Psycho-Babble Psychology Thread 313810

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cost/benefit analysis of therapy?

Posted by octopusprime on February 15, 2004, at 20:36:32

hello ladies and gentlemen

i am considering psychotherapy. i have some objectives in mind. i am not depressed enough for medications right now, but i have been in the people to come to me then go away. i basically think i have some bad behaviour patterns that need breaking.

however, my insurance allots $500/year for a psychologist. (i get the feeling that means msw's and others are not covered, but i can check)

there are some other things that would be good for my mental health that cost money: for example, i need to move out of my break-in prone/rodent attractive apartment, i need $900 cash to do this, and it would be good for my mental health (and make me less paranoid)past, and i am getting down again. i need to broaden my social circles, but i'm always telling

so for those of you in therapy, have you performed a cost/benefit analysis? is it better for you than running away to join the circus two weeks a year? would therapy be better than moving, getting a swimming membership, or taking a trip to mexico (which i could also do with my therapy money?)

i'm just soliciting opinions. i'm wondering if it would be a good idea to pay $1000+ out of pocket for therapy, or wait, and make other changes in my life, and hope things go better once i move/go back to school/the spirits align/ etc

thanks!

 

Re: cost/benefit analysis of therapy?

Posted by octopusprime on February 15, 2004, at 20:40:25

In reply to cost/benefit analysis of therapy?, posted by octopusprime on February 15, 2004, at 20:36:32

ok sorry, i'm a little drunk. here's what the second paragraph was supposed to say:

i am not depressed enough for medications right now, but i have been on the past. i need to broaden my social circles, but i always ask people to come to me then go away. i basically think i have some bad behaviour patterns that need breaking.

 

Re: cost/benefit analysis of therapy?

Posted by Racer on February 15, 2004, at 21:01:57

In reply to Re: cost/benefit analysis of therapy?, posted by octopusprime on February 15, 2004, at 20:40:25

Here's an analogy for you: say you've got a project going, and you start by saying, "OK, I know what I want to do, so I'll just start. I won't bother to make a plan, because it's so simple..." (Any programmers on this board are already laughing: that's what some of us like to call an Octopus project, because it always ends up with more arms than you intended.)

So, rather than starting blithely on your way, you sit down, maybe for big projects have a few blue sky sessions, maybe do some focus groups, whatever. You take the time up front to map out a plan, including all the steps you have to take to get there. In the end, you're more likely to end up with what you wanted, under budget, and ahead of schedule.

I think of therapy as the planning sessions. My therapist doesn't fix my life for me -- even though I wish she would, and she could, too, with her magic wand -- but she does help set my wheels on the track.

Yes, I think therapy is more beneficial than vacations, swimming club memberships, etc. The living situation? That's always harder, which I can say having lived in Oakland, CA -- in an area the cops wouldn't live in. I can't answer that one for you, but I will give you a tip for break-ins: best defensive weapon you can have in the house is a good fire extinguisher. If someone breaks in while you're out, that someone might take a gun, but not a fire extinguisher. You won't hesitate to use a fire extinguisher to douse an intruder as you might with a gun or a baseball bat. And believe me, hit someone in the face with a blast of the oxygen-sucking chemicals in a fire extinguisher? He'll stop -- at least long enough.

Good luck with your decision.

 

Re: cost/benefit analysis of therapy?

Posted by pegasus on February 16, 2004, at 1:48:31

In reply to cost/benefit analysis of therapy?, posted by octopusprime on February 15, 2004, at 20:36:32

Well, I think the cost/benefit analysis will always depend to a certain extent on your finances and your particular issues. It sounds like you don't have a ton of disposable income to throw around. And therapy is expensive. But it's good that you have at least some insurance coverage. And it sounds like the issues you are struggling with are those that can be helped quite a bit by therapy.

My own personal experience has been that therapy is worth more than almost anything else I can think of. I've changed so much because of the work I've done in therapy. My life feels like an entirely different place than it used to. Much much happier and more relaxed, and . . . free. So, what is that worth to you?

Of course, I should put in the caveats: I'm not really hurting for money at the moment. My main mental health issues are SI, depression and anxiety which are relatively easy to treat. I've responded extremely well to medications since I started therapy. Etc. So maybe therapy has worked better for me than it might for other people. But I'd pay just about my last dime for the type of changes I've seen from therapy.

- p

 

Re: cost/benefit analysis of therapy?

Posted by Medusa on February 16, 2004, at 5:48:48

In reply to Re: cost/benefit analysis of therapy?, posted by pegasus on February 16, 2004, at 1:48:31

> Well, I think the cost/benefit analysis will always depend to a certain extent on your finances and your particular issues.
>

AND on the therapist and the approach.

I've been to therapists where it was really clear that I would benefit by spending the money in another way. One I quit seeing when I realized the same amount of money could get me out of the city every weekend, and +that+ felt better and had a more positive effect on my work-week.

Right now I'm in therapy that costs a lot (out of pocket) and it's making profound changes, as P describes. I've been around, to lots of different therapists, and I know I wouldn't be getting these results from psychotherapy. In the long run, I'm convinced that the changes going on now will save and earn me far more money than I'm paying out.

While you're shopping around for and interviewing therapists, be sure to include a couple of short-term / solution-oriented systems ones in the mix. Talk therapy /analysis can be fascinating, but if you're looking for the biggest bang for your buck, it might not be the best option.

 

revised advice on the matter

Posted by Racer on February 16, 2004, at 11:21:16

In reply to Re: cost/benefit analysis of therapy?, posted by Medusa on February 16, 2004, at 5:48:48

Pegasus is right, when you don't have a lot of discretionary income, it is very hard to decide to devote a potentially large fraction of that to therapy, especially when you have other uses for that money. You say that your insurance pays $500 for therapy in one year? How about looking for a short term, goal oriented therapy model that will allow you to put together a detailed plan of what you can do for yourself to improve your situation while you're working on improving your financial situation?

That's a compromise, since there are often issues involved in this sort of situation that really do require more than a brief series of sessions. On the other hand, having a reasonable plan, one which has been worked out between you and a therapist who can act as a guide to what makes a plan reasonable, might be the best for your current situation.

That said, if you're thinking about going back to school, and from other things you've said, I'm betting you're on the younger side. If that's true, my heartfelt advice is this: get the therapy now, no matter what the cost, and avoid all the pain down the line. At the end of the day, I really and truly believe that working out the issues in the first place saves more than just money in the long run.

OK, so why do I feel as if I can give advice on this matter? Because I'm not on the younger side anymore. I was in therapy with a wonderful therapist for several years in my early twenties, and we did some good work together. The problem is, we didn't do all the work I needed to do, and the result is another twenty years of downwardly progressing trouble and strife and anguish. The depression has become so much worse, and it's exacerbated by the thought that I missed the opportunity to avoid it by finishing what we'd started twenty years ago.

So, learn something from my unfortunate mistake, if you will. Therapy is a wonderful tool, and, if it's available to you, it's worth the costs.

Ooooh! I even get to make an analogy! Yippee! It's like a can opener! If you have a can, and don't have a can opener, you can still find a way to get at the contents of the can. Screwdrivers, utility knives, chisels, etc, all those will allow you to access the contents, although it's much easier and less damaging to use a can opener. Therapy is a psychological tool, the way a can opener is a practical tool. So, rather than trying to open the can of your psyche with a chisel, why not try using a tool that's built specifically for that purpose?

And, last thought, I promise: all of my advice is based on the premise that you find a therapist who's right for you. If you find yourself seeing a therapist who just doesn't click, it probably won't work. That doesn't mean you have to stick with a bad therapist, or give up. If one approach or one individual doesn't work, you have the power to switch to someone else. (When I found my Good Therapist twenty years ago, I went to "interview sessions" with about a dozen therapists. Some, I walked out after ten minutes, with a "sorry, you're very nice, but I just don't think it'll work out." Paid them full session fees, of course. Others, those I wasn't sure of, I went to see a couple of times, still letting them know up front that they were still interviewing and I wasn't yet committed. In a very short time, I knew which one would be the best fit for me. It was an expensive (no insurance) and time consuming process, but I did end up with not only the therapist who worked so well with me, but also with the knowledge that she was the best suited for me out of a large selection of possibilities. That knowledge was -- excuse the buzzword -- empowering for me, and very valuable.)

Good luck, whatever you decide.

 

Re: cost/benefit analysis of therapy?

Posted by jane d on February 16, 2004, at 19:17:34

In reply to Re: cost/benefit analysis of therapy?, posted by pegasus on February 16, 2004, at 1:48:31

I've been thinking about this question myself recently. I'm watching my insurance run out and once it does I will need to decide if there is any way I can pay for therapy myself and then, if I can, is it worth it?

I think theres been some very good advice given here including looking for short term results but most people seem to be pretty strongly pro therapy. I probably should add here that the right therapy for me years ago would have been priceless for who I was at that time. Now I'm less sure.

In my area the cost of therapy is about the same as 2 meals out if that's something you do. Definately worth that. But it's also equal to more than a car payment, over half of the rent on a cheap apartment, much more than my grocery bills, and about equal to the amount all the financial advisors say I absolutely must put away to make sure I have enough money to retire or handle emergencies.

When I started therapy it was an easy decision. Without it I don't think I would have been able to hold a job to retire from. Now I'm trying to cram all the "necessary" stuff in before the insurance runs out and I'm not sure I can. And, this same therapy done a decade ago might mean I wasn't in this lousy financial position at all and I would be balancing therapy against the cost of a couple of meals out. But I also think that for some people it does make more sense to invest your money in a swim membership, a vacation, school, or a savings account. The trick is in figuring out which group you're in.

One thing to consider is will you/can you actually make those other changes on your own? Will you move, go back to school, go to the gym, take a vacation? Or have you been sitting around for years saying - "my life would be better if only I did that" and never knowing why you never manage to do it? Or, have you been doing this for years, moving, taking vacations, and finding out things never get better after all? That one's hard to see for yourself because each time you find your situation making you miserable will be a little different from the time before but it's a good reason to consider therapy.

I wish I could say "Of course. Try therapy. What do you have to lose?" but the cost is high enough that you will be losing something. And the more it's costing the more you need to gain to make it worthwhile.

Jane

 

Re: revised advice on the matter Racer

Posted by octopusprime on February 16, 2004, at 20:19:03

In reply to revised advice on the matter, posted by Racer on February 16, 2004, at 11:21:16

> Pegasus is right, when you don't have a lot of discretionary income, it is very hard to decide to devote a potentially large fraction of that to therapy, especially when you have other uses for that money. You say that your insurance pays $500 for therapy in one year? How about looking for a short term, goal oriented therapy model that will allow you to put together a detailed plan of what you can do for yourself to improve your situation while you're working on improving your financial situation?

this is exactly what i am interested in. my income is middle class, but i am paying back student loans and i manage money poorly. i never seem to have an extra few thousand dollars just lying around when i need it, i have to save. my financial situation will improve significantly in about a year (when the worst of the debt is paid off), but i really could use some therapy now.

but i could totally understand how therapy could take a while in my case. i've been the way i am since i was a kid. there are no abuse or trauma things here, just "normal" run-of-the-mill dysfunction.

> OK, so why do I feel as if I can give advice on this matter? Because I'm not on the younger side anymore. I was in therapy with a wonderful therapist for several years in my early twenties, and we did some good work together. The problem is, we didn't do all the work I needed to do, and the result is another twenty years of downwardly progressing trouble and strife and anguish. The depression has become so much worse, and it's exacerbated by the thought that I missed the opportunity to avoid it by finishing what we'd started twenty years ago.

Racer, i very much appreciate you sharing your experience. i am *very* concerned about me getting worse unchecked. the process you described finding a therapist certainly does sound expensive, but what's the price of my sanity? i'll meditate on this some more, thanks ...

 

Re: cost/benefit analysis of therapy? pegasus

Posted by octopusprime on February 16, 2004, at 20:26:05

In reply to Re: cost/benefit analysis of therapy?, posted by pegasus on February 16, 2004, at 1:48:31


Pegasus, happier and more relaxed is exactly what i'm after. but i'm not sure the meds are the right thing to do ... while i have struggled on and on with depression and anxiety, i don't show the classic major symptoms right now. i sleep and eat well. i can concentrate well enough to read books and participate at work (most of the time). i'm totally in the neighbourhood of functional, but deep down i know that something ain't right.

if you don't mind me asking, is it the talk that is helping, or the meds? (i know the relief of getting the right med at the right time, but i don't think now is the time for meds for me.) it's so hard to sort out the cause/effect relationships here!

thanks.

> Well, I think the cost/benefit analysis will always depend to a certain extent on your finances and your particular issues. It sounds like you don't have a ton of disposable income to throw around. And therapy is expensive. But it's good that you have at least some insurance coverage. And it sounds like the issues you are struggling with are those that can be helped quite a bit by therapy.
>
> My own personal experience has been that therapy is worth more than almost anything else I can think of. I've changed so much because of the work I've done in therapy. My life feels like an entirely different place than it used to. Much much happier and more relaxed, and . . . free. So, what is that worth to you?
>
> Of course, I should put in the caveats: I'm not really hurting for money at the moment. My main mental health issues are SI, depression and anxiety which are relatively easy to treat. I've responded extremely well to medications since I started therapy. Etc. So maybe therapy has worked better for me than it might for other people. But I'd pay just about my last dime for the type of changes I've seen from therapy.
>
> - p

 

Re: cost/benefit analysis of therapy?

Posted by pegasus on February 16, 2004, at 23:15:51

In reply to Re: cost/benefit analysis of therapy? pegasus, posted by octopusprime on February 16, 2004, at 20:26:05

Well, I'd have to say it's both. I did therapy for a while without taking any meds, and therapy definitely helped on it's own. Even my husband commented on it. And then when I started taking meds on top of that, my whole life turned around.

I understand about not wanting to take meds - I felt that same way. But boy am I glad I changed my mind. I hope to one day do all this without the meds, but for now, I'm just thrilled to be really happy and relaxed for the first time in my life. I think it's helping my therapy too. I don't get as tied up in knots on therapy days, and I don't have any T days where I can't muster the will to speak. That used to happen all the time. Now it feels like every therapy session is productive. So, that's something to consider, too, when trying to figure how to get your money's worth.

Good luck! I hope you are able to make a decision that really helps you.

- p

 

Re: cost/benefit analysis of therapy? jane d

Posted by octopusprime on February 17, 2004, at 1:12:15

In reply to Re: cost/benefit analysis of therapy?, posted by jane d on February 16, 2004, at 19:17:34

jane d - your post is very insightful. i know that therapy is not strictly necessary for me right now. i'll keep my job and keep on truckin without it, but i know i'm less than 100% and i could use some guidance.

i just created a savings account so i will use it. i can't keep money in my chequing account. i think it has a leak :). i did actually apply to school, and arrange transcript sending and things. it's not like it's just talk. but change is moving along at a creeping pace, and i feel like i'm just watching the pages on the calendar turn. so now i just wait. and wait and wait and wait.

but i've been through this before - since 1996 i've moved 17 times (some places were repeats) and wherever i go, there i am. i think i was happier in school, but then i did have some crushing depressions and some stunningly bad behaviour there, so maybe i wasn't. who knows?

i am young, i'm hoping for the wisdom of maturity to come to me. would the therapy really help mature me and straighten out some behaviour that i bring on myself? or would i mature faster if i travelled or did something else?

or maybe it's just the weather? i always seem to do better in the spring/summer. therapy won't bring the sun out any faster.

so much to think about.

> I've been thinking about this question myself recently. I'm watching my insurance run out and once it does I will need to decide if there is any way I can pay for therapy myself and then, if I can, is it worth it?
>
> I think theres been some very good advice given here including looking for short term results but most people seem to be pretty strongly pro therapy. I probably should add here that the right therapy for me years ago would have been priceless for who I was at that time. Now I'm less sure.
>
> In my area the cost of therapy is about the same as 2 meals out if that's something you do. Definately worth that. But it's also equal to more than a car payment, over half of the rent on a cheap apartment, much more than my grocery bills, and about equal to the amount all the financial advisors say I absolutely must put away to make sure I have enough money to retire or handle emergencies.
>
> When I started therapy it was an easy decision. Without it I don't think I would have been able to hold a job to retire from. Now I'm trying to cram all the "necessary" stuff in before the insurance runs out and I'm not sure I can. And, this same therapy done a decade ago might mean I wasn't in this lousy financial position at all and I would be balancing therapy against the cost of a couple of meals out. But I also think that for some people it does make more sense to invest your money in a swim membership, a vacation, school, or a savings account. The trick is in figuring out which group you're in.
>
> One thing to consider is will you/can you actually make those other changes on your own? Will you move, go back to school, go to the gym, take a vacation? Or have you been sitting around for years saying - "my life would be better if only I did that" and never knowing why you never manage to do it? Or, have you been doing this for years, moving, taking vacations, and finding out things never get better after all? That one's hard to see for yourself because each time you find your situation making you miserable will be a little different from the time before but it's a good reason to consider therapy.
>
> I wish I could say "Of course. Try therapy. What do you have to lose?" but the cost is high enough that you will be losing something. And the more it's costing the more you need to gain to make it worthwhile.
>
> Jane

 

Re: cost/benefit analysis of therapy?

Posted by jdgjdg on February 17, 2004, at 22:02:55

In reply to cost/benefit analysis of therapy?, posted by octopusprime on February 15, 2004, at 20:36:32

If you are not depressed enough for medications, therapy alone would probably benefit you greatly. Insurance companies are a pain when it comes to mental health coverage. I recently maxed out my lifetime mental health coverage. I understand about out of pocket therapy. Keep in mind, depending on who you see and your geographical location, the cost can be roughly $60-$200+ for a 50 minute session. I pay $90 for a session. Typically a LCSW(social worker) will charge closer to the lower end. I find them more helpful anyway. If you do end up needing medications, a psychiatrist(md) is much more expensive. Mine charges about $500 hourly. Generally, a therapist will want to see you weekly for a while. Eventually, you taper off to less frequent visits.

I don't know if you are supposed to name any authors on this website, but there is a great book called "The Depression Workbook" The author is Mary Ellen Copeland, M.S., M.A. I have found this book to be an excellent addition to therapy. It gives you a lot of the same techniques a therapist would use. It might be worth the $20 or so before investing the $ in a therapist. If your situation is bad, or worsening. I suggest you spend the money and see someone asap. It's a small price to pay for your mental health. If you get more depressed, you can end up missing work, getting sick more often, etc. Good luck. jdgjdg

 

Re: cost/benefit analysis of therapy? octopusprime

Posted by jane d on February 18, 2004, at 22:43:42

In reply to Re: cost/benefit analysis of therapy? jane d, posted by octopusprime on February 17, 2004, at 1:12:15

OctopusP,

You sound a bit like me and I do think I would have benefited from therapy earlier. If you can do it without going totally broke it miight be a good investment. But make sure it's with the right person. If you don't get a very positive feeling about them from the first visit it's not going to get better later. And if it were me (seeking therapy when I was younger with what I knew now) I think I'd try to make it clear that I needed something fairly short term, focused on what I wanted to be different in my current life, because I wanted time and money left over to take that trip to mexico. Good luck with whatever you decide on this. Your plans sound great.

Jane

 

Re: double double quotes jdgjdg

Posted by Dr. Bob on February 18, 2004, at 23:18:50

In reply to Re: cost/benefit analysis of therapy?, posted by jdgjdg on February 17, 2004, at 22:02:55

> there is a great book called "The Depression Workbook" The author is Mary Ellen Copeland, M.S., M.A.

I'd just like to plug the double double quotes feature at this site:

http://www.dr-bob.org/babble/faq.html#amazon

The first time anyone refers to a book without using this option, I post this to try to make sure he or she at least knows about it. It's just an option, though, and doesn't *have* to be used. If people *choose* not to use it, I'd be interested why not, but I'd like that redirected to Psycho-Babble Administration:

http://www.dr-bob.org/babble/admin/20020918/msgs/7717.html

Thanks!

Bob


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