Cheap (and good) therapy in San Francisco

Downtown San Francisco Cityscape looking at the Transamerica pyramid building

I often hear the shock in people's voices when they find out how much full-fee therapy costs in the Bay Area. Like everything else these days, the cost for good therapy has gone up and up. My dream for our future is that everyone will be able to access free mental health care with ease.

In the meantime, here are some amazing options for nearly-free therapy in San Francisco and the surrounding area. Many free and sliding scale clinics tend to have waitlists. I recommend calling and getting on as many waitlists as you can.

Scroll down to the end for more tips on navigating finding a therapist that works for you!

Liberation Institute

In the Mission at 3150 18th Street @ Folsom

415-606-5296 ext. 102

Sliding scale starting at only $5! This place is just incredible. Their offices are fully accessible for people of all abilities and backgrounds.

Golden Gate Integral Counseling Center

Near Civic Center BART Station at 507 Polk Street @ Golden Gate Ave

415-561-0230

Income-Based sliding scale starting at $25. This is where I learned to be a therapist and very dear to my heart. Golden Gate offers inviting offices close to BART. The best way to make an appointment is to call and do a free intake phone session, it will take about 20 minutes. After that they will match you with one of their therapists. The therapists are all well into their training but are not licensed. It has a social justice orientation, meaning the therapists treat the whole person: mind, body, spirit, soul within the context of our world.

Center for Somatic Psychotherapy

Downtown SF at 220 Montgomery @ Bush

415.217.8895

Income based sliding scale starting at $25. Similar to Golden Gate, this center is one of training sites associated with the California Institute of Integral Studies. Their focus is in somatic psychology, which focuses more on the body and depending on your needs and interest, may include more physicalization such as yoga, movement, or EMDR.

Pierce Street Counseling Center

2140 Pierce Street in San Francisco

415.776.3109

Income-Based sliding scale starting at $25. This is another training center affiliated with the California Institute of Integral Studies. The therapists here are trained in modern relational psychodynamic therapy but draw on a variety of modalities. They have cute, inviting offices in an old victorian mansion near Alta Plaza Park.

Church Street Counseling Center

1782 Church Street, San Francisco, CA 94131

415.648.2644

Income-Based sliding scale starting at $25. This is another training center affiliated with the California Institute of Integral Studies. I really like the therapy coming out of this center which specializes in Gestalt, sand tray and dreamwork.

Access Institute

In Hayes Valley at 110 Gough St @ Page

415-861-5449

Income-Based sliding scale from $35-110. Individual therapy, couples therapy, family therapy, child therapy, group therapy, and psychiatric services. This is an advanced training center for therapists who are well on their way to being licensed with a speciality in psychodynamic therapy.

Queer Life Space

In the Castro at 2275 Market Street @ Noe

(415) 358-2000

Income-Based sliding scale for individual, couples, and family therapy. They also offer tons of groups. I'm grateful this place is here in San Francisco for people who want queer and feminist therapy. They are doing great work and I've heard only good reviews from my friends and family.

St James Infirmary

(415) 554-9634

234 Eddy Street in the Tenderloin

St James is a peer-based clinic for sex workers that provides a wealth of services within a harm reduction framework including primary care, testing, needle exchange, peer counseling, massage, acupuncture, and mental health care. You don't even need insurance and its all free! St James offers 12 months of individual psychotherapy for active and inactive sex workers. The best way to make an appointment is to call for an initial phone intake.

Haight Ashbury Psychological Services

(415) 221.4211

3330 Geary Street in the Inner Richmand

Call for a free hour-long initial phone appointment to get started. Free Services for people on MediCal or MediCare / Healthy SF. I hear they have a highly trans-competent psychiatrist.

Alliance Health Project

415-476-3902

1930 Market Street in the Castro

AHP has a broad range of mental health services for LGBTQ individuals including therapy, psychiatry, substance use recovery, career and vocational counseling, and psychotherapy groups. Therapy is usually limited to 20 sessions. They are a part of UCSF and work with people whose health insurance covers UCSF care, such as Health San Francisco. Call to schedule an intake or drop by Monday, Wednesday or Friday from 9am-11am.


Harm Reduction Therapy Center

(415) 863 4282

45 Franklin Street, San Francisco

HRTC offers individual and family therapy in San Francisco, Oakland and Mill Valley for people who want to change their relationship to substances and friends or family of people struggling with substance use issues. I'm a big fan of their harm reduction model and this clinic was founded by some of the great leaders in harm reduction philosophy. Check out their website for the contact info to their other offices. Sliding scale based on income.

Lyon Martin

(415) 565-7667 ext 351

1735 Mission Street at the corner of Mission & Duboce

Short term individual therapy (12-20 sessions) and Therapy Groups, free with insurance. Long term psychiatry. Accepts MediCal and MediCare and will help set you up with insurance if you qualify. Uninsured folks may qualify for sliding-scale services. They also offer transgender, HIV, and gyno services in their primary healthcare clinic.

Mission Mental Health

2712 Mission St, San Francisco, CA 94110

(415) 401-2700

Bilingual therapy and psychiatry available to people with MediCal insurance and Medicare. They've recently added several therapists who specialize in serving transgender community to their team! To get an appointment you need to show up and wait in line at or before 8am any weekday. Its a good idea to be prepared to wait for a few hours or more to get that intake. They often have a long waitlist and it can take 3-5 weeks to get an appointment but once you are hooked up, its FREE!

SOMA Mental Health

760 Harrison St., 94107

415-836-1700

Therapy and Psychiatry for people with MediCal and MediCare. To get an appointment you need to show up and wait in line at or before 8:30am any Monday, Tuesday, Thursday or Friday. Its a good idea to be prepared to wait for a few hours or more to get that intake. They often have a long waitlist and it can take 3-5 weeks to get an appointment but once you are hooked up, its FREE!

Leather therapist chair in a warm office

5 Tips for Navigating the World of Low-Fee Mental Health

1. All therapists and clinics will start off with a 10-30 minute phone session where they gather some personal and contact info that helps them match you with a therapist who fits your needs. If you know you want to work with a queer therapist, specific gender or race, age, or modality, advocate for yourself during this call! You deserve to get matched with a therapist you feel truly comfortable with! Expect to provide some personal information including contact info, why you are seeking counseling now and basic mental health history.

2. If you need psychiatry, expect to wait weeks to months to get a low-fee appointment. If you're having a mental health crisis and need to get evaluated for psychiatry meds immediately, the best way is to go to Psychiatric Emergency Services at SF General Hospital. Many primary care doctors can prescribe basic antidepressants, anxiety meds and mood stabilizers if you tell them what's going on with your mental health.

3. Talk to a few different therapists or centers on the phone before you decide but sign up for all the waitlists. I think a lot of times when we don't have a lot of money, we feel like we shouldn't take up people's time and should "just settle for what we get". I want to bust through that myth and remind you again how valuable you are and that no matter what you can afford, you deserve good, safe, and effective mental health care. Since many places have waitlists, its a good idea to join as many as possible to keep your options open so you can have choice even after you've met your new therapist.

4. Don't be afraid if you don't like the first therapist you get matched with. Even if you're not paying, you are still doing the hiring and you get to hire the person that you feel good about meeting each week! It can be intimidating and vulnerable to talk about yourself to a stranger but its going to be worth it when you find that right therapist for you. Just because the first one isn't a good fit, doesn't mean you therapy was a bad idea.

5. Trust your intuition. Most therapists, including myself, rely on intuition to guide us through this process of healing. Our "gut" knows what we need and can usually be trusted to make a wise choice. Take some breaths, tune into yourself, and listen to what you need right now.

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