How to Pay for Therapy

If you’ve ever considered getting therapy, you may have faced many barriers. From finding the right therapist to facing stigma from your friends and family, there are a lot of reasons why it might have been challenging to start your therapy journey.

And then of course, there’s the sticker shock.

But while therapy may seem very expensive, there are various ways to pay for your sessions to make sure it doesn’t burn a deep hole in your pocket. We’ve outlined different ways to keep your therapy costs to a minimum.

Insurance: Make sure you take a look at your insurance policy. Many providers cover mental health services but they can be tricky to find. One of the easiest ways to find out if your insurance covers services or not, is to call your insurance and ask about information regarding “outpatient mental health services.” This is the insurance term for therapy. They may either cover a portion or provide partial reimbursement. Find out if you need a referral from your primary care doctor as well for therapy services. If you’re looking for more in-depth help and feel that you need hospitalization or partial hospitalization, you will need to ask for “inpatient mental health services.” These are not typically covered by insurance but they can provide you a list of your options.
- If you are in an HMO such as Kaiser Permanente, and you are referred to someone, make sure they are within your network to avoid extra charges. Kaiser is contracting with more and more private practice therapists to meet the needs of their patients.
Health Savings Account (HSA)/Flexible Spending Account (FSA): If your insurance does not cover mental health services or your deductible is very high, another possibility is contributing to your HSA or FSA if your employer provides this option. HSAs and FSAs are pre-tax dollars that can be used for health-related expenses. Check with your employer to see if they contribute funds as well. This can be very helpful if you’re paying for your therapist sessions out of pocket. Free money!
Employee Assistance Programs: Many employers provide employee assistance programs that include free therapy. However, these programs are typically short-term solutions. You may receive somewhere between five to ten free sessions depending on your employer. But this works well if you’re seeking immediate assistance while you look for a therapist that is the right fit for you and your budget. If you’re not sure if your employer provides this, reach out to your HR representative for more information.
Associates and Assistants: Associates and assistants have the experience and credentials necessary to conduct therapist sessions but are working on becoming licensed. They are registered with the Board of Behavioral Sciences, work under the license of a supervisor, and are approved to provide mental health services. Titles to look for are: Associate Marriage & Family Therapist (AMFT), Associate Social Worker (ASW) or Psychological Assistant (PA). Legally, associates and assistants are required to note they are “Supervised by” in their marketing materials. Typically, associates and assistants have lower rates than licensed clinicians as they are continuing to gain experience.
Universities: Many universities provide free or reduced cost mental health services to students and the general public-even if you’re not a student! Some universities have training centers where students learn how to provide therapy while completing their coursework. If you’re interested in these, contact your local university’s Marriage and Family Therapy program, Social work program, or Doctoral Clinical psychology programs to see if they offer these types of services. For example, locally in Los Angeles, Antioch University has a counseling center.
For students, contact your on-campus student health center to find out whether they have counseling resources. If you have student insurance, you can find therapists within that insurance network that may see other students for lower cost.
Community Support Groups: Many nonprofit organizations and counseling centers provide community support groups. These groups offer a lot of skills that you can learn to manage depression and anxiety. You can go whenever they are running. The group costs vary but there are some that provide support for free. The National Alliance on Mental Illness (NAMI) is a national organization that offers free peer led support groups for those with mental illness and family support groups as well.
Community Mental Health Centers: There are community mental health centers that focus on providing individual therapy. Not all, but some agencies may accept your insurance or have funding such as grants for those without insurance.
Sliding Scale: If you have exhausted all options but still face financial challenges, ask your therapist if they would provide a sliding scale option. Therapists don’t typically advertise this option as they have their set rates, but if you are a student or facing severe financial challenges, your therapist may be willing to work with you. This is typically reserved for extreme cases of financial hardship and should be a last resort. It is at the discretion of the therapist if they are capable of taking on a client at a lower rate.

While therapy is expensive, it is an investment in yourself and you’re worth that investment. But it doesn’t mean you have to go broke. By using the strategies above, we hope that you find the right therapist within your budget and this article has provided ideas on how to get started.

Author: Yvonne Monteverde

Parents are Getting Older: How to Help Without Burdening Yourself

There are times in which we leave some of the most important conversations with our family to emergencies or until we have to face it. As parents become older, our way of supporting and helping them can look a bit different than other communities. Here are a few tips and questions to assist you in reflecting on this piece and help get you started. Each situation is different and this is meant to serve as a guide.

Expectations

Have you been able to discuss with your parents-what are they expecting out of you when they become of age or if they are?
- Maybe they are expecting you to assist with rent every month.
- Maybe they are expecting minimal assistance such as groceries.
- Maybe they would like to eventually move in with you (or you and your family). This is important to note. We don’t know until we ask. This could be a scary conversation to have but it sets the foundation for additional reflections for yourself.
What about your siblings?
- Are you an only child? Do you have siblings? What do your parents expect from you [and your siblings]?
  Perhaps you are the youngest, or the oldest. Culturally or within your family there may be dictations on duties.
Real limitations
- Until what age do your parents feel they can continue to work? Are there any limitations in place? Perhaps they have a disability that does not allow them to work. Perhaps they want to work even after retirement.
  Are you living in another state? Can you only provide a certain amount of support? With online shopping programs you might still be able to help out even if you are not physically present.
- If your parent is suffering from a chronic illness (cancer, arthritis, etc.) or a mental health issue (i.e. dementia, Alzheimers, etc.), it’s great to look into caregiver programs or perhaps applying to be a caregiver yourself. We need to provide the best care that our parents can receive and it’s important to accept our limitations as well. Do you worry about being overwhelmed with things and possibly forgetting to give the right medication to your parents? Or would you want to be in a space where you can be present and professional assistance is there?
- Assisted living programs or hospice care are available. I know there is so much stigma surrounding these programs and what this means in the Latinx community. However, I want to encourage talking about these programs as a real possibility to a) break the stigma and b) allow a positive relationship with the centers and advocacy to provide the best care for your parents. (Check out Wendy Chamorro’s article How Culturally Relevant Care Impacted My Family)
Expectations of yourself
- How do YOU expect to assist your parents? Do you want to be in a place fiscally to be able to provide for them? Do you want them to move in? Do you want to buy them a home so they can have peace of mind?
  Be gentle with yourself on these expectations. Often we expect a lot out of ourselves.

How to Carry the Load

Programs
- There are so many community assistance programs that can help alleviate financial constraints. Make sure to look into these first to see how else you would like to step in. Application for food stamps and public assistance
  If they are much older, is a caretaker needed to help out? In Home Support Services, Social security, Disability services, working closely with their Primary care doctor. USC has a support center specific to caregivers.
  USC Family Caregiver Support Center (FCSC) | Los Angeles Caregiver Resource Center @ USC
Carrying the load together
- Do any of your siblings make enough money to assist and help out? Can you and your siblings share the load?
- Extended family and friends may also be able to help out! Aunts, cousins, adopted family members, neighbors can be our extended brothers and sisters at times.
- How does your partner feel about helping your parents out? Are they also able to step in and offer assistance?
Type of load
- Are you able to provide financial help? Most of us want this and it is the most practical, but there are other ways that we can help, such as:
  - Groceries? Perhaps you send them groceries through an application? Can you provide them with $50 every week for groceries? Maybe the best way to help is by cooking for them and dropping off food?
  - Helping with emergencies?
  - If the help is financial, are there certain limitations to what you would like to provide? (only emergencies, only up until this amount)

Reflection

Your motivations
- What is dictating your motivation to help your parents? Is it because you feel guilty, you feel shamed for not helping, or are being told this is your duty? This needs to come from within, so find some time to reflect deeply how important this is for you.
- Many of us have adopted roles within our families. If you are always the one swooping in to fix a problem or issue and save the day, maybe it is time to take a step back in this instance and allow others to assist. It is a huge responsibility to care for an aging parent.
Boundaries
- Assess your own financial boundaries. Emergencies happen and they can move things into crisis mode, but if you are unable to contribute when this happens , it is important to not feel obligated and only do what you can. If you continue to help when you’re unable, this may build feelings of resentment instead of security and safety.
- You may have a family that you would like to start or have started. It is important to have this discussion with your partner on how to navigate situations that may arise with your parents.
Other ways to support
- There are many other ways to help out if you cannot financially. There are many seniors who are isolated, feel alone, and would like more in person visits with their children and family.
Resilience
- Encourage them to spend time with their friends, senior center groups, and to stay active within their own community and create purpose. Parents have so much knowledge and love to give.

We have to remember our parents are resilient no matter their current situation, they have made it through worse things in life and will continue to survive and find a way.

Author: Yvonne Monteverde

Saying “No” to Family

The holidays came and went and with that was probably many family commitments that were probably energizing, but possibly draining on us. Often we find ourselves saying yes to things that we don’t want to because of a perception of obligation or responsibility.

Growing up Latina, “No” just wasn’t in my vocabulary. Culturally, we are pushed into things (i.e. take care of your hermanito) with no other options or made to feel guilty if we don’t (i.e. “you’re being selfish”) for not doing X, Y, or Z. We feel obligated by blood, by loyalty, by culture and we are part of the collective family vs. our own autonomous self. You have needs? I can just hear a bunch of Latina mothers saying “you don’t see me complaining.”

These patterns, habits, and guilt can follow us into our adult years, and may transfer to other areas in our life such as our jobs and relationships with partners. That’s for another article.

I think the term “boundaries” can be a foreign concept to us. It’s a very anglo concept and can sound so cold and callous. Setting boundaries in a Latinx household or community can be very challenging. From navigating chisme to giving up your room for visiting family (if you had your own room!), to having roles placed on you, boundaries are often non-existing.

Adding on to that, the disappointment eventually ensues. It can lead to a heightened sense of my family may no longer love me. After all how disappointing that we cannot do this one thing — our families gave us so much! How could we be so selfish and ungrateful?!

“Let me just say yes again.” We think to ourselves.

However, I challenge you to truly reflect on this perceived (maybe even stated) disappointment. Are you actually selfish? Are you actually ungrateful? Are these messages we receive about ourselves actually facts?

We can love our families AND place boundaries on them.

Take that in.

“I love my family AND I need to place this boundary for myself.” Perhaps this is all you can handle. Perhaps this commitment is not something that you can continue to accomplish.

I can assure you, as much as our families have done for us, we will never be able to repay them. I can also assure you that you have done enough.

We can put these commitments on a boundary scale. Is it truly necessary that I be a part of this? Will I suffer emotionally, mentally, physically, financially if I say yes? Am I wholeheartedly saying yes because I would like to, or out of guilt?

While setting boundaries may receive pushback at first, it’s important to think about the long-term benefits that you will reap from doing so. Practice taking a step back and reframing your commitments against this boundary scale throughout the year. There’s a lot more I could add about pushback, but like I said, that’s for another article.

Author: Yvonne Monteverde

The Truth About Self Care

There’s a lot of buzz surrounding “self-care” these days. With all of the jade rollers, palo santo, thousands of face masks, and bath bombs out there, it’s no secret that the marketing industry has really tapped into this idea.

As a Latina, the idea of “taking care of yourself” can seem so wrong, selfish, and inappropriate given what was happening in our community. Some of us were taught that family always comes first, and anything else beyond that is selfish. It wasn’t until I started working within the mental health industry that I started to de-program these negative messages received about self-care and take a look at it critically.

If you’ve taken an airplane, you know the safety spiel they talk about in the beginning about putting on your oxygen masks. They mention “if you have children, put on your oxygen mask first, then assist your children with their oxygen masks” If you ask a Latina mother whether she would put on her mask first or put the mask on her children, she will tell you, “my child.” And this is where we need to start taking a look at some history on these dynamics.

Marianismo, or the counterpart of Machismo, is the belief and ideals of a nurturing and caring female figure. While there are parts to take away that are beneficial and beautiful from marianismo (and I will argue machismo as well), this is the way that it has been for many centuries.

Part of Marianismo is becoming a “martyr.” No matter the amount of suffering you are going through, you need to bear it for the wellbeing of the family, or the well being of others. Don’t get me wrong, this is a beautiful thing–until it gets to the point of being detrimental to the self. We attempt to be everything for everyone as a result of this.

Yes-I love a good spa day and heading to Ross and buying a cute top I don’t need too, however, self-care can come in many other ways.

Do you need to take a break from going out every weekend? Do you need to put a boundary on your parents for X, Y, or Z reason? Do you need to stop jumping from relationship to relationship? Do you need to verbalize your need for a break from the kids from your partner? Do you need to finally take that step and go to therapy? Would you feel better if you felt more spiritually connected to your faith? Do you need to be around your community more or serve your community more? Do you need to ask for a raise?

Self-care demands that we pay attention to our needs – those more difficult questions that will truly make a difference in our lives. To nurture ourselves simply independent of our own thoughts of self-worth. You don’t “deserve” a spa day because you did so much work this week, you deserve it and owe it to yourself because it is a need, not a luxury. Once we start taking care of ourselves in a mindful and conscientious manner, we give our best to our families, our partners, our work, our community, and most importantly to ourselves.