I tried to give clients a break financially by joining health insurance panels but when the companies stopped paying for the counseling I had already done in accordance with our contract, I had to quit using them. Now only about 30% of counselors accept health insurance.
Health insurance was the first big threat to “good” counseling. The newest threat are the companies now representing private investment groups. For about $80 a month they allow the client four in-person sessions plus all the text and emails they desire using. This means that a therapist could end up spending an extra four to six hours and making $7.00 a session or less. The good thing about these groups are that the therapists making so little will give up and our profession will be rid of them but not before driving many good therapists out of business because they cannot compete with therapists willing to take so little. This is exactly what Managed Care insurance did back in 1992. Many of the best psychologists quit and starting selling women’s shoes at the old Rich’s Department Stores. They made far more selling shoes and never came back. It will take years for the investor groups to go away but by then most counselors will be providing inferior counseling to those still charging fair prices of $185 to $250. Only those educated as to the value of good counseling will continue coming to us. When the smoke clears the only good therapists will have to charge much more to stay in business and our clients will have to be rich. Even now psychologists have banded together to up their rates to $400 and more psychiatrists are getting $600 an hour. The trouble is that most people do not know the difference between a “good therapist” and “any therapist” and go for cheap or free if they can get EAP. They will bring it on themselves to have no counselors left but the very expensive ones and will suffer greatly. Many marriages will fail and mental illnesses will ruin people’s lives when they can no longer get quality therapy for cheap. We tried in 1972 to make counseling more popular and acceptable but lost because the public always chose cheap. And you know, we usually get what we pay for.
I work differently from most therapists. After a client spends a session with me I write down verbatim what client said, what I said and so forth. Every week I study all my notes to provide a continuum of reaching client goals faster than most methods of counseling. I charge a discounted rate of $190 and allow three hours a week for reflection, creativity and research on my clients’ behalf. The sliding scale for me is to allow “out of network”.
Why does quality counseling cost so much? A client should feel during the first session that the therapist is already resolving critical issues and will see a continuation of that at every session. When the client feels that no progress is being made, it is time to seek another counselor. I have offered a no pay benefit for twenty years and never has a client felt the need to ask for it.
Clients must always remember that when using health insurance they must be labeled mentally ill if the company is to justify payment. Also, using health insurance for payment, clients lose their right to confidentiality. The insurance company may ask for confidential records at any time. Also, having a licensed psychiatrist, psychologist or therapist see your child for therapy will assign him a mental illness that could follow him through electronic records for the rest of his or her life, often preventing hiring or promotions. Health insurance may be cheaper in the short run but very destructive in the long run.