Therapy can be great. It can also get expensive.
The Affordable Care Act included a mandate for insurers to cover mental health care as an essential benefit. But consumers may discover a huge gap between what is technically covered by their plan and what they can afford. If your plan includes a high deductible, you may have to pay hundreds or even thousands of dollars out of pocket before coverage begins. Or, you may not be able to find a therapist in your area who will accept your insurance. Some parts of the country do not have enough mental health professionals to treat the number of people who need them. And, depending on your cultural background, there can be a stigma about seeking traditional talk therapy.
“In many circles and communities, especially colored communities and immigrants, they just don’t say they can get help away from home,” said Curley Bonds, doctor and psychiatrist and chief medical officer for the Los Angeles District Mental Health Office.
Part of the stigma of therapy might come from not knowing what it is or who it really is for. The idea of ”seeing a therapist” could conjure up the mental image of a decadent wealthy person lying on a couch complaining about their mother. Or a complete stranger in a dark room who asks you to reveal your darkest secrets and then hurls a handful of medication at you. But none of these stereotypes reflect reality, said Katrina DeBonis, a psychiatrist and associate clinical professor at UCLA.
“A lot of people think of therapy as that indulgence as opposed to effective treatment,” she said. “You may think that therapy is only for rich people. Part of that is realizing that that’s not true. And it can be in combination with drugs or instead of drugs. “
Before giving up the idea of therapy altogether, DeBonis recommends that you ensure that you are fully aware of the details of your plan. Call the number on the back of your insurance card or visit your insurance website and find out what mental illness benefits are available. She said a number of plans with platforms for telemedicine or other virtual therapy have been completed.
If this is not possible, or if you’d prefer to try a different course of treatment, there are still plenty of free, inexpensive alternatives to traditional therapy.
If you need help now
If you are currently in a mental health crisis, there are free phone and text-based ways to get help. The national hotline for suicide prevention can be reached at (800) 273-8255; It is also available to Spanish speakers at (888) 628-9454 and to the deaf or hard of hearing.
If you cannot or do not want to make a phone call, the Crisis Text Line has crisis advisors available via SMS (send “HOME” to 741741), WhatsApp and Facebook Messenger.
Free alternatives to therapy
Your workplace, school, or place of worship: Check with your employer to see if your workplace offers an Employee Assistance Program. These programs often include several free sessions with a counselor.
If you are a student, find out about a school counselor.
In both cases the meetings are subject to the usual confidentiality restrictions. In other words, the person you are talking to is not going to go to your parents or other family members and tell them what you were talking about. DeBonis said he should ask about these privacy restrictions so that you are fully informed of your rights.
Many churches, temples, and other places of worship offer confidential support and advice free of charge.
Warmlines: Hotlines are usually for people in crisis. If you’re not in a crisis and just need someone to talk to, LA and Orange County have warmlines that you can use to discuss anything that concerns you, including fear, substance abuse, or loneliness. In addition to instant help, the person you speak to can provide advice and recommendations for additional resources if needed. The Los Angeles County’s Warmline is available from 10:00 PM to 6:00 AM at (855) 952-9276. The Orange County Warmline is available 24 hours a day, 7 days a week at (714) 991-6412.
Local Resources Via 211: Calling 211 from anywhere in America puts you in touch with someone who is familiar with your local resources for all sorts of things, including mental health, rental and mortgage assistance, transportation, child and elderly care, and professional training. 211 is available 24/7 in California. Call 211 and ask what your local government offers for mental health needs.
Support groups: Most of the places that offered personal support groups before the pandemic are still going the virtual route. The National Alliance on Mental Illness of Urban Los Angeles offers weekly peer support groups through Zoom, led by trained facilitators for people with mental illness or their family members. The Self-Help and Recovery Exchange has a regularly updated calendar of volunteer support groups, including those that meet on Zoom or in person at locations in Culver City and downtown Los Angeles. Group topics include substance abuse, addiction, grief and loss, coping with anger, and a variety of mental illnesses.
Online Peer Support: LA County offers 24/7 free peer support through the iPevail platform. You must be physically in LA County to register for the free account. A number of other cities and counties also offer free or subsidized iPevail support; If your region doesn’t, it’s $ 9.99 per month. 7 Cups offers 24/7 free peer support with the option to move up to a licensed therapist for $ 150 per month.
Peer Support Groups and Social Media Forums: There are many places on Reddit and groups on Facebook where people share their problems and experiences, and seek support for a variety of mental health issues. On Facebook, you can enter any problem and browse available groups. Look for subreddits based on specific conditions or experiences on Reddit, or start at more general places like r / findareddit, r / KindVoice, and r / internetparents.
Since the people you speak to are not trained professionals, their level of expertise and experience can vary, Bonds said, “They just want to watch out for things that are not managed by professional organizations. There can be different levels of quality. “
Pandemic-Specific Resources: The LA County Department of Mental Health has published information and resources aimed at people who are experiencing anxiety, panic, grief, stress, frustration, depression, or other mental health issues as a result of the pandemic. The department has also partnered with the UCLA Public Partnership for Wellbeing to provide a resource guide specifically for frontline workers, district workers, and educators and carers.
Meditation: “Have you tried meditating?” May sound banal, but experts say you should try meditation. “Practicing mindfulness can be helpful,” DeBonis said. “It’s free and evidence-based for many mental illnesses. Not everyone picks it up right away, but it’s worth a try. “
Guided meditations and mindfulness practice development can be powerful tools for mental health support. Apps like Calm and Headspace offer free trials and then paid versions. If you’re in LA County, Headspace is still free. There are also free videos on YouTube, free meditations on Spotify, and a range of podcasts available in the many places you can listen to podcasts.
Inexpensive alternatives to therapy
Scalable Clinics: There may be therapists or clinics in your area that offer services at lower prices depending on your solvency. Google “Sliding Scale Therapy Near Me” to see what’s available.
Graduate Schools and Teaching Hospitals: If there is a college or teaching hospital near you, they may offer therapy sessions at reduced prices with clinicians who are still in training. Contact them and ask what they offer.
Therapy Apps: Apps like Talkspace and BetterHelp offer therapy via SMS, phone, or video, usually for less than the average sticker price for face-to-face sessions. They charge a per-session, monthly or yearly fee, often with upsells for additional sessions or services.
Other Mental Health Apps: If you’re looking for apps that are appropriate for a specific medical condition, problem, or type of treatment, you can search over 200 in the One Mind PsyberGuide database. You can indicate that you’re looking for apps that target things like Chronic Pain, Dialectical Behavior Therapy, PTSD, Borderline Personality Disorder, Productivity, and more. Click on an app name from the database to see cost (some are free), credibility, user experience, and research based on the type of treatment being used.
Books and workbooks: Bibliotherapy is a separate sub-discipline of therapy. But you don’t necessarily need a licensed bibliotherapist to find the value of books or workbooks.
“You can make a lot of progress yourself if you are motivated and can access a book from the library or from Amazon,” says DeBonis.
DeBonis and Bonds made some recommendations. Both mentioned “Wherever You Go, There You Are” by John Cabot Zin and David Burns’ “The Feeling Good Handbook,” which DeBonis says takes a similar approach to cognitive behavioral therapy. Bonds said Ellen Bass’s “The Courage to Heal” was good for people with trauma. He also recommended “Overcoming Depression” by Lawrence Shapiro and the anthology “Black and Buddhist: What Buddhism Can Teach Us” edited by Cheryl Giles and Pamela Ayo Etunde.