Aviva Yoselis
Board Certified Patient Advocate

Getting therapy during COVID-19

How do I get therapy help in Israel? (courtesy)

At least once a week, I am asked if I know of any good mental health service providers who work within the kupah system, and can treat an adult who needs, well, help.  By help, I do not mean that the person is suffering from schizophrenia or had a psychotic episode.

I am talking about those of us who suffer from anxiety, or depression, or PTSD, or a difficult childhood, or recent trauma, or a death in the family.  Issues that may not (or may) have a specific diagnosis and medication attached, but that we need help with to manage.

You would think that I would have a straightforward answer to this question.

“Of course, go online and make an appointment with so and so.”  But it is not that simple.

So briefly, what are we entitled to, through the basket of services, to cover our mental health care needs?  I’ve elaborated on this in other posts, so I won’t go into too many details, but, in general, we have three tracks:

  • In-house: hospitalizations, rehab facilities, dormitories, are all covered under the kupah (with a hitchayvut/Tofes 17).
  • Mental health clinics: These are freestanding or actual kupah clinics that are now all under the auspices of one of the kupot. These clinics are often for those people who were just discharged from the hospital, or need more intense assistance and/or will be eligible to apply for sal shikum.  They usually offer an intake session, regular meetings with a psychiatrist, a therapist, and a social worker. Often group therapy or other types of therapy are offered as well. Payment is on a quarterly basis and is either ~35 ILS or the current cost of the hitchayvut.
  • Individual subsidized sessions with a recognized provider: This is the option that is relevant for most of the people who approach me, and yet the hardest to pin down.  Each kupah sub-contracts with a list of licensed professionals whom offer individual or group psychological counseling.   It is important to note:
      • This list is predetermined because the provider must have a contract with the specific kupah. You will not get reimbursed retroactively if you saw someone not on the list.
      • You must choose the provider from a list of providers, more on that soon, and contact that person, on your own. By calling them.  And leaving messages. And calling them again. And moving on to the next possibility when that provider tells you they are full.
      • All kupot must charge the same thing: 59 ILS for the first appointment and 142 ILS for each subsequent appointment to be paid to the provider.
      • You do not need a referral from anyone to make an appointment with these providers.

SO WHAT ARE THE PITFALLS OF OPTION 3 AND HOW DO WE AVOID THEM?

  1. Pitfall: Not knowing which providers work with your kupah. Solution: Each kupah website has the contact information of those providers, according to location, and other search parameters as determined by each kupah’s website, meaning every kupah organizes that information differently.

You must search for mental health or בריאות הנפש on your kupah’s website. (I don’t recommend using the app for this search because it’s too disorganized).

Maccabi: Choose your location and psychotherapy (פסיכוטרפיה)   from the dropdown list under area of treatment  תחום שירות.

Meuhedet: Complicated.  For your benefit, I’ve also created a list of providers, in English, in the Jerusalem area. Click here to see the list, if you’re interested.

Clalit: Choose location and psychotherapy or psychology from the drop down menu.

Leumit:  Choose location.

After your search parameters are entered, you will receive a list of one or many providers in your general area, who work with the kupah, and, theoretically, see patients.

2. Pitfall: The list is too large. Solution: If there are more than 4 or 5 people on this list, you need to narrow it down. You don’t want to overwhelm yourself before you’ve even started. I recommend:

  • Finding someone relatively close by or easily accessible to you.
  • Deciding ahead of time if you feel comfortable being treated by the other gender.
  • Google the name of the provider and see what pops up.

3. Pitfall: How do I know if the provider will work well with me? Solution: Some kupot will list specifics areas like expertise in offering CBT therapy or with children with ADHD, but for the most part you are on your own in determining whether the provider is a good fit for you.

For that purpose, I’ve put together a brief list of questions to help guide you in that initial conversation with the therapist candidate.

  1. Do you feel comfortable treating me in English?  [The provider doesn’t have to be a native speaker, but they should have enough familiarity with the language that it won’t be a barrier].  DO NOT TAKE THIS FOR GRANTED.
  2. What is the main type of therapy that you use?  My experience has been that Israel is still dominated by the psychotherapy model of mental health treatment.  Many therapists who work with the kupot have been trained in this methodology.  If you suffer from anxiety, for example, cognitive behavioral therapy (CBT) may be a better method of treatment for you, but you need to ascertain whether the provider has experience in that area.  If you saw someone in the past who incorporated different methods that worked for you, ask the provider if s/he has experience in that area.  If the candidate gets defensive, or says why is it relevant, or refuses to answer, then that may not be the best fit for you.   Again, this begins the conversation about approach; you don’t need to have firm conclusions about anything here.
  3. Do you work with some type of plan, or overarching goal, or are you more exploratory? Each therapist has planned their own approach.  Some come from the school of thought of let’s identify what problem you want to work on, begin the work, and resolve that issue. Others prefer a more open ended, let’s begin and see where it leads us, approach.  There are no right answers, here, just, what is right for you.  If, in your mind you want to do 10 sessions and feel resolution, and the provider feels that s/he can only begin to understand what the situation is after 6 sessions, you will be at cross purposes.
  4. Does the therapist have experience working with issues like yours? It’s completely fine to ask the therapist questions like, “Have you worked before with young mothers?” Or “have you treated this issue before?” Even though therapists have been trained to treat mental health problems in general, just like other health professionals, they often find their niche, and gather experience more in one area than another.
  5. Did you feel comfortable during the conversation? As I always tell people about finding a health provider in general, a lot of it is chemistry. It needs to fit, because you are forging a relationship with this person. If the conversation left you feeling awkward or unhappy, pay attention to that. If you hang up the phone with a smile, go with that as well.

Current COVID-19 Resources:

From the government: The Israeli Ministry of Health put together a specific fund that allows each kupah to offer 3 FREE telephone sessions with a therapist to anyone who feels they need to speak to someone during this crazy pandemic atmosphere we’ve all been experiencing for the past six months.  Click here to see how to set an appointment through each kupah.

Database: www.gethelpisrael.com is a resource listing of English speaking therapists, mostly private, but some do have agreements with the kupot.

Online therapy: Both Betterhelp and Talkspace are online platforms that can pair you with a therapist who meets your needs.  While the services are certainly pricier than the kupah, if you are having difficulty finding someone or in these times cannot leave your house, they may be an option.  Betterhelp is now also available in Israel, betterhelp.co.il, and prices are between 115 -185 ILS per week, paid monthly.

Have a question or something that I haven’t included?  Please feel free to leave a comment below.

About the Author
Aviva Yoselis, MPH, BCPA, founder of Health Advize, is the director of medical advocacy services for the Shira Pransky Project. She is an expert in the field of health research, health behavior modification and shared medical decision making, with over 25 years of experience facilitating seminars and teaching classes on health behavior and health systems navigation. She has a broad understanding of the biological sciences, bio-statistics, epidemiology, clinical trials and current issues in healthcare. She holds a Masters Degree in Public Health and was the first person to become a board-certified patient advocate outside of North America. Prior to moving to Israel, Aviva worked in the USA in health education and advocacy for low-income minority communities
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