Are there any reputable, affordable online therapy options?

June 4, 2024 5:00 AM

Occasionally (such as right now...) I go through some things where I'd like to speak with a therapist. Unfortunately, where I live, getting a therapist is a several-months process, and after several months the urgency of my initial need is gone. Right now there's several things on my mind that I'd like to talk through with a therapist - I've looked at the commercial options like "betterhelp" etc., but seen lots of warnings about quality.

Because it might be relevant: i'm based in Germany, but looking for English-speaking therapy. It doesn't help much that my budget would be somewhat low for therapy, maybe a maximum of €60/session).

Some context: I'm currently going through things with several of the closest people in my personal life, including my partner, and feeling quite alone. An ongoing goal of mine is to build a stronger network of close friends who I can confide in when having these issues, but if I'm honest with myself, I don't have that right now. A therapist is the first thing that comes to mind, but I guess the person doesn't necessarily need to be highly qualified, I just want to explain to someone my situations, get some perspectives, and decide on what steps I should take.

posted by unid41 to Human Relations (11 answers total)

You might try a warm line, especially if you have (or could arrange) a phone setup that looks like you've got a U.S. number. More info.
posted by lapis at 6:11 AM on June 4, 2024 [2 favorites]

I know several people using BetterHelp because they just don't have any other good options, and have successfully found therapists they like and feel they're getting good things done. I don't know the different packages but one friend did say they're paying $320US a month, I think that's for a weekly video session plus text support.

I use Brightside for my meds, and I haven't added on therapy services but my prescribers have all been absolutely spectacular MHNPs who are thoughtful and compassionate.

I'm sure there are duds, and BH has had accusations of sketchy data practices and I'm sure their labor practices suck, but I do think most individual providers are there to do good work.

But because so many people struggle to access mental health services, I've been curating a reading recommendation list, if any of these jump out at you as maybe stopgaps as you navigate whatever system you can to get with a real person:

- No Bad Parts: Healing Trauma and Restoring Wholeness with the Internal Family Systems Model
- The Grief Recovery Handbook, 20th Anniversary Expanded Edition: the Action Program for Moving Beyond Death, Divorce, and Other Losses Including Health, Career, and Faith
- Heal Your Nervous System: The 5–Stage Plan to Reverse Nervous System Dysregulation
- The Resilience Workbook: Essential Skills to Recover from Stress, Trauma, and Adversity
- The Anxiety and Phobia Workbook
- The Self-Esteem Workbook (A New Harbinger Self-Help Workbook)
- Burnout: The Secret to Unlocking the Stress Cycle
- The Modern Trauma Toolkit: Nurture Your Post-Traumatic Growth with Personalized Solutions
- Healing Your Wounded Inner Child: A CBT Workbook to Overcome Past Trauma, Face Abandonment and Regain Emotional Stability
- Adult Children of Emotionally Immature Parents: How to Heal from Distant, Rejecting, or Self-Involved Parents
- It Didn't Start with You: How Inherited Family Trauma Shapes Who We Are and How to End the Cycle
posted by Lyn Never at 6:14 AM on June 4, 2024 [16 favorites]

There is the option of Seven Cups. However it is heavily monetized and gamified. It's peer support, and it's free. I'm not saying I recommend it because I don't know what it is like now, but you could check it out.

Back when I wandered through it a few years ago, it seemed to be a safe place to do some venting and have some real time real people make supportive noises. People who were allowed to make supportive noises had to have taken the site's training to do it then, and that included things like not trying to solve the speakers problems, or make judgemental statements, but to mirror back things the person was saying, which sounded like they might be a key to insight.
posted by Jane the Brown at 6:22 AM on June 4, 2024

The problem with BetterHelp is not quality but confidentiality. They retain full transcripts (full! transcripts!) of all therapy sessions and have recently (as of just a couple of weeks ago) been fined $8 million for selling confidential client information to third parties. BetterHelp and TalkSpace and other online therapy providers deliberately include disclaimers in their TOS that says they do not provide therapy, and therefore they are not governed by HIPAA. You are literally risking your deepest secrets falling into the hands of corporations, the government, *your employer*, etc. when you use these services. Please don't.

Lyn Never's list of books is excellent. You can also reach out to therapists on Psychology Today who work in your state, anywhere in your state, and most of them will do it online if that is what you prefer. A lot of them will also take insurance so you will only owe a copay instead of the full fee, and if you have a high deductible insurance plan that doesn't cover therapy then a lot of them also offer a reduced fee on a sliding scale. You will likely be able to get actual HIPAA-protected licensed-provider therapy for cheaper than the $350 a month BetterHelp charges.
posted by MiraK at 7:40 AM on June 4, 2024 [7 favorites]

Oh I'm sorry - you are based in Germany not USA, I missed that. Apologies. I'm not sure how finding an independent therapy provider works in Germany. Can you reach out to the Berlin Psychoanalytic Institute? The team there is passionate about reduced cost and free therapy for the general public. Even if you are not located in Berlin, perhaps they can suggest resources to you. They are very responsive to emails. I've personally been in touch with Dr. Aleksander Dimitrijevic who is associated with the institute, regarding a different matter. But he, too, is passionate about making psychotherapy free to the public and knows a lot about resources in Germany.
posted by MiraK at 7:44 AM on June 4, 2024 [3 favorites]

I stashed this link from a long past post: moodgym. It's a self-directed CBT based site for depression and anxiety. Read the FAQs and see if it might be helpful.

This might also be a situation that group therapy or support groups can help with, if it's one of the many things people form support groups for?
posted by fiercekitten at 8:13 AM on June 4, 2024 [4 favorites]

At this point, after the pandemic, a large number of therapists will offer online sessions, particularly to clients who are not in a good position to meet someone in-person.

Have a look at individual therapists in the UK on Psychology Today or Counselling Directory as they will be close to your time zone.
posted by spibeldrokkit at 8:15 AM on June 4, 2024

You've probably figured out that you'll need to spoof your location (and probably not divulge where you are) to a US- or UK-based therapist. Do with that what you will.

This suggestion is going to sound odd, but bear with me. If you know anyone who goes to English AA meetings in your part of Germany, ask them for help. They may know someone, and if not, they may be able to ask a sponsor or other members at AA for therapy recommendations. There tends to be a good crossover between recovery and therapy-resource-awareness.
posted by yellowcandy at 9:40 AM on June 4, 2024 [2 favorites]

Try this site: Location Independent Therapists. You may be able to find someone based in another country but set up to see clients anywhere in the world/in Europe.
posted by EllaEm at 11:41 PM on June 4, 2024 [2 favorites]

I used Psychology Today in the UK to find a therapist at a very reasonable rate. What's great about this site is that you can set up 15 minute trial sessions with different therapists to see if you click, and the prices are very reasonable/ within your scope. Quite a few therapists though have insurance which restricts them to only UK residents, so you'll need to ping the therapists and ask if they take folks from abroad (some say they can't, some say they'll just need to file an exception with their insurance, and some won't have an issue). FWIW, I'm from the UK, I'm a US resident, I'm currently in South East Asia, and I'm seeing a British therapist (from Psychology Today) who is located in France.
posted by my log does not judge at 12:07 AM on June 5, 2024 [2 favorites]

Response by poster: Thanks so much everyone, lots of very thoughtful suggestions. In the end, after messaging 4-5 people on UK Psychology Today I found someone within my price range who is available this week (and is willing to work with international clients).
posted by unid41 at 5:49 AM on June 5, 2024 [2 favorites]