Counseling is a form of self-care which can be difficult to start doing. Even when the motivation is there, so many obstacles can get in the way of scheduling that first appointment, or even regular ongoing appointments. However, there are some good ways to deal with some of those big obstacles.

Obstacle #1: “I don’t understand how to use my health insurance.”

Most people want to use their health insurance, and most health insurances cover mental health counseling with licensed therapists (counselors, social workers, psychologists, psychiatrists, and psychiatric nurse practitioners). Here are the steps:

  1. Call your insurance provider and ask whether your insurance covers behavioral health outpatient counseling (individual, family, and/or group.). You also can find this information if you’re able to login as a member on your insurance’s website or talking to your employer’s human resource department.
  2. Find out if you have a co-pay or a deductible that is met for outpatient counseling.
  3. Find out if you have out-of-network benefits and how much you would have to pay (this is often a percentage of the cost of services).

Obstacle #2: “I don’t know where to look to find a therapist”.

There are many ways to find a therapist, and here are some places to start your search:

  1. Therapist Directories: a good place to start looking for a therapist is browsing therapist directories in your area. You can find these by doing an internet search of “find therapists in [your city]”. Directories often allow for you to search using zip codes, insurance, problems, and more.
  2. Insurance Websites: you are also able to get on your health insurance website and search for behavioral health professionals who take your insurance.
  3. Ask for a Referral: you can ask any of your current medical providers or school staff for referrals. They may already have a list of people with whom they often work, especially if you have a specific issue you want to work on in counseling.
  4. Friends & Family: often friends and family have recommendations if you ask. Seeing a counselor for the first time can be intimidating, and knowing a friend or a family member has trust in an individual will alleviate some of that anxiety.
  5. Social Media: many counselors have business pages on social media sites like Facebook, Twitter, and Instagram. By doing a search and visiting some of these pages, you can also get an idea for who they like to work with in their practices.

Obstacle #3 “I can’t find a therapist who takes my insurance.”

Sometimes finding a therapist in your city who both has openings and takes your insurance can be difficult. You may have tried the above steps and found no luck. Here’s what to do:

  1. Out-of-Network Benefits: if you have out-of-network benefits through your insurance, you have a wider range of therapists you will be able to see. Out-of-network benefits allow for you to see a licensed therapist who is not in-network. Sometimes a therapist will be willing to submit a claim and your insurance company directly pays them. Other times, you will have to pay the therapist in full, and they will give you a Superbill which will you submit to your insurance, and your insurance will then reimburse you. Often, this costs more than seeing someone who is in-network, but this is not always the case.
  2. Call your Insurance: when you’re unable to find a therapist in-network with your insurance, you may need to call your insurance and let them know your efforts. They will then need to search for you, and they will give you a list of people with current openings. When a reasonable effort has been made to find an in-network provider, your insurance may be willing to contract with a therapist who is out-of-network. You can request this with your insurance if you would like to do your own search for a therapist, or they may already have a list of people with whom they contract with in these scenarios. If this happens, your cost does not change.

Problem #4: “I cannot afford counseling.”

      Even when people are able to use their insurance, there are many reasons why cost can still cause difficulties for people. Sometimes a deductible has to be met, and the amount of therapy sessions you could do in a year still doesn’t even meet the high deductible. Sometimes the ongoing co-pay gets to be too much. Here are some ways you may be able to work around affordability:

      1. EAP: many people have an employee assistance program sponsored by their work as one of their employee benefits. This service offers a number of free counseling services. Once the free sessions are used, an option to continue using your health insurance is often offered. Contact your human resources department to find out if you have these benefits and how to use them.
      2. Sliding Scale: many therapists offer sliding scale fees. This is a lower rate based on what someone is able to pay. Often therapists who are currently working on getting licensed offer sliding scale fees, and you can find them through your local therapist directories.
      3. Payment Plan: If you find a therapist you really like, but the co-pays or deductible payments will be a financial hardship, you can inquire whether or not the therapist would be willing to do a payment plan with you.
      4. Meeting Less Frequently: most therapists will want to meet with you weekly, for good reasons. Sometimes weekly appointments are needed for progress in your goals, however, if you are only able to afford every other week or less, often this is better than nothing.
      5. Free or Low-Cost Counseling: If there are local training schools/programs for therapists, there will likely also be free or low-cost counseling centers with students who are training to become therapists. They are supervised by their instructors or other licensed professionals. You may contact local schools/programs to inquire or do an internet search for free and low-cost counseling in your area.

          Obstacle #5: “I can’t find anyone who can see me after work.”

          Another problem can be finding a time to do counseling. Therapists who have openings in the late afternoons, evenings, and weekends can be difficult to find. These time slots are rare and often swept up quickly.

          1. Lunch Hour Appointments: often therapists will have openings for lunch hour appointments, and if you can find a therapist near your work, this may be a convenient option for you.
          2. Early Morning Appointments: many therapists will offer appointments early enough that you may be able to attend a session prior to beginning your work day.
          3. Reoccurring Appointments: often, if you have an appointment at the same time weekly, your employer will make accommodations (depending on your work) where you may be able to come in early or leave later the day of your appointment.
          4. FMLA: If you have a job where you may not feel comfortable working with your supervisor to get time for appointments, you have a legal right to time off. If you meet the requirements for the Family Medical Leave Act, you can work with your HR department to take the time off for weekly appointments. You may be entitled to having time off paid, and you and your therapist will need to complete paperwork. FMLA also can be used to take children to needed counseling appointments.

          Obstacle #6: “I can’t find a therapist who can work with my child after school.

          Therapists who work with children and teens often only can offer a few slots after school and finding such openings is difficult. Here are some solutions which can be utilized:

          1. Reoccurring Appointments: just as employers are often cooperative around weekly appointments, so too are schools and teachers. If you talk with your child’s teacher or school counselor, you may be able to find a weekly time for an appointment which does not impact your child’s learning. This may be an early appointment, an appointment during a free period, or an appointment during a recess or lunch time.
          2. Late/Early Days: often high school students have schedules where they get out of school early, or they start later in the day. Looking at their monthly schedules and coordinating appointments with a therapist is very doable.

          Because of these obstacles, many people will wait until things have gotten increasingly bad in their lives to go to counseling. They have caused unnecessary emotional harm by not taking the time needed to work through the obstacles above. Don’t let these obstacles stop you from your life journey of happiness!

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