I came across this interesting (and truthful) article about therapy and therapists. I agree with it and thought it’s worth sharing. In a nutshell, the person on the couch isn’t the only one with problems. Your therapist will never tell you:

1.“Your childhood was bad? Wait till you see your bill.”

Among those who seek psychological help in the U.S., 40% undergo therapy with a social worker, psychiatrist or psychologist. All that talk doesn’t come cheap. There is no set charge, but therapists say rates can vary from $75 to $250 an hour. In fact, Americans spend around $10 billion a year on all kinds of psychotherapy — from relationship counseling to cognitive-behavioral therapy.

One therapist’s fees for different clients can also vary wildly. When shopping around for a therapist, there’s nothing wrong with negotiating. Many clinicians offer a sliding scale for those with limited funds. Sometimes, therapists dedicate a certain number of slots per week to low-income clients and there are counseling organizations that offer pro bono services to veterans and victims of natural disasters.

2. “I may not have any training.”

While qualified psychologists, psychiatrists and licensed clinical social workers all require years of training, there’s very little stopping anyone from taking a night course in astrology or philosophy and calling himself a therapist. Therapy is an umbrella term that covers many professions and problems. It’s more of a descriptive term than a professional one. In fact, anyone could advertise as a “therapist,” put it on a business card, set up a website and wait for people to call. Seek mental health services from someone licensed to practice by the particular state in which you reside.

3. “Will you ever stop talking?”

While therapists are paid to listen to a patient for about 45 to 60 minutes at a time, it’s not always easy, especially since people in therapy can get so wound up in the minutiae of their day that they ramble on instead of tackling real issues. Very often therapists are bored to death, tempted to take a nap, day dream, think about other “more interesting” issues and simply don’t pay attention to their patients.

4.“I need you more than you need me.”

After a few sessions, therapists often recommend additional treatment. But clients should watch for signs when it’s time to move on. If you feel like your therapist needs you financially — for instance, if he or she is pushing for more sessions even though you feel better — get another therapist.

Although the majority of therapists go into the profession because they genuinely want to help others, a weak economy can make it difficult for a therapist to let a client go. Therapists who are struggling to keep their practice afloat — or who don’t have a potential client to fill the available time slot — might be particularly inclined to try to squeeze extra money out of their clients.

5. “Maybe I’m the one who needs therapy.”

There’s no shortage of patients who complain that their therapist has as many issues as they do. When it’s time to say goodbye to a client, for instance, some therapists themselves can exhibit signs of co-dependency, anger, frustration, anxiety and fear of separation. Watch out for the troubled therapist.

6.“A morning run might work just as well.”

A little exercise goes a long way. In fact, the effect of regular exercise on mild to moderate forms of depression is similar to the effect of cognitive behavioral therapy.

There’s little consensus on how or why exercise helps. The public health recommendation for daily exercise — 75 minutes a week of vigorous exercise or 150 minutes of moderate activity — should be more widely prescribed by mental-health care providers, especially as studies show that 25% to 40% of Americans don’t exercise at all.

7.“I don’t have to practice what I preach.”

Some university programs and state licensing authorities require mental-health professionals to undergo therapy, but it isn’t universal. Utah and California are among several states that don’t require therapists to receive psychotherapy before they practice. It’s crucial for a therapist to lie on the proverbial couch in order to understand what the client is going through.

Plus, when a therapist needs mental-health care, seeking treatment from another therapist is considered preferable to self-treatment.

8. “Your secret is (sort of) safe with me.”

Most patients assume their sessions are confidential, but there are many instances where these sessions could be made public. The records of therapy sessions could become part of a divorce proceeding or employment dispute if a client alleges emotional or mental damages on the part of a spouse or co-worker. Or they could be disclosed if there is a legal dispute between the therapist and the client. In the United States, laws also vary by state.

9.“I’ll be there for you, but your insurance might not.”

Health insurance companies can place limits on how many therapy sessions they’ll pay for, and they may be keen to wrap up the sessions before the client is ready. Relying on insurance to pay for therapy isn’t always in a person’s best interest.

The insurance company will make their determination regardless of what you, or your therapist, feels is appropriate. If a client disagrees with an insurance company’s decision not to provide additional treatments, he or she can appeal. And people can continue treatment by paying out-of-pocket.

Handling insurance is currently still cumbersome for practices — and that the best therapists are increasingly the ones who won’t even accept insurance. Insurance has become so difficult and expensive to work with. While there some very good therapists that work with insurance, if therapists can afford to practice without having to accept insurance, they often will.

10. “Time’s up. Here’s a pill.”

There has been surge in the use of medication to treat mental health problems, studies show. In 2005, a mere 11% of psychiatrists — who, unlike social workers and some other kinds of therapists, are licensed to prescribe drugs — used talk therapy with all of their clients, down from 19% in 1996, according to a 2008 study in the medical journal of the American Medical Association.

Similarly, the proportion of patients visiting psychiatrists for talk therapy fell to 29% from 44% in the same period. Psychiatrists get reimbursed by insurance companies at a lower rate for a 45-minute psychotherapy session than for a 15-minute medication visit, the study found.

As talk time went down, pill-popping went up — a trend which some mental health professionals find troubling. The use of psychiatric drugs among adults increased by 22% from 2001 to 2010, and one in five Americans now take such meds. And it’s not just adults who are increasingly being prescribed drugs for mental health. Some 6.4 million children ages 4 to 17 have received a medical diagnosis of attention deficit hyperactivity disorder, an increase of over 40% in the past decade.

Therapy or no therapy, but there are many paths to having a more fulfilling and less troubled life, and psychotherapy is just one of those. Like with toothpaste, people have a choice.

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