[phaset]

I feel lost and I don't know what to do. I am sorry if I am repeating myself, I may have asked all this before in one way or another, also for the length of this post.

My insurance only covers enough for 12 sessions a year, and up until this year it was 6 sessions. For the last two years I have been paying mostly out of pocket to see my therapist every two weeks, plus a $1200 psychological assessment.

My wife and I had been looking to buy a house for a few years and had trouble saving for the down payment due to my therapy expenses. Earlier this year the perfect house for us came on the market within walking distance of our son's school, and at a great price for the neighbourhood. We jumped on it right away, but I had to put a lot of money on my line of credit to cover the down payment. Last summer my wife got pregnant and we had a baby girl at the end of may.

Despite having a decent paying job, money is now tight. We don't lead an extravagant lifestyle. We don't drink, smoke, whatever. But we now have additional expenses due to the house and the baby that have eat into our budget. I can no longer afford to pay for extra therapy sessions. The problem is I want them. I have great difficulty sharing things with my wife, though that has been getting better. I don't have any friends to support me, but I don't have the energy and ability to maintain additional friendships either. I appreciate having someone else to help me with my problems. I've only seen my therapist twice in the past 4 months to transition to seeing her once a month in September. I miss her quite a bit and am feeling overwhelmed with my life right now.

There is a community mental health clinic which I could see for free. When I was younger I was a client of the children's version of it. I was less stable then, but I always felt guilty that I was wasting their time on me rather than someone more deserving. I am seeing my psychiatrist next week and will ask her what I should do. I am thinking of asking her if she could refer me there but I keep thinking it is the wrong option.

Pros:
- I have no other way to have all my needs met.
- I need to talk about things with my therapist that would be very difficult seeing her once a month about, at the same time as dealing with the rest of my life.
- Less worrying about money.

Cons:
- I do not want to take away space from someone with greater needs.
- I am relatively stable, no great urgency to deal with things.
- I could survive without it.
- It's probably all icky evidence based CBT.
- GUILT, GUILT, GUILT!
- Possible loss of current therapist.
- Not sure if it is only for short periods of time. I want a therapist long term.

I am wondering if anyone has any thoughts, opinions, or additional ideas. I also am wondering if I am being greedy, please answer truthfully.

[Leah123]

Any chance you could rent a room in your home for a few hundred extra per month or supplement your income some other way, like picking up side jobs or selling something?

Or would there be less expensive therapy options to supplement your own, such as sliding scale at a clinic with interns or otherwise subsidized, so you could see the T you have once a month, and someone much cheaper another time per month?

I'm sorry you're in such a fix. I've cut back a lot too, though not as sharply as you and I have felt how hard it is to be crushed between life's demands and our own needs/wants.

P.S. You do not sound at all greedy to me, not at all. I do think it's going to be important to expand your support system to friends somehow though, but I do fully understand how tough it can be.

Why not at least go and talk to the people at the clinic. See what kind of program it is, what type of therapy, etc. before you rule it out. If, after gathering that information, it isn't what you need, you can always decline, but it's hard to make a decision when you don't have all the information quite yet.

[LonesomeTonight]

If you feel you need the therapy, then you have the need. Yes, there may be people worse off than you, but there are likely people better off than you (mentally) who use the clinic. I would just go have a consultation with them, ask about the type of therapy they use, etc. Even if the focus is CBT, you might be able to find a T there who does not strictly adhere to that format (my T is trained in CBT as well as other methodologies). I think it's at least worth giving a shot...

I'd also suggest talking to a therapist (whether there or your regular one) about how you feel like you shouldn't get therapy because there are others more deserving. Sounds like it could be something from childhood maybe... Out of curiosity, do you generally feel like others should take priority over you in other areas of life? Or that you're not deserving of what you have?

[phaset]

Originally Posted by Leah123

Any chance you could rent a room in your home for a few hundred extra per month or supplement your income some other way, like picking up side jobs or selling something?

There is no way I could live with someone else in our house, but don't have any extra room so it's not even an option.

I have looked at doing some freelance jobs but I am lacking motivation and am scared of picking up something larger than I can handle.

[divine1966]

I wouldn't feel guilty getting free services, if you can go for it, and you might also look into sliding scale therapy?

Sent from my iPhone using Tapatalk

[phaset]

Originally Posted by lolagrace

Why not at least go and talk to the people at the clinic. See what kind of program it is, what type of therapy, etc. before you rule it out. If, after gathering that information, it isn't what you need, you can always decline, but it's hard to make a decision when you don't have all the information quite yet.

I don't think I would ever rule it out in a "I will never go there" kind of way. I am hoping my psychiatrist has more information, the clinic is through the local health authority. From my research it can vary greatly depending on your needs. They do a treatment plan before you start.

Originally Posted by phaset

I don't think I would ever rule it out in a "I will never go there" kind of way. I am hoping my psychiatrist has more information, the clinic is through the local health authority. From my research it can vary greatly depending on your needs. They do a treatment plan before you start.

So it sounds like you need to meet with them and see what they have to offer, get the information directly from them. Your pdoc will only know very general info probably.

[phaset]

Originally Posted by LonesomeTonight

If you feel you need the therapy, then you have the need. Yes, there may be people worse off than you, but there are likely people better off than you (mentally) who use the clinic. I would just go have a consultation with them, ask about the type of therapy they use, etc. Even if the focus is CBT, you might be able to find a T there who does not strictly adhere to that format (my T is trained in CBT as well as other methodologies). I think it's at least worth giving a shot...

Yes, I would be ok with CBT if it wasn't strictly CBT. That is how my therapist in highschool was, I just didn't like the CBT aspects. I would see her again in a heartbeat though.

Originally Posted by LonesomeTonight

I'd also suggest talking to a therapist (whether there or your regular one) about how you feel like you shouldn't get therapy because there are others more deserving. Sounds like it could be something from childhood maybe... Out of curiosity, do you generally feel like others should take priority over you in other areas of life? Or that you're not deserving of what you have?

Yes, I have talked to my therapist about this, especially how I felt getting it for free. The fact that I am paying her reduces the feeling that I am not deserving enough. Yes, there are other things I feel like others should take priority, and yes it's related to childhood.

A bit of this is also that I am Canadian and think therapy should be free like the rest of our healthcare.

[phaset]

Originally Posted by lolagrace

So it sounds like you need to meet with them and see what they have to offer, get the information directly from them. Your pdoc will only know very general info probably.

I think I explained this badly, I would need a referral from my GP or pdoc anyway. I will try to get information before I commit to anything.

[Perna]

Have you thought about group therapy at all? That's much less expensive and you do the once a week and it's a bit like coming here but in person. You could talk when you need to and help others at the same time. If you have tried group "therapy" and it's not your thing, I would look at other groups or maybe college courses or other informal ways that you could get help and support, interact with other people in a less hierarchical situation than work, etc.

[Leah123]

P.S. Have you asked your therapist if they could add a second monthly session at a reduced rate? Or, if they might be open to reading an email monthly from you or doing a half session or phone call session?

[phaset]

Originally Posted by Perna

Have you thought about group therapy at all? That's much less expensive and you do the once a week and it's a bit like coming here but in person. You could talk when you need to and help others at the same time. If you have tried group "therapy" and it's not your thing, I would look at other groups or maybe college courses or other informal ways that you could get help and support, interact with other people in a less hierarchical situation than work, etc.

I have thought about doing group therapy and aside from being terrified by the thought of doing it, I would be willing to try it. I have been unable to find a list of groups locally, but I know the community mental health clinic runs some. All the local self help groups appear to be for youth or schizophrenia. I'm currently looking over meetup.com to see if anything seems interesting.

[phaset]

Originally Posted by Leah123

P.S. Have you asked your therapist if they could add a second monthly session at a reduced rate? Or, if they might be open to reading an email monthly from you or doing a half session or phone call session?

I have thought about that but I think I would feel horrible about that. Guilt again. I just checked her website and the bottom of her sliding fee isn't much lower than I am paying.

I will ask about sending her an email once a month, I think I would really like that. I've been reluctant to ask about email as I see how that affects people here.

[MoxieDoxie]

Does your job have open enrollment for benefits? If the do next time pick the insurance that has better mental health coverage. You might pay a little more a pay check for the better insurance.

[Restin]

Please, please don't feel guilty for wanting therapy for free at the county clinic. Every civilized nation has the obligation to assist those who aren't able to pay for therapy. The clinic intake people and therapists would be so happy to help someone like you who is as responsible and who has a wife and child he is committed to. Just think of how much better a citizen and provider you will be with your problems resolved. And how much happier you and your wife will be! That is what clinics and therapists are all about! And it isn't really free because the federal and local resources pay. You pay taxes aplenty, plus SS, and are doing your part. And you remind me of myself because I go to a county clinic and don't pay, yet I'm not psycho and not a menace to society. Also, when you start with the therapist, you should bring that guilty feeling up right away and settle your mind about it. Also, there are other private therapists and psychiatric clinics, in most cities, who accept a sliding scale. I once saw a chart online of how a sliding scale generally breaks down, and was surprised how beneficial it is.
With insurance it's necessary to get an order from the p-doc; but if you don't use your insurance for therapy, you certainly don't have to get his advice or permission.

[phaset]

As an update... I saw my psychiatrist today. She has made a referral to community mental health for me. She said that they are going to do an assessment and then determine what to offer me based on that. She also said to try it and see if I like it. I don't know what time frame this is all going to happen on.

Thank you all for your suggestions

Well done on talking to your pdoc! I hope the offer of the clinic is something suitable.

[Lauliza]

I would also echo another post about insurance. If you have a primary diagnosis of depression or anxiety then many private insurance companies will pay for more therapy sessions (sometimes unlimited, and especially if you are seeing a psychiatrist). So if a different carrier is an option to you and is possible financially, it's definitely worth looking into. If not then the clinic is a good option and I'm glad you took that step. A large number of Ts use CBT and also mix in some talk therapy.

[phaset]

Unfortunately they are strict on their limits and I have no option of choosing another. Thank you though.