What Therapists Won’t Tell you About your Request To Reduce your Therapy Fee

Photo by Nik Shuliahin

This week I was contacted by a new start up who, on the surface, seems to have a wonderful mission. They seek to address the accessibility issue to mental health treatment by problem solving the insurance maze. It is a good attempt at a solving a very large issue. When I spoke with them about whether or not I would take any cases, the conversation came down to rate per session and the level of psychiatric need of their clients. The rate they wanted to pay a psychologist was too little for it to be a viable option for most providers (without sacrificing) and they couldn’t answer my question about who their clients really were. I would be open to sliding my fee for a new immigrant to the country struggling with a domestically violent spouse but not for someone who just wants to complain about their boss.

While they have done a good job solving the problem on the consumer side, one of the real issues to accessibility for psychotherapy has to do with a therapist’s ability to earn a living wage from insurance cases. Most therapists simply cannot until they move out of direct client care and into administration of a larger group practice or build a private pay practice. The joy of private practice and helping people disappears when you realize you were making more money tutoring in graduate school. It’s not supposed to…