As a therapist, can confirm (in my experience) that the sheer numbers of people seeking therapy is becoming almost overwhelming. Everyone in my area has waitlists for months. The average student...
As a therapist, can confirm (in my experience) that the sheer numbers of people seeking therapy is becoming almost overwhelming. Everyone in my area has waitlists for months. The average student loan debt for a therapist is very high, due to needing a Master's Degree, but average salary is not enough to do anything but live paycheck-to-paycheck after you factor in your student loan payments. As a result, there's lots of demand for mental health, not enough supply (clinicians), and nobody is happy (except for insurance companies).
Many therapists work in the public sector for government entities. The government tends to deem mental health professionals in a pay-scale which is cost effective for the government, but is...
Many therapists work in the public sector for government entities. The government tends to deem mental health professionals in a pay-scale which is cost effective for the government, but is incongruous to degree requirements and prices charged for patients. In order to raise prices, there would need to be legislation signed off or have the gears of bureaucracy change slowly over time generally speaking.
There is more/easier money for private investors to open rehabs or sober homes. Unless you are a cash only business, you typically need to accept various insurances and similar to government...
There is more/easier money for private investors to open rehabs or sober homes. Unless you are a cash only business, you typically need to accept various insurances and similar to government services they have a pre-set rate that they feel therapists services are worth. Couple that when people cancel, then you have hours that likely are too close to fill with someone else so then you don’t get paid for that time. By the time you factor in the office you rent, your records system, etc. there typically is not a great pay.
That's one reason, yes. There's plenty of places that do raise prices, but the tradeoff is you start serving a very different kind of person -- the kind that can afford $200 out-of-pocket fees....
That's one reason, yes. There's plenty of places that do raise prices, but the tradeoff is you start serving a very different kind of person -- the kind that can afford $200 out-of-pocket fees. But the primary reason is that the vast majority of people use insurance and insurance will only cover what they want to cover. Insurance reimbursements vary widely (and I'm only speaking for what I know in the US Midwest) but a very general range is from $75-$100 per session for most. If a therapist works for an agency, they might only get a 50-60% cut of that depending on their licensure. And they will only see that when the insurance company actually sends the check.
Okay so, in a broad hypothetical, at $100/session, you might get everybody who has insurance whereas at $101 you might only get the people who are willing to pay out of pocket.
Okay so, in a broad hypothetical, at $100/session, you might get everybody who has insurance whereas at $101 you might only get the people who are willing to pay out of pocket.
My wife is a self employed Psychologist. She spends excessive time fighting with insurance companies over simply honoring claims, even when she called in prior to confirm coverage. The insurance...
My wife is a self employed Psychologist. She spends excessive time fighting with insurance companies over simply honoring claims, even when she called in prior to confirm coverage.
The insurance companies consistently say "their listed coverage on our own insurance portal isn't accurate. Nor is the verbal word of our employees when calling in to verify coverage"
Its all a clusterfuck for mental health providers.
The only real way to get consistent results is to go private pay, and that's definitely excluding the under privileged.
Same friend. It's a never ending cycle. I want to go to therapy so I can get a job and earn some money, but I need to get a job and earn some money so that I can go to therapy. My worst days are...
Same friend. It's a never ending cycle. I want to go to therapy so I can get a job and earn some money, but I need to get a job and earn some money so that I can go to therapy. My worst days are filled with tears and doomsaying while my best days are a blanket of apathy.
I've considered online therapy such as Betterhelp, but I'm extremely skeptical of it and I also don't want to contribute to a system that I have to imagine pays its therapists poorly. I haven't done research so I shouldn't be assuming, but just knowing how corporations are, Betterhelp and the like are too good to be true.
edit: I wanted to add that I also struggle with ADHD and I'm sorry to hear that you do too. I've literally lost jobs because I have a hard time with it. I use to take medication for it, but I am prone to abuse and decided to stop taking it. You'd think if I can stop getting it refilled, I'd also have enough restraint to take it as prescribed, but if it's in front of me, I'll take it. The come down of stimulants is awful.
I am on a non-stimulant ADHD medication called Strattera now. I can't report quite yet on its effectiveness, but it may be an option for you that jives with your physical health. Talk to your doctor if you can!
I'm an American living in Tennessee. When I take the eligibility survey, whether I qualify or not all hinges on this one question: "Has a physical, mental, or emotional health condition that...
I'm an American living in Tennessee. When I take the eligibility survey, whether I qualify or not all hinges on this one question:
"Has a physical, mental, or emotional health condition that limits their ability to work, attend school, or take care of their daily needs?"
I've always struggled with depression, so in the past I would've said no to this question. But my mental health has come debilitating. I've gone weeks only getting out of bed to use the bathroom. I'm miserable. It's not who I want to be, but I'm having a hard time breaking the cycle. My brain feels like it literally doesn't work.
So I guess I'm starting to feel like the answer to that question is yes, I have a mental condition that limits my ability to work. I assume I need a psychiatrist to make that call. I doubt me just claiming that is enough to benefit from medicaid.
I don't want this to be my new normal. I just need to be able to see some professionals with further drowning in debt. If I can make that move, then I could see something like a 3-6 month plan to get me back on my feet, at least to some degree.
It sounds like things have worsened for you since you last took the survey, can you take the survey again and put 'yes' to that one and try become qualified for aid? Would that allow you at least...
It sounds like things have worsened for you since you last took the survey, can you take the survey again and put 'yes' to that one and try become qualified for aid? Would that allow you at least apply and see what they need you to do?
At this point, I either have to get a job and risk a total mental crash again, or starting working my through our cumbersome system to get temporary medicaid and disability pay.
At this point, I either have to get a job and risk a total mental crash again, or starting working my through our cumbersome system to get temporary medicaid and disability pay.
If you're alright with the way you feel, you don't necessarily need to seek out therapy! That said, if it's something you're interested in but the cost seems prohibitive, a lot of therapists do...
If you're alright with the way you feel, you don't necessarily need to seek out therapy! That said, if it's something you're interested in but the cost seems prohibitive, a lot of therapists do offer sliding-scale payment or even waive payment if you can't afford it. Usually they'll mention sliding-scale on their website or on their page on psychologytoday.
I thought this and finally splurged this year for awhile. I think it made things worse to be honest. Fine for others but I don't think it's the magic pill solution a lot of it's lovers want it to be.
I thought this and finally splurged this year for awhile. I think it made things worse to be honest. Fine for others but I don't think it's the magic pill solution a lot of it's lovers want it to be.
I’m torn on therapy. I’m 39. I’ll be dead likely in 2-4 years (ALS) - but haven’t sought out therapy. I’ve debated it…. But so far I’m actually in a pretty good place mentally. Not sure if that...
I’m torn on therapy. I’m 39. I’ll be dead likely in 2-4 years (ALS) - but haven’t sought out therapy. I’ve debated it…. But so far I’m actually in a pretty good place mentally. Not sure if that makes me weird or like a psychopath or not…. Everyone tells me I shouldn’t be okay with it, but….
In your situation I'm going to go as far as to say that you should literally do whatever you want to do at any given moment for the rest of your life. As long as it doesn't hurt someone else, I...
In your situation I'm going to go as far as to say that you should literally do whatever you want to do at any given moment for the rest of your life. As long as it doesn't hurt someone else, I mean.
That said, seeing a therapist can definitely help you deal with questions like "does that make me a psychopath or not". We untrained folks love to diagnose others based on next to nothing.
Honestly the most questions I deal with are always, “How are okay with this? Why are you not sitting in a corner crying? Why aren’t you just traveling the world….?” Etc etc. It was something I was...
Honestly the most questions I deal with are always, “How are okay with this? Why are you not sitting in a corner crying? Why aren’t you just traveling the world….?” Etc etc.
If she was still alive, I’d ask my aunt for how she dealt with her final years of ALS in case she’d have advice to share. Sadly, she passed away 5 years ago.
If she was still alive, I’d ask my aunt for how she dealt with her final years of ALS in case she’d have advice to share. Sadly, she passed away 5 years ago.
The boom in demand reflects a growing mental health crisis and a national uptick in anxiety and depression — but also reflects healthier attitudes about therapy and more honest conversations about mental health.
By the numbers: 23% of U.S. adults visited a mental health professional in 2022, up from 13% in 2004, according to Gallup polling.
Only 31% described their mental health as “excellent” — the lowest share ever.
Among younger adults, those between the ages of 18 and 24, just 20% said their mental health was excellent.
Meanwhile, the barrier to entry to the field is very high in terms of schooling and certification while the compensation is anemic based on the demand and importance. Sadly, this is similar to...
Meanwhile, the barrier to entry to the field is very high in terms of schooling and certification while the compensation is anemic based on the demand and importance.
Sadly, this is similar to teaching, emergency response, nursing, policing (I realize this is subject to debate) and other critical service roles. It is curious how poorly society rewards people in these roles economically despite how essential they all are.
Where is the gap, then? On one hand, people are complaining that therapy is too expensive. On the other, people are saying that therapists don't make enough. How do you reconcile that? As far as...
Where is the gap, then? On one hand, people are complaining that therapy is too expensive. On the other, people are saying that therapists don't make enough. How do you reconcile that?
As far as the barrier to entry, it needs to be high. You don't want someone who took a class on YouTube doling out critically important advice to vulnerable people.
You reconcile it by acknowledging that both are true. Therapists are subject to the same costs of living that everyone else is. The price they charge can be barely enough to make ends meet, while...
You reconcile it by acknowledging that both are true. Therapists are subject to the same costs of living that everyone else is. The price they charge can be barely enough to make ends meet, while simultaneously being out of reach for many people, because times are tough.
And I think the years of schooling are enough of a barrier to entry. Removing the cost of that schooling would have beneficial effects in opening up that training to more people, and allowing those that complete it to charge less money to break even.
For those of you in the industry or those who are therapists, what do we think about all these "online therapists" that are getting heavily advertised on podcasts, like Better Help or Talk Space?...
For those of you in the industry or those who are therapists, what do we think about all these "online therapists" that are getting heavily advertised on podcasts, like Better Help or Talk Space?
I can't listen to a podcast without a Better Help ad.
Do they work? Is this all one big scam? What's the deal with these? They can clearly afford advertising so they must be making money?
My wife was a private therapist for a while. When Covid hit, she went remote and offered virtual services just like the ones that are advertised (except she was private). Like in person services...
My wife was a private therapist for a while. When Covid hit, she went remote and offered virtual services just like the ones that are advertised (except she was private). Like in person services it will depend on the therapist and the patient. The relationship between them will usually dictate how well the therapy works. There are many therapists who are not good at their job. There are patients who do not listen/act upon the advice they are given. Sometimes the personal values are not shared between the therapist and patient and therefore it does not work out.
In general, we tend to make better connections when we are physically in the same room compared to video calls. You are able to read and react to body language while sharing the same environment, distractions, etc. There are certain treatments that work much better in person (EMDR) than virtual. That said, virtual therapy can help and if you find the right therapist can be just as effective as physical.
So I can see how it feels scammy but the reason you're seeing it is likely two fold States made their telehealth rules easier during COVID, the state I am in used to still require patients go to a...
So I can see how it feels scammy but the reason you're seeing it is likely two fold
States made their telehealth rules easier during COVID, the state I am in used to still require patients go to a physical location for telehealth pre-covid, but post covid patients can take appointments from home.
ACA and other organizations are working on a counseling compact which has allowed counselors that participate in compact states to assist patient across state lines...this is not fully in effect but is being established however LCSWs have some ability for this I believe not my license to fully know. I just know their reciprocity is easier than LPCs.
So it's not necessarily scammy but I haven't worked for one to understand their work conditions. I've heard some improvements in getting enough patients to make consistent pay now which was a challenge when you'd get no call no shows it'd tank your paycheck.
I personally have a great experience with it. Therapy where I live is just a moot point at this point. I sought out therapy for three years. Both before COVID and after. But I finally got together...
I personally have a great experience with it. Therapy where I live is just a moot point at this point. I sought out therapy for three years. Both before COVID and after.
But I finally got together with an online telehealth and it's great. My therapist is in Michigan. And when I first started she only could see me about 8 times due to state laws. But recently state laws have changed and she can see me as many times as needed. Which is definitely needed.
As a therapist, can confirm (in my experience) that the sheer numbers of people seeking therapy is becoming almost overwhelming. Everyone in my area has waitlists for months. The average student loan debt for a therapist is very high, due to needing a Master's Degree, but average salary is not enough to do anything but live paycheck-to-paycheck after you factor in your student loan payments. As a result, there's lots of demand for mental health, not enough supply (clinicians), and nobody is happy (except for insurance companies).
If there's so much demand and so little supply, why can't you raise prices? Just not wanting to price out the "less fortunate?"
Many therapists work in the public sector for government entities. The government tends to deem mental health professionals in a pay-scale which is cost effective for the government, but is incongruous to degree requirements and prices charged for patients. In order to raise prices, there would need to be legislation signed off or have the gears of bureaucracy change slowly over time generally speaking.
Is there not enough demand for them to go to private practice?
Honestly seems like there should be investors lining up to fund a hundred therapists starting private businesses.
There is more/easier money for private investors to open rehabs or sober homes. Unless you are a cash only business, you typically need to accept various insurances and similar to government services they have a pre-set rate that they feel therapists services are worth. Couple that when people cancel, then you have hours that likely are too close to fill with someone else so then you don’t get paid for that time. By the time you factor in the office you rent, your records system, etc. there typically is not a great pay.
That's one reason, yes. There's plenty of places that do raise prices, but the tradeoff is you start serving a very different kind of person -- the kind that can afford $200 out-of-pocket fees. But the primary reason is that the vast majority of people use insurance and insurance will only cover what they want to cover. Insurance reimbursements vary widely (and I'm only speaking for what I know in the US Midwest) but a very general range is from $75-$100 per session for most. If a therapist works for an agency, they might only get a 50-60% cut of that depending on their licensure. And they will only see that when the insurance company actually sends the check.
Okay so, in a broad hypothetical, at $100/session, you might get everybody who has insurance whereas at $101 you might only get the people who are willing to pay out of pocket.
My wife is a self employed Psychologist. She spends excessive time fighting with insurance companies over simply honoring claims, even when she called in prior to confirm coverage.
The insurance companies consistently say "their listed coverage on our own insurance portal isn't accurate. Nor is the verbal word of our employees when calling in to verify coverage"
Its all a clusterfuck for mental health providers.
The only real way to get consistent results is to go private pay, and that's definitely excluding the under privileged.
Same friend. It's a never ending cycle. I want to go to therapy so I can get a job and earn some money, but I need to get a job and earn some money so that I can go to therapy. My worst days are filled with tears and doomsaying while my best days are a blanket of apathy.
I've considered online therapy such as Betterhelp, but I'm extremely skeptical of it and I also don't want to contribute to a system that I have to imagine pays its therapists poorly. I haven't done research so I shouldn't be assuming, but just knowing how corporations are, Betterhelp and the like are too good to be true.
edit: I wanted to add that I also struggle with ADHD and I'm sorry to hear that you do too. I've literally lost jobs because I have a hard time with it. I use to take medication for it, but I am prone to abuse and decided to stop taking it. You'd think if I can stop getting it refilled, I'd also have enough restraint to take it as prescribed, but if it's in front of me, I'll take it. The come down of stimulants is awful.
I am on a non-stimulant ADHD medication called Strattera now. I can't report quite yet on its effectiveness, but it may be an option for you that jives with your physical health. Talk to your doctor if you can!
What country are you in? I know Medicaid can pay for therapy.
I'm an American living in Tennessee. When I take the eligibility survey, whether I qualify or not all hinges on this one question:
"Has a physical, mental, or emotional health condition that limits their ability to work, attend school, or take care of their daily needs?"
I've always struggled with depression, so in the past I would've said no to this question. But my mental health has come debilitating. I've gone weeks only getting out of bed to use the bathroom. I'm miserable. It's not who I want to be, but I'm having a hard time breaking the cycle. My brain feels like it literally doesn't work.
So I guess I'm starting to feel like the answer to that question is yes, I have a mental condition that limits my ability to work. I assume I need a psychiatrist to make that call. I doubt me just claiming that is enough to benefit from medicaid.
I don't want this to be my new normal. I just need to be able to see some professionals with further drowning in debt. If I can make that move, then I could see something like a 3-6 month plan to get me back on my feet, at least to some degree.
It sounded like the answer was yes even before I read that comment. Depression can certainly beextremely debilitating.
It sounds like things have worsened for you since you last took the survey, can you take the survey again and put 'yes' to that one and try become qualified for aid? Would that allow you at least apply and see what they need you to do?
At this point, I either have to get a job and risk a total mental crash again, or starting working my through our cumbersome system to get temporary medicaid and disability pay.
If you're alright with the way you feel, you don't necessarily need to seek out therapy! That said, if it's something you're interested in but the cost seems prohibitive, a lot of therapists do offer sliding-scale payment or even waive payment if you can't afford it. Usually they'll mention sliding-scale on their website or on their page on psychologytoday.
I thought this and finally splurged this year for awhile. I think it made things worse to be honest. Fine for others but I don't think it's the magic pill solution a lot of it's lovers want it to be.
I’m torn on therapy. I’m 39. I’ll be dead likely in 2-4 years (ALS) - but haven’t sought out therapy. I’ve debated it…. But so far I’m actually in a pretty good place mentally. Not sure if that makes me weird or like a psychopath or not…. Everyone tells me I shouldn’t be okay with it, but….
In your situation I'm going to go as far as to say that you should literally do whatever you want to do at any given moment for the rest of your life. As long as it doesn't hurt someone else, I mean.
That said, seeing a therapist can definitely help you deal with questions like "does that make me a psychopath or not". We untrained folks love to diagnose others based on next to nothing.
Honestly the most questions I deal with are always, “How are okay with this? Why are you not sitting in a corner crying? Why aren’t you just traveling the world….?” Etc etc.
It was something I was not prepared for haha.
If she was still alive, I’d ask my aunt for how she dealt with her final years of ALS in case she’d have advice to share. Sadly, she passed away 5 years ago.
My father had it as well and passed at 53 in 2017. I have a fun rare genetic form haha. Lucky me!
I’m sorry to hear about your aunt!!!
From the article:
Meanwhile, the barrier to entry to the field is very high in terms of schooling and certification while the compensation is anemic based on the demand and importance.
Sadly, this is similar to teaching, emergency response, nursing, policing (I realize this is subject to debate) and other critical service roles. It is curious how poorly society rewards people in these roles economically despite how essential they all are.
Where is the gap, then? On one hand, people are complaining that therapy is too expensive. On the other, people are saying that therapists don't make enough. How do you reconcile that?
As far as the barrier to entry, it needs to be high. You don't want someone who took a class on YouTube doling out critically important advice to vulnerable people.
You reconcile it by acknowledging that both are true. Therapists are subject to the same costs of living that everyone else is. The price they charge can be barely enough to make ends meet, while simultaneously being out of reach for many people, because times are tough.
And I think the years of schooling are enough of a barrier to entry. Removing the cost of that schooling would have beneficial effects in opening up that training to more people, and allowing those that complete it to charge less money to break even.
For those of you in the industry or those who are therapists, what do we think about all these "online therapists" that are getting heavily advertised on podcasts, like Better Help or Talk Space?
I can't listen to a podcast without a Better Help ad.
Do they work? Is this all one big scam? What's the deal with these? They can clearly afford advertising so they must be making money?
My wife was a private therapist for a while. When Covid hit, she went remote and offered virtual services just like the ones that are advertised (except she was private). Like in person services it will depend on the therapist and the patient. The relationship between them will usually dictate how well the therapy works. There are many therapists who are not good at their job. There are patients who do not listen/act upon the advice they are given. Sometimes the personal values are not shared between the therapist and patient and therefore it does not work out.
In general, we tend to make better connections when we are physically in the same room compared to video calls. You are able to read and react to body language while sharing the same environment, distractions, etc. There are certain treatments that work much better in person (EMDR) than virtual. That said, virtual therapy can help and if you find the right therapist can be just as effective as physical.
So I can see how it feels scammy but the reason you're seeing it is likely two fold
States made their telehealth rules easier during COVID, the state I am in used to still require patients go to a physical location for telehealth pre-covid, but post covid patients can take appointments from home.
ACA and other organizations are working on a counseling compact which has allowed counselors that participate in compact states to assist patient across state lines...this is not fully in effect but is being established however LCSWs have some ability for this I believe not my license to fully know. I just know their reciprocity is easier than LPCs.
So it's not necessarily scammy but I haven't worked for one to understand their work conditions. I've heard some improvements in getting enough patients to make consistent pay now which was a challenge when you'd get no call no shows it'd tank your paycheck.
I personally have a great experience with it. Therapy where I live is just a moot point at this point. I sought out therapy for three years. Both before COVID and after.
But I finally got together with an online telehealth and it's great. My therapist is in Michigan. And when I first started she only could see me about 8 times due to state laws. But recently state laws have changed and she can see me as many times as needed. Which is definitely needed.