|
feevers



Registered: 12/28/10
Posts: 8,546
Loc:
|
A Beginner's Guide to Therapy 4
#25940356 - 04/17/19 05:46 PM (4 years, 9 months ago) |
|
|
The mental healthcare system in the US can be confusing and difficult to navigate. For those who think they could benefit from therapy, here's a brief overview that can help you quickly and inexpensively get the help that's right for you.
Isn't therapy super expensive?
Typically, no. Mental health services are now covered by most health insurance plans in the US. A simple call to your insurance company, or checking their website, is the best way to figure out exactly what's available to you. For many insurance plans, you just make an appointment for therapy and the therapist sorts things out.
So in terms of cost, the majority of people in America with health insurance can receive high quality 1 on 1 psychotherapy for $0-$30 per 45-55 minute session, depending on insurance. For those with no health insurance, therapy will often cost between $35-$250, depending on if the therapist uses an income-based sliding scale and state insurance regulations.
For those with no insurance, or insurance that does not cover mental health, some options are to check with a local social services agency or a community based health center, many of which receive federal funding to provide services to those in need. Many colleges and universities now offer free therapy services to students, schools with psychology programs often offer extensive services. Some of the alternatives listed at the bottom of this post may also be a better fit.
Do I qualify for therapy?
Most likely, yes. Do you suffer from anxiety, depression, addiction, OCD, any other psychiatric disorder, or any variation of what's included in these codes? If so, then your insurance will likely cover your psychotherapy. I would guess that it's rare to find a person that doesn't fit into any of these categories, in some way.
What type of therapy?
There are many varieties of psychotherapy. Some of these types are used to target specific disorders, some are broader and more general. Here is a list of many different types. If you are someone who knows what you'd like out of treatment, the best place to begin is by researching these modalities and figuring out which one sounds like the best fit for you. If you're someone who doesn't know where to start, and you don't have a preference for type of technique, that's more than fine and most people don't. Assuming a therapist/counselor takes you on as a client, whatever style of therapy they use will likely have been proven effective in treating what you're seeking help for.
Choosing a therapist:
Just because a therapist is better educated, has more experience, or has one title over the other does not mean they will be a better fit for you. Research suggests one of the biggest predictors of how well someone does in therapy is how well they mesh with their therapist. Choosing a therapist with the highest degree and most experience does not necessarily mean choosing the therapist who will be able to help you the most.
This is where the free consultation comes into play. A free consultation is something that many therapists will offer, it's typically a 5-minute in person or over the phone Q&A where they get a feel for if your situation is something they're a good fit for, and you can ask questions and get a feel for if they're someone you'd like to work with. It's encouraged that everyone who goes into therapy set up consultations with more than one therapist, and go into them with questions and a plan to "feel out" the therapist. After you complete the sessions, you can choose the therapist based on factors like who you seem to click the best with, who you have the most confidence in, who's style appeals to you the most, etc. It's fine to skip this process, it's just an extra step to help ensure that you find the best help for you personally. No one wants to waste time in sessions with someone they don't feel comfortable opening up to.
Your insurance company should have a list of in-network providers on their website, most of them are sortable by license type, therapy type, location, gender, etc. If there is no list, you can use psychologytoday.com's Find a Therapist page (Located Here) and just type your insurance into the search bar or select it from the 'advanced search' list. Psychology Today is good because you can read a profile on the therapist and see a bit about their style.
You can also do some digging on potential therapists. Look for them on psychology today, google their name to find if anyone's left reviews for them online on HealthProfs or other clinician rating sites. The best way to search is to include their licensure, so you'd just google "John Smith LMHC" and add the zipcode or state if the results are too broad at first.
Find local and affordable counselors: https://www.opencounseling.com
Types of therapists:
There are a lot of different types of therapists, and if you chose one for yourself you'll often have a choice between many of the below options. Here's a brief breakdown of the most common license types and their formal training:
Psychologists: PhD: Typically a bachelor's degree and 4+ years of graduate school. PhD's are often research-focused programs, many go on to work in research and academia. There are also Clinical PhD programs, which emphasize training in therapy and working with clients.
PsyD: Similar to a PhD, but typically more clinically oriented. PsyD programs often emphasize research less and are more heavy in education based on therapy, and internships working with clients. There are PsyD programs that are more research based, just as there are PhD programs that are more clinical.
Counselors: LMHC/LPC/LCPC: Requirements and titles vary from state to state. These are typically counselors who have a bachelor's degree, and a minimum of a master's degree (some have a doctorate) from a program with a therapy-focused curriculum. They will also have extensive field work experience providing psychotherapy.
LCSW/LICSW: This is a social worker that is trained in psychotherapy (if they're providing services). Social work curriculum is often broader, and it is possible for an LICSW to have less of an educational background in therapy than a psychologist or LMHC/LPC. That is not always the case, many social workers are well trained and amply skilled.
CCMHC (Certified Clinical Mental Health Counselor): the highest level of certified clinical counselor
LMFT/MFT: Marriage/family therapist. Typically a bachelor's degree and a master's in MFT. If you'd like to involve other family members or significant other's in therapy, these could be the best choice.
MAC/LADC I/CADC I: Substance abuse counselor. Varies from state to state, but typically they have a master's degree and have completed an additional 1-2 year program in Addiction Counseling, along with 250+ hours of internship experience. Can provide independent outpatient therapy. LADC II/CADC II: typically do not have a master's degree, cannot provide outpatient private practice therapy, but are likely to work in inpatient programs and groups.
Hypnotherapy: Certifying agencies are the National Board for Certified Clinical Hypnotherapists (NBCCH) and the American Society of Clinical Hypnosis. Hypnotherapy has been used to treat anxiety, phobias, substance abuse, sexual dysfunction, amongst many other things. May or may not be covered by insurance. Word of caution: if not specifically state licensed, a hypnotist or hypnotherapist may have no psychological training, experience, or a professional ethic under which they must abide.
ASECT Certified Sex Therapists: licensed mental health professionals, trained to provide in-depth psychotherapy, who have specialized in treating clients with sexual issues and concerns.
Psychiatry: If you feel you are are becoming a danger to yourself or others, or are experiencing symptoms that you believe will require medication to improve, make an appointment with your Primary Care Physician or visit a walk-in. A physician will either refer you to a psychiatrist/other resources or prescribe you medication themselves. Do educate yourself as much as possible on any potential medications. Many medications used for mental illness can have dangerous side-effects and build physical/physiological dependencies. For some people medication may be the best option, for others it could be the worst option, education and self-awareness are just as important as making sure you're working with a competent and thorough physician.
Occupational Therapy: OT's work in cases where someone's daily functioning skills are severely impacted by their addiction or mental illness. You would typically only qualify for OT services if you were having difficulty with living independently, or in an inpatient residential program. An OT will have a bachelor's degree and either a Master's or a Doctorate, and be trained in a wide range of physical and psychological rehabilitation.
There are many other professional licenses and certifications, such as recovery coach, life coach, peer support specialist. Many of these are not covered by insurance or would be someone you'd be more likely to work with in an in-patient program.
The most important factor in your healthcare, both mental and physical, is to be your own advocate. There are therapists and doctors out there who can help you change your life in unbelievable ways. There are also therapists and doctors who are simply working for a paycheck. These people can not only waste your time and money, but can also potentially harm you. Being an advocate for yourself means educating yourself to a point where you can recognize when a provider does not have your best interests in mind, and you can speak out and act accordingly to get the help you need.
Alternatives to psychotherapy:
Here are a few alternatives to traditional therapy that may also help:
Online Counseling: Online counseling could be an option for some people. There are many different services and a variety of different pricing structures, it's worth a shot for those without insurance or with time constraints. Formats can be skype/video chat, phone, text, email, etc.
Group Therapy: Some people find groups more helpful than 1 on 1. For those with no insurance, it's often much cheaper as well.
Online/Local support groups: Peer groups can be just as effective as independent therapy for some people, and there are no shortage of online support groups and local meet ups in many areas.
Addiction Recovery: Programs such as NA/AA and SMART Recovery have chapters all over the country. If you're a first-timer, look for a meeting with an "O" or "Open" designation, which means all are welcome. An "OS" or "OSD" designation may be ideal if you're looking to just blend in, as these are open meetings that focus on a speaker who comes in to share their story.
Refuge Recover: An AA style program based upon Buddhist principle, which integrates meditation and mindfulness into its meetings.
Self Authoring: Self Authoring is a tool that was developed by a team of psychotherapists. It's a program that involves prompts that encourage reflection and journaling about your past, present, and future. It's developed based upon many of the aspects of psychotherapy that have been found to be most effective.
Good luck and feel free to reach out with any questions!
Thanks to Markosthegnostic and one anonymous shroomerite for helping to verify information and contribute resources!
Edited by feevers (01/06/20 08:48 AM)
|
Jewstress
Momma


Registered: 03/21/19
Posts: 5,402
Loc: everywhere.
Last seen: 1 day, 19 hours
|
Re: A Beginner's Guide to Therapy [Re: feevers]
#25940479 - 04/17/19 07:12 PM (4 years, 9 months ago) |
|
|
Who are you?
Where did you get this information or did you take the time to research and type it all out?
--------------------
😇
|
feevers



Registered: 12/28/10
Posts: 8,546
Loc:
|
Re: A Beginner's Guide to Therapy [Re: Jewstress]
#25940646 - 04/17/19 09:17 PM (4 years, 9 months ago) |
|
|
Quote:
Jewstress said: Who are you?
Where did you get this information or did you take the time to research and type it all out?
I work in mental health, currently as an addiction counselor and am working on a doctorate in a rehab field.
It's something I've been meaning to write up for awhile, both as a resource for here on the shroomery and eventually also as a handout for clients when they leave the inpatient program I'm working with. The goal is to address the main questions people typically have or barriers to beginning therapy, and provide some general info and tips.
Edited by feevers (11/30/20 08:23 PM)
|
Doc9151
Mycologist



Registered: 02/23/17
Posts: 13,753
Loc: Gulf Coast USA
Last seen: 1 year, 6 months
|
Re: A Beginner's Guide to Therapy [Re: feevers]
#25943765 - 04/19/19 01:40 PM (4 years, 9 months ago) |
|
|
I noticed that you left psychiatrist off your list, is there a reason you didn't list them.
--------------------
  Psilocybe cubensis data collection thread. please help with this project if you hunt wild cubensis. https://www.shroomery.org/forums/showflat.php?Cat=0&Number=26513593&page=0&vc=1#26513593
|
feevers



Registered: 12/28/10
Posts: 8,546
Loc:
|
Re: A Beginner's Guide to Therapy [Re: Doc9151]
#25943820 - 04/19/19 02:13 PM (4 years, 9 months ago) |
|
|
Quote:
Doc9151 said: I noticed that you left psychiatrist off your list, is there a reason you didn't list them.
I listed Psychiatry as a category after the types of counselors.
The percentage of psychiatrists who still do therapy is very low. Many psychiatry programs feature very little coursework or hands-on work with psychotherapy.
My suggestion was to seek them out if there is any potential for harm, or if you feel your situation requires medication, as they will diagnose you and prescribe. Often if you seek out a counselor or psychologist first, they will bring up medication and if it's something you're seeking out they'll help you find a psychiatrist to prescribe while you remain in therapy.
If you were to call up your insurance company and say "I want to begin therapy, who is in network?" they would most likely list psychologists, counselors, or social workers. Many insurances require you to visit your physician and get a referral before seeing a psychiatrist, they're more in the realm of a mental health medical doctor than therapist in most cases.
|
Doc9151
Mycologist



Registered: 02/23/17
Posts: 13,753
Loc: Gulf Coast USA
Last seen: 1 year, 6 months
|
Re: A Beginner's Guide to Therapy [Re: feevers]
#25944263 - 04/19/19 06:11 PM (4 years, 9 months ago) |
|
|
I need some advice on finding a proper provider to treat someone with paranoid schizophrenia.
I practiced prehospital trauma and clinical medicine, but I have minimal experience in psychiatric disorders. I don't know if the mental health side has specialist in certain disorders or they are general practitioners...
--------------------
  Psilocybe cubensis data collection thread. please help with this project if you hunt wild cubensis. https://www.shroomery.org/forums/showflat.php?Cat=0&Number=26513593&page=0&vc=1#26513593
|
feevers



Registered: 12/28/10
Posts: 8,546
Loc:
|
Re: A Beginner's Guide to Therapy [Re: Doc9151]
#25945213 - 04/20/19 07:29 AM (4 years, 9 months ago) |
|
|
Quote:
Doc9151 said: I need some advice on finding a proper provider to treat someone with paranoid schizophrenia.
I practiced prehospital trauma and clinical medicine, but I have minimal experience in psychiatric disorders. I don't know if the mental health side has specialist in certain disorders or they are general practitioners...
If they're needing medication, the best bet would be to see their Physician and ask for a referral to a psychiatrist experienced with schizophrenia. Psychology Today has listings for local psychiatrists that specialize in psychosis, could also reach out to some of them and see what they'd recommend: https://www.psychologytoday.com/us/psychiatrists/psychosis Depending on where they live there may be hospitals that have schizophrenia programs and will see people in an outpatient capacity or as part of a day program.
If they're looking for therapy, they could check out https://www.findapsychologist.org, type in their location/radius, filter by area of expertise, and click 'Serious and Persistent Mental Illness (e.g., schizophrenia and other psychosis)'. There also may be psychiatrists on the Psychology Today site that provide psychotherapy as well.
|
Doc9151
Mycologist



Registered: 02/23/17
Posts: 13,753
Loc: Gulf Coast USA
Last seen: 1 year, 6 months
|
Re: A Beginner's Guide to Therapy [Re: feevers]
#25945663 - 04/20/19 12:37 PM (4 years, 9 months ago) |
|
|
Thank you, I appreciate your help and taking the time to respond. My wife has late onset paranoid schizophrenia and her current psychiatrist is ignoring her symptoms and she needs help before she drives me crazy. This has to be one of the hardest forms of mental illness to treat, mainly due to the patient having moments where they believe that they do not have any problems with their mind, that's when they stop medication and things really get out of hand.
--------------------
  Psilocybe cubensis data collection thread. please help with this project if you hunt wild cubensis. https://www.shroomery.org/forums/showflat.php?Cat=0&Number=26513593&page=0&vc=1#26513593
|
feevers


Registered: 12/28/10
Posts: 8,546
Loc:
|
Re: A Beginner's Guide to Therapy [Re: feevers]
#27494479 - 10/06/21 08:46 AM (2 years, 3 months ago) |
|
|
It's somewhat strange to see someone have their first episode of psychosis so late, but they're often triggered by a traumatic/stressful event. I'd also wonder if she might have stopped taking a medication she was previously on, sometimes jumping off a med suddenly can cause psychiatric symptoms
Im guessing I just replied to a BetterHelp bot though
Edit: clarification- was replying to a bot that's post was deleted, not Doc
Edited by feevers (07/19/22 06:06 AM)
|
Doc9151
Mycologist


Registered: 02/23/17
Posts: 13,753
Loc: Gulf Coast USA
Last seen: 1 year, 6 months
|
Re: A Beginner's Guide to Therapy [Re: feevers]
#27503444 - 10/13/21 05:11 PM (2 years, 3 months ago) |
|
|
Quote:
feevers said: It's somewhat strange to see someone have their first episode of psychosis so late, but they're often triggered by a traumatic/stressful event. I'd also wonder if she might have stopped taking a medication she was previously on, sometimes jumping off a med suddenly can cause psychiatric symptoms
Im guessing I just replied to a BetterHelp bot though
She was never diagnosed until she had a full blown episode, but I did get her family to admit there is family history, she's had a few relatives in the state hospital but no one ever talked about it until until it appeared in my wife. It's really sad, her mother told me that she had suspected it when my wife was younger but never mentioned anything because she was afraid it would stigmatize my wife and affect her ability to live a normal life. I suspect my wife is an exception to the norm, her symptoms appeared well after completing her university studies. I have to be honest, her symptoms didn't appear until after her 3rd dose of Psilocybe cubensis, 4 others I know have had a similar experience, symptoms appeared between the 3rd and 5th doses, all became suicidal in the beginning because of hallucinations and voices that started plaguing them during all hours of the day and night. All had a family history of bipolar schizophrenia. This is why I can't give someone their 1st time, I don't want that 💩 on my conscience.
Edit: word correction from and to on in last sentence.
Edited by Doc9151 (10/13/21 05:14 PM)
|
Mr.GuessWork
Stranger

Registered: 03/30/13
Posts: 4,563
|
Re: A Beginner's Guide to Therapy [Re: Doc9151]
#27503834 - 10/14/21 03:43 AM (2 years, 3 months ago) |
|
|
That's a pretty interesting observation. I was reading some stuff a while back about some of the longer term benefits in treating intractable depression with psilocybin when I came across this article on a mouse study that showed some long term neurological changes after a single psilocybin dose and suggested it might be part of what helps with the depression. I wonder if the something along the same lines isn't happening in the pathways responsible for positive symptoms in schizophrenia.
https://news.yale.edu/2021/07/05/psychedelic-spurs-growth-neural-connections-lost-depression
|
|