Please note I cannot directly endorse or vouch for the quality or competence of any of these organizations.

• Use your health insurance out of network benefits to reimburse a portion of private therapy costs. Most companies reimburse 40-80% of out of network therapy costs, with some reimbursing the full session fee.

• Try group therapy practices who have interns. Interns are graduate students learning to be therapists who practice under the supervision of seasoned practitioners; therapy with interns is typically offered at a steeply discounted rate. Examples of WA practices with graduate student interns:

  • River Bank Therapy

  • Self Space Seattle

  • Alliant Therapy Group

  • Bastyr Counseling Services

  • CityU Counseling Center

  • Antioch University Community Counseling and Psychology Clinic

  • MEND Seattle

• Try a nonprofit, low-cost directory service such as Open Path Collective

• Try community mental health centers, particularly if you are insured through the state (e.g. Medicare, Medicaid). Most community mental health programs offer many services beyond therapy, too, including wraparound care, psychiatric medication management, case management, substance use treatment, family therapy, and more. 

  • Asian Counseling and Referral Services - focuses on AAPI community

  • Compass Health

  • Consejo Counseling and Referral Services - focuses on Latinx community

  • Center for Human Services

  • International Community Health Services

  • Kitsap Mental Health Resources

  • Mental Health and Addiction Services at Harborview 

  • Navos

  • Sound Health

  • Therapeutic Health Services

  • UV Cares

  • Youth Eastside Services - serves people from birth to age 22

  • Need more options? Try calling a regional or state crisis line to be connected to an organization that suits your needs

• If you have state insurance/Apple Health, consider contacting your health plan provider for an in-network referral 

• Ever wonder why therapy is so expensive? What about why it's so hard to find a therapist you like? Here are a few resources which I feel accurately explain the problems which keep therapy inequitable and difficult to access

  • South Seattle Emerald: "Ask a Therapist: Why is Therapy So Expensive?"

  • Harvard Medical School Primary Care Review: "Here's Why Mental Healthcare is So Unaffordable & How COVID-19 Might Help Change This"

  • Mind Wellness Center: "Why is Therapy So Expensive?"

  • Center for American Progress: "The Behavioral Healthcare Affordability Problem"

• Crisis lines:

  • For a life threatening emergency, call 911

  • Call or text 988 for the national suicide and crisis lifeline

  • Call 711 for the 24/7 Washington state crisis line relay for King, Pierce, Clark, Skamania, Klickitat, Grant, Okanogan, Chelan, and Douglas counties; this crisis line can help you determine appropriate emergency mental health services

• Crisis lines for specific populations and specific challenges:

  • For teens: Call Washington Teen Link at 866-833-6546

    • To speak with a peer (another teen), call the line above from 6-10pm or chat and text from 6-9:30pm

    • To speak with an adult, call the line above from 3-6pm

    • To speak with a substance use clinician, call the line above from 3-6pm and press "2"

  • LGBTQ-specific support: Call, text or chat The Trevor Project for free, 24/7

    • Text "START" to 678-678, or call 1-866-488-7368. You can also chat with them online via the link above

  • Trans-specific support: Call the Trans Lifeline 24/7 at (877) 565-8860

  • For substance use, gambling, and mental health concerns: Call Washington Recovery Hotline 24/7 at 866-789-1511

  • Additional details including other regionally specific crisis resources 

• DBT Skills Training: Handouts and Worksheets- nothing beats the OG! There are open PDFs of this online (just Google it!) though I recommend getting a hard copy so you can fill it out yourself

  • Note: Please make sure you get the skills book, not the training manual, which is geared toward clinicians (you can get that too, if you like, but it's supplemental/far beyond what most clients want)

• The Skillful Podcast- solid podcast covering DBT skills application, great for those who prefer to consume information in this format

• DBT Skills List- a useful reference, and worth having easily accessible or saved to your phone photos or notes. Google "DBT Skills List printable" for a variety of additional options

If I had to pick the 10 skills I reference the most, they would be:

• 1. Mindfulness: basic definition and principles (HOW and WHAT skills)

  2. Mindfulness of current thoughts and emotions (building meta-awareness of self)

  3. Radical acceptance (including dialectics)- beware of common radical acceptance mistakes:

     1. • Radical acceptance does not mean you have to approve or be ok with facts about reality- just that you need to fully acknowledge those facts for what they are

        • You do not have to radically accept something that isn't a fact or a reasonable limitation on the future

        • Having radically accepted something does not mean you feel "at peace" with it (not at all!)

  4. TIP - for crisis, panic, and high distress

  5. 54321 - for grounding, mindfulness, dissociation, and/or crisis

  6. PLEASE - take care of the overall wellbeing to increase resiliency

  7. Identifying and labelling emotions - I highly recommend posting an emotion wheel on your bathroom mirror or somewhere easily accessible!

  8. Check the facts and cognitive distortions (overlapping skills from DBT and CBT, respectively)

  9. Opposite action - beware common pitfalls and misinterpretations of this skill-

     1. • Opposite action isn't for making yourself do things you don't want to do. Instead, the goal of opposite action is to change your current emotional experience

        • For opposite action to work, we need to do it all the way. No half-assing it!

  10. Clarifying priorities in interpersonal situations (then using skills accordingly)

A few words of caution: Consider this a "taster" or a place to start from. Trying these skills may help some AND doing all of the skills properly in group typically takes 6-12mo with a lot of trial, error, and feedback from a trained therapist. There's no replacement for learning the skills in their entirety, then picking and choosing what elements work best for you.