If you feel like you need additional support during a chaotic, uncertain time, you don't have to go at it alone. Therapy or coaching can help provide clarity and calm. And if you're concerned about meeting a therapist face-to-face in light of social distancing recommendations, there are a growing number of ways to find virtual support.
"Due to recent events, many local, reputable mental health providers who were formerly only available in person are moving their practices to an online basis," says Lisa Marie Bobby, psychologist and clinical director of Growing Self Counseling & Coaching in Denver, Colorado.
To find a mental health provider, Bobby suggests Googling "'online therapy in ____' or 'online therapy for anxiety' or other search terms that could help someone connect with a good, local therapist who is able to meet with them through online video."
Here are a few low-cost mental health care options that may be available in your area, as well as some strategies for picking the right therapist.
If you have insurance, check your benefits and see what kind of mental health services you're eligible for. Mental health coverage can vary widely in terms of both cost and services included.
Out-of-pocket costs for those who get treatment for mental heath or substance abuse problems tend to be higher than those for medical treatments, according to a 2017 study published by Milliman, a health-care consulting company.
If you don't have insurance, or if mental health services are limited or unaffordable on your current plan, you may want to weigh these low-cost alternatives.
Sliding scale therapists: If you find a therapist that's a good fit, go for a consultation and ask if they offer income-based sliding scale rates, Bobby told Grow earlier this year. Some therapists who have regular rates are willing to be flexible for clients with modest incomes in order to keep services aligned with their budget, she adds. At Bobby's practice, for example, therapists early in their careers charge $95 a session, but will slide down to $55 for clients with lower incomes.
Well-regarded training programs: At accredited graduate programs in counseling or clinical psychology, you'll find early career therapists who are passionate about what they do and building their practice, says Bobby. Look for COAMFTE and CACREP-accredited programs, or doctoral-level counseling programs that are accredited by the American Psychological Association.
University counseling centers: If you're looking for an extremely low-cost option ($5-$10 per session), contact your local university to see if they offer practicum experiences for student therapists-in-training. This "can be a little bit like getting a beauty school haircut," warns Bobby, but students generally have the support of well-trained faculty, and are eager to practice their craft.
Community mental health centers: These local organizations generally cater to the young and elderly and/or people without insurance. If you qualify for Medicaid, you may be able to qualify for free mental health programs as well.
Though text-based therapy programs have grown in popularity in recent years, Bobby does not recommend them. "It's very cookie cutter, trite advice that is not based on any understanding of how you got to be the way you are," says Bobby.
However, programs like Talkspace and BetterHelp are affordable options, and it may be worth doing your own research.
A free self-care strategy you can try from home, and one that can reinforce what you learn in your sessions with a therapist, is active journaling. "You'll see that if you're writing and reflecting and journaling over time, your thoughts will be more nuanced and subtle over time," says Ed Coambs, a licensed marriage and family therapist at Carolinas Couples Counseling in Matthews, North Carolina.
"There is a lot of things that are passing as 'therapy' that are probably a waste of money when it comes to achieving actual results in your life," says Bobby.
To find an effective practice, limit your search to therapists who use an evidence-based approach, meaning one that is grounded in research and best practices, says Bobby. Cognitive Behavioral Therapy, ACT Therapy, Gottman Method, or EFT for marriage counseling are all solid options.
Next, when you find someone who's a fit, ask for details about how they can help you. "They should also be able to describe how they will help you achieve your goals for yourself in a way that makes sense to you. Interview possible therapists before committing to one, and if it doesn't feel right, it probably isn't," says Bobby.
When you invest in therapy, the goal is create results in your life, "as opposed to something that's mildly gratifying but is the emotional equivalent of getting a relaxing massage," says Bobby.
A good therapist should do more than make you feel good.
"A powerful experience is partnering with someone who can challenge your old ways of thinking that may feel hard at first, who can work with you to do a deep assessment to figure out," says Bobby. "I tell people all the time, 'Growth isn't an event, it's a process.'"
If one-on-one therapy isn't the right move for you, one alternative is to practice self-care where you are in a more conscious and deliberate way. Writing in a journal, meditating, or listening to music can clear your mind and help you feel more centered, experts say.
You could also consider taking an online course to help you manage stress and anxiety, suggest Bobby. Learning mindfulness skills, cognitive skills, and relaxation skills "will be instrumental in helping [you] manage anxiety and feelings of depression," she says.
"These types of online courses are not a substitute for therapy if someone is dealing with a mental health condition, but they can be extremely helpful because they offer practical strategies that people can use immediately, plus homework assignments, etc.," says Bobby. "It can take a week or three for talk therapy to get going, and many people need relief now."
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