Many clinical psychologists and social workers indicate in their directory listings in the Yellow Pages if fees are set on the basis of a sliding scale-on the basis, that is, of ability to pay. It is worth a telephone call to find out. Many public and some private counseling agencies also set fees in this way. Reduced fees from psychiatrists are more likely through agencies that offer psychiatric care than from psychiatrists in private practice. For public agencies, look in the White Pages under the name of your county; then look for the heading "Mental Health Services" or "County Mental Health," or the equivalent. You will frequently find one or more mental health centers or clinics listed. In the Yellow Pages, look under "Clinics" for a listing of private and sometimes also public clinics. It is usually clear from their descriptions whether they offer psychotherapy or counseling or only treatment for physical illness or injury. Again, it may be worthwhile to mention that the costs of _group therapy_, whether through a clinical psychologist or a social work counselor, may be expected to be substantially less than the costs of individual therapy. (On the appropriateness of group therapy, see Chapter 13.) ONCE YOU HAVE LOCATED A THERAPIST If you believe you have found a therapist whose background, fees, and location meet your needs, I recommend that, when you {251} telephone for an appointment, you ask for an initial consultation. This will make it clear, in the therapist's mind and your own, that your appointment is for a trial session. (The fee is normally the same as for a regular appointment, but check on this.) When you go to this first session, it is very tempting to launch into what is troubling you. If you can hold yourself back in order to ask a few preliminary questions about the therapist's background, experience, approach, and a likely duration of treatment--in other words, encourage the therapist to talk to you a little bit about himself or herself--you will get a better idea of the _person_ behind the professional title. This will help you decide whether you want to continue with future sessions. However, it may take several weeks, or even months, for you to _know_ that the relationship will in fact benefit you. {252} 18 SHOULD YOU BE HOSPITALIZED? There are two main reasons for psychiatric hospitalization: 1. _You would be better off away from home_. Many things can play a role here. Perhaps there is too much family conflict at home, too much emotional strain, for you to improve. Or, your family may simply not be calm enough to handle the crisis. Or, perhaps you have too many strong and upsetting associations at home--e.g., if your spouse has just died or your daughter just committed suicide at home. Or, you may just have too little privacy at home; you feel forced to maintain a stiff upper lip in front of children, your spouse, or other family members, but you simply can do this no longer.