In addition to credentials, comfort, and connection, it is important to recognize that therapy is a confidential process, so make sure that you and the therapist discuss the nature and limits of confidentiality. Feeling secure enough to express yourself freely is a vital part of this trusting relationship. However, if your health insurance is covering some of the cost of your therapy, it will have to be made aware that you’re seeking mental health care and will most likely require your therapist to submit a diagnosis (such as “depression”) for you.
There is a possibility that you will have little say in who you see, since some HMOs and other insurance companies require their members to see designated mental health providers. This is not necessarily bad, as long as you are able to see a therapist who is properly trained and licensed. If the therapist you are referred to isn’t, you should ask for someone who is. Since insurance companies vary so much in their coverage, you may have other limitations regarding who you can see for help. Questions about this issue can be answered by your insurance company.
Other options for initial assessment providers include Employee Assistance Programs (EAPs), which are often available through the workplace. EAPs offer free short-term counseling and then, when appropriate, referral. Walk-in counseling centers also exist in some communities. These establishments will often offer short-term counseling for reduced fees. Another resource in many communities is United Way’s First Call for Help. This service differs from community to community, but is still worth a call if you are just starting out. Also through the United Way, a free national health and human services program, from which callers will be able to obtain information and referrals by dialing 2-1-1, is in the works. The program is already active in 22 states, so check www.211.org to see if your area is covered.
A few other resources for finding a therapist include religious institutions, which often offer pastoral counseling and may be able to apprise you of additional local treatment options; hospitals (especially those connected with a university or medical school), which usually have specialized departments of psychiatry, psychology, nursing, and social work; and not-for-profit or professional organizations. The Depression and Bipolar Support Alliance Web site maintains an “External Referral Services” page (www.dbsalliance.org/Resources/ExternalReferrals.htm) with links to and phone numbers for a variety of organizations that can help you locate a therapist. The American Psychiatric Association Web site (www.psych.org/dbs_state_soc/db_list/db_info_dyn.cfm) also lists contact information for local district branches in every state, which provide referrals, and the American Psychological Association can connect you to a referral system in your area if you call (800) 964-2000 and provide your zip code. Finally, your local American Diabetes Association (ADA) office will also be able to provide names of mental health professionals who are involved with them in some capacity. These professionals are likely to be knowledgeable about diabetes as well as mental health issues. You can find local chapter contact information on the ADA Web site (www.diabetes.org) or by calling (888) DIABETES (342-2383). In your search for a mental health provider, all of these organizations can act as buoys to guide you to a better understanding of where to go in this new area.
How do I pay?
The next big question is “How will I pay for this?” If you have insurance that includes mental health coverage, some of the costs associated with your psychotherapy should be covered. With the exception of co-payments or deductibles, most insurance plans pay for a certain number of sessions. But here is where navigation can become confusing. The federal government mandated mental health coverage in the Mental Health Parity Bill of 1996. While the intentions of this law were good, its scope was limited; as a result, standards for mental health coverage still vary from state to state. What this means is that you have to talk with your insurance company and read your insurance manual to determine how much therapy will cost you.