Dec 12, 2009

Group Therapy: Cost Effective, but is it Helpful?

As my loyal readers and those who peek at this blog on any given occasion know, I suffer from anxiety, depression and ADHD. That's not to say my life is miserable, but I've gotten myself into one of those ruts and decided to seek help. Due to refusing to go through insurance for mental health therapy (until a healthcare bill passes that does not allow denial of coverage due to pre-existing conditions), I have to be careful about my monthly costs to get help. Because it's all out of pocket. (*since I have a high-deductible HSA account the only real benefit of going through my insurance company would be to have the fee go towards my deductible. Group therapy isn't covered anyway, and mental health therapy for non serious conditions (ie ADHD, anxiety, minor depression) isn't covered much either.)

There's one doctor who is supposedly an expert in ADHD who, located nearby my work, charges $700 for the initial consultation. What? I know I live in a wealthy area but come on. That's absurd. I found a career counselor and therapist who offered a free consultation. She normally charges over $200 per hour but has package rates. Ultimately, though, I decided I need to see a psychiatrist first to find out if I need to be medicated. I kind of feel emotionally out of control. And while I had going the pill route, at this point I'm willing to try anything. The psychiatrist cost $280 for one appointment. A short, 20 minute follow-up appointment will be $150. She prescribed me Celexa (which I still need to get and find out how much that will cost me.)

But I know weekly or biweekly therapy would help greatly. And given my current state, weekly therapy would be best. I shopped around and tried to figure out the most cost-efficient option. That led me to group therapy. While the rates were $75 per session, I was quoted $50 per session to get started, with her hope that I'd also seek out individual therapy twice a month.

As the Wall Street Journal puts it, "Group Therapy Offers Savings in Numbers."

After two sessions of "process-based" group so far, I'm attempting to weigh the pros and cons of this treatment...

Pros:

- more affordable than individual therapy. $50 - $75 per 1 1/2 session.
- can afford to meet weekly, and its sometimes nice to just have that safe space that often.
- the value of your therapy doesn't depend soley on your therapist
- you get to find out what other people think about you and your actions
- other people are counting on you to show up so you go even if you don't feel like it
- you're required to pay for every session in a month even if you don't go, so you make an effort to go to every session.

Cons:
- even though the session is 1 1/2 hours long, it goes fast, and often isn't about you
- you're required to pay for every session even if you have to go out of town or get sick
- the benefit of the therapy depends on the dynamic of the group
- most people in group are also seeing individual therapists, it's hard when you're not
- the therapist has an odd role in trying to ask everyone how they're feeling at the moment, but holding back on actual counseling (that's for the individual sessions, which cost a lot more per person, after all.)
- while people are supposed to agree to at least 12 weeks when they sign up, people come and go. I can already tell the true value of the group comes from one that has been going a long time with the same people. Granted, bringing in someone new every once in a while and dealing with people leaving (abandonment) is theraputically good. However, too much of that and all you talk about is how you feel about people leaving and joining.

Have you ever had group therapy? What was your experience like?



2 comments:

sfordinarygirl said...

I was in individual therapy for 2 1/2 to 3 years with brief breaks in between. From the sound of your pros/cons list, group therapy doesn't sound like a bad choice. Studies have shown when you're in a group environment where people are sort of counting on you, your results are more effective.

Have you considered cognitive behavioral therapy or mindfulness-based meditation/therapy combos? I found the both of those combined in therapy changed my outlook, improve my perspective (much more positive) and gave me the tools I needed to combat those down swings. I know taking prescriptions is an individual choice and it works for some people but there are other alternatives. And the prescriptions can get pricey.

annieweiss said...

As a group & individual therapist in the Boston area for 19 years, I can attest to the profound effectiveness of group. "In individual therapy, people talk about their problems; in group, they have them." Reactions and patterns get "triggered" by the group interactions and can therefore be understood and resolved powerfully. Group members invariably deepen and improve their ability to have satisfying relationships. Though it is cost-effective, I in no way see Group as a lesser modality.
Annie Weiss, LICSW

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