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    Chavy
    Participant

    Hi, I wrote this in to the Yated where they have The Couch column, and I figured I’d share it here and get the feedback from therapists and participants:

    Dear therapist,

    I have a question which I hope you can help me with:
    I’m looking for a new therapist, one that is in-network and takes my insurance. I’m doing a ton of research, calling up therapists, clinics etc., but I keep bumping into the money issue. I just hung up with yet another therapist that didn’t work out, and I’m honestly feeling helpless, hopeless and demoralized. Is this how the system is going to work? Is money just going to keep running the show? I know this is a loaded question, one that you probably feel empathetic towards, but feel there’s not much you can do, but I’m asking that you perhaps stop, reflect and honestly see what there is to do about this situation. I’m assuming that many people have had this experience and felt similarly. Furthermore, It’s up to us, as a community, to see what we can do to address this very concerning issue.
    Thank you very much and look forward to your response.
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    Chavy
    Participant
    Topic Author

    Anyone have anything to add about this?

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    kayla
    Participant

    I am sorry nobody has responded to you. This topic is one many have spoken about and does not have an answer. Who wants to take responsibility? I am also plagued by your question and find myself frustrated by the unfairness of it all. We want to heal, we need help, but we can’t afford a minimum of $150+ a week for therapy. Yes, I know about clinics and interns and new graduates, but common we all know that will just push off our healing and not really get us anywhere. At this point at least I’ve given up the anger towards therapists. I understand that most therapists have spent years in school and more years in post-degree training, maybe have taken out loans, and invested a tremendous amount to build their skillset. Why should they take the loss? They need to make a living… It is their job after all. The fault lies in the healthcare system which doesn’t treat mental health as seriously as physical health and insurances won’t pay the therapists enough so they have to charge privately. I have no answers. I’m just writing to show you that I hear you, you’re not alone. I wish someone could step up for us and financial support would be readily available. Sadly, those who have the means are the ones who can heal and the rest of us…..?

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    Chavy
    Participant
    Topic Author

    Thank you Kayla for answering!! Yeah, therapy is extremely expensive and it’s demoralizing… I really appreciate your take that it’s also to do with the healthcare system and not entirely the therapists fault.

    However, the problem remains and it would be worthy and preferable to try and see what we can do. I honestly hate when people say “it’s reality.” Why does it have to be reality? Just like it came to this, something else can happen. Perhaps a group of therapists can call the healthcare system and explain the problem…  I don’t know, but I’m not going to just sit back and say that that’s reality when so many people are suffering, and neither should our community of therapists do that. When something isn’t working, we need to see how we can fix it.

    On a more positive note, I did get in touch with a therapist and hoping it’ll work! I’ll keep you updated.

    Hi Chavy,

    Thank you for sharing what you wrote in the Yated here in this forum.  As you mentioned, it is a pretty complex issue, a lot of it stemming from the state of our (American) healthcare system.

    There are generally 3 ways for clinical therapists to make a parnassah:

    1. in a clinic
    2. in private practice taking insurance
    3. in private practice with private pay

    The current healthcare set up is that if a therapist works let’s say in a clinic which accepts insurance, there is a greater incidence and likelihood of burnout for the therapist as the caseload for the therapist is impossibly high (we’re talking 60-80 clients a week), as is the no-show rate.  Therapists in clinics get paid fee-for-service rates, which is a very minimal fee, and they do not get compensated when a client no-shows.  In addition, these therapists put in hours of their time (without compensation) to do all the paperwork required by insurance companies, including writing explanations to insurance personnel who are not trained in mental health issues for why their clients may need more time in therapy.  It is impossible to live on this kind of income without any supplementation (which is impossible to do based on the overtime these therapists put in).

    Then there is the therapist who has his or her own practice and takes insurance where the therapy rate is lower than the private pay therapist but oftentimes the overhead costs of running a practice eat up the majority of income as well.  These therapists also have to justify their treatments and the amounts of sessions their clients need to insurance employees who are not knowledgeable in mental health.  And, this is why there are many therapists who do not take insurance and only do private pay.

    I like to use the analogy of tending to our physical health here.  If a person was physically ill, they would go to a doctor who most likely takes insurance.  With doctors, however, the insurance reimbursement rates are sufficient in covering the costs of running their offices.  With doctors, there are no obstacles with trying to prove why a patient might need extra doctor appointments to make the patient get and feel better.  If a patient requires more specialized care, the fee for the appointments may be out of pocket, and most often the patient doesn’t hesitate because after all, it’s their health on the line.

    When it comes to mental health, as you can see there are more challenges with the insurance companies as well as issues of reimbursement rates being sufficient for overhead costs and compensation for services.  Because mental health unfortunately isn’t always regarded as equally important to physical health, there can be more resistance to the suggested of specialized treatments which would require private pay.

    I hope this explanation helps to clarify some of the challenges and obstacles for therapists in running their practices and providing quality care to their clients within the current health system.

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    Chavy
    Participant
    Topic Author

    In response to Michali Friedman's post #9992:

    Thank you, Michali! It definitely does help explain it.

    But… is there any way a group of therapist can come together and lobby for the insurance to work with them?

    I mean, if this were a matter of life or death, I think something would have changed by now (hopefully!). I feel that if we just say it’s because of the healthcare system – which is true, we get a justified explanation, but no action taken to attempt to create change for the better.

    Whats your take on that?

    My pleasure!

    There are many many therapists who have been taking their own personal time, spending countless hours lobbying and advocating for this very thing.  Unfortunately, things take time to change, especially massive systems.

    Therapists do view these issues as necessary as life and death for many mental health issues but insurance companies often don’t view mental health the same way as physical health.

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    Chavy
    Participant
    Topic Author

    In response to Michali Friedman's post #9998:

    Wow, I hear and I’m especially warmed by the action that has been taking. (That just goes to disprove my thoughts of “victimhood”).

    Thank you, Michali!

    It’s my pleasure!

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