Therapy, it seems, is everywhere. We double-tap @MyTherapistSays memes on Instagram, we’re low-key turned on by Dr. Nicky on You, and we’ve wondered if it could help us deal with our Craigslist roommates (which we may not be dealing with if rent was lower! But I digress). Or the exes we can’t shake. Or those anxiety-causing Sunday emails from our bosses. Despite all that, locking down a therapist can feel weirdly daunting. Perhaps because it’s f*cking expensive?
Unless you’re enrolled in a plan from HealthCare.gov, your insurance company likely isn’t required to cover mental health. But even if it is, some plans have pricey co-pays or high deductibles and don’t offer a good selection of in-network providers, meaning you could pay up to $300 per session. (For their part, many therapists say insurance companies aren’t paying them enough for their services, so they may not take insurance at all, says Katrina Gay, national director of strategic partnerships for the National Alliance on Mental Illness.) Adding more fuel to the emotional dumpster fire, the demand for therapy, especially online therapy, has skyrocketed in recent years (hi, global pandemic!), but the number of therapists has not. The result: People who need therapy can’t get it, and those currently in therapy can be thrown for a loop if their coverage changes.
But there’s hope, people. (Lots, actually.) Take Ashley, a 26-year-old IT analyst who aged out of her parents’ insurance last year. When she realized her employer’s plan didn’t cover therapy at all, which would cause her regular sessions to cost more than her car payment and insurance combined, her therapist helped her find a university clinic where graduate students could treat her for just $15 a session. She says it’s worked out great for her. And that’s only one way to save loads of cash while still getting the help you (read: we all) need.
Here, Cosmo’s definitive guide to getting quality affordable therapy no matter how broke you are.
First, find out what your insurance covers.
It’s a harsh truth that not all insurance companies cover therapy, so find out if mental or behavioral health-care providers are included before you sign up, ideally. If you can’t stand reading boring paperwork, just call them to ask about your options. It’s easier than you think.
If your insurance sucks...
Set aside pre-tax bread. If your plan doesn’t cover in-network therapy with a low co-pay, find out if they let you put untaxed money from each paycheck into a health savings account (HSA) or flexible spending account (FSA). You can save up to 40 percent more (depending on your tax bracket) than if you used the post-tax money from your checking account.
If you’re already seeing a therapist you love…
Ask if she’ll tweak her rates based on your budget, says Alyssa Petersel, founder of My Wellbeing, a New York City–based service that matches patients with therapists. You won’t see these pay-what-you-can deals advertised, but it’s worth calling your current provider (or one with potential) to ask if they’ll work with you. Many will, says Petersel.
If your preferred therapist won’t cut you a deal…
Oftentimes, mental-health providers hold regular meetings with groups of people struggling with similar issues, like grief or stress, for a lot less money than a 1:1 sesh. Ask your go-to if she does this or if she can refer you to someone who does.
And group therapy's not just about cutting costs. Although you’re not getting undivided attention, you’ll still have the opportunity to be heard and learn various coping mechanisms with a community of people who can understand what you're going through. "It can be very healing to hear that you are not alone, and that others share or are dealing with similar stressors," says psychotherapist Krystal H. Parrish, PhD. And you’ll have your fellow groupies as ~accountability buddies~ to stick to your therapy goals and report back to the group on how you're tackling them, Parrish adds.
If you live near a university…
Supervised student therapists can be just as effective as the licensed kind when it comes to treating anxiety, depression, and more, per the American Psychological Association. And bonus, they’re as cheap as $5 to $10 per session. So check out the Association of Psychology Training Clinics to find grad-school therapy-training programs offering services in your area.
If you literally have $13 in your bank account rn…
There are clinics where you can score sessions on the house. Although they’re not easy to find, you can ask any therapist for a referral or use the Substance Abuse and Mental Health Services locator tool to find mental-health service providers offering payment assistance.
If you’re willing to sacrifice your brunch fund…
For a one-time $59 fee—this gets better, promise—the nonprofit Open Path will hook you up with a therapist willing to drop their rates to $30 to $60 per in-office session. And if your home base isn’t a therapy hub, some providers offer remote therapy via FaceTime or phone sessions. Although it’s not dirt cheap, your lower rate is locked in until you get better insurance or a big-ass raise.
If you’re cool with paying more for convenience…
Connect with a licensed therapist who specializes in your specific needs using therapy apps like Talkspace (from $69/week) and 7 Cups (from $38/week). You can message a therapist literally whenever you want advice or someone to listen.
Oh, and here’s what’s up with text therapy.
It can be great for a quick(er) fix.
Struggling with a work dilemma or relationship drama? “These problems may not necessitate long-term therapy, so accessing a professional through text could be all you need to resolve the problem,” says licensed psychologist Ashley Hampton, PhD.
Text therapy might be the move if you're intimidated by therapy.
If you're just dipping your toes into the therapy waters and want to see what this kind of healthy communications skill-building is like, then text therapy could be the right way to start. "I believe providers need to meet clients/patients where they are. If in-person, or face-to-face communication seems daunting, text could be a great option," Dr. Parrish says. And then, once a therapist coaches you through your concerns and questions initially via text, it could be worth it to meet with a therapist face-to-face at some point (via one of the above methods, obv) to go a little deeper. "I think it is helpful to learn how to cultivate in-person relationships as well," adds Dr. Parrish.
You’ll get in the zone faster.
Leaving work early, dealing with an annoying commute, parking, and answering work emails in the waiting room can leave you stressed TF out, making it harder to process and articulate your thoughts and feelings. “Someone meeting with me from home is already in their safe place, so they’re more relaxed from the start,” says licensed psychologist Lisa Marie Bobby, PhD. And when you’re done with your sesh, you can spend time reflecting—instead of fighting traffic, says Bobby.
You can use Emoji (!!!).
Sometimes your feelings on your boss’s passive-aggressive comments can only be described as 😤. And when it comes to text therapy, that’s a legit way to contextualize your emotions, says mental-health therapist Tasha Holland-Kornegay, PhD.
A version of this story originally ran in our April 2019 issue.
Nina is a health and culture reporter who has written for SELF, Glamour, Cosmopolitan, the New York Times, and more. She loves vegetable gardening, crossword puzzles, and her beloved mystery mutt.
