how does money affect your therapy?

Just curious about how you feel about the financial aspect of therapy? My therapist has a sliding scale and I pay the max and can afford it and in theory I approve of the sliding scale but I resent the patients I see who look like they pay less (my assumptions based on their wearing jeans and sneakers in the middle or end of a work day). I try not to let it bother me but I can't help but feel resentful that I'm essentially subsidizing their therapy especially since I grew up poor and have loans and work really hard for my money. I tell myself I'm being an ***** it's great that a wider range of people have access to therapy but sometimes I feel like it bleeds into therapy and I'm like you just have to listen to me so you can pay your rent and afford to work with your real patients! Though I would never say that or bring up money. And in some ways I wouldn't want to pay less because I think I'd feel pressure to be a model patient or censor myself when talking about lifestyle things like vacation plans or expensive events I attended or even clothes I wear. How do you all feel about it?

I wear sneakers and jeans in the middle of the day and pay the full price. I am employed full time at one job and self employed at another. My time and dress is very flexible. I only look businessy when actually in court. I think your perceptions of who pays what may be skewed. I don't find myself worrying about what other people pay. I agreed to pay x amount for x amount of time. That is all I really consider. If the time I spend becomes to me not worth the amount I pay, I can quit all therapy, try to renegotiate, or find a new therapist.

Well I know that the person after me pays very little because I saw their invoice on my therapist's desk when I was paying once (not being nosy just happened to see it when I was writing a check which was my t's bad I guess). But I totally concede that you can't draw conclusions about what people are paying. They could be a tech millionare and wear hoodies. Or a very successful artist or have family money. But in general that's not going to be the case and I think it's fair to say that what someone is wearing at 2pm on a Wednesday (plus bag and hairstyle and accessories/makeup) probably says something about what kind of job they are likely to have and how much they are likely to be paying as a result. The opposite side of jeans/sneakers patient is that it's quite easy to spot a banker or finance/executive type. But yes it's an assumption based on little information and it's not nice or fair. Still I think if you selected ten people randomly from a crowd and had to rank them based on perceived annual salary you wouldn't do too badly though you may get one or two spectacularly wrong. But that issue aside I'm interested if others think about what they pay relative to others and if it affects the therapy.

I also ride a bike to the therapist's. I am a professional. I do not dress like one to see the therapist.

I do not think about what others pay (some people have insurance co-pay so they pay less but the insurance co pays too). What others pay does not have any bearing on me and therapy.

It sounds like it would be valuable to talk about your feelings about success and worth.

A related question is whether you feel the financial burden of therapy stresses you out or makes you impatient about the process in negative ways.

Success doesn't equal worth to me it equals safety.

I subsidise my T's other patients, as well as myself I guess, through taxes since he is paid mostly by the county. I am very happy about that system. When I went to a T where I had to pay the full amount I felt stressed out by how much I was paying; not having to worry about that means, for me personally and yes I know this is not true for everybody, much more effective therapy and faster progress.

If others with greater financial needs paid less to see my T I would approve very much - money problems is a huge stressor and cause of mental turmoil. I might feel guilty for taking up T's time if I knew there were, e.g., unemployed people waiting to see him. But I have no such knowledge and I know that I have no superpower to divine people's work status by their clothes, so it's nothing I could actually consider. (And anyway the fee is the same for everybody - approximately US$80 per year, regardless of financial status.)

So I'm afraid this is not something I can relate to, but it seems like a useful topic for you to reflect on - good for you for doing that!

Well, it sounds like you believe that what you pay includes subsidies for others' treatment, and you sound resentful of that. So do you think they are threatening your financial security? How so? And that undermines your safety?

Then talk about the relationship between money and safety in your life. Either way, it really has nothing to do with other people and their circumstances and your T's financial negotiations.

I do view it as a subsidy because I assume T needs x dollars to cover expenses and I'm paying a larger percentage of that than some others. I don't view them as a threat to my safety at all because I've decided what to pay based on my situation and what they pay has nothing to do with that. If I can no longer pay or renegotiate I can leave therapy and again they have nothing to do with that. It's just frustrating to work hard and know that other people are getting something for less. I agree with the sliding scale concept, I'm just trying to figure out how to get comfortable with it in practice and not let it get in the way of the therapy. In life money offers some degree of safety. If I get sick I can pay for it, if I lose my job I'm good for a while, if my car breaks down I'll get it fixed, etc. I just don't want to be in a situation where there are solutions that are unavailable to me for financial reasons. Obviously there are also kinds of safety you can't buy. Money as a safety net is really a separate issue though.

Money as a safety net could be a separate issue, but it seems like you're connecting it to therapy and your satisfaction with therapy. Something is going on worth exploring with your T.

It is expensive but I can cope. I take pride in paying the full rate. (Is that sane?)

PS:

I was concerned that I was spending our money on me, but my wife says my mental health is a good cause that she is glad to pay for.

I started paying the full rate; now I pay 4 times less. I always wore jeans and snickers, though, despite the fact that I'm a lawyer. I do not understand what exactly bothers you, but either way you could and should discuss it with your T.

The way ppl dress has nothing to do with how much money they earn.
Plus the most expensive designer jeans/snickers don't have visible labels so unless you're a true fashion freak you cant tell the difference - at least I can't

Anyway, I pay full price, I think my T offers sliding scale cause I know some pay less. Never bothered me though (would bother me if I had to pay less- that would be really difficult for me so I consider myself very fortunate in that regard). However, from what I've read I sensed that you feel like T likes them better? Like you are just a job (stg to help him pay for his life) and they are the real fun (like he treates them because he truly cares?) Can't this be?
Money is always important, even more for ppl who came from poorer background.
Still I too think that you should talk about this in your therapy...

My son's old hoodies, faded jeans, and old worn out converse. Most often a home-made "hobo sack" for a purse. If there was a sliding scale, I'd most likely pay the highest, but since I have insurance I pay just a co-pay.

You really can't tell by looking. Not only am I a professional, but I deal in finance and I can tell you the most wealthy people don't look it. They have their money because they don't waste it on clothing and accessories. They are thrifty.

I'm a professional but do not make a ton of money or anything...I pay a copay but if i had no insurance I would likely pay full price for most therapists. Mine is willing to do a sliding scale for me if my insurance stops paying, but I really think he is the exception to the rule. Long story. Nonetheless, I don't always go to my appts. in my work clothing. I want to be comfortable so I will change into jeans/hoodie etc.

I grew up poorer than my peers so I understand. Money can bring up so many feelings/beliefs - talking to your T about it could really help

I am on a sliding scale, but I do not pay the least amount. There are people who pay quite a bit less than me, and I do not resent them. My Ts sliding scale starts quite high, first off. Second, I'm a professional and am usually in full business attire when I see my T, but I have gone in jeans and workout clothes (not sure what my outfit of choice really has to do with anything). Thirdly, at my counseling group, no one subsidizes anyone else's therapy. The group I go to is non-profit. They have a benefit every year where people donate to their scholarship fund. This is how therapy there is subsidized, through kind, generous gifts of others. What I pay and what others pay and wear has no bearing on my therapy, and I'm extremely grateful to the unknown donors for their generosity. If this bothers you that much, then you should tell your T about it.

I think you really shouldn't judge by appearance. I am self-employed and work from home, so I don't dress smartly. If you looked at me you'd think I was a scruffy student. I pay the bottom end of my T's private fee scale but he also has people who pay a subsidised or concessionary fee. Personally I pay an amount I can afford and I think it's worth it. I wouldn't like to think of anyone making assumptions about how much I pay by how I dress. I'm also not interested in how many of my T's clients pay more or less. He and I have agreed a price for my therapy and that's all I really think about.

I think it would be interesting and worthwhile to speak to your T about this.

You really can't judge a person's income from what they happen to be wearing when then are at a T's office. I am a professional, but my job often allows me to wear jeans and t-shirts for casual days and spirit days (high school teacher). We actually have entire months we can wear jeans as a fund raiser for our special education grand ball or to raise money for our Christmas Angel Tree students, etc. Some people work odd hours. For instance, my husband starts work at 4:30AM and gets off about 2:00PM, so he is able to go home, change out of his suit, and change into something more comfortable before he heads to T's office.

I honestly don't think about the income of other people in the office. Not my business and it is just too entirely difficult to make those kind of assessments (not that I would). I pay full price for my sessions. Well, actually insurance is billed the full price and I pay the co-pay.

I am a professional charging an hourly rate, and I sometimes work for reduced fees or no fees at all. When I choose to offer less than my full rate, it is because I am willing to earn less money. I don't see it as some of my clients paying "more" to subsidize the other clients. I would charge them the same thing even if I had no low income clients.

I don't know why it would be any different for T's. The fact that you believe that other people are benefiting because you pay for a service speaks to some larger issue you have with your T, or these hypothetical other clients, or the world at large. I'd encourage you to dig into it and see what it has to teach you.

I'm another professional who dresses casually the vast majority of the time. Almost all of my clients are out of town and I work at home. The person I know who has the fanciest/most designer clothing and accessories has filed bankruptcy, has borrowed thousands of dollars from friends (I declined), and has her college age daughter living with her and gets food stamps. Their two wage earner household is well above the average American income. I am in agreement with the others above that having beliefs about people based upon their appearance is probably not as accurate as you think.

Okay, but when I saw your cat ears hat I'd know you were a baller.

I pay my insurance copay & don't think much about it. I could also afford to pay his full fee every week, yet I'm still one of those scruffy folks in jeans.

I am lucky to have a job that allows me a lot of paid time off. If T is unable to get me in with a late time slot, I will often take the whole day off from work to have a mid-day session. On those days I usually wear part of my gym attire, as that will inevitably be my next stop.

Considering I've been a basically unemployed single mom for 1-1/2 years, I am digging myself a hole financially by continuing to go to therapy. I know I'm in denial about the financial impact.

There was a time when T offered to provide me with therapy at a lower rate, basically saying that I can pay whatever I can afford....He went on to tell me that he probably has too many clients that he takes on for free...that one person brings in home baked goods to help give "something". I don't know if he was trying to make me feel better about the idea.

Instead, I ended up racking up a huge therapy bill, avoiding making a decision. I am now caught up, by taking money from my savings - thousands of dollars - and cannot fathom agreeing to anything less than what he is fully due.

I realize this is my issue. And when I think of others getting therapy from him for free when I am in such a bad financial situation, I do feel a twinge of resentment - but then I realize that it's my issue because he offered to help me in the same way. I'm a bit stubborn, I suppose.

Me too. I had no idea people might be walking around looking at me and resenting me because I was dressed casually. Yikes!

As I wrote on another thread, it's kind of the opposite for me. I would like a range of clients in my job and right now I see all low income clients. It could be your T enjoys seeing a range of clients too?

You have such strong ideas (and perhaps incorrect--that your T prefers the clients with less money) about this that I think you should indeed bring it up with your T.

For myself, I would not feel right asking T for a lower fee. I don't like to ask people to make exceptions for me or to give me special treatment. I go less frequently if I can't afford it, or cut back on my budget in other ways. I don't concern myself with what other clients might or might not pay my T. I have enough of my own problems without concerning myself with those of other clients! My insurance does not cover therapy but other people's does, so I guess I pay more than a lot of clients. Life ain't fair, is it??

Your post indicates otherwise, you are judging others on your perception of their success or lack thereof.
It is something you should talk about in therapy.
I always paid out of pocket, even when I had insurance. Right now, I am broke and have no therapy which is beginning to be a problem. (educated, professional, still self-sufficient but if I weren't, like any one else, it would not be by choice; and I am glad to be able to help others who have less than I do---life is a sliding scale---and you do not know where you may be at another time in your life, you may need someone to "subsidize" you.
Some must fail in a capitalistic society for others to "succeed". (read economics) ----if nothing else you are only one fall or accident away from traumatic brain injury, incapacitation and needing your butt wiped by another. Just like the rest of us humans.