Is Bay Area Boom Driving Up Cost of Therapy?

(Getty Images)
(Getty Images)

Going out to dinner is really stressful for Carolyn Desimone. She has a lot of friends who work in the tech sector, and they always want to go to trendy places.

“I went out for ramen with some startup kids and it was 30 bucks a person. It was stupid,” she says. “Everyone at the table is making twice as much as I do.”

And they’re willing to spend twice as much on food. It’s an economic dynamic she notices in the cost of therapy, too. Desimone pays $65 an hour at a community clinic to get help with her anxiety.

“The pool of my friends, they’re all $100, $120 per appointment,” she says. “I’d never be able to do that. I couldn’t do that and pay my rent.”

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The influx of tech workers to the Bay Area has had a profound effect on the local economy: Affordable housing is nearly impossible to find. Dining out has become a competitive sport. And now, it seems the tech sector is applying upward pressure on the cost of some mental health services, too.

“One big variable is money,” says Michael Klein, a clinical psychologist in San Francisco. “The other is stress.”

IPOs and venture capital rounds have armed tech workers with a lot of disposable income. With that money comes intense competition, long hours and the ever-looming threat of failure. That means there are more people willing to pay higher prices for someone to talk to.

“There are more and more people that have the affluence that they can afford therapy, and they have enough stress where therapy becomes more of a need,” Klein says.

Some large tech companies will even foot the bill. Managers see really talented engineers mess up projects because they don’t know how to work well with others.

“Their emotional maturity is on the lower side,” says Klein.

Klein is something of a geek whisperer. He’s been practicing in San Francisco for 20 years, and he often treats socially awkward tech workers.

When he asks new clients how they feel, they can’t answer the question.

“They don’t know what I’m talking about,” he says.

But after six months or a year of therapy, that changes.

“They blossom,” Klein says. “They can really track different emotions in themselves. And then they can start to notice them in their co-workers.”

Therapy Prices Rise

The increased demand for therapy from tech workers is compounded by another trend. About half the therapists in private practice in the state don't accept insurance, according to a recent survey by the California Association of Marriage and Family Therapists. That means their clients have to pay out-of-network fees, or completely out of pocket.

“Most people in the tech world can afford to do that,” Klein says.

Therapists can set prices accordingly -- leaving receptionists, waiters and teachers competing with wealthy tech workers for appointments. Established therapists in the Bay Area routinely charge $150 to $200 an hour.

“Many experienced therapists charge a lot and they’re out of reach to lower-middle-class or some middle-class people,” says Klein.

There are other options, he says. Less experienced therapists charge less, and there are several training institutes in San Francisco where people can see unlicensed therapists for as low as $30 a session.

Yet, even some of those clinics have had to raise their prices recently.

Take the Access Institute, where Carolyn Desimone goes for care. It is now facing its own set of financial pressures because of the tech boom -- evidenced by the new neighbors who have moved in since the clinic opened its doors 10 years ago in Hayes Valley.

A few blocks down the street in one direction is the Twitter office. In the other, near the corner of Hayes and Gough, there’s now an artisanal chocolate shop, an Oysteria and a Warby Parker glasses shop.

When the lease at Access Institute was up for renewal last year, the landlord wanted to increase the rent by almost 90 percent.

“We had been paying $5,900 a month,” said executive director Bart Magee, speaking over the construction noise outside his office. “It’s going to go to $11,000 a month.”

Magee managed to negotiate -- a bit. He still has to pay the full increase, but not for another five years. In the meantime, he got a 40 percent rent hike.

“That’s $50,000 a year that we could have provided more services; with that we’re not going to be able to,” he says, adding that the clinic has had to raise salaries as well, so the therapists who work there can afford the increases they’re facing in cost-of-living expenses.

Magee says the clinic had no choice but to raise its prices.

He’s also looking for new philanthropic donors, but he says the clinic needs a long-term plan for when the full rent increase takes effect or they won't be able to stay.

“There’s really no place to go,” he says. “Our commercial real estate has gotten to be one of the most expensive in the country.”

Carolyn Desimone says she doesn’t know what she’d do if Access Institute were ever forced to move or shut down.

“That would be really hard,” she says. “I’m worried that if I lost them, that the barrier to entry would seem too hard to find somebody else, and then I would get really bad again. I’m afraid I would be too overwhelmed by having to find somebody, that I would just not."

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Curious about the boom/bust cycle that is reshaping the Bay Area? Check out our Boomtown series.

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