How much to sit on the couch?

April 29, 2008 10:10 AM

How much do therapists usually cost?

I'm looking for a therapist after hemming and hawing about it for a long time. I have two options at the moment. An elderly woman (80ish) psychologist who worked alongside my father at a mental hospital, who I think would see me very cheeply if not for free. Or a woman I spoke to on the phone, who was recomended to me anonymously on this site. I just spoke to her and she said that she charges $100 a session. I'll be paying out of pocket. Actually my parents have offered to pay for this, since I have no insurance and we both feel that this is an important thing for me. Money and price is an issue though.

So is $100 an hour a totally normal rate for a qualified therapist? This is in the big city in a really rural and somewhat poor state.

I'm wondering if I should go with the friend of my fathers. They are not close (have not spoken in many years) but worked together for many years and had a really good relationship. There would be no issue of me worrying about her telling my dad anything (my dad and I are very close and he knows most of my ish anyway). I'm a little worried that she's quite old, is retired and not seeing other patients and might not be totally up to date with things. Also that she historically dealt with severe mental illness at the hospital, and I'm more worried about relationship issues and my career, creative work, anxiety. She also lives 1 hour away. Also that my father and I have very similar personalities in some regards, and very different in others, and I'd be worried she'd be thinking about my father as we talked.

I don't know too much about this other lady. She seems nice. My parents have been totally onboard for this, and probably would spring for it, but I feel weird asking them for this amount of money.

So questions are:
1) Any advice for finding therapists in general?
2) is that a normal rate?
3) Do you think I should give my father's friend a try?

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

Yes, 100 is a normal rate. Yes, I would give your father's friend a try, if only because I'd be really curious to hear an 80-year-old's perspective. You can always try her first and switch later.
posted by astruc at 10:29 AM on April 29, 2008

Since you're in your state's big city, maybe there is a school for therapists/counselors. In my area, at least, such schools often let people have sessions with late-stage students, for practice and evaluation and what-not. The downside is that you probably won't be able to develop a long-term relationship with whomever you speak with.

As a Canadian, I'm really unsure what social services in a rural, poor state are like, but the optimist in me says there may be some sort of government agency that can offer services or subsidies.

A friend of mine recently spoke very highly of an on-line therapy service she was using. I can't speak to that route, but I can ask her for details if you're interested. (e-mail me)

As for the rate you've been quoted: It seems sort of middle-of-the-road for what I've paid and known to be paid for sessions, but the economies of our areas probably aren't equivalent.

If I were you, I wouldn't go with your father's friend. It seems you've already made the case for being uncomfortable with it. I think your concerns are fair, but who knows if they are vaild? The travel time certainly seems like it might make the whole process unattractive to the point of being less helpful.
posted by chudmonkey at 10:30 AM on April 29, 2008

$100 is normal or even on the cheaper side for a highly qualified therapist. A lot of therapists have a sliding scale, so you can pay what you can: maybe an option if you're shopping around. Therapy, to me, is partly about speaking to someone who is completely objective to my situation. This means that I could never see someone who knew any of my friends or family in any kind of way - something to perhaps consider.
posted by meerkatty at 10:44 AM on April 29, 2008 [1 favorite]

Most therapists charge on a sliding-scale fee or take insurance, one or the other. The sliding-scale fee is determined based on what they believe you can afford; insurance, when it covers mental health issues, leaves you with just a co-pay. The rate you are being offered is, for my area, very middle-of-the-road (I have paid between $60 and $100 per session on sliding scale).

However, driving for an hour each way would be the deciding factor for me. If your parents are willing to pay, try the local one for $100 first; if you don't like that therapist, try the free one that's far away would be my suggestion. Even though ethically she is required to not share your information with your parents, psychologically it is sometimes easier to open up to a stranger with no mental baggage projected into the situation from the get-go.
posted by Unicorn on the cob at 10:49 AM on April 29, 2008

It's perfectly okay to ask for a reduced rate, due to lack of funds. I also recommend that you come up with some interview questions for any therapist you consider, ex.: What is your educational background? What type of therapy do you practice/ Do you have experience with *whatever issue you may have, like phobia, anxiety, etc. You'll get some idea of compatibility from the discussion, as well as the answers to specific questions.
posted by theora55 at 10:54 AM on April 29, 2008 [1 favorite]

nthing that $100 is normal. I wouldn't see anyone that knew my parents personally, since I end up talking about them quite a bit in therapy.
posted by desjardins at 11:00 AM on April 29, 2008 [2 favorites]

yes, normal rate. i spent last week looking for a shrink that accepted my insurance. most of them did not and quoted rates from $80-$140 an hour (well, 50 minutes). this is in philadelphia.

personally, i would not go for an 80 year old shrink--retired--who worked with my parents for years. preconceptions, huge generational difference, might not be up on the newest pedagogy, drugs, treatment modalities, etc.
posted by misanthropicsarah at 11:38 AM on April 29, 2008 [1 favorite]

$100 is actually pretty okay. I agree with misanthropicsarah about the generation gap, treatments, contexts... I know there are brilliant and with-it 80 year old psychologists out there, but I would be ... concerned about it. The minute you start going on about your in-depth internet [anything], she might think you have some kind of serious problem, while a younger psychologist might be more familiar with how pervasive it is in modern life. And there is the friend-of-parents thing ... I wouldn't be nearly at ease as much if I was talking to a friend of the family as opposed to someone entirely unrelated, which is kind of the whole point.
posted by blacklite at 4:12 PM on April 29, 2008

I had a sliding scale therapist in Austin I really liked. Don't know if she still is. I would not see a family friend.

Email me-- [e-mail]
posted by liketitanic at 6:19 PM on April 29, 2008

It depends. For me, I made sure to call my health care provider and get their whole "list of approved therapists, etc". It makes a huge difference as my co-pay each time is only $25 instead of God knows what kind of cost I could be paying.

If you have health insurance, be sure to check with them first and ask them for the list of therapists in your area taht are covered by them. For the money you could save, it's worth it.

- Travis
posted by isoman2kx at 1:38 PM on May 7, 2008