PHP for Active Duty Service Members Includes Art Therapy

News | Aug. 15, 2024

Walter Reed Offers Partial Hospitalization Program for Mental Health Care

By Bernard Little

Walter Reed National Military Medical Center, BETHESDA, Md  –  

Walter Reed offers the Partial Hospitalization Program (PHP), providing support and skills to assist people in managing their behavioral health challenges while living at home.

The program offers a structured treatment setting with a scheduled list of activities during the day, and participants returning to their homes at night, explained Navy Lt. (Dr.) Meghan Quinn, a psychiatrist, PHP chief and assistant chief of Navy Graduate Medical Education at Walter Reed.

PHP patients have no acute safety risk for themselves or others, Quinn explained. They can function at a higher level when they stay in contact with their loved ones (not housed separately or isolated) and patients like it. They can see their partners, kids, pets and others on a daily basis, which is beneficial to their recovery and treatment, she added.

The program began at Walter Reed Army Medical Center (WRAMC) and transferred to Bethesda, now Walter Reed National Military Medical Center, following (Base Realignment and Closure) BRAC and WRAMC’s closure in 2011.

During the COVID-19 pandemic, the program experienced a reduction in hours, but last year, it resumed its hours prior to the pandemic. PHP is now celebrating its one-year anniversary of comprehensive trauma and general mental health treatment provided to active-duty service members, said Quinn. She added that nearly 300 patients have received this care during the last year.

The PHP at Walter Reed is a full-day program, with patients coming here as their place of duty with command approval. There is great benefit in staying in military spaces, Quinn explained. Regular communication with the patient’s command and outpatient treatment team on their progress can include fitness for duty recommendations with an eye on military standards and goals of both patients and their command.

Quinn explained the structured program is four or five weeks “The content builds so you can start at any point and not wait,” she said. There is generally a technician-led group first thing in the morning, and one closed group each day where patients and staff can address heavier topics, such as coping with suicidal thoughts.

There is a final optional group most days that patients can “wind down depending on what [kind of] day it’s been,” Quinn said.

“[The PHP] has the capacity to treat up to 40 patients at one time,” said Quinn. “We try to keep the ratio manageable so groups don’t get too big, and everyone can participate.” She went on to describe how patients are divided into two separate treatment programs upon intake. The Comprehensive Recovery Program (CRP) focuses more on general mental health topics, and the Trauma Recovery Program (TRP) helps patients process traumas that have occurred at any point in their lives that are impacting their current functioning now. These treatment programs may be split into smaller cohorts at times based on type of trauma, or other factors.

In addition to Quinn, core staff for the PHP includes 10 primary therapists (four psychologists, six social workers, an art therapist, two psychiatrists, a nurse practitioner. “The staff here are fantastic. They have a lot of experience working with military patients and their specific concerns.” She added most are former military or spouses of service members. Rotating trainees include one psychiatry resident, and at times, medical students, 66C (psychiatric nursing) students, and Interservice Physician Assistant Program (IPAP) students.

All patients receive formal art therapy once a week and participate in trips outside of Bldg. 85T at Walter Reed, the current home of the PHP.

“We have had a few recreational activities. We’ve been to the zoo, have gone rock climbing in Rockville, Maryland, to Great Falls, Virginia and to Brookside Gardens, Maryland,” Quinn said.

There is also horticulture therapy, and Quinn added that a therapist also arranges for patients to receive regular visits from Walter Reed’s facility dogs.

“All of our patients see their prescriber weekly for medication management, in addition to having two individual therapy sessions most weeks,” Quinn added. “We meet as a clinic team once a week to discuss the progress and clinical condition of every patient in the PHP, so we are able to truly give a comprehensive overview of their status and treatment.

Quinn explained that there has been a stigma about people seeking help for mental health care, particularly service members, fearing the impact it may have on their careers. “People in the military are often hesitant to try [therapy] but here [to provide the] best mental health [care].”

According to a 2006 study in Military Medicine, 97 percent of service members who seek mental health treatment do not experience any negative career impact. In addition, seeking mental or behavioral services will not affect a service member’s security clearance (https://tricare.mil/PatientResources/MediaCenter/TRICARE-Videos/Will-Mental-Health-Services-Affect-My-Security-Clearance#:~:text=The%20short%20answer%20is%3A%20No.)

Quinn added that the PHP includes a number of adjunctive therapies, including Transcranial Magnetic Stimulation (TMS), which she collaborates with Dr. Vanessa Torres-Llenza to tailor these therapies for patients. TMS uses magnetic pulses directed toward the brain to treat severe depression or anxiety, Quinn shared.

Another adjunctive therapy used in the PHP is battlefield acupuncture, in which five tiny, sterile needles are placed on a patient’s ear, which simply fall off after a short time. “It was originally [used] for pain and insomnia and is a great adjunctive therapy where depression decreases,” Quinn explained.

The program has also experienced positive outcomes with Alpha Stimulation, which helps with chronic pain and insomnia, and assists patients with relaxation, Quinn explained.

Quinn added that the PHP has a memorandum of understanding (MOU) with Building 62 at Walter Reed to house patients who come from long distances, since this is the only PHP of its kind in the National Capital Region (NCR). “We meet that need, and [patients can] stay when commands [elsewhere] don’t have access [to a PHP program].”

“We are always looking at ways to adapt the program to meet the needs of our current patients and monitor trends in referrals,” said Quinn. She explained that this has led to incorporating trauma treatment into the general mental health program, including adding eye movement desensitization and reprocessing for post-traumatic stress. 

“[We would like to] have information on the program spread,” Quinn said. “We have resources to work and connect with them. [We love how] patients talk to each other and get referrals. Somebody in your company was here and now word [about this PHP] is making its way around.”

She said that nearly every rank, including enlisted personnel up to E-9 and officers up to O-6, have taken advantage of the PHP. “This is the only adult PHP in the NCR without going out of the network,” she stated.

For general questions about the program, contact the PHP front desk at 301-400-2110.

If you are having a mental health emergency, please call 911, 988 (988 Suicide and Crisis Lifeline), or go to your closest emergency room.

Art Therapy Highlighted as Beneficial for Migraine and Chronic Pain

I am honored to share an article I was interviewed for about the benefits of art therapy for migraine and chronic pain for the Bezzy Community. Many thanks to Hannah for reaching out and highlighting what art therapy can do!

https://www.bezzymigraine.com/discover/living-well-mig/health-can-art-therapy-help-you-manage-migraine-symptoms/

Can Art Therapy Help You 

Manage Migraine Symptoms?

Living Well

August 06, 2024

Content created for the Bezzy community and sponsored by our partners. Learn More

Photography by Olena Malik/Getty Images

by Hannah Shewan Stevens

•••••

Medically Reviewed by:

Tiffany Taft, PsyD

Art therapy can help manage migraine pain and offer an alternative to talk therapy. It doesn’t require artistic skill and can fit diverse needs.

Splattered paint covers my hands, arms, and every other bit of skin my apron doesn’t protect. A once-white sheet of paper is also awash with a rainbow of colors and shapes. For the first time in weeks, I’m not thinking about pain.

I reluctantly attended my first art therapy workshop, doubtful that I would connect with the practice. However, I left rejuvenated by the unique approach.

While no therapy is a cure for conditions like migraine, art therapy can play a significant role in helping people manage the impact of chronic pain.

What is art therapy?

“Art therapy is a therapeutic practice that combines the creative process with psychological counseling to promote emotional and mental well-being,” says Sophie Cress, a licensed therapist and mental health expert.

Unlike traditional therapy, art therapy uses art-making instead of verbal communication as a medium to explore and express thoughts and emotions.

“The aim is not to produce aesthetically pleasing art but to use the creative process as a means of personal exploration and healing,” says Cress.

Art therapy can include an array of mediums and activities, like:

• painting
• drawing
• sculpting
• collage-making

An art therapist typically leads one-on-one or group sessions. However, you can implement techniques independently at home. Art therapy focuses on physical creations, allowing people to process their emotions and thoughts through what their hands create.

While talk therapy is absolutely beneficial, art therapy is a great option if you’re unable to find the words to express your feelings. The two modalities can even be combined.

“Art therapy can be a gentle way of exploring thoughts and feelings surrounding lived experiences,” adds Kayleigh Ditchburn, an art therapist with migraine. “It can provide a space to build confidence, relationships, self-esteem, self-awareness, hope, and physical and mental well-being.”

How can art therapy help people with chronic conditions?

“Chronic conditions often bring about a host of emotional and psychological challenges, including feelings of helplessness, anxiety, and depression,” Cress says. “Engaging in creative activities provides an outlet for these emotions, allowing individuals to express and process their feelings in a constructive manner.”

The creative process can also offer a welcome distraction from physical pain, Cress adds.

For me, using art therapy alleviates some of the stress associated with chronic pain.

I pour my feelings into the paper, letting them spill out freely as red, green, and blue hues that explode into abstract images. Every stroke of the brush removes a pound of weight from my mind, enabling me to tackle my health with more positive energy.

“Art therapy can also help someone express what it feels like to have chronic pain because trying to describe chronic pain from an injury, trauma, condition, or disease can be very difficult to put into words,” adds Lacy Mucklow, a clinical art therapist. “It can show others what they are truly experiencing, and feeling more understood can be healing as well.”

Ditchburn has found huge benefits in using art therapy as a self-awareness tool.

“This all has a knock-on effect and relieves the severity of the symptoms over time,” she says. “It has not prevented my migraine. However, when I do go through episodes, I am now more aware of how to cope.”

Every stroke of the brush removes a pound of weight from my mind, enabling me to tackle my health with more positive energy.

Is there any science behind art therapy?

Numerous studies support art therapy as a potential coping mechanism for chronic pain.

A 2024 study found that art therapy can help with chronic pain by understanding and addressing the individual’s pain experience, using distraction techniques, and improving mental and emotional well-being. By extension, the researchers recommend art therapy as a preventive tool for migraine.

The 2016 research Mucklow refers to found that participants’ cortisol levels, as measured by saliva samples, went down after 45 minutes of art-making. Results were consistent across age, gender, and race and ethnicity as well as for people with previous art-making experience, meaning the practice benefitted everyone similarly. 

Mucklow adds that even a short 15- to 20-minute art creation session can be an outlet for mental, psychological, and physical stress.

‘It sounds interesting, but I’m skeptical’

I understand people’s skepticism around alternative therapies outside the realms of mainstream psychology. It nearly stopped me from trying art therapy, too.

But we’re all unique humans, and there is no one-size-fits-all to therapy, so why not try something a little different?

If it’s not for you, you’ve only lost an afternoon, but if you do connect with the therapy style, you’ll add a beneficial skill to your toolbox of coping mechanisms for chronic pain.

“For those who are skeptical about trying art therapy, it’s essential to approach it with an open mind and consider it as an opportunity for self-discovery rather than a test of artistic ability,” advises Cress.

Remember, art therapy isn’t about becoming an art genius or even an amateur artist. It’s about processing your feelings through artistic practice.

“Art therapy is not for artists; it is for everyone,” says Mucklow.

The art you create is only for you.

Finding the right art therapist

“Choosing to start art therapy is a big decision, regardless of where you are in your journey, as is choosing an art therapist that suits you,” says Ditchburn. “I would say shop around first.”

Don’t be afraid to explore your options, just like with traditional therapists. You might not always gel with someone, and it’s OK to move on to another therapist if you don’t feel comfortable with someone.

“It’s important to highlight the versatility of art therapy,” says Cress. “Whether in a clinical setting, a community center, or at home, art therapy can be designed to fit various contexts and personal situations.”

Creating your own art therapy

If you vibe with art therapy but can’t afford to attend in-person workshops, you can practice at home. You can check out YouTube videos to help you along.

“Doing art therapy homework between sessions while seeing an art therapist can be beneficial to continue progress,” says Mucklow. “A common approach that can be helpful is to do art journaling.”

Set aside 10 to 30 minutes a week to pour out your feelings onto some paper, whether it’s with a pen, colored pencils, or anything else you find in your house.

Art therapists are a valuable resource you can tap into, but if working with one isn’t attainable right now, don’t let that stop you.

You can create a safe space for exploring your feelings through art in the comfort of your own home, and you’ll discover a rewarding coping mechanism that can help make migraine more manageable.

Takeaway

Art therapy is an evidence-based way to manage chronic pain, including migraine. You can find a professional therapist, participate in group workshops, or even do it yourself at home.

Art therapy isn’t about the art you produce. Instead, it’s about expressing yourself through art-making.

You don’t have to be an artist or have any skill, and it can benefit just about anyone.

About the author

Hannah Shewan Stevens

Hannah Shewan Stevens is a freelance journalist, speaker, press officer, and newly qualified sex educator. She typically writes about health, disability, sex, and relationships. After working for press agencies and producing digital video content, she’s now focused on feature writing and on best practices for reporting on disability. Follow her on Twitter.

Have thoughts or suggestions about this article? Email us at article-feedback@bezzy.com.

"Color Me Calm" Helps People During Job Hunting

It is so wonderful to hear how "Color Me Calm" is still helping people for various reasons...including the stress of job searching!

Book Review: "Therapy Private Practice"

I connected with Jackie on LinkedIn as a fellow art therapist. She writes a lot of essays about various topics, such as being an art therapist, being autistic, and wisdom of how she does her work. I was delighted to receive her book on establishing a successful private practice, and wrote a brief review below.  If you are a therapist or provider of any kind, I would recommend that you check out her book to help your practice and yourself thrive!

“Therapy Private Practice: Creating a private practice that enriches you as a human and therapist” 

by Jackie Schuld, LPC, ATR-BC, REAT

As an art therapist who works in private practice part-time, this is the book I wish I had available to me when I thought about venturing into the private practice world. Rather than going solo, however, I ended up joining a group practice, which helped with a lot of the whys and wherefores I didn’t have time for or was ready to learn to do myself. I am still a part of that group practice, and it works for me since I do it very part-time on the side, but I was still quite interested to hear Jackie’s take on creating a private practice that works for you in case I decide to move over to solo practice later on.

One thing I appreciated right away was that the Table of Contents is listed both in page order and in topic order.  As a Gold/SJ, that made me very happy, especially if I want to reference something later, it will be easier to locate via topic. Topics that she covers include beginning your practice or changing what kind of practice you have, financial advice, marketing, meeting your own needs, policies that will support your practice, and even thought patterns that impact you.

Another thing that I appreciate about this book is that the chapters are short essays that are very readable.  Sometimes it’s hard to sit down and read a lengthy book that gets into the weeds (which can be just what we need at times), and this book gives us bite-size pieces to chew on and consider.  Jackie makes it clear that she is your cheerleader in making a practice that helps you – as well as your practice – to thrive.

Some of the chapters are about giving permission to make adjustments to make a practice that fits you and not necessarily what other people think it should be. Others advocate for art therapy and counseling as a field and not selling ourselves short with all of our time, investment, experience, and expertise. She wants all therapists to figure out how they work best and thrive with that, even if it may not make sense at first. Things don’t have to be the status quo, and there are ways to have a successful practice without self-sacrificing so much, as people in helping professions are so wont to do. Accessing resources, finding supports, setting boundaries and limits, finding your own niche, playing to your strengths, and the like are paramount to establishing – and maintaining – a successful practice, however you may define that to be.

Part of the content that also struck me is her line drawings that illustrate the book, which I am so happy she included (as an art therapist, I think we are drawn to that), many of which remind me of Shel Silverstein’s artwork from “Where the Sidewalk Ends” and his other poems.

Jackie’s book covers a lot of cogent topics related not only to private practice work, but also work within the mental health setting that gives good food for thought. It may be time to reinvent our work so that we will not burn ourselves out and better meet the needs of our clients, which is why we went into mental healthcare in the first place.  Will everything in the book apply to you and your situation?  Probably not.  However, it is a great read that will give you different perspectives and insights that can help you be the best – and more replenished – therapist that you can be.

Baltimore's Child Magazine Features Article About Art Therapy

I am so pleased to be interviewed with some other esteemed colleagues for an article on art therapy and how it can be helpful for children (and other ages) in Baltimore's Child magazine! Thank you to Dr. Sharon Hollander and her sister Michelle for creating another informative article to make people more aware of art therapy, especially during March, the month of Creative Arts Therapies Week! I appreciate the feature and resources to point people in the right direction.

https://dmag.baltimoreschild.com/March-2024/index.html

Adventures in Art Therapy Ranks #6 on Feedspot's Global Top 35 Best Art Therapy Blogs

 I'm very pleased to learn that my art therapy website has been ranked as a Top 35 Best Art Therapy Blog *worldwide* on Feedspot! I am shocked to learn it ranks #6, not far behind the American Art Therapy Association and the Psychology Today Arts and Health websites.  Many thanks to all who frequent my page!

https://arts.feedspot.com/art_therapy_blogs/

Mattel Creates Art Therapist Barbie in Career Doll Series

Just discovered a new Barbie I need to get! 🎨

Out of all the professions they could have chosen for their Career Series, I'm surprised they decided to represent an art therapist!

 https://shop.mattel.com/products/barbie-art-therapist-doll-hrg48

Unbox Dreams!

Barbie® doll has added another career to the more than 250 on her resume -- art therapist! This themed playset features Barbie® therapist doll, Chelsea™ patient doll and 10 storytelling pieces to inspire role-play fun.

Product Details

With the Barbie doll art therapy playset, kids can draw up all kinds of ways to play! The themed set comes with Barbie therapist doll and a patient doll who has a unique feature -- kids can rotate the emoji on the small doll's shirt to help express her emotion. A total of 10 accessories, including an adorable kitten, art supplies and mood stickers, engage imaginations in storytelling and role-play as they explore careers in mental health. So many pieces make the set a great gift to inspire dreams and imaginations in kids 3 years old and up. Dolls cannot stand alone. Colors and decorations may vary.

• Barbie doll expands her resume of 250+ careers with this art therapy playset that lets kids explore a career in mental health!
• The playset comes with Barbie therapist doll, a toddler small doll and a pet kitten, plus accessories and features to engage kids in storytelling!
• Interactive action adds to the role-play fun kids can rotate the emoji on the patient's shirt to switch up the expression and help her talk about her feelings!
• There's a comfy bean bag chair for the small doll, and Barbie doll can bend her knees to sit criss-cross applesauce on the floor!
• Additional pieces encourage imaginative play like a child's painting, paint palette, paintbrush, scissors, glue bottle, tablet and pencil -- use the mood stickers on the mini cardboard chart for even more self-expression!
• With so many ways to play, the Barbie art therapist playset makes a great gift for kids 3 years and older, especially those who love music and arts!

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Well, I finally got my Art Therapist Barbie!

She is on my bookshelf in good company with my Bob Ross Funko Pop.

Apparently, Mattel consulted with AATA before creating her and they have a nice writeup on the back of the box about Art Therapy.

https://arttherapy.org/news-art-therapy-barbie

Frederick's Child Magazine Features Article About Art Therapy

 I'm very pleased to share an article written for Frederick's Child Magazine about art therapy is now live! Dr. Sharon Hollander interviewed me as part of her feature to highlight what art therapy is and how it can be helpful for people in the February/March 2024 edition, pp. 24-25.

https://dmag.frederickschild.com/February-2024/index.html

Finding Affordable Therapy

Sometimes, finding affordable therapy can be difficult.  Here are some ways to make therapy more accessible.

https://therapist.com/resources/free-affordable-therapy/

How to find free or affordable therapy

Reviewed by Susan Radzilowski, MSW, LMSW, ACSW

Written by

Elise Burley

Last updated: 09/12/2023

More people are looking for therapy today than ever before.1 But for those who don’t have insurance, or whose insurance doesn’t cover mental health services, therapy can be very expensive. The average cost of a single session ranges from $60 to $200 per hour or more, depending on a therapist’s training, specialty, experience, and other factors.

To help make mental health services more accessible and affordable, some organizations offer free or low-cost therapy. Most of these services provide support for anxiety and depression—two of the most common mental health conditions—and some also address specific problems such as substance abuse, eating disorders, or domestic violence.

If you’d like to find an organization in your area that offers free or low-cost therapy, you can do an online search or contact one of the resources listed below to see if they can help. If you’re insured, look for a therapist who’s covered by your plan; if you have a primary care provider, you can ask them for a referral.

Finding therapy through your insurance

If you have insurance, your plan may cover in-person or online therapy. Here are some steps you can take:

1. If you’re not sure whether your plan covers mental health services, call the customer service line and ask. Many insurance companies have a specific department that handles mental health coverage.
2. If you’re covered, find a therapist who’s in your network. This means the therapist accepts your insurance plan and will bill your insurance company directly for sessions. It also means the therapist will accept a predetermined rate for the session, which is often lower than the rate they charge clients directly. You may have a copay for each session, and you may have to pay out of pocket for care until your annual deductible amount is reached. Contact customer service at your insurance company to ask what the cost will be.
3. If you don’t know whether a therapist is in your insurance network, ask the therapist or check their website—our directory also includes this information for many clinicians. To get the most up-to-date information on coverage, though, it’s best to talk with your insurance company. 

Given current demand for therapy, it can be challenging to find a mental health professional who’s in your network and accepting new patients. This can be especially true if you’re looking for a clinician of color—according to a 2022 Bureau of Labor Statistics study, 77% of mental health counselors identify as White.2 See below for links to several organizations that help members of systemically excluded communities get low-cost or free culturally competent therapy.

If you choose a therapist who’s not in your network, you’ll have to pay out of pocket for sessions. Some insurance providers provide some out-of-network coverage, but it can still be relatively expensive.

Options for therapy without insurance

Sliding-scale therapy

Some therapists offer sliding-scale sessions by reducing their standard fee based on a client’s income and ability to pay. This doesn’t always make therapy affordable, but it can help. Sliding-scale programs are also available at some nonprofit mental health organizations, community clinics, and health centers.

To find a sliding-scale therapist near you, go to our therapist directory and search by location. Select “Refine your search,” then “Insurance and payment,” then “Yes” under “Sliding scale.”

Employee assistance programs

Some employers offer employee assistance programs (EAPs). These come in different forms, but they generally include free services that help employees deal with personal or work-related problems. An EAP may offer support for stress management, depression, anxiety, substance abuse, eating disorders, relationship problems, and other concerns.

Note that EAP counseling is often limited to 10 sessions or fewer. Services provided by an EAP are confidential, so details aren’t given to the employer. To find out if your workplace offers an EAP, contact your employer’s human resources department.

Student wellness programs

Many colleges and universities are able to offer low-cost or free therapy, counseling, or psychiatric services to full-time and part-time students.

To learn what your school offers, contact your student services center or do an online search for “student mental health services” and the name of your college or university.

Organizations for systemically excluded groups

The following organizations help people of color and/or LGBTQIA+ people access and afford culturally competent mental health care.

• Lotus Therapy Fund (Asian Mental Health Collective) offers financial support to eligible Asian or Asian American applicants for eight therapy sessions.
• Loveland Therapy Fund (The Loveland Foundation) provides financial assistance to Black women and girls for therapy, with sign-ups reopening on a quarterly basis.
• BIPOC Therapy Fund (Inclusive Therapists) invites eligible people of color to apply for community-funded therapy services, then connects them with professionally licensed providers from the same community.
• National Queer & Trans Therapists of Color Network’s Mental Health Fund helps queer and trans people of color pay for sessions with participating therapists.
• The US Department of Health and Human Services’ Indian Health Service (IHS) seeks to improve the health of American Indian and Alaska Native people. In addition to information and resources, the IHS site maintains a nationwide map of tribal and urban Indian health facilities, including behavioral health programs.

National organizations

In the United States, free or low-cost mental health resources are available through several nationwide nonprofits and government programs:

The National Alliance on Mental Illness (NAMI) offers a wide range of support services for people living with mental illness, as well as their families. NAMI’s services include in-person and online support groups, education programs, and referrals.

The National Association of Free and Charitable Clinics (NAFCC) provides information on more than 1,400 clinics across the country that offer free or low-cost health care services (often including therapy options) to people in need, whether they’re insured or not.

The National Eating Disorders Association (NEDA) helps people manage and overcome eating disorders such as anorexia, bulimia, and binge eating disorder through a variety of outreach initiatives. NEDA’s site provides links to free and low-cost support resources.

FindTreatment.gov, part of the Substance Abuse and Mental Health Services Administration (SAMHSA), is a confidential resource that helps people find treatment programs for substance abuse disorders and other mental health concerns.

The US Department of Veterans Affairs (VA) offers a wide range of mental health services to veterans and their families, including individual and group therapy, medication management, and peer support.

Community clinics

Nonprofit community-based clinics can offer a range of low-cost or free health services—including mental health services—to clients regardless of their ability to pay. Services vary by location but may include individual or group therapy, medication management, depression and anxiety screenings, support groups, and substance abuse treatment referrals.

To find an organization near you, do an online search for “free therapy” or “affordable therapy” plus the name of your city or town. You may also want to check with your state’s department of mental health or social services. Many states have directories of affordable mental health services on their websites.

Support groups

Support groups are another way to get the help you need at minimal or no cost. These groups meet regularly online or in public places, such as churches or libraries, and are open to everyone. One example is Alcoholics Anonymous (AA), a free 12-step program for people who want to stop drinking. You can find a list of support group resources through Mental Health America.

Crisis lines and chat services

If you need help right away, call a crisis line or chat online with a trained professional. Crisis lines like the 988 Lifeline are available 24/7 and offer free, confidential support. Chat services are typically open during certain hours of the day, but they also offer immediate help and support. These services vary according to the type of help you need.

Depression, suicide, and emotional distress

• 988 Lifeline: Call 988 or 1-800-273-TALK (8255)
• Crisis Text Line: Text HOME to 741741

LGBTQIA+ youth and adults

• LGBT National Hotline: 1-888-843-4565
• Trans Lifeline: 1-877-565-8860
• The Trevor Project: Call 1-866-488-7386 or text START to 678678

 Domestic violence and abuse

• National Domestic Violence Hotline: 1-800-799-SAFE (7233)
• Childhelp National Child Abuse Hotline: 1-800-422-4453

Sexual assault

• RAINN National Sexual Assault Hotline: 800-656-HOPE (4673)
• RAINN Live Chat

Substance abuse and addiction

• SAMHSA’s National Helpline: 1-800-662-HELP (4357)
• Alcoholics Anonymous: 1-800-839-1686

 For additional support services, visit our Helplines page.

Therapy apps

While mental health apps aren’t a solution on their own, they may be an affordable way to support your emotional health while you look for therapy that fits your budget. Some apps offer exercises rooted in mindfulness, such as breathing and muscle relaxation; some offer AI-assisted chat features; and some offer paid chat access to a live coach.

No matter your income level, help is available now for your mental health. Don’t hesitate to reach out to any of these resources for support.

About the author

Elise Burley is a member of the therapist.com editorial team. She has more than a decade of professional experience writing and editing on a variety of health topics, including for several health-related e-commerce businesses, media publications, and licensed professionals. When she’s not working, she’s usually practicing yoga or off the grid somewhere on her latest canoe camping adventure.