Why I can’t go to counseling

I can’t afford it

Everyone knows that all healthcare services are inherently over-priced and insurance often doesn’t cover things, or says they cover something only to surprise me months later with a bill toward my deductible.

It’s true in many cases that healthcare costs can quickly add up, but counseling may be less costly than you think. Insurance deductibles are higher than ever in our current healthcare market. More and more plans are becoming truly just useful in case of emergency with deductibles that mean insurance will cover practically nothing. My heath care plan is to never get sick and only have coverage in case I get into a traumatic coma-inducing accident. While the insurance market is getting more disappointing, that doesn’t mean that therapy would be totally unaffordable.

Depending on your location, therapy services often cost less than a standard doctors visit. And if you are using insurance discounts (with an in-network provider) the cost may be half of prices listed on the provider’s website. Additionally, many smaller practices offer other discounts such as prompt pay discounts, sliding scales based on income, hardship options, and possible reduced costs for seeing interns who are usually educationally more qualified than many case managers, social workers, and other helping professionals. Additionally, there may be programs available for low cost or free counseling in your area, you can ask your employer if they offer an Employee Assistance Program, but you will never learn about your options until you ask around.

What will my employer think?

It might affect my future career prospects. I’ve heard horror stories about my crazy uncle bob who got hospitalized for his bipolar depression and was never able to get into the air force. What if I get some label that limits my ability to climb the corporate ladder?

Is it possible for an employer to access your mental health records? Technically yes in SOME cases. There may be some careers that could require access to your mental health records for employment and would be able to limit your options based on that information—That being said the number of careers in this category are extremely limited. Certain high- level government jobs may be able to require disclosure—we’re talking special clearance required types of positions like the pentagon. Certain high level and high stress Military positions might be able to access this information, but this information could only be obtained with your consent.

The vast majority of employers have no legal ability to access your mental health information without your explicit and written consent. This is a basic tenant of the health information portability and accessibility act. Without your written consent or a judge provided subpoena your records would NOT be released to an employer. In the case when an employer might get a subpoena—I can’t really think of an example, because it’s never happened in our practice. Maybe if you threatened to murder your coworkers and boss and they needed to assess the seriousness of your threat…but even then, it would be unlikely.  In my professional practice over the past 10 years and working with 20 other professionals, I have never seen a request for records that was not initiated by the client (such as if you filed for disability or leave based on mental health reasons).

What if I have to request time off from work in order to attend appointments?

You still have no obligation to release records or even share with an employer the reason for a mental health visit. Some employers may ask for a letter of attendance, but that is all of the information that needs to be disclosed. I went to an appointment at this time at this office. Thank you have a nice day.

Therapy doesn’t work

For most people this is simply not true. The research shows that generally speaking, therapy does work. That being said, if you have no intention of doing therapeutic work outside of the therapy office—it may not work. If you attend weekly appointments and continue doing life in exactly the same ways you may start to recognize as dysfunctional—then your life will continue to feel like a mess. If you choose not to be honest with your therapist about what needs to be addressed, you may not feel real change. (We may appear to be supernatural mind readers—and some of us a have a gift for weeding through nonsense, but I assure you we are still human and cannot always figure out what’s wrong if you won’t share).  If you are a parent hoping to drop off your child or teen to “be fixed” in therapy, but don’t intend to support or be involved in their healing process—it may be a very slow process. If you are not interested in making changes or addressing your stuff, but just want to vent about the unfair things other people do to you—it won’t change your circumstances. All of these scenarios may seem like common sense, but many people do attend an appointment and expect a magic pill to solve life’s problems. Therapy can help and for people invested in improving, it usually does.

Not every therapist will be able to help you. Therapy is a very personal experience and the personality, approach, demeanor, and skills of the therapist DO make a difference. Therapy is not the same as a doctor’s visit, in which you chat with someone for ten minutes about your symptoms and walk away with a prescription. You won’t feel comfortable sharing with just anyone and different people connect better with different people. Some people like to work with a therapist who is direct and will challenge them to address their issues and grow. Others like someone who is gentler and nurturing who can open the doors to personal insights without pushing. Some people want a therapist who incorporates humor or even faith to enhance the healing process. All of these are good things for some people, but you need to find the right fit for you for therapy to fully work for you.

I don’t want to be That person who needs therapy

We have come a long way, but there still remains some stigma about seeking mental health counseling. Some of you may cringe each time I use the term “mental health”. You may picture someone in the old school insane asylum talking to themselves and behaving oddly. Mental health refers to any emotional, spiritual, cognitive, and even physical ailments related to the mind. It is a spectrum not a yes or no evaluation. Just as you don’t either have or not have physical health (Maybe your blood pressure and weight are healthy, but you struggle with lots of allergies) Similarly, mental health is a spectrum based on many different factors.

There is a funny meme that says, “I’m in therapy to learn how to deal with people who should be in therapy.” This meme can also ring true. Many people seek therapy NOT because something is WRONG with them, but because they are facing difficult people or difficult life circumstances that would benefit from counseling support. Would you rather continue to engage in unhealthy relationship patterns, or learn to do better and ultimately, feel better?

Some stigma relates to the notion that seeking therapy is a sign of weakness. The old adage, “pull yourself up by your bootstraps” comes to mind. People who have experienced sadness, but not clinical depression, seem to be more likely to lean on this mindset. In reality, therapy can be harder work than ignoring your problems. Your therapist may challenge you to face difficult or traumatic life experiences that others may never examine. You may have to make major behavioral changes or changes in your relationship in order to find healing. It takes the commitment of time, financial resources, and effort to engage in therapy in a meaningful way. Therapy is not a process for the weak. It takes strength and courage to even take that first step and schedule an appointment.

Hopefully, throughout this reading, I have challenged your notions about why you can’t go to therapy. There are options available and wonderful therapists eager to help you. If you need to talk to someone, maybe you will have the courage to make that first phone call.

December 2018, Jennifer Beall, MA, LPCC