What to Do If You Can’t Afford Therapy

There are lots of good reasons to get therapy. An effective session could help you overcome childhood trauma, unearth deeply entrenched emotional baggage, and teach you new coping skills and techniques to manage the stress of everyday life. And if you’re dealing with a mental disorder like depression or ADHD, then therapy is often essential in managing symptoms. 

Unfortunately, therapy ain’t cheap. In the Philippines, one session can set you back anywhere between 1,000 to 4,500 Philippine pesos ($17-76). To put that into perspective, the cost of therapy in the United States ranges between $60 and $200, but the estimated average salary in the US is almost ten times more than that in the Philippines.

Therapy also isn’t easy to come by.

“In our clinic, for example, the average waiting time is three weeks. And that’s already very fast,” Mary Grace Orquiza, a psychologist based in the Philippines and the director of Gray Matters Philippines, told VICE. “Most clients who come to us from referrals from other institutions have been waiting for a schedule for around two months. It’s really that long.” 

Orquiza said that one of the main reasons therapy is so inaccessible is the scarcity of licensed professionals. There are only about 1,000 psychologists and 600 psychiatrists in the Philippines, and not all of them are actively providing their services. 

Other countries have this problem too. In Singapore, the ratio between psychiatrists and the country’s population is about 4.5 to 100,000. In Malaysia, it’s 1 to 100,000. In India, it’s a grim 0.75 to 100,000.

One of the factors impacting the availability and accessibility of mental health services is the stigma associated with it. In many Asian countries, mental health is still taboo. This influences the number of people willing to get into the industry, and the number of organizations that support such services.

Luckily, times are changing. The pandemic has opened our eyes to the value of mental health. And while institutional change will require more time and investment, there are a few alternatives to therapy that people can explore in the meantime. 

Take note that these suggestions are not substitutes for therapy. There’s a chance you may develop one mental health problem or another at some point in your life. So, if you feel like your mental health is disrupting your day-to-day, it’s best to consult a licensed professional. 

“Therapy is a scientific thing,” Orquiza explained. “Professionals attend schools, go through extensive training, and further their education through workshops or training. It’s based on science and research, wherein we apply various psychological principles or things that we know about human behavior to help someone alleviate their suffering.”

But there are cases where therapy, though helpful, would not be necessary to achieve a certain goal. This includes making decisions, seeking guidance, and dealing with unresolved issues. 

Orquiza explained that each person is equipped with unique coping mechanisms, and so some scenarios can be resolved by just talking to someone and getting a “nudge in the right direction.” 

In these cases, life coaching would be a good alternative to therapy. 

“Life coaches are not licensed professionals like psychologists, psychiatrists, and guidance counselors, but they do have their own functions,” said Orquiza, adding that life coaches can help people improve their relationships, careers, and overall well-being. 

It’s not that life coaches have all the answers. But through a series of conversations, they can help steer people toward answering these tough questions themselves. Need help drawing boundaries between work and life? Can’t understand how to beat the procrastination habit? A life coach can help in these regards.

In therapy, distressed people are often advised to meditate or practice breathing exercises because the physical act of calming down can impact mental health. 

“[Meditation] helps with the physiological responses of the body… Once your body is calm and relaxed, you can think better,” said Orquiza. 

“Another good thing about meditation is that, because you’re more attuned to yourself—more aware of what’s happening to you, your thoughts, feelings, and emotions—you process a lot of information and a lot of things about yourself. It can help you reflect, gain insights about yourself, and lessen feelings of threat.” 

Orquiza recommends meditation apps to her clients, particularly those based on compassion-focused therapy and cognitive behavioral therapy (CBT). 

“I usually recommend CBT apps because they help people address dysfunctional thoughts. It also helps people identify goals and how they can make it more possible,” said Orquiza. 

“I also recommend compassion-focused apps because they teach you how to be more kind, gentle, and compassionate with yourself—[things] you would normally do for another person, but usually have difficulty showing yourself.” 

Just like our physical health, Orquiza said that prevention is better than cure when it comes to our mental well-being. 

“It’s important that we nourish ourselves before we develop mental health problems,” said Orquiza, adding that finding a balance between work and rest can help keep our mental health intact. 

“Work is important because it fosters a sense of achievement. But if we neglect other areas of our life, we’re more prone to experience burnout and stress. We must allow ourselves rest and relaxation, pleasure, enjoyment.” 

While therapy can be hard to come by, there are a number of mental health hotlines that you can reach out to for help. But before you do that, Orquiza said it’s important to understand that the function of a hotline is inherently different from that of therapy. Where the latter provides long-term interventions, hotlines are more for people who face immediate threats, like those who are experiencing suicidal thoughts. 

“Crisis hotlines function as a brief intervention,” said Orquiza, adding that the crisis counselor on the other line will assess the problem and provide a short-term intervention or recommendation.

“The goal is really to make you feel better instantly and to lessen the risk to you and your life. So if you are in a crisis situation like that, you can call a hotline.” 

Crisis hotlines are also useful for referrals. You can reach out to a hotline to get in touch with organizations that offer low-cost or no-cost therapy. In the Philippines, that would include the National Center for Mental Health, the Philippine Mental Health Association, or hospitals like the Philippine General Hospital. Certain local government units also provide counseling services for free. 

“But individuals should be wary of centers or organizations that offer very cheap services, especially if these centers or organizations are not verified to have licensed professionals,” said Orquiza. 

With mental health conditions on the rise, more companies now offer mental health benefits to their employees. For instance, some companies have mental health leaves, in-house counseling sessions, or even therapy stipends. 

The same goes for health maintenance organizations (HMOs). Some have begun offering coverage for mental health conditions for the first time. 

While a lot of these services can only offer baseline solutions, they can help cut the cost of therapy as a whole. If you haven’t looked into it yet, it might be worth emailing HR to get an idea of the options available to you.

If you or someone you know is considering suicide, help is available. Call 1-800-273-8255 to speak with someone now or text START to 741741 to message with the Crisis Text Line.

Follow Nikki Natividad on Instagram.