More older adults are seeking therapy than ever before. What finally changed?

The numbers behind the shift

Thriveworks’ internal data captures what’s happening within one major provider network, but external survey data suggests the trend is broader. In Thriveworks’ annual Pulse on Mental Health report, conducted in partnership with Wakefield Research among 2,000 U.S. adults, the percentage of seniors who had attended therapy rose from 43% in 2024 to 46% in 2025. More notably, the share of older adults planning to start therapy within the next 12 months jumped from 14% to 20% in the same period.

That forward-looking number suggests the growth isn’t plateauing: Older adults are increasingly open to seeking help, not just doing so when circumstances force the issue.

Why more older adults are seeking therapy now

No single factor explains it. What’s changed is a combination of growing need, shifting attitudes, and real improvements in access—converging at once for a generation that once largely went without.

The weight of physical health

Aging often comes with a medical reality that is difficult to overstate: According to the CDC, more than 90% of adults over 65 have at least one chronic health condition. Many are managing cancer, dementia, heart disease, or diabetes, and research consistently shows these conditions co-occur with depression and anxiety at high rates.

“Clients might be just looking for some help dealing with the more emotional aspects of adjusting to an illness or managing an illness,” says Caroline Merz, Ph.D., a psychologist who specializes in working with older adults. “There are many emotional and behavioral aspects of dealing with illness that can be helped by therapy, like behavioral strategies to improve their illness management.”

Caregiver burden adds another layer. According to a 2025 survey by the National Alliance for Caregiving and AARP, 42% of caregivers are 65 or older—caring for a spouse, parent, or other relative. And according to a separate 2023 AARP survey, 56% of caregivers say the role makes it difficult to take care of their own mental health. Dr. Merz says a significant portion of her caseload involves caregivers working through burnout, anxiety, and depression—learning to prioritize themselves, arrange respite care, and reframe their thinking around the role.

The isolation factor

The U.S. Surgeon General declared loneliness a public health epidemic, and older adults bear a disproportionate share of it. Around one-third report feeling lonely; 24% are socially isolated. For many, the losses accumulate—a spouse, longtime friends, physical mobility, the ability to drive.

“Loneliness can create a cycle where there’s social withdrawal, depression, and anxiety, which then leads to decreased feelings of self-worth,” says Holly Humphreys, a licensed professional counselor with Thriveworks. Her clients often describe feeling cut off after losing a partner, seeing their children less frequently, or finding themselves unable to stay as connected to friends as they once were.

Research links bereavement not just to emotional pain but to elevated risk of both physical and mental health complications. Humphreys says many of her senior clients come to her specifically because of grief and the loneliness that follows a major loss. Therapy helps directly: it provides social connection and encourages older adults to build or nurture meaningful relationships outside the therapeutic relationship.

But isolation doesn’t always drive seniors to therapy directly. Sometimes it’s their kids. “Making the younger generations a lot more aware of mental health services has actually helped the older population as well,” Humphreys says. Many of her clients sought help because a son or daughter noticed they were struggling and encouraged them to reach out. The mental health literacy of one generation is quietly expanding access for the one before it.

How access to care finally started to catch up

For all the cultural shifts, access to mental healthcare has historically been the practical barrier. And that’s changing in ways that matter most for this demographic specifically.

Telehealth has been the single biggest structural change. “All of the difficulties that are involved with getting physically to an appointment are eliminated by telehealth,” Dr. Merz says. Commute time, mobility limitations, lack of transportation—gone. She estimates approximately 98% of her clients are seen virtually. And today’s older adults are more digitally capable than the stereotype suggests, navigating telehealth platforms from smartphones and tablets with increasing comfort.

Federal policy has helped. Recent legislation has extended Medicare telehealth coverage for mental health care at home through December 31, 2027, meaning older adults can access therapy remotely with insurance coverage. Integrated care models—where mental health providers are embedded within primary care offices—are also making a difference. When a patient’s regular doctor screens for depression at an annual wellness visit and makes a warm referral, the barrier to starting care drops considerably. Dr. Merz notes this is particularly common in VA clinics, where psychologists work alongside primary care providers to screen for anxiety, depression, and PTSD.

What changes when older adults get support

The benefits of therapy for older adults extend well beyond symptom reduction, though that matters too.

“By reducing their symptoms of depression and anxiety, that helps improve their emotional stability so they feel like they’re not riding a roller coaster of emotions all the time,” Humphreys says. “Increasing their independence gives them a greater capacity to recognize that they can still do daily activities and self-care.”

Dr. Merz describes it in terms of ripple effects. “Quality of life goes up. It’s not uncommon for physical health to improve. And certainly there’s enhanced social connection, which we know is associated with a whole host of positive health outcomes.” She adds that many clients come to feel more “in the driver’s seat of their own lives”—a meaningful shift for a demographic that can face real losses of autonomy.

“A lot of my clients come in feeling like life is just happening to them. Therapy gives them back a sense of agency—like they have a say in how they navigate this chapter,” Humphreys says.

What still stands in the way

Progress on senior mental health care is real, but it’s uneven. Depending on who you are and where you live, the barriers to getting support can still be significant.

A shortage of specialists

Perhaps the most structurally significant barrier is one that rarely makes headlines: There simply aren’t enough therapists trained to work specifically with older adults. “Older adults are the fastest-growing segment of the population,” Dr. Merz says. “The percentage of mental health care providers who have an area of expertise or specialty in working with older adults has not kept up with the percentage of older adults who are seeking mental health care services.” A general therapist can address general mental health concerns, but the specific clinical landscape of aging requires specific expertise.

Cost

Medicare covers mental health services, but not all providers accept it, since reimbursement rates are significantly lower than out-of-pocket fees. Therapy without insurance coverage can cost well over $100 per session—out of reach for many seniors on fixed incomes. Even with coverage, navigating insurance approval and billing can be its own obstacle. “What might help is Medicare continuing to cover mental health services and also offering competitive rates so that therapists don’t opt out,” Dr. Merz says.

Stigma that persists

For all the cultural progress, stigma hasn’t disappeared. This is particularly true in some senior communities, where mental illness may still be viewed as weakness or a threat to independence. Humphreys notes that cultural and generational barriers compound this for many minority populations, with research suggesting stigma is more likely to persist in some ethnic minority communities. “We still have a ways to go in addressing the generational and cultural barriers that prevent some older adults from being comfortable enough to admit they’re struggling and reach out for help,” she says.

Transportation and mobility

Even with telehealth widely available, some older adults prefer in-person care. And getting there remains a real challenge. Humphreys points to two practical solutions worth expanding: integrated care models that allow seniors to combine therapy with primary care visits, and peer counselors who can meet older adults in their homes, particularly to address loneliness.

The bottom line

The 27% growth in older adults seeking therapy reflects something shifting in how a generation that once prided itself on self-reliance is starting to think about asking for help.

Humphreys puts it plainly: “I see that as a positive. They’re actually utilizing the services instead of trying to go through this by themselves and not seeking help when they need it. There have definitely been some great strides in getting more help to them, but I think there are definitely areas where we can do better.”

More trained specialists, competitive Medicare reimbursement, and expanded integrated care models would go a long way. The trend is moving in the right direction. Keeping it there will take intention.