The Untold Story of Your Therapist

This blog is dedicated to all my therapist friends who are doing hard work in broken systems.

My parents divorced when I was 5 years old. It was a fight of lions. 7 years of custody battles later, the fight had long lasting effects on my life. To this day I rarely talk about it unless you are on my inner circle. Welcome to my inner circle. But in full transparency by the time I was a teenager, it was clear that I needed therapy.

I met with my therapist every two weeks throughout middle school. We all know that middle school can be tough without extenuating circumstances. And I had all the extenuating circumstances.

Therapy changed my life trajectory. It gave me a space to be authentic. It gave me the freedom to “not be ok." And most of all, it gave me the gift of insight into all my irrational thoughts, big feelings, and impulsive teenage behaviors. This gift of insight has been priceless in my life.

I have been a therapist myself now for over 15 years. I love my job. I am the job (IYKYK). And I am blessed by the clients who I work with. But this year has been challenging while building my own practice. The mental health crisis is truly a crisis of money and resources. I fear that it will worsen as a result of inaccessibility of services.

If you have tried to get a therapist in the last twelve months you know that there are large wait times. There are not enough therapists to go around. Our job is full of care taker burn out and secondary trauma responses as we sit across from clients sharing the hardest parts of their life story. The emotional weight of sitting with other humans during their darkest times is taxing. Many healthy therapists including myself set boundaries on client care to avoid burnout. If you are truly sitting with clients in their pain, 8 clients a day is too many. Keep this in mind as your read the following.

Every insurance carrier has a process. This process is long and arduous at best. I get calls almost daily in regards to my availability and the insurance that I can take. The truth about the big boys…

Cigna does not reimburse well, meaning I get paid half a normal rate. In fact a lot of therapists do not accept Cigna because the pay-cut is significant. This is not greed. If there are limits to how many clients that can be seen each day to ensure that your therapist is healthy, then this number matters.

BCBS, another major player in the insurance game, has quite literally strung me along 90 days at a time, while making promises about the next steps. After over a year of waiting, faceless people say that my practice “should” be able to bill them by August. And there is no recourse in regards to the incredible amount of time it takes to be contracted as an individual clinician. I am quite literally at their mercy without a large agency to back me up. This explains the wait times for therapy appointments and the lack of therapists who take insurance at all. Let me tell you how easy it is to take private pay.. swipe swipe.

Medcost just approved my practice. This felt like a huge win because it is an insurance carrier of a major employer in my area. I was pumped. Only to be told a few days later that they sublet their mental health insurance to a different company. Oh good, I have really developed a fondness for more paperwork and a promise of 90 more days. I plan to integrate this fondness into my life. The next time one of my children makes a request, I plan to ask them to submit it in writing and then I will get back to them in a very reasonable 90 day period.

I could go on and on. I have similar stories for each company. So when people give up on therapy as a result of frustration, I get it. The long wait times, lack of resources, and few providers that take insurance could be prevented. As a therapist I want to provide services to as many people as I can. But I am also a business owner whose survival is dependent on payment and longevity in my career. The next time someone says mental health crisis, consider the factors that prevent the therapist from helping. We are tired from covid just like a lot of you, but we are still trying to give the best care in spite of these hurdles.

Sometimes I wonder how my life would have been different if I didn’t get therapy when I needed it. It honestly scares me and it should scare you too. I would not be who I am today without the skills I learned as teenager.

We are living with broken systems but the mental health crisis can be changed. Policies can be changed. Money can be allocated. Wait times can be decreased. And while I am a very small cog in this wheel, my story matters and so does yours.