Online therapy for teen
April 16, 2024 3:31 PM Subscribe
My 16 year old daughter has asked to see a therapist. Thing is, I'm currently unemployed and uninsured -- so this will be entirely out of pocket, and I'm looking for affordable options.
Online is fine. Even preferred.
When she asked me to see a therapist yesterday, it was a bit of a milestone since when I suggested it in the past she said she "did not trust therapists." She has struggled with performance (sports, public speaking) and social anxiety. When I gently asked what she wanted to cover... was it anxiety -- she said "yes... and just everything." I left it at that.
Last year (when I was employed and insured) she did do a few online sessions with a service that was provided through my health benefits, and is not available to individuals. She seemed okay with it, but for whatever reason didn't continue. For whatever reason she is ready now and I want to honor that.
Do you have any recommendations for affordable online therapy? I have heard of BetterHelp.com but never used them. Considering her age, their website links out to teencounseling.com, and it looks like the cost will be about $70 a session, which is reasonable to me. Because they select the therapist for you, I'm a little concerned with the quality and fit.
Do you have any experience with either BetterHelp or TeenCounseling? Do you have any other recommendations for online therapy that is in the $70-85 range?
When she asked me to see a therapist yesterday, it was a bit of a milestone since when I suggested it in the past she said she "did not trust therapists." She has struggled with performance (sports, public speaking) and social anxiety. When I gently asked what she wanted to cover... was it anxiety -- she said "yes... and just everything." I left it at that.
Last year (when I was employed and insured) she did do a few online sessions with a service that was provided through my health benefits, and is not available to individuals. She seemed okay with it, but for whatever reason didn't continue. For whatever reason she is ready now and I want to honor that.
Do you have any recommendations for affordable online therapy? I have heard of BetterHelp.com but never used them. Considering her age, their website links out to teencounseling.com, and it looks like the cost will be about $70 a session, which is reasonable to me. Because they select the therapist for you, I'm a little concerned with the quality and fit.
Do you have any experience with either BetterHelp or TeenCounseling? Do you have any other recommendations for online therapy that is in the $70-85 range?
Many private practitioners will work with the 70 to 80 dollar range per visit, it isn't the going market rate but it is enough to make a session worthwhile for many therapists depending on the insurance and market.
If you go the private practice call around route you will need to make it very clear upfront what you are willing to pay don't just ask for sliding scale. Like go into it saying I'm looking for a therapist for my teen I can pay $75 a session. Can you work with me and second question is do you know anyone who will?
posted by AlexiaSky at 3:50 PM on April 16 [3 favorites]
If you go the private practice call around route you will need to make it very clear upfront what you are willing to pay don't just ask for sliding scale. Like go into it saying I'm looking for a therapist for my teen I can pay $75 a session. Can you work with me and second question is do you know anyone who will?
posted by AlexiaSky at 3:50 PM on April 16 [3 favorites]
This answer in a previous Ask was very helpful for me. There's also OnlineTherapy.com.
posted by cocoagirl at 3:53 PM on April 16
posted by cocoagirl at 3:53 PM on April 16
Best answer: I’m a therapist. I don’t feel great recommending BetterHelp or similar because of significant privacy concerns. (See: recently published study using chat transcripts from talkspace... that therapists and clients didn’t know would be made available for research.) That said, here are some affordable options:
Look at group practices in your state (telehealth means you can cast a wider net) and see how many offer lower cost or sliding scale therapy with interns and recent grads. These clinicians have the most current training, are passionate and motivated, and are receiving ongoing supervision to review their cases.
You can also look at Open Path Collective to find therapists with sliding scale availability.
If there’s a university near you with a counseling program, they may run a low-cost clinic.
If your daughter has Medicaid, the previous options still apply, but you can also look at psychology today’s therapist finder and search by insurance provider for that. (Just be mindful, if your daughter’s plan is through a provider that also has commercial plans, like United, you’ll need to do a bit more detective work because there will be therapists who are INN for the commercial plans but not Medicaid.)
Feel free to message me if you have questions I can potentially answer.
posted by theotherdurassister at 3:56 PM on April 16 [24 favorites]
Look at group practices in your state (telehealth means you can cast a wider net) and see how many offer lower cost or sliding scale therapy with interns and recent grads. These clinicians have the most current training, are passionate and motivated, and are receiving ongoing supervision to review their cases.
You can also look at Open Path Collective to find therapists with sliding scale availability.
If there’s a university near you with a counseling program, they may run a low-cost clinic.
If your daughter has Medicaid, the previous options still apply, but you can also look at psychology today’s therapist finder and search by insurance provider for that. (Just be mindful, if your daughter’s plan is through a provider that also has commercial plans, like United, you’ll need to do a bit more detective work because there will be therapists who are INN for the commercial plans but not Medicaid.)
Feel free to message me if you have questions I can potentially answer.
posted by theotherdurassister at 3:56 PM on April 16 [24 favorites]
Sometimes schools will have relationships with therapists who work with teens, or even have one on site contracted via county or state funds. I would check with the counselor or school social worker about resources available.
It is likely there are various low-cost or free therapy options local to you as well. In my town we have a "Community Counseling Center," and a free "clinic" staffed by prelicensed MFTs.
On the off-chance you are in CA and qualify for Medi-Cal they do cover therapeutic services and pay therapists pretty well. You can choose a therapist who seems like a good fit and takes medi-cal, rather than being assigned one/waiting for one to call you.
posted by Otis the Lion at 3:59 PM on April 16 [3 favorites]
It is likely there are various low-cost or free therapy options local to you as well. In my town we have a "Community Counseling Center," and a free "clinic" staffed by prelicensed MFTs.
On the off-chance you are in CA and qualify for Medi-Cal they do cover therapeutic services and pay therapists pretty well. You can choose a therapist who seems like a good fit and takes medi-cal, rather than being assigned one/waiting for one to call you.
posted by Otis the Lion at 3:59 PM on April 16 [3 favorites]
Definitely check to see if your daughter is eligible for Children’s Health Insurance Plus (CHIP) in your state (for instance, here are eligibility guidelines for NYS). If you have little or no income right now, she may be able to get free insurance, which will open up some therapy options for her.
posted by ourobouros at 4:33 PM on April 16 [10 favorites]
posted by ourobouros at 4:33 PM on April 16 [10 favorites]
Many therapists work on a sliding scale and would likely agree to see your kid for $70-80 (almost guaranteed anywhere outside of very high COL areas). I live in an MCOL area and have had to ask for a $50 rate when I was unemployed, and I was able to pay it back when I got a good job but I did get 7 months at $50 per session with the therapist I had been seeing for 4 months prior. Please call around. Check psychologytoday.com to find therapists listed all over your state - anyone who is located anywhere within your state is allowed to offer online therapy to your kid, so you will have more choices than we used to before the pandemic.
Please try not to use BetterHelp unless you have exhausted all other options. It is a shitty shitty business which exploits therapists by paying $20-$25 an hour and forces them to work aguainst patients' best interests for business reasons. And it exploits patients by harvesting patient data for profit. I cannot begin to enumerate the horrors of their business model. I hope you will treat them as an absolute last resort.
posted by MiraK at 4:59 PM on April 16 [7 favorites]
Please try not to use BetterHelp unless you have exhausted all other options. It is a shitty shitty business which exploits therapists by paying $20-$25 an hour and forces them to work aguainst patients' best interests for business reasons. And it exploits patients by harvesting patient data for profit. I cannot begin to enumerate the horrors of their business model. I hope you will treat them as an absolute last resort.
posted by MiraK at 4:59 PM on April 16 [7 favorites]
I hear you, finding a therapist is hard even with insurance, let alone without. Still, almost anything is a better solution than Better Help. If you live near any universities with counseling or marriage and family therapy programs, there are likely community clinics in your area where all those students train and then work as supervised associates after they graduate. Also seconding the recommendation for Open Path Collective. Good luck!
posted by gigimakka at 5:08 PM on April 16 [1 favorite]
posted by gigimakka at 5:08 PM on April 16 [1 favorite]
In this situation I would use psychology today's site to find providers in your geographical area who work with sliding scales/self pay and contact them directly, being clear about your income and what you can pay. My own therapist moved off my insurance plan recently, and we worked out a $60 sliding scale fee based on my current income with no issues from her at all. I would try this route very thoroughly before anything like BetterHelp or other app type services.
posted by augustimagination at 5:09 PM on April 16
posted by augustimagination at 5:09 PM on April 16
I was also going to suggest that Open Path Collective will give access to therapists who are willing to accept a certain number of clients at a reduced rate. They tend to be early in their career - some are prelicensed (student, intern or associate) but many are fully licensed. There is a $65 fee to get linked up with a therapist, after that you work directly with the therapist. The fee is $40- $70 per session ($30 for student intern but that may be less experienced that you really want)
If you don't find what you want there, you can try Psychology Today as augustinmagination suggested but be prepared lot of dead ends and no replies.
When you do reach out, it is best if your daughter can do it herself. If not, it would be helpful if you made it clear to the therapist that your daughter wants therapy and asked for your help in finding someone and that if therapist indicates she is open to taking your daughter as a new client, all future contact will be directly between them. Therapists want to know if they would be working with a teen who actually wants help or who is being pressured by their parents to get counseling.
posted by metahawk at 7:48 PM on April 16 [1 favorite]
If you don't find what you want there, you can try Psychology Today as augustinmagination suggested but be prepared lot of dead ends and no replies.
When you do reach out, it is best if your daughter can do it herself. If not, it would be helpful if you made it clear to the therapist that your daughter wants therapy and asked for your help in finding someone and that if therapist indicates she is open to taking your daughter as a new client, all future contact will be directly between them. Therapists want to know if they would be working with a teen who actually wants help or who is being pressured by their parents to get counseling.
posted by metahawk at 7:48 PM on April 16 [1 favorite]
You could go on healthcare.gov to get insurance for you and her if not insured- you may be eligible for medicaid if you currently have no income. But you should be able to get a different plan either way.
If you can't get insurance for some reason, I'd check out openpath.org. you can also see if private therapists elsewhere having sliding scale openings.
posted by bearette at 4:48 AM on April 17 [1 favorite]
If you can't get insurance for some reason, I'd check out openpath.org. you can also see if private therapists elsewhere having sliding scale openings.
posted by bearette at 4:48 AM on April 17 [1 favorite]
In my community, there is a volunteer collective of therapists, psychologists, psychiatrists and social workers through a progressive faith community that offers free services for the uninsured and (very important!) underinsured (i.e. if you have a high deductible plan and can't afford the deductible). The services are not related to the faith community at all, and the volunteers are not necessarily even a part of that faith community. It is just the mission of that faith community to try to meet peoples' mental health needs.
I'm not sure how one finds similar programs, but keep doing what you're doing - asking people.
posted by vitabellosi at 11:22 AM on April 17 [1 favorite]
I'm not sure how one finds similar programs, but keep doing what you're doing - asking people.
posted by vitabellosi at 11:22 AM on April 17 [1 favorite]
I am a therapist (not licensed in New York) who takes all my state's forms of Medicaid and offers telehealth sessions--we do exist! At least in my state, Medicaid in any form covers the entire cost of mental health therapy--families pay nothing. This is definitely worth checking into, as it may open more doors and/or simply be easier to search for than sliding-scale therapy.
posted by epj at 12:11 PM on April 17
posted by epj at 12:11 PM on April 17
Are you near a University? Many counseling and/or psych programs have free/sliding scale services. It will likely be a grad student, but they're supervised.
posted by Gyre,Gimble,Wabe, Esq. at 3:55 PM on April 17 [1 favorite]
posted by Gyre,Gimble,Wabe, Esq. at 3:55 PM on April 17 [1 favorite]
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Are you in a US state that provides free health care to minors? This would expand your options (in terms of quality) pretty dramatically.
posted by furnace.heart at 3:47 PM on April 16 [4 favorites]