Community Counseling Clinics: A First-Timer’s Guide
Community counseling agencies are the hidden gems of mental health care in America. Founded to serve a noble mission, they have made it possible for millions of Americans to get affordable mental health care while living in their home communities.
Many community counseling centers still abide by the ethos of serving everyone regardless of their ability to pay. We wish more people knew about them!
However, there are some important things you need to know before you contact a community counseling center. Understanding what they are and how they work will prevent you from going through unnecessary headaches and will help you get the most out of your experience.
In this article, we’ll explain what community counseling agencies are, how they work, who they’re for, and how you can benefit from calling or visiting one even if you don’t end up going to one. We’ll even tell you the exact questions you should ask when you make your first call.
What Is a Community Counseling Agency?
Community counseling agencies are group mental health practices that offer affordable therapy.
It’s important to know that “community counseling center” and “community counseling agency” are not technical terms and that there are many different types of programs that call themselves community mental health agencies.
DEEP DIVE
The Different Types of Community Counseling Agencies
There are many kinds of providers that call themselves community counseling centers, including:
- Community mental health centers and other public mental health agencies
- Local or national non-profits or charities that provide mental health services
- Community health centers with integrated behavioral healthcare departments
- College or university counseling clinics or other free teaching or training clinics
- Private group therapy practices or private specialty mental health clinics
Differences among these types of programs can affect how affordable they are and who is eligible for their services.
For example, while most public or non-profit agencies offer affordable rates and accept both public and private insurance, private group practices and specialty “community” clinics don’t always offer discounted rates and may not accept as many insurance plans.
On the other hand, public and non-profit agencies often have stricter eligibility requirements and are harder to get into than other types of counseling agencies, though this varies from state to state.
Regardless of the type of agency, therapy is generally more affordable when therapists come together to practice under one roof. Not only can they share expenses and reduce costs, they can also often access types of funding—including grants, proceeds from local charity networks, and public funds—that are usually unavailable to individual therapists in private practice.
Who Are Community Counseling Agencies For?
Community mental health programs often focus on serving uninsured or underinsured clients with limited incomes. In fact, many community counseling centers, especially those that participate in the public mental health system, have strict financial eligibility requirements and don’t serve clients who have the means to go elsewhere.
Many, but not all, non-profit community counseling agencies have a mission to serve a particular group of people. Some specialty clinics specifically serve veterans, trauma survivors, or members of minority groups. Many focus on providing services to people with serious mental illness.
However, this isn’t true of all community counseling agencies or even of all public mental health programs. Some states’ public mental health systems are open to all people who need mental health services, regardless of their particular diagnosis or income. Many community and public programs accept both public and private insurance and offer sliding-scale rates to people who lack insurance.
PRO TIP
The differences from provider to provider can be so great—even within the same subtypes of community counseling programs—that there is no consistent way to tell ahead of time whether you’re eligible or what they offer. This is why we always recommend calling a specific program to ask what kinds of clients they serve, who is eligible, and whether they offer discounted or sliding scale rates, before you decide whether they’re a good option for you.
What Should You Expect When You Call a Community Counseling Center?
When you call a community counseling center, expect to talk to people who care and who want to help you.
The people our team members have called have nearly always been kind, respectful, and responsive to genuine inquiries. Many will take their time to look up other numbers or providers that you can call if their agency is not the right fit.
So, even if you end up calling an agency that isn’t taking new clients, or one where you’re not eligible for services, it’s usually still worth it. The people who answer are often able to help you find a local agency that is the right fit for you.
PRO TIP
Intake workers learn about a huge range of local mental health resources as part of their training, and when you talk to them on the phone, they can give you more depth of knowledge of those resources than you can find on your own with an internet search. As an added bonus, you can talk to a live human being who is likely to be kind and supportive of your efforts to find a mental health provider.
Since the pandemic, it has become a little harder to immediately connect to a live person at a mental health agency. However, we encourage you to hang on if you don’t get connected to a live person right away. While you might have to briefly hold, or even leave a message for someone to call you back, you should be able to get in touch with a community mental health worker relatively quickly.
What Should You Ask When You Call a Community Counseling Center?
When you’re researching community counseling programs, we highly recommend that you ask a lot of questions before asking for an appointment. This will help you make an informed decision about whether that particular program is right for you.
For example, not all community mental health programs offer therapy, so if you’re looking for therapy, you should first confirm that the particular program you’re calling offers it before you sit on their waitlist for a month.
Asking the right questions also helps you prepare for your initial appointment. Knowing what to bring will keep you from having to cancel and come back or from being billed for a full fee because you didn’t have the right documentation.
PRO TIP
What Questions Should You Ask at a Community Counseling Agency?
Some of the questions we suggest that you ask at a community counseling center include:
- Do you offer therapy?
- Do you offer long-term therapy or only short-term therapy?
- What kinds of clients do you serve? Who is eligible for your mental health services?
- Do I have to be diagnosed with a specific type of mental health condition to go here?
- Do you accept clients like me, who are [employed/unemployed, insured/uninsured, etc.]?
- Do you accept insurance? Do you accept my particular insurance plan? Do you offer a sliding scale or a discount to people who don’t have insurance or who don’t have an insurance plan you accept? Who qualifies for those discounted rates?
- Do you think I might qualify and that I should come in for an intake assessment?
- Do you charge a fee for an initial assessment appointment? If so, how much?
- What documents and other things should I bring to my first appointment?
One of the biggest challenges of getting set up for services at a community counseling agency is gathering all the documentation they ask you to bring. You may or may not need to bring pay stubs, bank statements, tax statements, proof of being married or having children, or other documents to be able to receive a discounted rate. Finding and remembering to take all of the right documents can be an obstacle to getting started at a community counseling agency.
This isn’t always the case, though, which is why it’s good to ask first. There are also differences between agencies in whether they charge a fee for that initial assessment or only charge you after you’re accepted and start receiving services there—so be sure to ask that, too.
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What Does It Cost to Go to a Community Counseling Agency?
The cost of going to a community counseling agency varies widely. It’s possible, but rare, to get services at a community counseling center for free. Usually, you’ll pay something, but less than you’d pay to go to a local therapist in private practice.
If you meet income criteria, you might pay as little as a few dollars for a session. If you don’t meet the agency’s criteria for a discount, you’ll pay more. Some community agencies can charge more than $100 for a full-fee, non-discounted therapy session, though you’ll often pay much less. It depends on the agency and where you live.
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What Income Level Qualifies You for a Discount?
Due to their commitment to the principle of serving all clients in the local community regardless of their ability to pay, an agency’s idea of “low income” might differ from yours.
Most community counseling agencies use the Federal Poverty Level (FPL) as a reference. The cap for a discount at many public or non-profit agencies is usually measured by a percentage above the FPL. This means that, depending on where you live, you might not qualify for a discount even if you’re living paycheck to paycheck.
Community counseling agencies also vary in the types of insurance they take. One of the ways you can tell an agency is a community agency or non-profit is that community counseling agencies consistently (though not always) take Medicaid. Most also take Medicare. Many accept a range of private insurance plans, especially plans that are popular or widespread in your community.
One perk of community counseling agencies is that many also serve “underinsured” clients, which means that if you have an insurance plan that lacks or has subpar mental health insurance, you may qualify for the same discounted rate you’d be able to get even if you had no insurance.
What Should You Expect at Your First Community Counseling Appointment?
When you go to a community counseling agency, don’t expect to start therapy right away. At many agencies, even if you meet eligibility criteria, you’ll be put on a waitlist for the next available therapy appointment. Waitlist times can range from days to weeks. At some underfunded public agencies, you might even be on a waitlist for months.
Nearly always, your first appointment at a community counseling agency will be an intake appointment in which you complete an in-depth mental health assessment. This means you’ll answer a lot of questions to help the intake worker (who is often, though not always, a therapist) determine whether you’re eligible for the program or whether they need to refer you elsewhere.
For More Information
For more information about what getting an assessment is like, and what you can expect the first few times you meet with a therapist, you can read our article “What to Expect from Your First Few Therapy Sessions.”
In some cases, you can get this initial assessment appointment right away, but then, after you’re determined to be eligible, be placed on a waitlist for your first therapy session. Because demand at most agencies is high, you usually won’t get to choose your own therapist, but will be referred to the therapist who has the first available appointment.
Is Therapy at a Community Counseling Program Different from Private Practice Therapy?
Therapists who work at community counseling agencies and therapists in private practice work in the same field and receive the same training and education. Most states require therapists to be licensed—or under the supervision of a licensed therapist and actively working toward licensure—to practice regardless of whether they’re practicing independently or at an agency.
Many therapists start their careers at community counseling agencies where they can work toward licensure. (Most states allow therapists to get their license after completing a graduate program and 2-3 years of supervised clinical experience.) This means you may be more likely to get a new or pre-licensed therapist at a community counseling agency. (Though community agencies also often have veteran therapists on staff who have worked there for many years.)
HEADS UP
Keep an Open Mind
Keep in mind that it isn’t necessarily a bad thing to get a therapist who’s relatively new to the field. There are many requirements a person must meet before they can even start a career as a therapist, including having to complete a rigorous graduate program.
New therapists come out of school with fresh access to what they learned. They are also less likely to be burned out than therapists who have been in the field longer. So, we encourage you to keep an open mind about seeing a therapist who’s younger or newer.
For more information on the pros and cons of seeing a pre-licensed therapist, you can read our article “The Surprising Reason You Might Want to See a Less Experienced Therapist.”
However, we also encourage you to advocate for exactly what you want, prefer and need in a therapist. Note that it can sometimes be easier to find certain types of therapy in certain settings. For example, it may be easier to find a Jungian therapist in private practice or to find dialectical behavioral therapy (DBT) groups at a community counseling agency.
It's important to find out whether you can get long-term therapy at a community agency or if they only offer short-term therapy.
Some community counseling centers have had to cut their therapy budgets and limit their therapy programs due to state funding cuts. Some agencies focus on other kinds of mental health services and only offer short-term therapy to help clients work through a specific problem.
So, before you sign up for therapy at one, it’s a good idea to ask whether you can see a therapist at a community counseling program for as long as you want to go to therapy.
Why Are Community Counseling Agencies Like This?
It can be frustrating to learn about all the barriers you have to push through to get therapy at a community counseling agency.
You may have to meet restrictive eligibility requirements, bring a lot of documentation, and wait on a waitlist for weeks before you can see a therapist.
At many community agencies, you can only get short-term therapy, and at some, you can’t get any therapy at all.
What’s the deal? Isn’t the point of a community counseling agency, well, counseling?
The simplest answer is, “not always.”
DEEP DIVE
History Corner
In short, the community mental health movement that began in the 1950s and 1960s wasn’t strictly about therapy. It was about establishing a range of mental health services in the community that could help people get mental health care without having to be admitted to a psychiatric hospital. These programs were largely developed to serve people with severe mental health conditions.
If you don’t have a severe mental health condition, whether you can get therapy at a community mental health center will depend on how your state’s mental health system has evolved and how well it is funded.
It will also depend on whether the agency is even part of the public system at all. Some community counseling agencies are independent non-profits that were founded specifically to expand access to therapy.
The most important thing to understand is that if the community counseling center you’re calling doesn’t offer therapy to everyone (or at all), you should be able to find an agency that does. Many communities have affordable non-profit programs that provide therapy to people who don’t qualify for public mental health services.
Where Can You Find a Therapist?
If you think it’s time to start seeing a therapist but haven’t found one yet, let us help. You can use the search tools on OpenCounseling to find free or low-cost therapy where you live. You may also want to consider trying affordable online therapy on BetterHelp (a sponsor).
Other options include using insurance (and searching for a therapist on your insurance plan’s website) or calling a mental health crisis or information line to ask for a local referral.
Conclusion
Community mental health centers and counseling agencies are a great place to start your search for affordable therapy. There are therapists and social workers at these agencies who are trained specifically to help you find a provider.
Mental health agencies are in the business to help people, after all—including the ones who don’t fit their particular agency’s criteria! The free help you can get at a community counseling agency is often incredible, whether you end up going there or going to another place they told you about.
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Something else you might learn at a local community counseling agency is that there is a hotline or referral service you can call to get information about local mental health programs.
In many states, you can get information about, and even referrals to, local mental health resources when you call 2-1-1. Other states have specific dedicated mental health referral hotlines.
Many states specifically get funding to help their citizens do exactly what you’re trying to do—find affordable mental health care—and they often put that funding into hotlines and helplines.
If you want to find affordable therapy where you live, we recommend that you check out the page for your state’s public system on OpenCounseling to see if there is a referral or information hotline you can call, and to either call that number or a local community mental health center.
Calling a local hotline is often the best way to learn about your options and find affordable care in your area. No one is going to be upset that you called, so don’t worry or try to figure out if you’re eligible before you call. Just reach out—you might be surprised how quickly you can get the help you need!