CLEVELAND, Ohio — When you feel depressed and overwhelmed, finding a therapist can seem as doable as climbing Mount Everest in shorts and flip flops.
Where to go, how much it will cost, how to find someone who understands your problems and what kind of therapy is the best for you — the questions pile up until it seems easier to just drop the whole idea and hide in bed.
Don’t do that. Help is more abundant and more affordable than you think.
“Mental health is a slippery slope, and can take you down really quickly,” said Sheerli Ratner, a clinical psychologist in the department of family medicine at MetroHealth Systems. “If you need help and ask for it, you’re a hero. That’s being brave. That’s being strong. That’s fighting to get better.”
Cleveland.com’s Coping Through COVID aims to help Northeast Ohioans cope with the stress caused by the coronavirus pandemic. This installment offers help with overcoming barriers to mental health therapy, including cost and access.
Make an appointment with your primary care physician. A good first step toward finding help with pandemic-based depression, anxiety, family problems or other concerns is to talk to your regular doctor, who can serve as a gateway to mental health services, Ratner said.
“It’s easier to ask for help from someone you already have a relationship with,” Ratner said. “You already know how to make an appointment.”
At MetroHealth, staff psychologists work alongside physicians, and are often called into appointments for patients with mental health concerns. The psychologist can do an assessment right then, or schedule one for a future date, Ratner said.
The majority of psychotherapists have moved to telehealth and virtual visits since the start of the COVID-19 pandemic, said Dr. Jeffrey Janata, director of the division of psychology at University Hospitals. Patients have adapted to virtual sessions because they save time and effort, Janata said.
However, eye contact is difficult and body language is lost when using screens, so it takes longer to build a warm and trusting relationship between client and therapist, he said.
The right therapist is one you can afford. Locally, private sessions with a therapist range from $150 to $300 per hour, before insurance, Janata said.
Low-cost or no-cost counseling is available. Many therapists charge on a sliding scale. Counselors in training, support groups and counseling services at colleges and universities are other free or low-cost options.
Foundations and nonprofits that focus on mental health are also sources for affordable therapy.
Take time to find a therapist who is right for you. Think about whether you want to talk to a man or woman, or someone who is married with children. It’s smart to interview a potential mental health provider over the phone before scheduling that first session. If the two of you decide you’re not a good fit, ask the provider to suggest another therapist.
“You want it to be a dynamic process and feel empowered,” Ratner said.
Once you start searching for a therapist, you’ll likely encounter terms for various kinds of psychotherapy, such as cognitive behavioral therapy, acceptance and commitment therapy and more.
Ask what kind of therapy the counselor recommends. During the first counseling session, ask how many sessions will be needed to make progress. You should feel as if you are getting an informed and honest answer, Janata said.
“It’s so dependent on the duration and complexity of the problem,” he said.
Below is information that will get you on the road to finding help with mental health issues. It includes simple first steps for getting started, how to find a mental health professional, how to find lower-cost therapy, types of mental health professionals and types of therapy. Most information came from MetroHealth’s Ratner, UH’s Janata, the website Good Therapy, Self magazine and Psychology Today.
Four simple steps for getting started
- Contact your health insurance provider and ask for a list of in-network providers covered under your plan. Be sure to ask if your insurance covers telehealth counseling sessions.
- Make an appointment with your primary care physician.
- Email your company’s HR department to find out if your employer offers an Employee Assistance Plan.
- Pledge to make one call a day, or share this list with a trusted friend who can make initial calls for you.
The Psychology Today website lists useful databases and educational articles that are helpful for people seeking therapy. This is a screenshot of the Psychology Today website.
How to find a mental health professional
Here are websites that offer searchable directories of therapists for finding a local provider, mental health information, group therapy information, mental health screenings and more:
American Psychological Association: Consumer resource for information on psychological issues, fact sheets, confidential telephone counseling, searchable directories and more.
Anxiety and Depression Association of America: Directory of therapists and support groups, mental health apps, community resources, low-cost treatment and more.
BetterHelp.com: Private online counseling and matching to a licensed therapist.
Boris Lawrence Henson Foundation: Searchable directory of mental health providers and programs serving the Black community across the country.
International Board for Certification of Group Psychotherapists: Searchable database of group therapists.
Depression and Bipolar Support Alliance: Online support groups and more.
Mental Health America: Crisis resources, screenings and education on types of mental health treatments and professionals.
NAMI (National Alliance on Mental Illness) Greater Cleveland: Find peer support groups and programs, mental health fact sheets, live chat, community resources and more. All NAMI programs are free of charge.
Open Path Collective: Database of therapists providing affordable, in-person and telehealth psychotherapy sessions for individuals, couples and families.
Psychology Today: Database of therapists, organized by specialties and geographical location; educational resources.
Substance Abuse and Mental Health Services Administration: This branch of the U.S. Dept. of Health and Human Services has a searchable database of treatment programs.
Thero: Crowdsourced comprehensive mental health directory, including options for telehealth, low fee/no fee and sliding scale.
U.S. Department of Veterans Affairs: Veterans can find a VA location that offers mental health services.
Virtual Psych: Database of state-licensed psychiatrists, therapists and psychologists.
The Boris Lawrence Henson Foundation:, founded by actress Taraji P. Hensen, works to make counseling affordable in the Black community, which has been disproportionately affected by the pandemic. This is a screenshot from the foundation’s website.
How to find lower-cost therapy
Investigate these options to find free or low-cost counseling near you:
The Boris Lawrence Henson Foundation: The foundation, which works to make counseling affordable in the Black community, is raising funds to defray the cost of up to five counseling sessions. The grants will be made on a first-come, first-served bases until the funds are exhausted.
Colleges and universities: Many Northeast Ohio colleges and universities allow clinicians in training to see clients at a reduced rate and under the close supervision of licensed professionals. They typically charge reduced rates but are under the close supervision of a licensed professional, so you’re still receiving quality care. Many college students can access free or low-cost counseling at their college or university, and some universities open their services to community members. Here is a sample of what is available:
The Clinic for Individual and Family Counseling at the University of Akron offers affordable general counseling services to individuals, couples, families and groups in the Greater Akron community. Graduate students in counseling programs spend part of their residency offering counseling iunder supervision of national certified and licensed faculty. The clinic offers sliding fees.
The Case Western Reserve University Psychology Clinic links Northeast Ohioans seeking counseling with university PhD students in clinical psychology, who are supervised by licensed psychologists. The sessions are by phone or videoconference. Click the link for more information or call (216) 368-0719.
The Cleveland State University Counseling Center continues to offer individual and group counseling at no cost for students. It also offers Tess, an artificial intelligence chatbot, that can help students manage stress by providing coping skills and strategies via text messages.
At Kent State University, counseling services are provided free of cost to Kent State students, staff and faculty, and at low cost to community members.
Employee Assistance Programs: These are free or low-cost workplace counseling services that many larger companies offer to help employees cope with stress related to personal finance, work, relationships, legal concerns, and drug or alcohol use. Most employee assistance programs offer a fixed number of counseling referral sessions, at no cost to the employee.
Group therapy and support groups: Group therapy sessions facilitated by a licensed therapist are a lower-cost option for mental health concerns. Groups led by nonprofessionals can provide a supportive place to share concerns, and are often free or cost less than traditional group therapy. To find a therapy or support group, ask your therapist for suggestions, search the American Group Psychotherapy Association or Psychology Today websites, or search the internet for advocacy group websites for the specific problem you’re facing.
Health centers and free clinics: Community-and federally funded health centers and free clinics often offer support groups and other forms of therapy at lower prices. Find them by using this searchable clinic directory at this link.
Medicaid: The Ohio Department of Medicaid offers individual or group counseling, psychological testing, mental health assessment and other services, all with no co-pay. Check the Medicaid website for complete information.
Medicare: Original Medicare provides a yearly depression screening if your physician accepts Medicare. Medicare Part B helps pay for some outpatient mental health services, including a depression screening, individual and group psychotherapy and family counseling. Check the Medicare website for complete information.
NAMI (National Alliance on Mental Illness) Greater Cleveland: All mental health programs and support groups are free of charge.
Sliding scale: Ask a prospective therapist if he or she uses a sliding scale to fix prices for clients. This allows individuals to pay based on what they can afford.
Veterans: People who qualify for Veterans Administration health care can get mental health help as part of their benefits, according to the Louis Stokes Cleveland VA Medical Center website. The Cleveland VA Medical Center provides evaluation and treatment for many mental health issues.
The website Betterhelp.com matches clients to licensed therapists, making the search for mental health help easier. This is a screenshot from the website.
Types of mental health professionals
Which mental health professional is right for you? There are many types of mental health professionals, and you may need to do research to figure out which type is a good fit.
Here are some common types of mental health professionals. Information came from the Washington Post and Mental Health America.
Certified Alcohol and Drug Abuse Counselor: A counselor with specific clinical training in alcohol and drug abuse. Trained to diagnose and provide individual and group counseling.
Clinical Social Worker: A counselor with a master’s degree in social work from an accredited graduate program. Trained to make diagnoses, provide individual and group counseling, and provide case management and advocacy; usually found in the hospital setting.
Mental Health Counselor: A counselor with a master’s degree and several years of supervised clinical work experience. Trained to diagnose and provide individual and group counseling. Diagnoses mental health conditions, but they cannot prescribe medications.
Psychiatrist: A medical doctor who has completed a four-year residency in psychiatry. Can prescribe medication and often work in partnership with counselors, psychologists and social workers.
Psychologist: A psychologist who has completed a doctoral program in clinical psychology, which leads to a PhD or Doctor of Psychology. Trained to make diagnoses and provide individual and group therapy.
Types of therapy
Here are some common forms of therapy, and how they work. Information came from Psychology Today.
Acceptance and Commitment Therapy (ACT)
Clients learn to accept difficult emotions, and begin to make changes in their behavior, regardless of their life circumstances or feelings. ACT for Depression (ACT-D) helps clients improve their relationships with themselves and others.
Cognitive Behavioral Therapy (CBT)
The type of therapy is based on the idea that thoughts, feelings and behavior are all connected. The goal is changing a patient’s way of thinking to change responses to challenges. This approach can be applied to many mental health issues.
Dialectical behavior therapy (DBT)
Clients learn new skills for dealing with painful emotions and reducing conflict in personal relationships. These skills include mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness. DBT is often used to help people with depression, anxiety, borderline personality disorders, addictions, eating disorder, and PTSD.
Interpersonal Psychotherapy (IPT)
Clients improve their interpersonal relationships by addressing unfulfilling relationships, manage unresolved grief and difficult transitions such as retirement or divorce.
Trauma-Focused Cognitive Behavior Therapy
This form of cognitive behavioral therapy helps individuals and families struggling with the effect of early trauma. It can be helpful for children and youth with post-traumatic stress and mood disorders resulting from grief, abuse or violence.
More stories in Coping Through Covid series
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