thank you for your responses. to answer your question, struggling2, the SCA and the sliding-scale would be about the same for me financially. both would be about a 50% reduction in her fee. the main difference between the two is that with the SCA she would end up getting the full fee (partially from me and partially from the insurance company), whereas the sliding-scale would end up being a loss for her. i said before that it was $17 off, but it would actually be $37 off - so a net loss of $148 per month on her end.

lolacabanna, she has told me explicitly that the insurance piece isn't any extra work for her - aside from the initial call/fax. she does not have to "jack" with them at all, report and explain anything to them quarterly, or do any other leg work each month. in fact, just to be sure, i asked her about this again yesterday and she confirmed this for me.

i ended up calling her this morning, and leaving a long message about how i am feeling. she called me back later and left a message saying that she wasn't trying to make me feel "uncomfortable or nervous" about all of this, but that we should talk about it further. she then called me back a half-hour later (i was in meetings both times she called), saying that she didn't want to keep me waiting any longer. she said that she had made a decision, and that was that she doesn't want to work with the insurance company (aka do the SCA). she reiterated her sliding-scale offer, and said we would still continue to meet once a week. interestingly enough, as she was talking about the insurance, she said something about it in regards to her other clients. it's hard to explain, but i'm finally understanding that her distain and unwillingness with that is not necessarily about my insurance company, but insurance companies in general and her past experience with them. this is also consistent with the things she has said in session about insurance companies, and for some reason i didn't put it all together before.

anyway, i called her back and thanked her for the messages. i told her i was relieved that the decision was made, and that i appreciated her just telling me what was up. i then went on to tell her my feelings about the sliding-scale. i told her i wasn't willing to accept it, and gave her four reasons why:

- i feel like it would change the boundaries
- i would feel less important of a client if i was paying less (like if she had the choice between giving me or someone else a certain appointment, the full-paying client would always take priority)
- i wouldn't feel comfortable calling her outside of session if i needed to talk, like those benefits are reserved for full-paying clients
- i'd feel guilty if i went out to eat or shopping, like any extra money i had should be going towards therapy

so, that's that. i went on to add that it's been nerve-wracking to handle all of this over the phone - actually, over voicemail - and that i was feeling insecure about our relationship. i told her that i wanted to make sure that everything was ok and that nothing has changed between us. i asked her to call me when she could, so that we could just check in for a moment.

so.. that's the latest. again, i really appreciate everyone's feedback. it's been really nice to be able to work through and process a lot of this stuff on here with such great support.