Online Counseling: Counselor “Fit” and Your Finances

Now that you’ve mastered researching online counseling and have an array of options for you, how do you find the right counselor for you? Before I get too far into this topic there are several basic things that I need you to know or consider so that you are an informed consumer before you go too far down the research rabbit hole. When you’re looking for a therapist, first consider these items:

• Counselor/client fit is the number one predictor of positive client outcomes. Just like in any solid relationship, feeling like your counselor truly “gets” you is critical to you feeling better! What this means:
• Overall, you will likely spend less time in therapy if you find the “right” person from the start
• Subsequently, because you might spend less overall time in therapy you will spend less money. How is that not a win?
• You have LOTS of options for types of therapists (and I’m not even talking about different modalities in therapy, just structure!) The first thing you need to consider is your history and what your needs are. If you have a history of mental health issues and, for example, have been suicidal or have been hospitalized for mental health issues, what you are looking for is different than someone who is experiencing emotional discomfort for the first time in their lives. Do a strong “internal inventory” of what it is you’re hoping to get out of establishing a relationship with a counselor as it relates to your history and current mental status. I also recommend talking with your doctor to get their perspective on what they think you might need.
• How do you intend to pay for therapy services? If you want to use insurance or a program like an EAP, this may be more limiting than if you are willing and able to pay privately for therapy services. There are, of course, pros and cons to each way of going about it.

So let’s get more into this. You know that fit is important, and you want to find that perfect unicorn therapist who is just the right match for you. Heck, you think that she could finish your sentences she seems to get you so well. Amazing! So how do you find her?

Most therapists fall into several “types” of places of employment, and they are as follows:

• Community mental health agencies - agencies that exist to serve the general population who might seek counseling. Usually have excellent and existing relationships with other mental health and social services, accept a variety of insurances. Can offer employment both to licensed professionals as well as those who are working toward earning their licenses.
• Group practice therapy offices/practices - group practices have sometimes started with one sole practitioner that decided to expand, sometimes they’ve formed out of a team of like-minded professionals or carefully collaborating professionals whose skills and interest areas benefit the whole group or overall offerings of the practice. Most often group practice employees are all licensed (sometimes there are interns or pre-licensure folks, too.) Many group practices accept insurance on some level, some do not.
• Private practice practitioners - This is what I offer. Private practice owners are one-person productions who are the therapist AND the person running the business (sometimes we hire assistants to help!) so they are actively engaged in all aspects of the practice. In many instances, private practice practitioners have chosen to “specialize” on some level, meaning that they’re very skilled and trained in working with a specific population or on a specific issue. For me, my speciality is online counseling for women in PA and MD who are experiencing feeling overwhelmed with life - motherhood, divorce, etc. Some private practices accept insurance, some do not. I, for one, do not. And that is the topic of another blog.

With therapists falling into all of these different categories, how can you possibly know what you need? First, I direct you back to question number 2 above - your history. If you are someone who has a history of mental health struggles, your best option will be to look first in community mental health agencies that offer online counseling near you OR group practices that specify that they have an “on call” rotation that their counselors do as part of their work. More often than not, because sole private practice owners are just that, a party of one, they are not equipped to manage emergency mental health crises. You are best served to choose a practice that has numbers so that there is a greater likelihood that, should a mental health emergency arise, you can access someone who is on call for exactly that purpose.

The next step that is truly most important to people in their decision making process for selecting a therapist is… money. If you want to go through insurance, you will limit the number of practitioners that are available to you, but limits can also be a good thing and can focus your search. When you search for practitioners in your area (refer to my former blog for how to most effectively do this), you will then need to call to see which insurances they accept if their website doesn’t spell this out (again, another reason to go directly to the practice’s website, rather than Psychology Today, because this information is often fully laid out for you here.) Similarly, if you are looking for counseling through an EAP program, your first call should be to your HR office, as they can likely direct you to the organizations to whom they refer.

Now, let’s pretend that you aren’t sold on using insurance and instead want to look for more cost-effective ways to work with a therapist, and let’s pretend you found a therapist who 1 - does not accept insurance (private pay) and whose posted rates seem high for you. Many therapists offer what we (in the biz) call “sliding scale” slots in which we alter our fees based on what we set as our own internal priorities. For some counselors, this may be an income-based table that they use to determine what they ask clients to pay. For others, this may be a values-oriented system that they use to determine what they ask a client to pay if it’s not their full rate. Here’s an example, using my practice. My regular rate for a 50 minute counseling session is $125. In the way that I have structured my practice (for the income that I need to make), I drop this rate to $100 for a handful of clients. My criteria is that I do this for women who are in college, graduate school, or are in a “learning” opportunity that pays them very little. Because I want to be more accessible to women who are working hard to advance themselves professionally, this is how I have chosen to structure my business. As a private practice owner, I get to set these terms, and this is what feels comfortable and values-based to me in a way that allows my business to grow while working within my mission of empowering women to grow.

Another “sliding scale” option is for you, a potential client, to search for a therapist through Open Path Collective https://openpathcollective.org, an organization through which therapists offer their services at a reduced rate. Rather than you having to ask a therapist if they slide their scale, this organization provides consumers with a standing list of therapists who do this as part of their practice. You will have to call, of course, to see if an individual therapist has a slot available, but this is a great resource to use to search for a reduced rate therapist slot.

A final word about money and payment for therapy. If the “fit” with your therapist is just ok or you don’t feel that you can truly share your whole self with that person, even though they were “the right price,” you will inevitably pay more and stay longer in therapy, costing you both money and time. For example, if you choose someone that seems “pretty ok” and has a $60 per session rate over someone who seems “perfect” for you but costs $120 per session, my advice would always be to choose the latter. Counseling should be an investment in yourself  in which you are putting in the time, money, and most of all, the energy, to work toward a more ideal version of yourself. Having the right guide beside you makes all of the difference.

Now, we haven’t even touched on “types of therapy” that people offer, and that’s a topic for another time. But I’m guessing that first and foremost, fit and finances are on your mind as you look for a therapist. I offer online counseling in PA and in MD for women who are feeling overwhelmed. Whether it’s to me or to someone else, I hope this helps to guide you in the right direction!