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Trending Reluctance To See A Therapist

OasisRedbeard April 20th, 2022
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I've noticed - in Listening discussions - of a trending reluctance to see a therapist, especially for issues that require one. I make a particular point in my chats that long-term, complex issues are best handled with professional therapy, and the answers I get back is a concern about cost (first) and location (second).

Indeed, if you do an online search for a list of provider profiles, you'll notice many psychiatrists, psychologists, LSWs, etc., charge anywhere between $75 to $375 to see them (for sessions ranging between 30 minutes to an hour). Money like this - especially during uncertain times like now - is out of reach for many.

However, there are workarounds:

1. If you live in the U.S. (like me) and you're employed (or your spouse is employed) then you have what's called an Employee Assistance Program (EAP) which entitles the individual to between 1 and 5 free therapy sessions, before further sessions are covered by insurance (or out of pocket). Your company's HR is best suited to provide more information.

2. If you live in the U.S., but unemployed/lacking income, the SAMHSA Hotline can provide local resources for mental healthcare, regardless of your income situation. I can attest (from past personal experience) that the resources I was provided with pointed me in the right direction during a time of need with no gainful cash flow.

3. If you live OUTSIDE the U.S., but your employer doesn't have an "EAP" equivalent, or you're unemployed/lacking income, the first point of contact is your local health ministry. If this entity is of no assistance - but you have reliable internet access - then there's no harm done researching/contacting reputable therapists online with video conferencing ability. Although I can't make any promises about what can be *potentially* arranged, therapists are not in the business to just turn anyone away - it's terrible optics and violates the cardinal "first, do no harm" rule. Before I learned about the SAMHSA resource in my jurisdiction, I did my own research online and was surprised what I found. All it required was reaching out.

Although having an active 7Cups Listener is a great resource, it should never be seen as a substitute for therapy. I've been emphasizing this quite a bit, as of late.

I hope this post fits this forum's criteria, is read, and helps someone.

OasisRedbeard

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RarelyCharlie April 20th, 2022
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@OasisRedbeard I agree. I haven't noticed this trending, but then I haven't been taking new chats recently.

One thing I often point out is the total cost of therapy. You might see a $75 therapist once a week for 2 years, say, which comes to $7,500 using your figures, and with an inexperienced therapist you might get absolutely nowhere, and have to start again with a different therapist for maybe another 2 years. This is a pretty common experience.

Or you might see a $375 therapist for an assessment session and a treatment plan session, spend $750 and know exactly what you have to do to recover. This is also pretty common (but probably less common). Anyway, finding a really good, experienced therapist is very important, in my opinion, if you want to keep costs down and actually recover. A lot of therapists out there are good listeners, but good listeners are free at 7 Cups or on your local warmline.

Another thing maybe worth pointing out is you don't have to be mentally ill to benefit from therapy. Some therapists specialize in general problem-solving (particularly using Solution-Focused Brief Therapy). The assumption is that you are mentally well but life just got complicated, and an expert can help you untangle it.

And some therapists specialize in working with couples or families. Again, there's no assumption that anyone is mentally ill, just that relationships are hard to get right and experts can help.

Charlie

OasisRedbeard OP April 20th, 2022
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@RarelyCharlie Yes, an effective therapist is another thing (that's what I forgot to include in the OP, as well as needed self-copyedits - DOH!)

Generally speaking, though, a therapist who lacks knowledge, skills, and/or sensitivity is going to be fairly obvious after the first or second round with them - if it doesn't already show in their online reviews. That's what I was referring to when I mentioned "terrible optics". User reviews of any commercial service - including therapy - can be devastating for the merchant.

However, treatment failure can also be a compatibility/communication issue: some therapists are deadset on a particular approach (e.g. tough love, CBT, DBT, EMDR) that isn't going to be a one-size-fits-all success story for everyone. Still, it's up to the client/patient to research what the therapist's strategy/expertise is (beforehand) and bring up any concerns about therapy failure directly to THE therapist (or to the office that employs them).

JaneSustenListens April 20th, 2022
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@OasisRedbeard this is great. I will link to this when I have someone saying they don’t know how to go about therapy. I know it’s hard and complicated and it stinks to have to do the work of finding help when you are feeling bad enough to need help, but this is really good information!

AffyAvo April 20th, 2022
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I half agree with some of this.

Just because an issue is complex and long-term doesn't mean it's something that therapy can really do much to help with it.

I also also knowing where to go is very location dependent and can be fairly complex.

Here, I would say if therapy isn't available through an EFAP (this is something employers and schools choose to offer, it's not mandatory that they do) or other option through school or employee benefits, then going to the health system is a good first contact. If someone has a doctor or nurse in a PCN short term therapy may be offered for free and there are also other health care professionals who offer services to support mental health that isn't therapy, for example social workers and mental health nurses. Just to note as I have noticed that many understand a mental health nurse to be something different than what they are here. Here these are NOT psychiatric nurses. They can help with things like setting goals, developing coping skills, making a plan when dealing with a medical crisis, etc. If they feel like an issue would benefit from psychotherapy they will refer, as it's not something they offer.

If that's not an option/has been unhelpful the next point of contact I would recommend is the health care system's section for Addiction & Mental Health. They have a helpline which offers information about services and referrals, as well as support.

CYC135 April 20th, 2022
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@OasisRedbeard thank you.