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How To Get Therapy When You Can’t Leave The House

Clare Schneider/NPR

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With the U.S. at the epicenter of a global pandemic, therapy sessions (or goals to start them) might be taking a back seat. But between telecommutinghome schoolingunemployment woestoilet paper shortages and an ever-present sense of doom, mental health care is more important than ever.

A new poll by the Kaiser Family Foundation found that 45% of adults say the pandemic has affected their mental health. But as states battle the spread of the coronavirus with stay-at-home orders, people can’t attend their regular therapy sessions.

Good news: There are ways to start or continue therapy right where you are. Some are even free.

Shereen Marisol Meraji, Life Kit guest host and co-host of NPR’s Code Switch, talked to NPR’s Lauren Hodges about some at-home therapy options.

This conversation has been edited for length and clarity.

For people who aren’t in therapy, why might they want to consider it now — especially when we can’t walk into a therapist’s office anytime soon?

Well, because this is a really stressful time! The news is scary and depressing, but we kind of have to stay on top of it, keep watching, keep reading to get the latest guidance from the government: How long are schools closed? Are we allowed outside? Which businesses are open?

We’re also home-schooling kids, dealing with unemployment or less income, worried about sick friends and relatives. It’s a lot. And it can be really helpful to talk to a third party, let off some steam and get a little advice to manage it.

What about cost? People are worried about money right now. Is therapy covered by insurance?

If you have insurance, it depends on the plan. Check your policy. Make sure it’s covered. And your insurance company can also give you a list of options and names so you don’t waste your time talking to people who don’t take your insurance.

If you already have a therapist, just ask them how they can continue your sessions and if anything will change with their copays. Since this is such an unprecedented situation, they might still be figuring it out. That also could mean they’re flexible and open to suggestions that could work for you.

What if you don’t have insurance?

I know a lot of people are dealing with losing their insurance under their former employers. You do have options. You can ask for the sliding-scale rate, meaning the therapist works with you based on what you can afford. There’s also this website called Open Path Collective, where therapists offer sessions for between $30 and $60. That’s a pretty typical copay for insured patients. Call some of those people, ask how they’re holding sessions right now and what they’re doing to go online.

And it’s worth mentioning during this national emergency, Medicare coverage will now include three types of virtual services: telehealth visits, virtual check-ins and e-visits. So if you have Medicare, a good way to use this benefit is to search for providers that accept it. I searched on Psychology Today, filtered for Medicare in the insurance option and found providers that take it.

If you already have a therapist, how easy is it to make this switch to online or teletherapy?

I talked to Seth Gillihan, a clinical psychologist in Philadelphia. He has switched all of his patient sessions online. He said it might feel weird for the first few minutes of that first video chat but that you’ll hardly notice it after a while: “What people seem to find is that you forget about the medium relatively quickly. I think about it kind of like watching a movie. At some point you stop being aware of the fact that you’re staring at a screen, and you get really immersed in the story.”

So get set up on your phone or laptop, make sure you’ve downloaded the right app, find a comfortable, private spot away from your family or roommates. Go into a closet if you have to! Make sure your Wi-Fi is good. And just like regular therapy sessions, you can write down some stuff you want to talk about beforehand. Or you could just wing it and see what comes up for you.

One caveat I do want to mention: Make sure that your therapist is licensed to practice in your state where you physically are. That’s really important. Otherwise, the therapist can’t legally treat you.

Is it still going to be effective?

I think it’s pretty helpful to have that neutral person to process our frustrations and confusions with, no matter how we’re talking to them. It can be tempting to talk to friends and family members about our problems because they’re right there. But over time, that can be emotionally draining and taxing on our relationships. Therapists are trained professionals. They can give us advice, help us gain perspective. And they’re bound by the law to keep things confidential. So that’s a big plus with them.

Are there other options?

There are apps specifically designed for online therapy that use text and video messaging. They’ve been around for a couple years. So they were ahead of this whole curve. BetterHelpTalkspace and Larkr are a few that come to mind. (We should mention that BetterHelp is an NPR sponsor.)

And there are a lot of support groups that have moved online right now. One of the more well-known ones is Alcoholics Anonymous. They’ve been using Zoom, Google Hangout[s] and conference calls to keep their members coming to meetings.

I went on Psychology Today and looked up local groups that meet all these different needs — grief counseling, anger management, addictions, whatever the issue is. And they all have group managers you can reach out to. Ask them how they’re arranging these digital meetups. The best thing is a lot of these groups are free or low cost.

I also want to put out some free 24-hour hotlines for people who might not have Wi-Fi or who are just really struggling and really need to talk to someone right now, maybe on off hours or just don’t have any money to spend on therapy or mental health counseling. The Department of Health and Human Services has the National Helpline. That’s 1-800-662-4357. There’s a group called Integral Care. They run a hotline with 15 languages. They’re at 512-472-HELP.

And because this can feel like a really hopeless time for some people, I want to share the National Suicide Prevention Lifeline, which is 1-800-273-8255. Please call if you’re thinking of hurting yourself. There is definitely help waiting for you, no matter your situation.

Let’s do a quick recap. What are the most important things to know about getting therapy right now?

It can feel really tempting to put your mental health on the back burner right now because there’s so much happening. But you might need help more than ever. And it’s not great to just constantly download that onto your friends and family because they’re going through the same thing too. Therapists are trained professionals. They have confidentiality in mind. If you have insurance, you can ask your insurance company to help you find a provider or a method. And if you don’t have insurance, there are lots of free options and low-cost options for you out there.


Do you have tips on navigating life in the time of the coronavirus? From social distancing to home schooling your kids, we’d love to hear from you. Leave us a voicemail at 202-216-9823, or email us at LifeKit@npr.org. Your tip could appear in an upcoming episode.

If you want more Life Kitsubscribe to our newsletter.

The audio portion of this story was produced by Clare Schneider.


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