How Founders Can Find (and Afford) A Good Therapist

  • January 25, 2020

If you’re a YC Founder, read the section of the User Manual called “Scaling Yourself” for the YC-approved advice I wrote for founders seeking emotional support. It also contains a list of great therapists you can contact who already see many YC founders and are familiar with tech and startups.

“How do I find a therapist?” is one of the most common questions I get from early-stage startup founders. Their immediate follow-up question is something like, “We’re only paying ourselves enough to cover the basics. How can I afford therapy?”

First – props to you for being brave and reaching out for support. It’s a sign of good decision-making to realize that you would benefit from extra help, and you don’t need to wait for a breaking point to do it. Talking with an expert is preventative medicine for burnout. You should do it before something breaks. As Pete Koomen (Optimizely, YC W10) said on an episode of Startup School Radio, you need to scale yourself in order to scale your company. For many founders, that begins with seeing a psychotherapist who can help you manage the emotional turbulence running a startup even before you hire your first employee or achieve PMF.

Finding a Therapist

Call the Well Clinic. Well Clinic’s intake process makes it simple to find a therapist perfectly suited to you, and all of their clinicians are brilliant, warm, and immediately engaging. Well Clinic was started by a serial entrepreneur who later became a YC Founder, so you can trust that their process is efficient and high-quality.

First, you’ll call them to set up a second 15-min call with a therapist who specializes in client-therapist matching. This “intake” call will be a brief conversation during which you’ll talk about what you’re going through and what you’re looking for. You can mention any special factors that should be considered in the matching process like your location, your scheduling constraints, your budget, etc. The intake therapist will then match you with the clinician on-staff whose style, experience, and availability is best-suited to meet all your needs. That’s it!

FYI I don’t get any kickback from the Well for my endorsement of them – it’s actually illegal for therapists to pay out for referrals – and our only relationship is that I occasionally provide trainings about the psychology of startups and founders to Well Clinic therapists (for free) to help them provide founders with the absolute best care. I recommend them because I feel the pain of the therapist-finding process, think the Well has solved it, and I deeply trust the work that Well Clinic therapists do. There’s simply no reason not to be in therapy given how easy the Well makes it for you to land with someone who can really help you from day 1.

Other therapists I recommend who see many YC founders (and YC Partners!):

  • Dana Iscoff: http://danaiscoff.com
  • Ali Vogt: https://www.alivogt.com
  • Virgine de Paepe (mentioned below): http://emdrtherapist.com
  • Lesley Van Voorhees (Lesley is especially good with early-stage founding teams): https://tinyurl.com/yx8fpgu3
  • Sasha Lustgarten (specializes in sleep): https://sashalustgarten.com

Affording a Therapist

Cost is commonly a blocker for early-stage founders but the investment is worth it and it shouldn’t stop you from getting into therapy. You should expect to pay somewhere between $80-$180/hr for therapy, and should plan to go to therapy once weekly for a few months at least.

​There are two things you can and should do to unblock here: First, pay yourself more, and second, negotiate the cost of therapy down.

First, pay yourself an extra $500-$1k per month as a “‘personal development” allowance to help defray the cost. Have a conversation with your cofounder if necessary and say that YC and I both recommend this line item. You can mention in this conversation that you know you’d really benefit from seeing a therapist AND if you were to do so, you’d be more productive for a much longer time (anecdotally, by multiple years) at your company. It’s a win/win to bump your pay up for this reason and if YC just happened to fund you $150k, this increase is both reasonable and justifiable. I suggest you provide the same salary increase for your cofounder if they’re interested in the idea too. FYI, investors won’t freak out about this line item on your financials because it’s symbolic of your proactively caring for the most important asset of any early-stage company: the founders.

Second, you can negotiate the cost of therapy down. Advertised rates are almost always negotiable but you have to ask (and it’s not weird for you to do so). When you call the Well, you’ll tell them in the intake call what your budget restrictions are and they’ll put you with a therapist who can match that. If you’re engaging with non-Well Clinic therapist, ask whether they have any “sliding scale” slots available and describe your circumstances including the ideal hourly fee you can comfortably afford (after having decided on the amount of that ‘personal development’ allotment).

Please keep in mind that therapists offer sliding rates to help clients who are truly experiencing hardship – your neighbors who are experiencing physical violence, the effects of long-term and inescapable poverty, and/or who are at serious risk of harm. You own your own business, may have just raised $150k at least, and are in control of how much you pay yourself. So don’t hesitate to explain your circumstances and ask for a lower fee, but maintain some perspective on how much therapists may be willing to flex to your situation.

If you don’t live in the Bay Area (i.e. if you don’t pay California state income taxes) then you’ll need to find a therapist in your state of residence. The licenses that therapists work under specify that they cannot treat a client outside the state they’re licensed in because it’s potentially unsafe for the client. In this case, refer to the profiles listed on Psychology Today and send a few emails to any therapists who catch your eye.

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Amy Buechler

I've worked with thousands of the world’s best startup founders as Y Combinator’s first Batch Director and only embedded Founder Coach.

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