights or Sundays, only week from 10-3.
They gave me someone else. Same thing, 6 months later

I called the clinic and they told me that once a therapist gains some experience, it's typical and I need to be more flexible and willing to come during the day to prioritize my mental health.
That turned me off.

Oy that’s painful. Here’s the thing. Therapists are people too. They have families. Officially therapy is during business hours. In the frum world we expect therapists to be available at night but realistically you are asking for a lot. Kudos to you if you find someone after hours. But don’t be upset at therapists who need to stop!

amother

↑ OP ↓

Yesterday at 8:17 pm

This has been incredibly helpful and insightful.

I've thought about therapy on and off over the years...
I lost my father as a relatively young mother, and I have several smaller "normal" challenges in my day to day life. Do I have a major need for therapy? No. Do I wish I had someone who wasn't my husband and friends to be in my support system? TOTALLY.

Is this a reason to go for therapy? I'm still not sure.

That being said, what clinics are there in the NYC area? What's the process of getting a therapist there? How long is the wait in general?