When should I go to therapy?
Now. It is always a good idea to get a proper mental health evaluation. Life is hard and every one of us struggles in one way or another. It is good to have an objective, trained professional to help you maximize your inner strength in order to tackle your day to day.
Will I be in therapy forever?
No. At first you meet with a therapist every week. This pace will allow you to get to know each other and establish goals for your treatment. As things progress you’ll decide together to meet every other week, then monthly, and then just as needed. Eventually you’ll go on to live your life and inevitably something new will pop up that you may need support with. Since you have a therapist that you’ve worked with in the past, you would start by giving them a call and getting back to the weekly meeting rhythm with new goals to focus on.
What is a therapist, exactly?
A therapist is a person who has at least a masters level degree in mental health counseling, psychology or social work. Some therapists will have just graduated school and have an initial license (for example LCSW -Licensed Clinical Social Workers) showing that they took a state exam to be able to practice mental health. The top licenses in Massachusetts are LMHC (Licensed Mental Health Counselor), LICSW (Licensed Independent Clinical Social Worker) and LMFT (Licensed Marriage and Family Therapist). All of these people are able to meet with you and provide good quality mental health treatment to you.
Some therapists work independently. We say that they have a private practice.
Some therapists work as part of small group practices. Some practices focus on working with specific communities (like we do at Colorful Resilience LLC, working primarily with LGBTQ+, BIPOC, immigrants and first generation folks).
Some providers work in community mental health agencies or non-profits. The good thing about these places is that they are usually a “one stop shop” for people who need multiple resources (like medication, groups, case management, and other services), and they always take MassHealth and Medicare (which are the health insurances you can get through the government).
What about a psychologist?
A psychologist has a PhD. They can provide therapy, although they usually focus on psychological testing and/or research. A PsyD is also a doctoral program, but it is focused solely on the clinical practice of psychology.
OK, but what if I need medication?
A therapist does not prescribe medication. Medication is prescribed by either a doctor (MD, PA) or a nurse practitioner (NP). Therapists refer their clients to behavioral health prescribers, which are doctors or nurse practitioners who specialize in working in the mental health field. It is a best practice that if a person takes medication for their mental health they are also seeing a therapist. That being said, seeing a therapist does not mean you have to be on medication. That is a decision that you and your therapist will make together.
My mom says I don’t need a therapist because I am not crazy. If I choose to see a therapist, does it mean that I am crazy?
No. Choosing to see a therapist means you want to take care of your mental health in order to have all the tools at your disposal to thrive. Exercising twice a week doesn’t mean you are obese, it means you take care of your physical health. Getting your nails done every two weeks doesn’t mean your nails are terrible, it means you take care of your nails regularly. I could go on and on, but you get the idea.
What are the different levels of care for mental health in Massachusetts?
Generally speaking, here are the different levels of care for mental health in Massachusetts:
Outpatient therapy: This is your typical therapist that you see once a week. This is where you want to be, because seeing an outpatient therapist regularly may prevent you from having to access other more intensive levels of care.
Intensive outpatient therapy: Here you meet with a therapist 3 to 5 days a week for about 4 to 6 weeks. After completion, you would get discharged to outpatient therapy.
Partial hospitalization: This is where you would go for two weeks, typically from 8am to 2pm, to access therapy groups to talk about your feelings and learn ways to cope, get medication evaluation and management, and have individual therapy. After completion, you would get discharged to outpatient therapy.
Inpatient hospitalization: This is when you go to the hospital for 2 weeks, staying overnight, for medication and sometimes group work. It is intended to stabilize very decompensated mental health presentations. You may be discharged to intensive outpatient or outpatient therapy depending on how you are doing.
There are other resources to support all of these levels of care, like rehab or eating disorder programs, etc. You can learn more about programs or resources that might be right for you from your primary care doctor or your outpatient therapist.
I’ve decided I want to take care of my mental health. How do I go about this?
1. Figure out how to pay for it:
You need to know what your health insurance coverage looks like. You can also call the member services number on the back of your health insurance card and ask “How much is it going to cost me to see an outpatient therapist for routine mental health services?”
Insurances have deductibles and/or copays. A deductible is an amount of money you need to pay the provider (a therapist is a mental health provider) directly before your insurance starts paying the provider. A copay is a partial payment (usually $15 to $40) you need to pay the provider directly to complement what the insurance company is paying the provider. If you
have MassHealth, it is likely that your copay is $0 and you do not have a deductible. Having commercial insurance (which is insurance you traditionally get through your or your parents’ employer) does give you more options when trying to find a mental health provider. Some providers do not take MassHealth, and the reasons for this can be found here:
https://colorfulresilience.com/the-mental-health-care-system-in-massachusetts/
2. Make some calls, get on some waitlists:
Start by calling your insurance company and asking for a list of therapists in your area who take your insurance. Call them, leave messages, and get on their waitlists.
You can also visit https://www.psychologytoday.com/us. You can search for a therapist in or close to your zip code who takes your insurance and has expertise on the things you need support with.
Check out these local resources:
1. http://colorfulresilience.com/
2. https://www.facebook.com/leavesofchangecounseling/
3. https://multiculturalclinic.squarespace.com/
4. https://transhealth.org/
5. https://chd.org/
6. https://www.csoinc.org/
7. https://www.bhninc.org/
8. https://www.servicenet.org/
9. https://www.baystatehealth.org/services/behavioral-health
