Seeking Mental Health Services.
Due to a history of health disparities within the Black community, there have been a number of factors that limit the access to appropriate treatment for optimal physical and emotional health. There are multiple barriers (APA, 2017, 2020) that have served to limit access to mental health treatment including:
Socioeconomic Status (SES)
Stigma
Provider Bias
Inequality of Care
Distrust of the health care system
Lack of providers from diverse racial/ethnic backgrounds
Lack of culturally competent providers
Lack of insurance, underinsurance
This page serves as a resource to help you navigate the system of seeking mental health services. See below questions and answers and helpful infographics to answer your questions regarding how to obtain mental health treatment.
What is Therapy?
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Confidentiality
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Insurance vs. Self-Pay
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What is Therapy? • Confidentiality • Insurance vs. Self-Pay •
What is therapy?
Each therapist has a different theoretical orientation. It is a framework of how a therapist organizes an individual’s particular personality characteristics and behaviors. Below is a summary of a few of the major ones.
Psychoanalytic Therapy
Psychodynamic Therapy
Object Relations Therapy
Cognitive Behavioral Therapy
Existential Therapy
Dialectical Behavior Therapy
Energy Psychology
The therapist’s theoretical orientation gives you an idea of how they will form a hypothesis about your experience. Each approach has different interventions and practices. Depending on your needs one type of therapy might be more helpful than another. One way to differentiate therapy is skill based vs. insight or process-oriented therapies. An example of a skill-based therapy would be Cognitive Behavioral therapy where you are taught coping strategies to help you manage your mood. Insight oriented therapies, (Psychodynamic Therapy etc.) focuses on talking out issues with the goal of gaining better understanding and insight.
See section on various issues and treatment modalities.
How do I choose a therapist?
It is important that you choose wisely when selecting your therapist. You will be talking about issues that are private and personal and you want to build a therapeutic relationship with someone you trust.
You definitely want to seek out someone who is professionally trained within their field to provide mental health services. You also want to make sure your therapist has expertise in the area that you are needing (i.e., expertise in mood disorders, trauma, children, etc.).
You might have to try several therapists to make the right fit for you. As is the case with your other healthcare providers you might not have a perfect fit with the first person you see. So keep in mind that you might need to work with several people to find the right fit.
You should also keep in mind that it might take a few appointments to get a good sense of your therapy and your therapist. The first session usually involves your therapist asking questions about your background so you might not get a feel for your therapist’s approach in the first appointment. Take a few sessions to see whether the relationship with this therapist could be an appropriate match. Ultimately you might find that you need to change therapists. Each therapist values the opportunity to talk out your needs but also your potential dissatisfaction. Therapy is an opportunity to learn skills in how to appropriately and effectively communicate your feelings and your experience. Therefore, if you are unhappy it can be very beneficial to have a conversation about it, even if you decide to still end treatment. This approach will help you not only in therapy but in your relationships in everyday life.
See find a Therapist to see a list of Black therapists in your area. This list continues to grow so keep coming back. Also refer to your insurance health plan or utilize other web searches or platforms.
How much time will I be in therapy?
The duration of how long you will be in therapy depends on the particular concerns you are bringing to therapy. It also depends on the severity of symptoms you are experiencing as well as the model of psychotherapy that you are working under (i.e., short-term or long-term care). You and your therapist will discuss this when you meet and come up with a determination of what might be appropriate for you.
Therapists have different session lengths that they work with. For example, some therapists work off a 45 or 50 minute session limit vs. an actual hour. However, your therapist should discuss this with you when setting up appointments. One final thing to think about is frequency. The most typical therapy frequencies are every week or every other week. Usually the more often that you attend therapy the more that you will find that you are getting out of therapy. The less often that you go means trying to squeeze everything that happened out of session into your next one or feeling like you are not getting anywhere in your treatment. No matter which you ultimately choose, you will discuss this with your therapist as you consider your goals for treatment.
What is the difference between a therapist’s credentials (i.e., social worker vs. master’s level therapist vs. a psychologist)?
Basically, all types of providers have been trained to offer mental health treatment, the difference lies in the type of training. Understandably, an individual who has a doctoral degree (5-6 years of graduate education and training) has longer training than a master’s level therapist (2-3 years of graduate education and training). In addition, the three types of degrees offer somewhat different focuses in their training.
What are boundaries in therapy?
Boundaries in therapy include the rules and guidelines for behavior to ensure a safe and healthy therapeutic relationship. Therapists are required to maintain several boundaries in therapy.
Because therapists want to focus on your care and not confuse the parameters of the therapeutic relationship, no other relationship is tolerated. This means that therapists are advised not to engage in friendships or romantic relationships with the people that obtain services from them. This is to ensure that the focus remains on you and the concerns that you are bringing to therapy.
“Everything is private right”?
The information you share with your counselor is confidential. However, to keep you, others, children and the elderly safe, exceptions to confidentiality will be explained to you when you begin treatment. One exception that will be discussed relates to concerns for safety. Therapists have a duty to ensure the safety of you, other individuals, children and the elderly. Your therapist will explain this to you but make sure to ask questions to make sure you understand.
It must mean I’m “crazy” if I go to therapy.
Unfortunately, some stigma still remains regarding utilizing mental health services. Also, individuals feel like only individuals with severe issues “need” therapy. The reality is that individuals can benefit from therapy no matter the level or the severity of the issues bringing them into treatment. Therapy can be very valuable in helping you gain a better understanding of your feelings, behaviors, thoughts and overall experience. Almost any issue can be addressed in therapy. If you are unsure about whether your particular issue can be addressed in therapy, feel free to inquire about this when making an appointment. The list below is not exhaustive but provides multiple areas that therapy can be helpful.
Payment/Cost/Fees:
When searching for a therapist you can begin by obtaining a list from your insurance health plan. You can do this by calling your plan and requesting behavioral health providers in a particular zip code. Just remember that if you use your insurance, the insurance company will have a record that you are seeking mental health treatment. They will not have access to your therapy notes because those are confidential. However, most individuals searching for a therapist of color is finding that they do not accept insurance. As a result, individuals are deciding to seek out therapists of color in a desire to obtain cultural sensitivity and understanding and pay out of pocket for their services. Therapists will have varying fees but they are typically based on the level of their training and the geographical region.
If you choose to pay out of pocket you are still able to submit your payments to your insurance company and get reimbursed (dependent on your plan, 50-80%) if you have out of network mental health benefits. It is important to contact your insurance company and inquire about your particular plan’s benefits.
Below are a few of the questions you can consider asking:
Do I have mental health out of network benefits?
Do I have a deductible?
Have I met my deductible? If not, how much have I met?
What is my reimbursement rate?
What is the process to submit a claim for reimbursement?
Basically, once you submit your claim and have met your deductible you will begin to receive reimbursement checks from your insurance company. This often helps those who are paying out of pocket feel as if it is not such a financial burden to pay for mental health treatment.
