Fall five times. Stand up six?

February 29, 2012 7:56 AM

All attempts at establishing a relationship with a therapist have failed. Now what?

Late 20s, female, living in the southern suburbs of the Twin Cities and dealing with a lot of stress, loneliness, unemployment/underemployment (Problem #1) and increasing amounts of anxiety. My only requirements for my therapist have been

1. reachable under my own power in one bus trip or less (I do not have personal transportation and cannot involve friends or family members [Problem #2] as I wish to handle this privately) - this allows me to go to sessions and return before anyone realizes I've been gone for very long

2. willing to work with me with regards to my finances (I have some tax refund money (> $1000) to work with, but as I am unemployed currently I have to make it last indefinitely)

3. willing to hang with me on a religious level (I am Christian but progressive and increasingly anti-mainstream)

My experiences so far:

I've done my research mostly through the Psychology Today directory. There are four therapists practicing within walking distance of my home and one free walk-in clinic within a short bus ride. Other practitioners are either too far away or too expensive/do not offer a sliding scale. I thought that at least one of the four would be able to accommodate me and that it wouldn't be an issue. However, of the four, two never responded to my initial email, one sat me down in her office, rejected my attempts to work out a payment plan after I explained my situation, and very much made me feel like she did not want to work with me for financial reasons but for ethical reasons could not say so outright, and another refused to see me and referred me to a therapist in a distant city well outside my transportation range despite my briefly mentioning my issues.

When I entered the walk-in clinic, the therapist on hand quickly determined that the answer to my issues as I described them was "to think happy thoughts" (I confirmed this with her); we then argued at great length over the value and efficacy of that advice until she stated to me that she wouldn't give anything to be me (or a person of my age) in the current economic climate. I said, "It sounds like you're saying it sucks to be me," and she confirmed this. I found the statement shocking for a therapist and offensive. (Aren't therapists supposed to at least be empathetic, or at least not flatly rude like that?) When I told her that I could not believe she had said such a thing, she could not understand my incredulity. I walked out.

These experiences have left me at a loss. I have had a therapist relationship before while underemployed about 5 years ago where I was unable to continue seeing the woman because I had nearly run out of money and she suddenly announced that she was moving her practice much further than I could reasonably travel. I have come to the conclusion that either I have the misfortune of having inflexible therapists in my area or that my requirements are unreasonable, and that I cannot seek therapy until I either acquire a job with health insurance (so far impossible over the past 8 years and even then not a guarantee of anything) or magically acquire a large amount of money.

My question, having said all of this, is what, if anything, should do now? I have tried Mood Gym and personally found it flawed, limited and unhelpful (not that that should stop anyone else). I feel that I have no options unless I acquire money as previously mentioned or find myself in a crisis situation, and having been told first-hand stories about being dropped off by an ambulance in a random neighborhood by HCMC for being a low-income self-committed mental health patient and therefore "not worth it", that doesn't really sound like an option either.

Disposable email address: [e-mail]

posted by anonymous to health & fitness (10 answers total)

Can you call the therapists who didn't return your emails? Don't write them off because they didn't respond. I find email to be a poor form of communication with health professionals especially if you are trying to initiate the first appointment.
posted by kanata at 8:12 AM on February 29, 2012 [5 favorites]

You've tried to make appointments with five doctors. Two won't accommodate you without insurance, and one was a flake. Sounds about normal.

It's sad to say, but in this current state of the medical industry, you have to keep shopping. Yes, it puts the burden all on you, but that's where we are with healthcare these days. Keep trying, ask friends and other medical professionals (and other resources in your area) who else is around. There are generally social workers who work on sliding scales who can help, they're just like little nuggets of gold among all the sand.
posted by xingcat at 8:14 AM on February 29, 2012 [1 favorite]

I had some success finding a spiritually minded therapist through my local church community (fairly liberal place). Maybe try approaching some churches or religious organizations that you identify with in your community for assistance? I approached my community (without being a member - joined afterwards) and got a subsidy for counselling with a community center and spiritual counselling from the pastor. A friend did something similar with the local Unitarian Universalist community when they were going through a rough patch, found them very welcoming and provided a great referral.
posted by snowysoul at 8:27 AM on February 29, 2012 [2 favorites]

Also, come up with a good excuse to be away from your home regularly to allow you to travel further if it turns out that you cannot find someone willing to accommodate your issues locally.
posted by koahiatamadl at 8:49 AM on February 29, 2012 [1 favorite]

The psychology today directory is OK, but not great. I did a quick google search for "sliding scale psychotherapy twin cities" and found this website. If I were you, I'd keep looking. I am particularly fond of counseling centers that are affiliated with a clinical/counseling psych PhD program, because while you may get stuck with a student, they are being supervised so closely that you are much less likely to encounter the kind of dick behavior you've already experienced (plus they almost always offer very flexible rates). There are a lot of therapists out there and some of them suck. The flip side is that some of them are awesome and can help you change your life.
posted by Mrs.Spiffy at 8:52 AM on February 29, 2012 [2 favorites]

The resources Mrs. Spiffy pointed you to are very good and most are on the bus lines.

I'm not sure if this is the clinic you referred to as the walk-in but they have more than one therapist available (many services provided by community therapists who also choose to donate their time here), so you could definitely request to see another.

The Univerisity of Minnesota department of psychology also operates an outpatient clinic with a sliding scale.

I know that you're struggling, and I truly hope things get better for you. It might help to have a little wiggle room with some of your requirements. The easiest would be to allow yourself a slightly greater geographical range, if possible, to open up some additional resources.
posted by goggie at 9:09 AM on February 29, 2012 [2 favorites]

It totally sucks that you found a bunch of therapists who couldn't accommodate your needs, and one who seems just plain flaky and unprofessional.

But, yeah, you've got to keep shopping, just as you would for a primary care doctor. I think snowysoul and Mrs.Spiffy have some really good ideas for next steps. If there's an Episcopalian church nearby, I would also ask their rector/vicar/priest in charge of community outreach for recommendations; we are a very psychotherapeutic denomination.
posted by Sidhedevil at 9:16 AM on February 29, 2012

I think you need to compromise on 1 and 3. Therapy is a commitment and an investment; and it might involve several long bus rides or scraping up the money to pay for a cab. You could also consider biking once the weather improves.

As for religion, don't worry too much about it. You're looking for a good therapist first and foremost, and any good therapist will be able to work with your religious issues, even if they are a different religion or no religion at all.
posted by yarly at 9:22 AM on February 29, 2012 [2 favorites]

I feel ya! Finding a good therapist is HARD.

Writer John Gardner said (in a writing instruction book, oddly) that 80 percent of people are incompetent at their jobs. I think it's definitely true in the world of professional therapists. It's very sad, especially since the stakes are so high.

It sounds like you've got your wits about you, and you can recognize a bad therapist immediately - good on you for calling that woman out on her ridiculous directive to "Think happy thoughts!" You know what to avoid, and you're way ahead of most clients that way.

The insurance piece is making things more difficult for you, unfortunately. I don't necessarily blame a therapist for not wanting to take on someone at a reduced rate. It's up to any individual helper to decide what they need to be making in order to stay in business. Many can't afford to use a sliding scale fee structure, but some will.

It's also possible to see a therapist for free, if you can find one who does pro bono work as a way of giving back. Hard to find one of these, and it'll be a brief course of therapy rather than an open-ended one. But they exist.

You said "all attempts at establishing a relationship have failed," but it's really only been five tries that haven't worked out for you. Don't get discouraged, just keep at it. Easier said that done, I know! (I recently found a therapist after having had five disasters, like you.) Good luck!
posted by cartoonella at 9:24 AM on February 29, 2012 [1 favorite]

I said, "It sounds like you're saying it sucks to be me," and she confirmed this. I found the statement shocking for a therapist and offensive. (Aren't therapists supposed to at least be empathetic, or at least not flatly rude like that?)

FWIW, i read that not as rude, but as acknowledging that you do face challenges that are no fault of your own. it sounds pretty empathetic to me. i'd prefer that kind of honestly compared to the NOTHING IS OUT OF YOUR CONTROL, YOU CAN DO ANYTHING AS LONG AS YOU DON'T HOLD YOURSELF BACK WITH NEGATIVE THOUGHTS attitude of a lot of CBT advocates.
posted by cupcake1337 at 1:15 PM on February 29, 2012 [1 favorite]