Therapy for Residents?

[whiskey]

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Does anyone know how much once weekly dynamic psychotherapy costs in NYC?

What "sliding-scale" rate would be appropriate for a resident/trainee?

Thanks in advance for any thoughts.

 

[whopper]

It may depend on what the program offers. Asking the Chief would be a good first step since the Chief if worth his/her rank is supposed to respect your need for privacy in this matter, and if he/she doesn't know the answer will know who to ask. My own current place of employment offers therapy at a cost of only $10 per session, the rest is covered by the state. I remember my residency program had something in place to get therapy for residents if need be for cheap. If a resident does get therapy, try to make sure it is not done by someone within your program, or even in the same hospital. That would indeed be crossing some boundaries.

 

[whiskey]

Thanks, Whopper, for your reply.

I'd be interested to hear anyone else's experiences, especially with regard to negotiating a fee for psychotherapy as a resident.

 

[sunlioness]

Does anyone know how much once weekly dynamic psychotherapy costs in NYC?

What "sliding-scale" rate would be appropriate for a resident/trainee?

Thanks in advance for any thoughts.

Don't you have mental health coverage with your insurance? Then the cost of a therapy session would be the cost of a co-pay. That's what I did.

I honestly don't know that a resident would qualify for a sliding scale fee. Compared to attendings, residents don't make that much. And it certainly doesn't seem like much when one actually calculates the hourly rate. But compared to a lot of Americans, the annual salary of a resident physician is pretty decent.

 

[masterofmonkeys]

are we talking 'resident in therapy' like a lot of programs encourage residents to go for regardless of psychopathology?

or 'i have mental health issues, I need to see someone'.

Because I thought that most programs that encourage the former have resident discounts and a few even offer it for free, and that at most of these programs your therapist will be on faculty?

 

[dianamd]

Does anyone know how much once weekly dynamic psychotherapy costs in NYC?

What "sliding-scale" rate would be appropriate for a resident/trainee?

Thanks in advance for any thoughts.

Assuming you mean psychiatrists who don't take insurance, it is very expensive on your own, north of $200 per session.

Some programs, such as Mount Sinai and Cornell, offer greatly discounted fees or give you a certain number of completely free sessions -- with therapists who otherwise don't take insurance.

Others might not give you that deal -- it's program-dependent.

You can always go through your health insurance and pay $12 or whatever copay per session. Or, as a resident told us at one school, you could moonlight in order to pay for your therapy. Sorry, that's too much for me!

Good luck 🙂

 

[tomato]

Residents in my program pay anywhere from $80 to $300 per session, according to what I've heard. Keep in mind that if a desirable psychotherapist is out of network, many insurance companies will still pay a portion of the cost if you submit bills to them after the fact (mine pays 50% on the first 60 sessions). On top of that my program pays for the first 10 sessions of the year. You could also funnel some of your meager residency salary into a flex savings account, making it pre-tax. Good luck!

 

[whiskey]

Thanks for the helpful replies.

Just to clarify, I'm specifically referring to out-of-network providers, which our insurance doesn't reimburse in any way. And my program doesn't offer any special deals, as far as I can tell.

Maybe "sliding-scale" is the wrong terminology; I don't mean to imply that residents are poor by national standards, just that $300+ full fees aren't generally feasible for trainees.

I actually spoke with an accountant who said that residents can claim an "unreimbursed business expense" and get back any amount in excess of 2% of their total salary, which, i reckon from the prices that others are quoting, would be quite sizable.

Wow... I am amazed by the huge range of fees that people are citing!

 

[whiskey]

are we talking 'resident in therapy' like a lot of programs encourage residents to go for regardless of psychopathology?

or 'i have mental health issues, I need to see someone'.

I guess the former, though this seems like a bit of a false dichotomy to me

 

[slope]

Hey whiskey!

I've been reading your posts on this thread and here is my 2c on being a resident who is in therapy (In my case it is a requirement not of my program, but of the Institute for Psychoanaysis). As you well mentioned, "resident in therapy" or "having your own mental health issues" is at the very least a dichotomy that is far from being useful. I cannot give you information about the psychotherapy community from NYC because I don't live there anymore. I live now in Chicago.

One of the things that really matter is who your therapist will be and how to choose your therapist. But that's a whole other topic in itself.

As far as its affordability is concerned, it is very true that most therapists practice (very) steep fees. What you can do once you contact a therapist is find out if he would accept insurance or not; and if yes, if he/she will give you some room for negotiating the fee. I don't know what kind of insurance you have, but many carriers will reimburse for some of it. (Find out from your insurance company not only how much they cover, but what exactly they cover; do they cover the average fee, based on the location of the provider, or the actual fee?). If you have a PPO, it might work easier for you than if you have a HMO. Another thing you might try is contact a psychotherapy institute (and you have quite a few in NYC) and request a list of their advanced candidates; you could go in therapy with an advanced candidate. Do not underestimate them just because their title is "advanced candidate" because to get there, you go through hell....more or less!

If you have any other questions or you need clarifications on the above, please let me know.

Good luck!

 

[sunlioness]

I was just going to say that I never heard of therapy being so expensive. But then I realized I live in Pittsburgh and you guys are talking NYC. I would imagine the cost of therapy reflects that as much as the cost of housing or anything else. Around here, most masters level therapists (LCSWs, LPCs and the like) seem to charge around $100/hour.

 

[Psychintern2006]

N Y U Institute of Psychoanalysis will be a great place to begin your search. I have heard they provide discounts for residents. Probably google the address etc.

 

[toby jones]

You could check out the psychoanalytic training institutes. I've heard that an analyst in training may well be prepared to negotiate an affordable fee - especially when the person is a student in a related field. Especially somewhere where there is a glut of analysts (like NY).

 

[masterofmonkeys]

As you well mentioned, "resident in therapy" or "having your own mental health issues" is at the very least a dichotomy that is far from being useful.

I do agree that it is something of a dichotomy. If someone had no psych issues they wouldn't benefit from therapy. Most people who voluntarily undergo it claim benefit from it.

What I was getting at was more of a GAF score/distress angle. For the former category, we are not talking about an immanent health NEED per se. I'm not sure whether you could get insurance to cover it (although an HSA would I'm sure). And I thought that in most places where resident-in-therapy is encouraged your therapist is often a faculty member at some level or another.

I'd rate my GAF score somewhere in the 90s, but I can readily identify Cognitive-behavioral and psychodynamic issues in myself. And I'm sure there are others I haven't personally identified. Which is one of the reasons I'm looking forward to therapy. I'd be hard-pressed to find anything in the DSM to diagnose myself with though.

 

[toby jones]

> If someone had no psych issues they wouldn't benefit from therapy. Most people who voluntarily undergo it claim benefit from it.

I guess that was what made me think about an analtytic training institute where the focus is on 'better achieving your potential' or 'self development' rather than 'fixing' a 'dysfunction'. Or at least where 'dysfunction' is used in the fairly innocuous Freudian sense of 'everybody is ****ed up'. I'd be personally interested to see what would happen if a bunch of health professional (who presumably aren't mentally ill) were required to do something like Linehan's DBT skills training. I'd be highly surprised if they didn't find some benefit to it (though presumably it wouldn't be expected to impact such things as inpatient days or suicidality). Everyone can benefit from talking to a caring other - can't they?

While the doors have been opened to related health professions in recent years it used to be the case that only MD's were able to apply to be analytic candidates at analytic training institutes. That means that seeing someone who is training as an analyst (and who needs to complete a number of analyses where suitable patients are hard to get) might well be a fairly cheap way of seeing someone highly qualified.

It is interesting that in order to train as an analyst you need to complete a course of analysis yourself. Personally, I think that that is a wonderful idea (how else are you going to be able to sort the transference from the counter-transference etc?) As such... That form of therapy (or a therapy that is at least influenced by that theory) could be a terrific form of therapy for a health professional (who is presumably capable and willing to engage in self reflection).