hi. self-pay shrinks are shrinks who don't do insurance. you pay at the time of service. if you have insurance, they'll provide you with something to see if you can get reimbursed, but they don't the paper work. the + there is that there's greater confidentiality, they usually have more flexible hours, and they seem (around here...) to lean more towards talking along with the drugs. the - is...well...out of pocket costs, obviously. having said that, the ones around here charge less for their services than paying out of pocket with most shrinks, probably because they don't have the same sort of office staff.

i hope things get better for you. im kind of looking around, too, and...wow. psychiatry is a hot mess right now, or so it seems.