Why is therapy so expensive?

You have been feeling stuck and stressed. You have tried to fix your problems and asked for support from friends or family, but it feels like you only get temporary relief. You’re tired of being on the hamster wheel of trauma, anxiety, or depression and have decided to try therapy or counseling. You hop online and start to search for professionals in your area, and you find some that you think would understand you and be able to help you with your problems. However, it feels like all the good therapists you like aren’t affordable. 

You start to add up the costs in your mind and begin to feel frustrated and hopeless. This therapist must be making a killing! Isn’t this person supposed to help people? How can anyone afford this? Know that these thoughts are totally normal, but let’s take a step back and consider what you’re paying for. Remember, the service you get from a discount store is different from the service you receive at a high-end boutique.

Therapist’s background and training

A Licensed Masters Social Worker (LMSW) has a master’s degree in clinical therapy and counseling. Some clinical social workers even have a doctorate.  After receiving an undergraduate education, this degree required at least two years of schooling and fieldwork (working without pay). After receiving a Clinical Masters in Social Work (MSW) degree, professionals have to become fully licensed within seven years of obtaining their degree in order to practice in the State of Michigan legally. To tally up the years required to be fully licensed, we have four years of undergrad, at minimum two years of masters’, and an additional 2-7 years of on the job work. So, your social work therapist has experienced 8-13 years of training to obtain their full license. In addition to school and training, MSWs are also required to have supervision, state exams, background checks, and licensing.

After becoming fully licensed, there are continued costs of supervision and continuing education. You want your therapist to be educated on the latest research and practices to be sure you are receiving the best care. Some therapists go through additional training to earn certifications to provide specialized care to their clients. Training can cost thousands of dollars per year, and during this time therapists cannot see clients. Therapists also keep up to date on best practices through purchasing books and journals. So chances are a therapist you are interested in has trained long and hard to be able to provide the best care to you. 

Dedication to your healing

We have all had experiences of seeing health professionals and felt we did not receive the best treatment. Maybe they were running 30 minutes late and then made you feel rushed during your appointment time. Perhaps you did not think that your needs were met, that you weren’t heard, or that you didn’t get the best treatment. It is crucial that you feel respected, understood, and that you are receiving the best services.  

A good therapist will be choosy about whom they see for therapy. Therapists should only take on the people they know they can help. No therapist specializes in everything, and so choosing clients who are a good fit is essential to make sure you meet your therapeutic goals as quickly as possible. If someone isn’t a good fit, a therapist will often try to provide you with resources and referrals to be sure you do get the help you are looking for. If you feel disappointed that a therapist does not feel you are a good fit, it can be helpful to reframe this experience as, “This therapist cares about me and my wellbeing, and feels there is someone who will help me start feeling better.” This is actually an act of love and respect and not rejection. 

It may seem like you’re paying a lot for a 50-minute session, but there is a lot of behind the scenes work that goes into your sessions. Outside of your session, your therapist may be engaging in supervision, working on your treatment plan, and tracking your progress. Also, if a therapist takes your insurance, there is additional documentation needed that is required in meeting insurance standards. So even when you’re not in the office, your therapist is working for you. 

Finally, seeing too many clients, feeling overwhelmed, and having trouble making ends meet can cause therapists to resent their clients. This would result in a waste of your and the therapist’s time. A therapist that understands and respects their own needs will be able to provide better services to clients. 

Multiple hats: Being a therapist and a business owner

Therapists who own their practices are also entrepreneurs and wear the hats of managers, billers, receptionists, administrators, and other office staff. Therapists who run their practices are also responsible for the overhead of a business, including rent, liability insurance, phone, Internet, fax, websites, marketing, electronic medical records, and assistants or medical billers. Solo practitioners have more control over the care they provide, which allows them to focus on specialties and offering unique services. Although this may seem like an extra burden, those who venture out as a solo practitioner often feel very passionately about the care they provide and do not want the constraints of working for someone else. For example, if you were interested in walk-and-talk therapy, you might have to find a solo practitioner because it might not align with the values of a group practice and insurance may not cover it. So, a therapist might cost more than other therapists due to the level of service they are trying to provide. 

Your comfort is the foundation for healing

Your comfort is a priority when it comes to healing work. If you don’t feel comfortable, it’s going to be incredibly difficult to get the desired change you want. Here are some things to consider: How does the office look and feel? Does the therapist have any extras in their office to make you more comfortable such as coffee or tea? If they have a specialty, do they have any specialized equipment, furniture, or other items that other offices might not provide? Any amenities that offer you increased relaxation and comfort are helping to create the space for you to heal. Also, when therapists have specialties or certifications it can help give you the peace-of-mind that you are seeing someone who is trained, experienced, and passionate about the work they provide. 

More about Elizabeth Eiten, LMSW, CCTP

I want to give you a better understanding of my education and dedication to your healing journey. I am fully licensed in the State of Michigan as a Clinical Social Worker, and I am also a Certified Clinical Trauma Professional. I am passionate and dedicated to the work that I do and the people I chose to work with. All my practices are evidenced-based, solution-focused, and individualized to your unique strengths, values, and needs. To read more about me, check out my bio. I am also a solo practitioner, which allows me to provide unique services such as meditation training and outdoor therapy at our office. Outside of the therapy office, I also offer meditation workshops and training. 

In my office, I see fewer clients because I want to make sure those who seek my services are getting my full focus and attention. I could see more clients for shorter therapy times, but you wouldn’t be getting the best care (I also might have trouble remembering you!). However, when I charge slightly more and see fewer people, I have space to honestly know and understand you while providing the best care possible. With this said, I care very much about the people who visit me in my office and want to make sure they feel safe, respected, and that I am giving them my best energy. 

If you are ready to commit yourself to getting unstuck, contact our office today for a free 15-minute phone consultation at 248-291-7322. 

Overcoming Childhood Emotional Neglect: The Path to Resiliency

Overcoming Childhood Emotional Neglect: The Path to Resiliency

If you have experienced emotional neglect, therapy can be an opportunity to nurture yourself in ways that were not provided to you in childhood or in current relationships. You can develop a positive sense of self, confidence, and know you are worthy of love and belonging. Just because these skills were not given to you in adolescence does not mean that you cannot develop them in adulthood with the help of a trusted professional.

Healing Trauma: A holistic mind-body approach

Those who experience trauma struggle with a combination of problems due to unwanted, abusive, and/or traumatic experiences. After trauma, survivors may experience depression, anxiety, PTSD, trouble caring for themselves, and relationship issues. Recovery from trauma does not necessarily result in being “free” of the traumatic events that affect you, but the opportunity to live in the present without feeling flooded with thoughts and feelings from the past. Trauma is not a mindset, but rather a physical, emotional, and spiritual illness.

In Bessel Van Der Kolk’s, The Body Keeps the Score: Brain, Mind, and Body in the Treatment of Trauma, he explores the biological effects of traumatic stress on the body including how trauma rewires the brain. As Van Der Kolk describes, “Trauma is not the story of something that happened back then. It’s the current imprint of that pain, horror, and fear living inside people.” For those struggling with PTSD the trauma continues to live in their body after the event(s). Trauma affects us psychologically, physically, emotionally, behaviorally, cognitively, relationally, and spiritually. With that said, psychotherapy needs to be holistic and incorporate mind-body therapies.

Dr. Nadine Burke Harris, who wrote The Deepest Well, explores how adverse childhood experiences can have lasting effects on human health. Childhood adversity changes human biology, which results in increased rates of heart disease, diabetes, asthma, and other illnesses. When our brain is constantly in fight-or-flight we produce toxic stress in our bodies. This toxic stress affects our mental health as well as our physical health.  Given this, treating trauma requires an integrative approach.

Survivors of trauma can exhibit the following symptoms:

  • Hypervigilence: looking out for danger, trouble sleeping, easily startled, angry outbursts
  • Avoidance: of certain spaces, thoughts, people, or objects
  • Reliving: nightmares, flashbacks, and triggers
  • Dissociation: feeling disconnected from the body and/or amnesia
  • Feelings of shame and problems with mood

Other symptoms of complex trauma may include:

  • Difficulty regulating emotions: feeling “out of control” when experiencing strong emotions
  • Trouble remembering large parts of personal history
  • Low self-worth, chronic feelings of shame or guilt, and negative self-talk
  • Not feeling a sense of self, or sense of self is dependent on another person
  • Trauma bonding, which is a strong attachment between an abused person and their abuser formed as a result of the cycle of abuse
  • Emotional numbing
  • Self-harming
  • Addictions

Healing from trauma is possible.  Occasionally, individuals may experience post-traumatic growth in the final stages of recovery. Working with a skilled and experienced therapist who incorporates a mind-body approach is essential to recovery. There are three stages of recovery in trauma therapy explored below, which are adapted from Judith Herman’s Trauma and Recovery.

Safety and Stabilization

The first step in this stage is developing an understanding of the effects of trauma and treatment. There are three main types of safety that are strived for in this stage:

  • Feeling safe in our bodies
  • Feeling safe emotionally
  • Feeling safe in our environment

This work includes learning new coping skills and learning how to manage overwhelming emotions. This stage practices living in the here-and-now. Survivors are learning to remember trauma as opposed to reliving it. This involves developing a safe living situation, a safe and stable job, and a support system. Creating safety is the foundation for future stages of trauma work.

Overcoming Traumatic Memories

There is grief related to experiencing and overcoming trauma. In this stage, we process trauma by putting words to experiences and emotions. It is not necessary or required to discuss details of traumatic events, however, memory processing can help eliminate triggers we continue to experience related to specific memories. Also in this stage, mind-body therapies are the most effective because trauma lives in our bodies as well as in our minds. When we make space and time to grieve our experience we can move past it to live more fully in the present.

Integration and Living in the Present

Over time, we begin to develop shame resilience and create meaningful lives. At this stage, survivors start to reconnect with the present moment and make choices about how to engage in their lives. Survivors challenge themselves in healthy ways to increase resiliency and create meaning in their experience. This is an opportunity to reconnect with people, activities, and other parts of life. As survivors start to live life in their healthy and present selves trauma feels further away.  Survivors develop an understanding that trauma has been part of their experience but is not who they are.