Ask a Therapist: Alternatives to Therapy During Tough Times

by Liz Covey, LMHC

Question: I've been trying to get in to see a therapist for months now, and I can't even get a call back much less find someone who takes my insurance. What else can I do if I can't find a therapist with an opening soon? I'm afraid I will get more depressed as time goes on without some help. But I'm also wondering if I should think outside the box for other options right now, since nothing is working out. Any suggestions you have would be appreciated.

Dear Reader,

Ours are not ordinary times.

In ordinary times, there are many therapists with openings, some of whom you may be unable to afford but many who take insurance. Or who have low-fee slots. Or who can refer you to organizations that can help you out.

I'm sorry to say it, Reader, but these days, that playbook is out the window. Therapists and social service organizations are full to brimming with existing clients who, were these ordinary times, would have wrapped up and moved on some time ago but instead linger due to new and pressing concerns that arose in the last year. These same clinicians are also getting calls from former clients whose symptoms have worsened due to isolation, grief, job loss, or stress at home in the pressure cooker environment that is quarantine.

As your question indicates, these are extraordinary times. The kind of times that call for "outside the box" thinking as you say. We are compelled under these circumstances to come up with innovative approaches — entirely new ways to meet our needs and care for one another. Just as the groundbreaking concept of the blood bank was conceived by an Army captain on the battlefield of the Western Front during World War I, extreme conditions cause us to have to think bigger — and more importantly — better. So it is today with mental health care.

Where traditional therapy may fail us — either by lack of desirability, availability, or accessibility — let's pick up a discussion of what other avenues there are to address our social and emotional needs, a thing that is more critical now than in ordinary times since so many people are suffering. Each of these suggestions offers help from people who have some training in compassionate care and who can provide it in ways that are more accessible and in some cases, immediate.

Reach Out to the Crisis Text Line: Text 741741

The Crisis Line concept has had a millennial tweak, and it's a good one. Whereas talking to someone on the phone used to be a main mode of communication, for many today it no longer is. This crisis service is enabled by texting 741741 to begin a discussion or reach out for help, and it is a more approachable way for many people during a time of hardship. Some say the digital communication also feels more anonymous, so they feel free to type things they might have a hard time vocalizing to a live person — a stranger — on the line.

Virtual Therapeutics — Listening Line, Low-Cost Alternatives, & Apps

In keeping with the critique that therapy is too expensive or lacks flexibility or variety, organizations have formed to offer alternative support networks — and at a lower cost (but with much less training on the part of the helper, to be clear). One example is the listening line, a service from A Sacred Passing, described on their website as "a place for folx to call and talk where they will be met with a non-medical, trained human who will hold space and witness the words of the caller." They too offer a text service, which you can access by texting PEARL to 206-278-2553.

Another alternative to the traditional therapy model is offered by 7 Cups — an organization whose website boasts that they are the "world's largest emotional support system" and offers "caring listeners" for free. They provide online volunteer support, peer-group chat rooms, and also their version of low-cost therapy via messaging (not formal sessions) with trained and licensed professionals. Their site features written resources as well, with articles covering a wide range of topics that someone in a tough spot might find useful, such as breakups, loneliness, anxiety, and sleeping well.

Other ideas from the digital space are social media interest groups, apps, or mental-health-focused accounts, which are particularly relevant for younger or tech-oriented folks who are more likely to already spend a lot of time on relevant platforms. Some popular ones include Woebot for interactive Cognitive Behavioral Therapy guidance, Shine for BIPOC support, and the Instagram account @millenial.therapist.

Work With a Coach

One of the biggest disruptions in the helping professions over the last decade has been the emergence of the Coach (also known as Life Coach). What is the difference, you might ask, between coaching and therapy? A coaching certification program called JRNI puts it this way: "Unlike counseling or therapy, coaching assumes a baseline level of emotional wellness and focuses on the present and on co-creating the future."

In the words of Ellen Forney, the well-known local cartoonist who has established a mental health coaching practice, "therapy is a deep dive, and coaching targets skills." Forney wrote the book Rock Steady: Brilliant Advice from My Bipolar Life, and her work, mostly with folks with mood disorders like Bipolar, centers on the themes of that book, which is a useful workbook for living (and thriving) with a mood disorder based on Forney's own personal experiences as someone who does. When I asked Forney how she would distinguish coaching from therapy, especially since her focus area is mental health, she told me that "the work that therapists and psychiatrists do is the bricks of treatment, and what [coaching does] is the masonry, which keeps the bricks together." She tells me that her work focuses on helping people to develop and track specific skills and strategies for long-term stability.

Another coach I talked to, Chelsea Farmer, describes coaching as "a creative partnership." She says it offers something that "provides you with unconditional support around decision making, by helping you to harness your goals in the spirit of living the life you want to live." She emphasizes how the pandemic has shaken the foundation of many of life's structures, whether in work, childcare, or relationships, and that we are invited in this time to consider which of those we want to keep and which we might reconsider when we make our eventual return to something like normal. "Coaching can really help you figure that out," says Farmer.

Coaches often take a specific focus in their practice from areas they know well based on their own personal and professional experience. For Forney, this is her own journey as a person and accomplished artist living with Bipolar disorder. Farmer had a long career as a restaurateur and thus primarily works with those in the service industries or who are transitioning into other fields from this sector.

Fees for coaching, while they may not be significantly lower than therapy, do tend to be more short-term focused and distinctly goal-directed. Forney, for example, structures her work in four-week segments, meeting once weekly with her clients. Farmer is offering free initial sessions for an introduction to coaching work to new clients, a practice she says is common in the field.

Talk to a Religious Leader in Your Community

An often overlooked resource in mental health these days is the one that might be the most accessible and available: clergy in welcoming communities. The very skills that one seeks in finding a counselor could be found by those trained in their religious tradition to serve their community, which is a mandate of every mainline religious institution. The pastor, priest, imam, or rabbi — or their staff — are equipped to listen, to give care and support, or to direct you to resources in their community where you might find help. Though not everyone's cup of tea, open and affirming congregations can be immediate resources for those who are inclined to find help in a spiritual organization. Some keywords to look for on religious websites are "pastoral care," "outreach," or "service work."

So whether it's a text, a download, or an outreach, remember that there are some flexible options out there for meeting your needs today with volunteers, mentors, peers, and professionals who are there for you. These extraordinary times are not only challenging, they also invite us to risk trying new things. Such outside-the-box measures are worth a try, if for no other reason than necessity.

Hang in there, Reader. It looks like we are (slowly) rounding the bend on this thing.

Featured image: "Walking The Ledge Part IV" by StarMama (under CC BY 2.0 license).