Understanding Sliding Scale Therapy

We field a number of questions about sliding scale therapy in New York, and about what patients can expect when they come looking for some financial relief. Although each therapist and each individual case is different, there are some basic definitions that may help you in your search for an affordable option. This site includes a simple overview of low cost therapy, and includes this helpful passage that prescribes Step One in your search:

The first place to check is with your current therapist. Many, but not all, therapists offer a fee service schedule for cash-only clients that may “slide” – that is, the fee goes down based upon your income. If you’re making a middle-class salary, the discount offered by such sliding scales may not be much. But if you’re in the lower socio-economic class, this discounted fee schedule can cut a regular therapist’s fee in half or more.

We take pride in our commitment to community mental health, and that means searching tirelessly for ways to serve more people of different incomes and backgrounds whenever possible. Our sliding scale therapy options include experts across a number of fields, including LGBT therapy, depression therapy and many more.

If you’d like to apply for a round of therapy that falls within your means, please don’t hesitate to reach out to PPSC with any questions.

What to Expect from Low Cost Therapy

Finding good low-cost therapy is often more meaningful than simply nailing down a good price. For many people, sliding scale psychotherapy represents a lifeline. But it can also represent a potentially awkward topic undertaken with their therapist:

Gutheil and Gabbard write, "Money is a boundary in the sense of defining the business nature of the therapeutic relationship. This is not love; it's work" (1993, p. 192). Thus the fee and fee arrangement are important determinants of the nature of the therapeutic process and the boundary of the patient-therapist relationship.

Reaching out to experienced analytic therapists is the easiest way to avoid a protracted negotiation over price. Many of them will have worked out similar arrangements in the past, and become adept at sidestepping some of the difficult and embarrassing parts of this conversation. You may even come away feeling better understood and supported than you did going in.

Working out a good system to evaluate and agree on pricing is a tricky process, but once it’s done, you can move forward with the really fruitful work of psychotherapy. Just watch out for a few familiar pitfalls along the way:

As with any fee arrangement, therapists should try to clearly articulate, preferably in writing, and agree upon the arrangement. The concern with the sliding scale is that it can put therapists and clients in a conflict of interest where clients may have an investment in presenting a scaled down financial picture in order to obtain a lower rate. If this negotiation takes place at the beginning of therapy, it can contaminate the therapeutic relationship. Some factors, such as retirement investments, upcoming inheritance, etc., cannot be easily factored into the equation of the sliding scale.

The moral: be open, speak clearly, and don’t be afraid to ask for what you need. At PPSC, we proudly offer sliding scale therapy for patients across New York. Start here to learn more.

One More Endorsement for Psychoanalytic Psychotherapy

We wrote recently about the growing number of think pieces dedicated to “rediscovering” psychoanalysis and calling for its return to the mainstream. (Some of us maintained that it never went away, but no matter.) This recent piece in Forbes makes the case as well as any of them, pointing not just to the lasting and substantive benefits of analytic therapy, but also to its increasingly strong showing in a number of empirical analyses:

For example, a 2013 randomized control trial demonstrated the efficacy of psychoanalytic psychotherapy for treating panic disorder. A 2010 meta-analytic review of available outcome studies showed that “empirical evidence supports the efficacy” of psychoanalytic psychotherapy. It further showed that the magnitude of change in psychoanalytic psychotherapy is “as large as those reported for other therapies that have been actively promoted as ‘empirically supported’ and ‘evidence based’.”

But the piece also identifies one of the key criticisms leveled at this kind of therapy, namely that its bespoke nature resists a one-size-fits-all training regime, or testing protocol:

Because psychoanalytic psychotherapy adapts technique to the unique individuality of each patient, it can seem to some like all art and no science. “Where’s the manual!” goes the cry. The fact is that psychoanalytic psychotherapists typically rely on research to guide the moment-to-moment decisions of a clinical encounter, especially infant development research and increasingly neuroscience. If CBT, as a way to illustrate, can be thought of as someone expertly playing sheet music, psychoanalytic psychotherapy is more like well-structured improvisational jazz.

Of course this isn’t a flaw, but the source of psychoanalysis’s prodigious strength—and the reason so many people of different beliefs and predilections find it singularly effective.

Our psychoanalytic therapists offer depression therapy, anxiety therapy, LGBT-friendly therapy and even low-cost therapy right here in New York. To get started right away, click here.

A Brilliant Author’s Defense of Psychoanalysis

If you don’t recognize the name Gary Shteyngart, you may have seen his endlessly witty verbal pyrotechnics in places like the New Yorker. Shteyngart is that rare writer who can capture the endless regression of our interiority without getting bogged down in all the sad parts. To what does he credit his prolific effectiveness, after a lifetime of false starts and cowering anxiety? A lengthy psychoanalysis that helped him surface all the issues that held him back. As one thoughtful piece in UTNE noted:

But psychoanalysis is a profound exploration of human subjectivity—our inner world with all its memories, desires, and impulses—and its relation to the external, objective world. And it is much more than a treatment. It’s also a set of theories about the complex nature of human experience. “Analysis is the most elaborate and nuanced view of the mind that we have,” Nobel-winning neuroscientist Eric Kandel recently told a meeting of the American Psychoanalytic Association.

The piece is part of a broader trend toward celebrating the rebirth of psychoanalytic therapy—or at the very least, disproving its premature death. After all, analytic therapy remains the most in-depth tool we have for enacting lasting change, and the studies bear this out:

Jonathan Shedler, an associate professor of psychiatry at the University of Colorado School of Science, has examined the efficacy of psychodynamic therapy—a term describing treatment based on psychoanalytic theory and methods but briefer and less intensive—for everything from depression and anxiety to panic disorders, personality disorders, and substance abuse. He has found that the benefits of psychodynamic therapy extend well beyond symptom relief.

“The benefits of newer therapies often start to decay after treatment ends,” Shedler contends. “Studies of psychodynamic therapies show that people not only look much better in terms of symptom relief, personality functioning, and social functioning after treatment, but also stay better. What’s more, they display continued improvement.”

The whole piece is worth a read, not least because it helps resolve some of the sticky debates between neuroscience and psychology, revealing both camps to be far less at odds than many have feared.

Want to get started with a psychoanalyst or low cost psychotherapy today? Contact PPSC here.

Anna Freud Celebrated by Google

It is a small but significant moment when a distinguished psychoanalyst such as Anna Freud takes over the Internet’s home page for a day. Such was the case this month when Google devoted one of its trademark “doodles” to Ms. Freud’s work and legacy.

As this article describes, Anna Freud deepened and expanded her father’s work, taking a particular interest in the psychology and pathology of children. Her teachings led her to assume a number of prestigious posts, where she continued to preach her singular devotion to the emotional issues of young people:

Freud became a member of the Vienna Psychoanalytical Society after presenting her paper “Beating Fantasies and Daydreams” in 1922 and became a director in 1935 of the Vienna Psychoanalytical Training Institute. . . .

When the second world war broke out, Freud opened the Hampstead War Nursery for children who had been left homeless, and often orphaned, as a result of the conflict. Her research into the impact of stress and separation on children was published along with Dorothy Burlingham.

Although our therapists owe a great deal to the Freuds, we are also proud to offer the vanguard in professional thought about issues such as relationship therapy, depression therapy, and gay-friendly therapy. At PPSC, we also offer low-cost therapy and plenty of flexible choices to patients, young and old, who want to understand themselves and their struggles more clearly.

To learn more about how you can benefit from analytic psychotherapy, start here.

The Struggles of Mental Health Belong to All of Us

It is a familiar tale by now: a mass shooting alarms the nation, and calls go out simultaneously for a change in our gun laws and a tightening of our mental health safety net. Rarely does lasting change arise from these moments, but we may soon be near a tipping point. One psychologist in Congress – indeed, the only psychologist in Congress – is aiming to change this issue with a new legislative effort. His reasons are simple:

Two years after Newtown, the nearly 14 million Americans with serious mental illness must navigate the same patchwork system that failed the nation on December 14, 2012.

Says Murphy: "I ask members of Congress to look those Newtown families in the eye."

We have long endured a patchwork mental health support system in America, and many are now advocating for something like parity with other health issues. Although funding for mental health service has improved, there remain a number of essential loopholes that allow troubled young people to bounce from social worker to therapist to counselor without any unified system to offer consistent support.

At PPSC, we are advocates for the power of therapy, especially if a patient might benefit from analytic therapy which can surface the issues that underlie many violent outbursts. That’s one of the reasons we try to make it easy for patients to afford quality care, with a number of low cost therapy options for New Yorkers who require some pricing flexibility.

To learn more about how you can find essential psychotherapy within your means, please contact PPSC today.

Low Cost Therapy in New York

Finding low cost therapy can be a great relief. Many people who are troubled by depression, anxiety, substance abuse or relationship difficulties are candidates for psychotherapy, but they may not be able to afford the high rates of many New York therapists. There is an easier way. Many of the analytic therapists at PPSC offer sliding scale rates for people who cannot afford the standard rates. That means that patients in search of low cost therapy can typically find a number of good options within our ranks.

Psychoanalytic psychotherapy, or analytic therapy, is an in-depth approach to uncovering and understanding the central issues in any person’s life. Analytic therapy is the most established approach in psychology, a mix of in-depth techniques that build understanding through a process of exploring important memories and emotions.

Our therapists understand that different needs must be met with different compromises. For the gold standard in low-cost and low-fee therapy in New York, please contact the affordable psychotherapists of PPSC today.

The Significance of Freud

Those of us who work in analytic therapy owe a great deal to Sigmund Freud, whose ideas brought grounding and energy to the discipline of modern psychology. Although many critics have rightly taken issue with some elements of Freud’s theories which no longer comport with enlightened gender politics, the balance of his foundational ideas remains as useful as ever. Now a new book has been published that explores this story in full: “Becoming Freud,” by Adam Phillips. This excellent NYT review uses the publication as a touchstone for a ranging conversation about the nature of mind. Our favorite quote follows. It’s long, but worth it:

The discovery of and exploration of the unconscious was the central drama of Freud’s life, the one thing he kept passionate faith with throughout private and professional vicissitudes. It was through attention to the unconscious that he made his major discoveries, the most important being that from birth to death we are, every last one of us, divided against ourselves. We both want to grow up and don’t want to grow up; hunger for sexual pleasure, dread sexual pleasure; hate our own aggressions — our anger, our cruelty, our humiliations — yet these are derived from the grievances we are least willing to part with. The hope of achieving an integrated self is a vain one as we are equally divided about our own suffering; we do in fact love it and want — nay, intend — never to relinquish it. What Freud found most difficult to cure in his patients, Phillips tells us, “was their (mostly unconscious) wish not to be cured.” There’s not an analysand in the world who will not recognize the bitter if profound truth of these words. As a historian of analysis once said, the best one can hope for in analysis is reconciliation, not cure. But oh! that reconciliation. What a gift it is.

Reconciliation and discovery remain hallmarks of psychotherapy, and we are proud to continue building on some of the most effective breakthroughs in our understanding of ourselves.

If you’d like to learn more about depression therapy, anxiety therapy, or low cost therapy in New York, please contact PPSC today.