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"Help! I Can't Afford Therapy!!" - Finding Affordable Therapy in Denver

Updated: Apr 1

Written by Ashley Gray, LCSW, MFTC

Therapy is expensive. That is a difficult truth. Many people want or need therapy and cost can be a barrier. Another barrier to people getting the care that they need is not having the correction information to find the therapy that they need. I wanted to create a post that helps people find the support that they need, as well as understand why the barriers exist.

These can be emotional discussions to venture into because they surround money and support. Money and support help us feel secure in our lives, not as vanity, but as absolute necessity. People need money and support to survive and thrive. If this topic makes you feel angry, frustrated, defensive, or any other big emotion, that makes sense because it is likely coming from a part of you that feels motivated to protect your well-being. It is simply a human response. One that is felt by both potential therapy clients and therapists when venturing into this topic. I encourage you to be aware of your emotions and needs behind your emotions when reading this, to help you identify what you may need from this article or what you may need to advocate for outside of reading this article.

Why is Therapy so Expensive?

As a potential therapy client, you do not have to care about any of this information. As therapists, we want to support you well and we don't want you to worry about this information about why therapy is expensive. I only share this because I sometimes get this question and usually people are grateful to know the answer. If you would rather not know, feel free to skip this section or any other section you choose.

Sometimes there is an assumption that the cost of therapy is arbitrary and based only on therapists wanting to make a lot of money. It is a bit more complicated than that. Therapists want to help people and therefore want therapy to be affordable. Unfortunately, there are a number of systemic issues that impact the expense of therapy. For starters, therapists have to pursue at least a bachelors and a masters degree, sometimes more. Then after that, therapists need to complete at least two years of supervision, where a licensed therapist reviews the unlicensed therapist's work and the unlicensed therapists often pay thousands of dollars for this supervision. Some therapists may be actively paying for this while they are seeing clients or they are at least paying on the student loans needed to pay for this education.

After a therapist gets their education and it is time to be employed as a therapist, there are a lot of jobs for therapists that overwork therapists and have them seeing a ridiculous amount of clients a day and/or are not paying therapists a living wage. This is why therapists go into private practice much of the time. Most therapists are their best personally and professionally when they are seeing 25 or fewer clients a week. Due to the emotional weight of therapeutic work and necessary admin work seeing clients 40 hours a week, is not possible. Seeing 25 clients a week is usually only possible in private practice or a group practice. Most other organizations will almost certainly have therapists seeing more clients than this.

It is very expensive to be a therapist in private practice. This is in part due to needing confidential systems like Electronic Health Record Systems and other online systems. Also, if a therapist is only seeing 15-25 a week, which is where most therapists feel most comfortable, then that therapist is only being paid for 15-25 hours a week, not 40 as some imagine. Also, when a therapist is self-employed they have to cover their own PTO, insurance and retirement, self-employment tax of 15% percent on top of whatever else they may be taxed. Most therapists, are putting about 30% of what they bring in towards taxes and another 30% toward overhead. Therefore, their take home is about 40%. Unfortunately, in order to make this math work and be able to take care of themselves and their families, they have to charge a rate that is much higher than a co-pay. Now of course, everyone's situation is different and these are rough numbers, but this is roughly how it can shake out.

Why Does It Feel Like Most Therapists Don't Accept Insurance?

It is true that more and more therapists have been moving away from accepting insurance. It is also true that most therapists have accepted insurance at one point or have wanted to accept insurance to make therapy more accessible. What often keeps therapists from accepting insurance or leads them to get off of insurance panels are things like being compensated too little for sessions, insurance recouping payments years after therapy has ended, reimbursement rates not increasing with inflation, not being reimbursed in a timely manner (sometimes waiting months for payment), insurance dictating what therapy should look like and all of the extra work that goes into maintaining the appropriate documentation for insurance. In some instances the compensation by insurance companies barely covers overhead for the therapist's practice, let alone allow them to take care themselves and their family. Something else that can happen with insurance payments is that insurance companies can conduct an audit years (up to 7 years in Colorado) after therapy has ended and determine that the claims that they initially approved were done in error and require the therapist to pay back what the insurance company has paid them. This amount is sometimes in the thousands. When this does happen insurance companies require copious amounts of documentation to be sent to them from the time that the treatment happened. Unfortunately, this happens more often than you would imagine. I explain this to illustrate the work and risk that can be associated with accepting insurance.

Now, of course, this is not the fault of the client, but the client, unfortunately, ends up being impacted. It is also not the fault of the therapist that these are the options with insurance, but the therapist also has to make the necessary decisions to keep their business afloat and care for themselves and their family. Unfortunately, accepting insurance does not always enable them to manage those responsibilities, so they often opt out of accepting insurance. Not every insurance company is like this and not every therapist experiences these issues (though many do). If you decide to use your insurance, you can check out my last blog post where I talk about how to find a therapist that accepts your insurance.

How Can I Access Affordable Therapy?

If this has left you wondering how you could possibly afford therapy and do so in a way that is also beneficial for the therapist, I have some suggestions. Therapists do care about providing accessible care and they do so through a few different avenues. Many therapists in private practice offer reduced session fees/sliding scale (wording varies by therapist) and/or pro-bono services. They may advertise this on their website or directory listing, it is also okay to ask about this even if you don't see it on their website. Sometimes they can provide referrals for practices that offer that, even if they don't. It is important to note that therapists often have a brief application process and a limited number of spots for pro-bono, reduced session fees/sliding scale fees.

If you have an HSA or FSA funds, you can use those funds to pay for therapy. Most therapists accept this form of payment. Using you HSA or FSA allows therapists to get paid their full fee amount, while allowing you to use pre-tax dollars to cover therapy expenses.

Another option is to use any out-of-network mental health benefits you may have. How it works, is that you would pay the full session fee for each session and receive a superbill from your therapist for each session. A superbill is a simple form that reflects your name, DOB, diagnosis, insurance information and information about the type of session you had (individual or couple) and the amount you paid for the session. It does not at all list what was discussed in session. Then you submit this to your insurance and they reimburse you for a percentage of your session fees. Clients often have much greater luck being reimbursed than therapists do when working with insurance. I always suggest checking in with your insurance about these benefits because you often need to meet a deductible before you would receive reimbursement. Most therapists in private practice offer superbills. I, myself, offer superbills,reduced session fees, bro bono, and accept HSA and FSA funds.

Where Can I Find Affordable Therapy?

When I am asked for this information I have a few different go-to places I like to mention. I will list them and then explain a bit more about them.

Khesed Wellness is located in Colorado, Texas and Michigan and offers therapy that is "50% market rate or less", in addition to having multiple pro-bono programs for marginalized individuals.

Denver Family Institute (DFI) is an organization that trains Marriage and Family Therapists (MFT) and provides affordable therapy. As the therapists in training are working on their clinical hours under the supervision of a seasoned therapist, DFI is able to offer affordable therapy for their clients. This is because therapists working on their internships in grad school and training programs need to do a certain number of internship hours where they are seeing clients for free as they are getting their education. The fee that you pay for sessions ($25-$130) is based on your income, there is a fee estimator on the website that helps you figure out what you might expect to pay. The session fee that you pay helps keep DFI operating and offering affordable therapy to the community.

Open Path Collective is an organization that connects potential clients with therapists that offer sliding scale spots in their practice. As a potential client, you pay a one-time fee of $65 to have lifetime access to the Open Path directory and then you have access to a number of therapists across the country that offer sliding scale therapy. The cost per session can vary from $30-$70 per session depending on the therapist.

The Loveland Foundation does not have their own therapists, but funds therapy (12 sessions) for Black women and girls throughout the country. They have partnered with therapy directories to help you find the right fit. They are able to do this work thanks to donations.

Because there is such a demand for these resources there is often a longer wait to be seen. I suggest reaching out to these resources as soon as you think you may need them since there may be a wait list for some of these resources at times. I will say that Open Path Collective would be the least likely to have a wait list since the entire directory is for reduced cost therapy.

If You Can Afford Therapy And Want to Help Others Do The Same

If you are someone who can afford the full fee when seeing a therapist, paying the full fee helps the therapist offer sliding scale and pro-bono sessions as it allows them to cover their necessary expenses of their business. If you would like to make a donation to organizations that offer affordable therapy, all of the organizations above accept donations. If none of these organizations speak to you, but you would still like to help others find affordable therapy, I encourage you to search for organizations doing similar work in your area. You may find more than you think.

I hope this post helps you find the right therapy fit for you or maybe even a way to give back. If you are in Colorado and would like to work with me in therapy, you can use the contact buttons at the top of this page.

I'm wishing you the best on your healing journey! :)

P.S. If you want to sign up for my newsletter, so that you don't miss a blog post and you get the latest information about free resources, services and news follow this link. There will be a pop-up on the page that will prompt you to sign up. If you get the pop-up after you sign up, you can use the yellow "x" in the corner of the page on your desktop or bottom of the page (you may have to scroll) on your phone to exit. If you're looking for free mental health freebies, you can check out my free attachment test and regulation guides here.

This post is written by individual and couples therapist, Ashley Gray of Arvada, Colorado. Ashley works with her clients using Gottman Method Couples Therapy, EMDR Trauma Therapy, Prepare and Enrich, attachment focused therapy and techniques from Emotionally Focused Therapy. As a therapist, she is passionate about helping people build healthy relationships and supporting people with the resources they need. In her free time, Ashley hikes, paddle boards, reads, spends time with her husband and her cuddly dog. For more information about Ashley and her practice, click here.


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