Finding counselor/therapist for a teenager?
November 3, 2022 9:19 AM Subscribe
We're trying to find a counselor or therapist for our 13-year-old daughter in Portland, Oregon. Looking for any advice to help move the byzantine process along.
Like pretty much everywhere, providers are swamped, and those who are even accepting new patients often have months-long waiting lists. Having to schedule around school limits things even more.
Of course we'd very much prefer someone in-network. She's on my ex's health insurance, the Oregon Health Plan (Medicare), which has a short list of providers. And she doesn't really have a primary care provider, which complicates the process of getting a referral.
Out-of-network options are somewhat more numerous and much more expensive, but we may have to go that route after all.
We'd also like to have her evaluated for ADHD. Most of those places seem to require a referral from a provider to be able to bill insurance, if they even do.
Right now we're in the call-everyone-possible phase, trying to coordinate efforts (I hope, eventually) through a shared spreadsheet. So far it's an incredibly slow and frustrating process. Are there any other approaches or options we could look into?
Like pretty much everywhere, providers are swamped, and those who are even accepting new patients often have months-long waiting lists. Having to schedule around school limits things even more.
Of course we'd very much prefer someone in-network. She's on my ex's health insurance, the Oregon Health Plan (Medicare), which has a short list of providers. And she doesn't really have a primary care provider, which complicates the process of getting a referral.
Out-of-network options are somewhat more numerous and much more expensive, but we may have to go that route after all.
We'd also like to have her evaluated for ADHD. Most of those places seem to require a referral from a provider to be able to bill insurance, if they even do.
Right now we're in the call-everyone-possible phase, trying to coordinate efforts (I hope, eventually) through a shared spreadsheet. So far it's an incredibly slow and frustrating process. Are there any other approaches or options we could look into?
The fact of the matter, in my experience, is that in order to find a therapist you almost always end up out of network. In my case, I was able to be about 80% reimbursed by my insurance once I submitted the claim but I did have to come out of pocket for it. I would make sure you understand your out of network benefits -- it's quite different to being "out of network" for a regular doctor like a family doctor.
posted by Medieval Maven at 10:35 AM on November 3, 2022
posted by Medieval Maven at 10:35 AM on November 3, 2022
I'm a therapist, but not in Oregon. Since she's on OHP, you probably don't have out of network benefits that apply. Definitely double check, but typically it's not permissible to use that type of coverage in a way that would involve the therapist being paid more than the standard reimbursement rate (i.e., if a therapist's rate is $150 per session and your Medicaid pays $105, the therapist can't charge you the remaining $45).
If you have your own insurance, you might be able to do a two-pronged approach of finding family therapy for you and your daughter in the short term (billed through your coverage), while waiting on individual therapy for her. It wouldn't be a waste of time to work on some family-based topics and skills, even though your priority is getting her set up for individual therapy. Plus, your family therapist might be able to help you find a good long-term fit.
If you haven't already explored your options state-wide, that's worth considering, too. Most therapists are offering telehealth services, and anyone licensed in Oregon can see your daughter. (Of course, some kids do better with in-person therapy, so this isn't a magic bullet, but I've seen positive results doing telehealth with teens.)
Finally, and this might be something you've already explored, reach out to your daughter's school counselor/social worker. Some schools have relationships with community mental health organizations such that therapists can come to the school to meet with kids during the school day, which would alleviate some of the scheduling challenges. Additionally, the school may have a referral list they can share with you.
posted by theotherdurassister at 11:04 AM on November 3, 2022 [2 favorites]
If you have your own insurance, you might be able to do a two-pronged approach of finding family therapy for you and your daughter in the short term (billed through your coverage), while waiting on individual therapy for her. It wouldn't be a waste of time to work on some family-based topics and skills, even though your priority is getting her set up for individual therapy. Plus, your family therapist might be able to help you find a good long-term fit.
If you haven't already explored your options state-wide, that's worth considering, too. Most therapists are offering telehealth services, and anyone licensed in Oregon can see your daughter. (Of course, some kids do better with in-person therapy, so this isn't a magic bullet, but I've seen positive results doing telehealth with teens.)
Finally, and this might be something you've already explored, reach out to your daughter's school counselor/social worker. Some schools have relationships with community mental health organizations such that therapists can come to the school to meet with kids during the school day, which would alleviate some of the scheduling challenges. Additionally, the school may have a referral list they can share with you.
posted by theotherdurassister at 11:04 AM on November 3, 2022 [2 favorites]
We'd also like to have her evaluated for ADHD. Most of those places seem to require a referral from a provider to be able to bill insurance, if they even do.
This is a separate track almost entirely; a therapist might be able to do some screenings to sort of determine 'yes probably/no probably' but will unlikely diagnose a kid with ADHD; this is the scope of a full psychological evaluation which are famously expensive on OHP. Interfacing with a psychiatrist and PCP after are probably almost required for this to be worth it. Expect 6-8 month waits, and lots of kind of shitty providers.
School based health centers often have therapy services (that are, unfortunately already probably full at this point in the year, but worth checking in with), and take OHP by default. Even if your kid doesn't go to those schools, you may be able to contact them for assistance.
County-level resources are going to be a good interface point if you are sitting inside of the venn diagram of 'have OHP' and 'do not have a PCP.'
posted by furnace.heart at 4:13 PM on November 3, 2022
This is a separate track almost entirely; a therapist might be able to do some screenings to sort of determine 'yes probably/no probably' but will unlikely diagnose a kid with ADHD; this is the scope of a full psychological evaluation which are famously expensive on OHP. Interfacing with a psychiatrist and PCP after are probably almost required for this to be worth it. Expect 6-8 month waits, and lots of kind of shitty providers.
School based health centers often have therapy services (that are, unfortunately already probably full at this point in the year, but worth checking in with), and take OHP by default. Even if your kid doesn't go to those schools, you may be able to contact them for assistance.
County-level resources are going to be a good interface point if you are sitting inside of the venn diagram of 'have OHP' and 'do not have a PCP.'
posted by furnace.heart at 4:13 PM on November 3, 2022
Is your teenager on board with this? I shouldn't have to explain my question but it never seems to occur to anyone that this could be an issue. If she is not on board, prepare for a devastating blow to her self esteem and perhaps years of resentment. Decades, if you double down.
posted by serena15221 at 4:24 PM on November 3, 2022 [1 favorite]
posted by serena15221 at 4:24 PM on November 3, 2022 [1 favorite]
Hi, therapist here, I live in Portland and know 1 million therapists. If you want to message me you can, or I would recommend anyone at Bridge City Counseling or Family Roots.
posted by fairlynearlyready at 9:17 PM on November 3, 2022
posted by fairlynearlyready at 9:17 PM on November 3, 2022
If you can't find an in-network therapist and you have an HSA or FSA card - I've had Medicaid in Oregon several times but I don't remember if that's one of the benefits - you can pay their fees with that until it runs out.
posted by bendy at 3:04 PM on November 4, 2022
posted by bendy at 3:04 PM on November 4, 2022
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I've found it helpful to have write up a short email ready that describes your situation and offers your contact info so that you can copy and paste that over to each provider that piques your interest, that way you can put a bunch of balls in various courts and see what comes back to you.
Sending good vibes your way, and glad that your daughter is on the way to getting the help she needs.
posted by wowenthusiast at 10:32 AM on November 3, 2022