Let’s Be Honest: Therapy

Let’s be honest—when it comes to therapy, most of us fall into one of two camps: those who think everyone needs it, and those who think it’s for “people with real problems.” But here’s the plot twist: we all have real problems. Some of us just yell at our kids, others cry in traffic, and a few have in-depth debates with perfect strangers online. (No judgment.)

Still, for many frum Jews in Los Angeles, therapy feels like a luxury: fancy, expensive, and ultimately inaccessible. Unlike other major Jewish communities—think New York, Lakewood, even Detroit—Los Angeles has been flying solo without a coordinated frum behavioral health system. Until now.

A group of community leaders have been trying to build a mental health system for frum Los Angeles that is both affordable and clinically excellent. Radical, I know. The goal? High-quality therapy that respects your values and doesn’t require you to sell your soul to afford it.

Let’s talk money for a second, shall we?

Private practice therapy often runs you $175–$250 per session. So why does therapy cost so much?

Well, therapists are not just nice people who nod sympathetically. They’re highly trained professionals who are required to keep learning, investing in supervision, and maintaining licensure. They pay rent for office space, liability insurance, and yes—student loans from that one grad school with the really great trauma track. And while they’re saving lives, insurance companies are busy saving pennies by making reimbursement processes so convoluted you’d think government officials designed them. Wait, they did.

So many private practitioners opt out of insurance altogether, and it’s not because they’re greedy—it’s because the math doesn’t work. Taking insurance often means endless paperwork, months of reimbursement delays, and rates so low they’d barely cover a therapist’s coffee habit, let alone their overhead. And the kicker? Claims are frequently denied for vague reasons that require an advanced degree in cryptology to decode.

Yet despite the cost, many frum people choose private practice—and for good reason. The benefits are real. We have phenomenal therapists, with compassionate care and specialized training in Los Angeles. Private practice therapists often offer a higher level of personalization, flexible scheduling, and most importantly, cultural sensitivity. They know what “shidduch crisis” means without a DEI course. They understand the complexity of balancing mental health treatment with halachic values, family expectations, and the intricate dance that is yeshiva admissions. There’s comfort in knowing you won’t have to explain your entire lifestyle before even getting to the issue you came in for.

Also, let’s be honest: many private practitioners go above and beyond. They take calls between sessions when clients are in crisis. They invest their own money into advanced trainings and supervision to stay sharp. They work after hours, slide their fees, and hold sacred space for people navigating grief, trauma, anxiety, and relationships. It’s not easy work—and it’s certainly not cushy.

But here’s the challenge: when the only accessible path to that level of care comes with a hefty price tag, the people who need it most are often the ones shut out. That perception isn’t just unfair; it’s dangerous. But here’s the thing: therapy isn’t a boutique service. Therapy is a lifeline. A support system. Sometimes it’s the only thing between functioning and falling apart. And yet, because it’s so personal, people get squeamish about paying for it. They’ll drop $5,000 on a Pesach program but wince at $175 for someone to help them not scream at their spouse. Go figure.

Now, let’s address the uncomfortable truth: price does not equal quality. There are therapists who charge $250/hour with less training than their price should indicate. The point is, we’ve fallen for the price-quality heuristic—the flawed idea that more expensive always means better. It doesn’t. 

So what should you actually look for in a therapist, besides competence? 

Two non-negotiables: Evidence-Based Care and Measurement-Based Care.

Evidence-based care means the therapist is using approaches that are supported by solid research. Think Cognitive Behavioral Therapy (CBT) for anxiety, Dialectical Behavior Therapy (DBT) for emotional regulation, EMDR for trauma—not moon crystals and “let’s just talk about your childhood again for the 15th week in a row with no plan.” Evidence-based therapy respects your time and your struggle. It gives you tools, not just sympathy. It’s not about how "deep" the session felt; it’s about whether your symptoms improve.

Measurement-based care means your therapist tracks your progress with data—not just gut feeling and tissue count. They use simple, validated tools (often questionnaires or rating scales) to monitor your symptoms over time, just like a doctor checks your blood pressure. That way, you’re not six months in wondering if anything’s actually working. You get to see the impact and adjust the plan if needed. It’s therapy, but with a GPS.

Honestly, it’s wild that this isn’t standard in every practice. According to The Kennedy Forum study titled Fixing Mental Healthcare in America less than 20% of all therapists use outcome measures. Imagine going to a cardiologist who never checks your heart rate. Mental health deserves that same standard of accountability.

So what’s the solution?

We need to build something better. And in Los Angeles, we are.

A new initiative is taking shape to provide high-quality, affordable, culturally attuned therapy for the frum community. It’s being built by people who understand the system from the inside out—after surveying mental health professionals, rabbanim, and lay leaders who are tired of watching people suffer in silence because they can’t afford support or don’t trust the care they’re offered. Enter Nosei LA, named after the virtue of Nosei B’ol Im Chaveiro—carrying the burden of your peer. Nosei LA aims to be more than just a private practice; it’s a community clinic designed to offer culturally sensitive mental health services, referrals, education, and advocacy to individuals, families, schools, and synagogues across Los Angeles.

The vision? A clinic where people can access excellent care without choosing between their values and their wallet. A place where rising therapists receive strong supervision and training. A system built not just to treat issues, but to build resilience. In short: the kind of mental health infrastructure our community deserves.

This isn’t about charity. It’s about dignity. Mental health care should be as accessible as LA traffic or unsolicited parenting advice at shul. It should reflect our values, serve our families, and meet people where they are.

Let’s be honest—therapy is not a luxury. It’s not a status symbol. It’s not something you only do when life completely implodes. Therapy is a tool. A necessity. A pathway to healing. And if we build a system that honors that truth, maybe—just maybe—we’ll finally stop treating mental health like a guilty secret and start seeing it as the opportunity that it is.

So, what do we need from you?

Advocate. Donate. Normalize. Talk about therapy without whispering. And the next time someone tells you they’re in therapy, don’t say “Oh… why?” Say, “Nice. Me too.”

Let’s build this thing. Los Angeles, it’s our turn.