By David Joel Miller.
Can’t pay for therapy?
The times you need help the most are likely to be the times you are least able to pay. People with emotional problems often have other problems, no job or a low-paying one, physical health problems, housing issues. If you had those other problems wouldn’t you be depressed or anxious?
Now if this is an emergency, if you or someone close to you is thinking of suicide, has a drug overdose or other critical problem, please call your local emergency number. In my area, we have 911 services and every night many people call that number and end up in hospitals where they can be linked to help. People who chose to not call emergency services can walk into an emergency room and seek services. These days emergency rooms across America are filling with people with mental and emotions problems, people with nowhere else to go.
We continue to hope that the services for the people in need will match the need. So far it isn’t happening. The recent downturn in the economy has resulted in strained budgets and budget cuts. Mental health and substance abuse dollars keep shrinking at the very time the need is growing.
The first place to start of course is your local mental health facility. If you qualify for services they are likely to be covered or offered at extremely low rates. These days the need is so great most public facilities are limited to serving only those with the most severe need, people who are suicidal or have hallucinations. Even if you don’t qualify for ongoing therapy, you may be able to get emergency services or they may be able to refer you to free or low-cost services.
So if you are someone who has fallen through the cracks, who needs counseling or therapy but has no insurance, doesn’t qualify for services or your diagnosis does not meet the “medical necessity” for services, how do you get help? Here are a few suggestions, some are more available than others, and some are more painful than others but if you need help and haven’t been getting it these are things you might try.
1. Read the internet
Especially read blogs and sites about recovery. The internet can be had for little or no cost. These days’ even homeless people have email. Most libraries let people use computers for some amount of time. This has brought information to everyone. It has also caused problems. Not all sources of information are helpful. Watch out for sites that are sponsored by a company that wants to sell you something.
Read about recovery. Some writers are in lots of pain; their writing is therapeutic for them. I read those sites but I find it is good to limit readings about pain unless there are also posts about recovery. Read blogs that spread the cure, not posts that spread the disease. Also, avoid reading too many posts about diagnosis. Self-diagnosis is a trap even professions can fall into. You need an objective professional person to make a good diagnosis. That said, if someone has given you a diagnosis, read about your condition. If the things you read don’t match what is happening to you, ask questions. Not all professionals agree on things and sometimes they get things wrong.
2. Read self-help books.
There are lots of self-help books out there. I wish I could give you a list of the best ones. I am working on that list but so far it is not ready. I asked colleagues for recommendations and at this point, no two therapists have recommended the same book or books. Read a self-help book that speaks to you. What you need to learn may be different from what someone else needs to learn. You can get self-help books for very little money. Libraries have them for loan. Some can be downloaded from the internet for free or at a low price. I have picked up some great ones at thrift stores for fifty cents to two dollars. If you find a great one please leave a comment here and share your find.
Avoid books that require you to be dependent on or give unquestioning loyalty to a person or group. A.A. literature says here are “suggestions” that have helped us. If you find a better way we wish you well. If you have to do things the author’s way chances are the book is designed to help him and not you.
3. Self-help groups.
The old standby of self-help groups are Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). The success of A.A. has spawned over 200 self-help groups based on the twelve-step model. There are also specific groups for people with co-occurring or dual diagnosis issues. There are also some groups based on specific needs that do not involve the twelve steps. Please don’t be put off by the twelve step programs talk about a “higher power” even nonreligious people, atheists, and agnostics are welcomed and they often find there is something they can believe in if it is only the ability of the group to be helpful.
4. Colleges and schools
Many colleges have therapy available for students. These services are in addition to the department that does academic counseling. Check with the health services on campus if you are a student. Universities that offer counseling or therapy major often have clinics where new therapists under the supervision of experienced instructors, provide therapy services to members of the community. These university sponsored programs have low-cost or reduced cost options. School counselors can sometimes help with family issues, parenting and child behavioral issues.
5. Community-based resources
Non-profit organizations are sometimes able to provide some services to people in the community who are otherwise unable to access services. Check with charitable organizations. Some areas have a 211 phone service that is able to provide social service referrals.
6. Ask therapists and counselors about sliding fee arraignments
Some practitioners are able to see clients for reduced fees. Don’t be afraid to ask, but expect to have to show proof of income.
7. Consider group therapy
Group counseling is not second-rate services. Sometimes being in a group with others can be a powerful experience. Group fees can be significantly less than individual counseling. Some practitioners offer large group counseling at extremely low fees. In my area, there have been large groups run by professional therapists that were sponsored by churches or community-based organizations that were free. The therapist donates their time and the organization provides the space. The people who attend get free services that they would otherwise not be able to afford and the counselor often gets referrals for their private practice.
8. Substance abuse facilities
Substance abuse facilities often have outpatient groups that are extremely reasonable. They also may have free or low-cost groups for the family members of clients in substance abuse treatment.
9. Think about your priorities.
How much is your recovery worth? Many a time a person has told me they couldn’t afford therapy but they continue to pay hundreds of dollars each month for hair or nail appointments, home shopping or their drug of choice. Is it true you can’t afford help or is it that you have not made your recovery much of a priority?
10. Consider Religious counseling.
Pastors, Rabbi’s Priest, Bishops and other religious leaders often have training in Pastoral counseling in addition to their religious training. Seek out people who seem to care about you and about being of service.
If any of you know of other resources let me know so I can pass the information along. Till next time –
For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at http://www.counselorfresno.com/recommended-books/
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