gma45: Paying cash is not an option, then I wouldn´t have this problem. As you say, you can´t get more than a yes or a no but it´s still a delicate question as it may be interpreted wrong. That is, me begging for free therapy. Both the therapist and me know of the limitation so billing me without knowing won´t come into question.

I think a step further and really wonder where the therapist´s responsibility for the clients well-being is to take place? Just stating that the client will be thrown out seems cruel to me, that is without having any suggestions how to proceed the treatment in some other way.