Therapy is a seriously useful health tool. It’s a safe place to talk about really hard things, a pressure release valve, and a crisis intervention service. It’s a training camp to help your brain think more usefully, and a hand to help you get unstuck from all kinds of frustrating spots. The skills and support I got in therapy let me kick bad coping mechanisms to the curb. They helped me accept the reality of my life with depression and anxiety so I could begin to grow despite them, instead of just struggling against them.

But for all its benefits, therapy can be hard to manage. It’s hard to make time for, hard to get to, and really hard to pay for. I have health insurance and an employer who works with me on scheduling needs, but getting to and paying for weekly appointments is still A Thing. I can only imagine the difficulty if you lack transportation or have an illness or disability that limits your mobility. Or how hard it is to manage the time crush of another appointment if you have multiple jobs or are jugging kids, work, and to-do lists.

And then there’s the sticker shock – if you don’t have insurance, or can’t find an in-network therapist, single sessions can easily cost $100-plus. Getting ongoing treatment at that price can be daunting to downright impossible.

I am a huge fan of therapy, but also the first to admit that the mental healthcare accessibility situation is not great right now, no matter how you slice it. The thing is, though, if you can find a way to get into therapy, it can be life-changing (and in some cases, life-saving). It’s helped change my life from one I was just surviving, to one I am really living. I hope you can have that experience, too. On that note, I’ve put together some resources on more accessible and affordable therapy routes you could try right now.

Access and Time Issues:

  • Online and tele-therapy – there are lots of new ways to connect to therapy online. Organizations like Betterhelp, Talkspace, and Amwell let you receive confidential professional therapy in your home at times that are most convenient for you. These services, and more and more local therapists, can provide text-, online chat-, or video conference-based therapy. A quick Google of “online therapy” will provide you plenty of options to research; ask your local therapists about their remote therapy options.
  • In-home therapy – therapists can travel to you for regular sessions if you can’t get to them. This can be just like the individual therapy you’d receive in an office or clinic, but can also be helpful when a child has an issue that family therapy might help. Some insurers will cover this.

Cost Issues:

  • Sliding scales – many therapists provide lower-fee slots for those paying out-of-pocket. The amount you pay is adjusted for your income. You can find therapists who use sliding scales through Psychology Today’s Therapist Finder, or contact local therapists to ask if lower fees are available. 
  • Community mental health clinics – these clinics, funded by federal or state governments, provide free or low-cost therapy (including to people insured by Medicaid). You can use the Facility Finder at SAMHSA to locate community clinics near you. 
  • University mental health schools – affordable therapy is often available at research schools. Graduate students provide it as part of their training, under supervision from their licensed psychologist instructors. Sometimes their fresh perspective can be a great fit! Try Googling universities in your area and checking their websites for more information.
  • Group therapy – it’s often focused on a particular kind of therapy, like Cognitive Behavioral Therapy (CBT), and is usually a fraction of the cost of individual sessions. Group therapy can be a powerful option – not only does it help you build skills, it can provide unique insight and support from people going through the same kinds of things you are. Psychology Today’s Group Finder can help you find groups, or you can speak to local therapists about their options.
  • Online therapy – not only is this more accessible to those who have difficulty with mobility or who lack time, it can also be cheaper than in-person therapy. Google “online therapy” and check out your options – each has a different way of approaching services and payment.
  • Open Path – Open Path Collective is a group of therapists with a mission to provide affordable in-office therapy to all who need it. If you find a therapist you like through this non-profit collective, you pay a lifetime membership fee ($59) and your individual sessions will cost between $30 and $60.

For those of us lucky enough to have insurance, but who still find the therapy process difficult and expensive, here is some additional info that might help you get started with care:

  • Your Employee Assistance Program (EAP) – you often get a number of free therapy sessions when you use your EAP. These are confidential by law – they can’t share anything with your employer. Talk to your HR person or a manager for contact information.
  • Your insurer’s provider network – you can call your insurer’s customer assistance line or check their website to find covered mental health providers. It’s best to double check that this information is current in the process of setting up an appointment.
  • Psychology Today –  using the navigation bar on the left side of the site, you can limit your search to therapists who take your insurance. Again, make sure this information is right when you ask about services or set up an appointment.
  • Out-of-network reimbursement – many therapists don’t accept insurance, for some annoying but not-really-their-fault reasons (it has to do with complicated rules around the kind or frequency of care insurers will cover). But they will help you get money back from your insurance company after your sessions by providing you a monthly invoice to submit.