I’m New to Therapy: How do I pay for it?

The most efficient way to get an answer to this question is to ask the therapist you’re interested in directly. We are used to explaining our fees and the options for paying for them. Here are the most common ways that people pay for their counseling.

  1. Pay Out of Pocket. 

The simplest manner of covering the cost of therapy is to pay out of pocket. You can ask about the therapist’s fees prior to your first session. These hourly rates are usually comparable to the hourly rate you would pay someone with similar training (a master’s or doctorate degree) and compensates not just for their time in session, but also for their time to create your treatment plan. In addition, a mental health therapist keeps documentation and is a second “holder” of your story. If you can find the room in your budget, this is the option allows you and your therapist to decide how often you can come to therapy, how long you will come to therapy, and what issues you can get help with, and you don’t have to let an insurance company to limit those sessions due to cost. Therapists’ hourly rates can vary widely, so, as I mention in How Do I Find A Therapist?, find a few that interest you and seem like a good fit instead of deciding on a rate first.

  1. Utilize Your Health Insurance.

Coverage for mental health services is included in all major insurance plans per the Affordable Care Act. That’s because poor mental health can affect your physical health. Depression can cause risky decision making or poor diet. Panic attacks can put you in the emergency room to rule out heart attacks. These examples just scratch the surface of the interaction between body and mind. So, call your health insurer and ask for a “behavioral health referral”. Ask for 3 different people you can call. Ask them for your co-pay and if your deductible applies. Also, ask if they allow you to go “out of network” to find a provider if you’re not thrilled with the referrals they’ve provided or you have your heart set on working with a therapist that is not contracted in their network. Remember: if you use your insurance, you have to abide by the limitations of your insurance coverage. This may include a limit on how many times you can see the therapist, how long the sessions can be, and what issues can be addressed. 

  1. Find therapists who accept a “sliding scale.” 

A sliding scale is a discounted rate based upon the financial need of the client and the availability of the therapist. Many therapists calculate a discounted rate and post that they accept these sliding scale rates on their website under “rates” or “fees” section. Another way to find therapists who provide discounts is Open Path Collective (openpath.org), a directory to link clients to the therapists they need in their price range.

  1. Seek Resources in Your Local County.

Many states and counties have developed therapeutic services to provide preventative and more comprehensive care for residents in need who cannot afford to seek help at full price. Search “[Your County] Department of Behavioral Health” or “[Your County] Department of MentalHealth” and look around their website to find local mental health resources. For example, the county of San Bernardino contracts with therapy clinics to provide free therapy to veterans. Searching your local county website is the best way to find what is available for you. There may be more in your area than you think.

  1. Consider an online Subscription Service

There are a few companies that are offering online access to therapists for a monthly fee. The most heavily advertised ones are BetterHelp.com and TalkSpace.com. Typically, they charge a monthly fee and then you get a weekly video chat with a therapist and some additional access via text message throughout the month. These programs are in their early stages, but anecdotal evidence from both therapists and users indicates that people do experience relief and find them to be cost effective. This is not a great option if you are in the middle of an emergency (with thoughts of hurting yourself or others). There are some other practical reasons why you may want to go in to a therapy office that I will review in a post to follow soon. Online therapy can also be challenging if you are not very tech-savvy, although improvements are being made in this area all the time.

6. Go to the Emergency Room.

Of course, if you are experiencing a mental health emergency (e.g. thoughts of harming or killing yourself or someone else), go to the emergency room (with a supportive person if they are available, or call 911 if you can’t get yourself there). Cost is difficult to determine here, but a life is priceless, and if you truly can’t pay for your care, you can come to an agreement with the hospital after you’re stabilized. Don’t let a hospital bill keep you from getting the help you need in an emergency. 

There are more creative ways that clients have found to afford therapeutic services. As I find more, I will share them. Therapy truly is something anyone can benefit from, and finances don’t have to be a barrier to getting the care you need.

Mrs. Andreana Mabry, M.S., LMFT, is a Black licensed marriage and family therapist practicing in Southern California. Aspiring home chef. Pronouns She/Her. Say hi to your dog for her.

Veterans and Active Duty Military Crisis Line
www.veteranscrisisline.net 800-273-8255

Rape Abuse & Incest National Network
rainn.org 800-656-HOPE

National Suicide Prevention Lifeline
suicidepreventionlifeline.org 800-273-8255

The Trevor Project
thetrevorproject.org 866-488-7386

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