What you need to know before starting therapy?
So you finally come to the conclusion that you need therapy as you evaluate all the struggles that you are going through.
You know you need it but how do you even start? Oftentimes getting the process started (like exercise) is the hardest part. Luckily, I’m here to guide you as a Mental Health Therapist on the process! You may seen ads for large national platforms that offer therapy but what if you want to see someone locally or would prefer in person sessions. Since COVID, telehealth has allowed accessibility and convenience for many of us. You can be in your pajamas, have your pets and children (intentionally or unintentionally) pop up in your sessions or go to your car during your lunch break. As you can see, telehealth definitely has its advantages. But what if you want to get away from your house, kids, and pets? What if you work from home and feel isolated and never get to go out and want an in-person interaction? These are some of the preliminary questions to consider before you start searching for a therapist. Here are some other questions to also think about as you begin your process.
Can I use my insurance?
Most people would prefer to utilize their health insurance because you pay a hefty monthly premium for it so it makes sense why you would want to use it. However, if you don’t work in health care or in the insurance business, most Americans have little understanding of how their insurance benefits work. In my work with people, many automatically assumed that because you have health insurance, everything will be covered at 100 percent. Unfortunately, that is not the case. In order to know if a therapist or an agency takes your insurance, they have to be in-network with your health plan. That means that they have an official contract with the health insurance company and they have agreed upon a contracted rate to pay your therapist or agency everytime you see them. All insurance plans work differently and have different rules so it’s important to call and verify your plan. I get it. No one wants to be on hold for 45 minutes on the phone calling their health plan and being on hold and yelling “Rep-pre-sen-a-tive!!!”. If your insurance company has a website, you can also start an account to find who is in-network as a start. Let’s say you did find a therapist who is in-network with your plan. How much do you get charged? It depends on what your annual deductible is and how much the contracted rate your health care plan agreed to pay your therapist or agency. Let’s say for example, the contracted rate is $150 and your annual deductible is $3000. This means you will be paying $150 each time you see your therapist until all your expenses reach $3000 (this can include other medical expenses also). Once you reach your deductible, you then have a co-pay that varies depending on what percentage your healthcare plan covers (e.g 70 percent so that means you are responsible for 30 percent of the cost).
What if the therapist I want is not in-network?
Great! You found a Therapist that you feel you could vibe with, will understand you because of both of your similar backgrounds but..they’re not in-network with your insurance plan. What now? Don’t lose hope yet. Sometimes, your insurance may have out-of-network benefits that you can utilize. The disadvantage is that you may have to pay more but you get to use the providers that you want. Other options is that the therapist may charge you an out of pocket pocket charge but offer you what is called a superbill. This is an invoice of your total cost for therapy sessions (weekly, monthly) that you can provide to your insurance plan to see if you would be eligible for reimbursement. I say eligible because in order to use your health insurance plan, there needs to be “medical justification” for you to seek therapy. So let’s so you come for stress or issues with your job or family related issues but there is no medical diagnosis for this, your insurance may deny the claim. Once you find a therapist that you work well with, it’s important that they have a conversation with you about the pros and cons of having a diagnosis. Some clients may be fine and relieved to have a diagnosis, while others may feel the stigma. Certain occupations may relieve you of your position if there is evidence of a mental health diagnosis so it’s important to have this discussion. Depending on your situation, you may choose to use your health insurance but also be aware that your health insurance plan can request your medical records to review and they can still deny your claims. One of my next blogs will address this.
Why is the Therapist asking me for a consultation?
So you finally made this far! You were able to check which therapists are in-network with your insurance plan or you may have decided to pay out of pocket. You mark a few profiles that you feel may be a good fit for you. You notice that a few of the therapists offer free consultations as an option or require that a consultation take place? Why? This is an extra step for you as you’re so ready to get started; but here are some reasons why you should take advantage of the free consultation.
- As you want to ensure that the therapist you choose is a good fit for you, therapists also have to ensure that you are a good fit for them. Yes. As the client, this should be about you but if you’re presenting concerns is something the clinician does not specialize in, this will not be an effective therapeutic relationship.
- You may ask, is this consultation over the phone or video? Depending on your therapist and you, you can do both! Depending on the population, certain groups of people may not be as tech savvy (geriatric population) and having a phone consultation may be more accessible. However, if you do have knowledge and access, a video consultation may be more feasible. In my experience, most people have preferred video as this allows for non-verbal communication and sometimes, it helps the client see who they will be working with.
- Depending on your therapist, they may offer between a 15-20 minute free consultation. During this time, the clinician may ask you what your current presenting challenges are, what are you looking for, and a schedule that you’re looking for.
- This is also your opportunity to ask your potential therapists questions. You may ask them about their background and experience, what modality they may be using (e.g Cognitive Behavior Therapy, Dialectical Behavior Therapy, Solution Focus), how often you will be attending therapy, and any other questions that you may have.
- If both you and your therapist are a good fit, the next step is completing the intake paperwork. Most therapists will likely require that you complete the intake paperwork within 24-48 hours before your first session. Why? If you are using your health insurance, your therapist will need to verify your benefits before starting. They also need to ensure that all the forms are signed and completed to ensure legal compliance.
Did I just sign my life away?
So you and your therapist have decided to go forth and your intake appointment was scheduled. Your therapist stated that they will be sending intake forms your way. How do they even send the forms? Before I was in private practice, I was used to having forms printed out and completing them with a pen before my first appointment. To my shock (I’m easily shocked and impressed) forms are now sent to you via email or you log into the Electronic Health System (EHR) that the therapist is using and complete and sign the forms this way. Now, I get it; completing the intake forms may seem like you just signed your life away or promised to give your first born child or pet away. Some of the questions may seem repetitive that you answered two forms ago. Completing these forms does seem like a lot and may deter you from following through. However, if it’s too much for you in one setting, you can complete them in several settings. Just remember when your intake session is and as long as you can complete and have it signed before your 24-48 hour mark, you should be okay. Here are some possible forms that you may be asked to complete:
- Client Contacts (Who to contact in case of an emergency)
- Client History (Asks about presenting issues, family history of mental health/substance use, etc)
- Client Information (Your name, address, contact number)
- Client Insurance (Insurance card, may need to upload a copy or take a picture of the card)
- Consent for services (You are agreeing to services. I would advise you to read this section as some therapists may include their no-show, late cancellation fees under this section).
- Payment authorization (Many therapists who take credit cards will need you to have an active credit card on file so they can charge your co-pays or full-fee sessions)
- Notice of Privacy Practices (How the company/therapist will protect your privacy)
The above forms are just a few that your therapist may have you complete. There may be additional forms that they will ask for you to review and sign. This is to ensure that you have a clear understanding of the procedures that the agency or the therapist have put in place and that you are agreeable to them. Once all of this is completed, you’re ready for your first therapy session! My next blog will focus on what the first therapy session usually entails. What other questions do you have about the therapy process that will help shed light on therapy?
