Is Therapy Worth It?
What if you can't afford treatment?
By Kevin L. Gyoerkoe, Psy.D.

If you suffer from Obsessive-Compulsive Disorder, Cognitive-Behavioral Therapy (CBT) is a highly effective form of treatment.  However, while it is a cost-effective form of treatment, the expense of therapy is daunting for many people.  In this article, I'll outline concrete steps you can take to get the help you need if you feel you can't afford treatment.  In identifying these steps, I kept two broad goals in mind:  helping you find resources to better understand OCD and resources that will help you reduce or eliminate OCD in your life. 

Consider the True Cost of Therapy
Before you decide that you can't afford treatment, be sure to discuss your situation with a professional trained and experienced in treating OCD.  Ask about the fee per session and try to get a rough estimate of how many sessions you might need to achieve your goals.  This will give you an estimate of how much a course of treatment will cost.  While the individual sessions may seem expensive, progress is often rapid and long-lasting.  Unlike other forms of therapy, CBT for OCD is designed to be brief and focused.  You might be surprised to find that the total cost of a course of treatment for OCD is similar to many other unexpected life expenses (car or home repair, medical or dental procedure, vet bill) or luxury items (a new TV or a small vacation).  For some, it may simply be a matter of prioritizing treatment over other expenses. 

It may also help to compare the cost of treatment to the cost associated with having OCD.  Some call this the "OCD tax" and it comes in the form of lost jobs, damaged relationships, lost time, less productivity, and the expense of certain rituals (cleaning supplies, etc) among other penalties.  When you compare that to the cost of treatment, you might find that the true cost of therapy is less than you anticipated.

Ways to Make Therapy Less Expensive
If you've researched the cost of therapy, and you still feel it's too expensive, the good news is there are several ways to reduce the cost of treatment. These include: Sliding Scales
Some therapists and treatment centers offer a sliding scale for therapy services.  This means that the fee for treatment is adjusted based on need and ability to pay.  When you're doing your research to select a therapist to help you overcome OCD, ask if they offer a sliding scale.  This reduces the cost per session and lessens the overall cost of treatment.

Adjusting the Frequency and Duration of Sessions
When we think of therapy, we often think of a weekly 50 minute session.  However, if you're seeking help but concerned about the expense, there are other options.  Since there's no evidence that less frequent meetings are any less effective, many patients choose to meet every other week to lower the cost of treatment.  If you're willing to work hard in between sessions and follow the homework your therapist assigns, this can be an excellent option to cut the expense associated with therapy.  In addition, while exposure therapy sessions often require adequate time for habituation to occur, you can discuss the possibility of shorter sessions with your therapist to reduce the fee per session.

Training Sites
Another way to reduce the expense of treatment is to seek help from a center that provides training to students interested in treating OCD.  These sites often offer reduced fees if you're treated by a student.  If the student is being closely supervised by a professional who is an expert in OCD, the treatment you receive can be highly effective at a reduced fee. 

Group Programs
Another option to reduce the cost of treatment is to consider a group program.  These are often conducted in a more intensive format.  This means that the sessions are frequently longer (1.5-2 hours) but the overall cost may be less since it is in a group setting.

Other Options
If after researching the possibilities above you've decided you can't afford treatment, there are other options to consider that meet our two goals of education about OCD and learning the techniques to overcome it.  An excellent option to consider is the use of a self-help book written by an OCD expert.  These books provide thorough information about OCD as well as walking you through the steps needed to make progress in your quest to rid yourself of this disorder. There are several excellent self-help books that offer education about OCD along with step-by-step instructions for practicing exposure and response prevention therapy.  Self-help books I recommend include: Another option to consider is a support group.  Support groups are often low-cost or free and provide education and social support if you're struggling with OCD.  Groups led by an OCD expert can provide guidance and education about practicing exposure on your own while peers provide troubleshooting and encouragement.

Conclusion
While individual therapy for OCD can be expensive, the overall cost of treatment is often comparable to other unexpected expenses.  In addition, there are several ways to reduce the cost of treatment.  These include seeking a therapist who has a sliding scale, adjusting the frequency and duration of sessions, getting treatment at a training site, and seeking help through a group OCD treatment program.  Self-help books, such as the ones listed above, and support groups are other low-cost alternatives that will help provide education about OCD as well as guidance in overcoming this disorder.