This is what happened in my session with T2 about having to stop therapy...

So when I first walked in she asked how I was and then said it had been a while...I had to cancel last week because my H didn't get home from picking up my older son from XC practice on time but I had also canceled the week before.... So she asked what happened and I said well that's a good way to say what I needed to tell you. I had to cancel my appt because I didn't have the money.... And I'm going to need to stop therapy with you because I can't afford it and see someone through insurance... Because I don't have out of network benefits... She said she understood... I told her I met with someone at her old employer.... She thought it was interesting I picked a young male...I said I liked his profile...

She asked if I was satisfied...I said it was too early to know...said picking a t is a little like Russian roulette...

So she asked if there was other reasons I was leaving? I said no really just the money..she asked if I was comfortable with her and I said I was and that I always felt I could be honest.We talked about how far I've come and I talked about how much I've learned and listed all these things she's helped me with... She said I had really grown and that I was committed and then she said..that we have been together for quite some time and that she cares for me and knows how difficult it can be to changed Ts.... then she said...

That if I wanted to stay she would be willing to see me for the cost of my copayment. I must have made a face because she said I guess I surprised you. And I just nodded. She said that she has a certain number of slots open for this and she wouldn't offer if she didn't want to.. And that when I was able to pay more, that I could let her know and we would adjust from there..

And then she said that she knows that it would be hard for me to do because I like to be feircely independent. Mentioning how I don't let my h carry in groceries...she said that if the $ is truly the only reason then it would be good for me to allow her to do this for me to see that it's okay to have a healthy interdependence....

At the end I made appt for next week to either be a wrap up session or regular and said I would text her in advance to let her know which...

I actually cried all the way home .... because she cared enough to offer that...

(keep in mind my T is usually very even keel...almost emotionless... so for her to say that much or talk about "us" or mention anything she thinks is very very rare)

I'll post another excerpt from the next session that was so upsetting if anyone reads this far.

ETA: read my next post too

[Ambra]

I empathise with you.. I'm going to have to do the same talk in 2-3 months as well, if I don't get a new job. And I am really really scared about it, since I'm in the middle of "the mess" right now. But mine is a very recent relationship so I don't expect anything like this.
Whatever you may choose to do she's there, she cares a lot and it must be a good feeling to know that.

The follow up session was horrible....

So she asked what i wanted to do and i said i wanted to stay and then she said she
wanted to go over how she works it... I was thinking that she already did the prior week when she explained that she had spots for reduced fee clients and that she expected them to pay more as they were able and expected them to let her know when their situations changed.

Then she said i dont think most of this would apply to me... But she said that she has a certain number of spots for people at a reduced fee and that she trusts that i will pay more as I am able. she said that she doesnt think i would take advantage but then a few minutes later she said if i said i was going to Hawaii she might ask about that. She went on and on about the reason that she wants clients to tell her if their situation changed was so she could offer to someone else who needs it. But after all of the clarifying of each statement that "not that I think you would do that" or"I know I could trust you to tell me when the situation changed" and all she said she would check in every 2 or 3 months to see if my situation had changed..

so then when she had sufficiently shamed me ....she tried to get us to talk about other stuff just about when i could actually look at her...she was scheduling and then asked if the week of thanksgiving would work for me because "I know you like to come every other week"... i felt like she had kicked me in the gut....

(its what i did during spring last year because i couldnt afford it and then i took the summer off because i couldnt afford it but when i came back in September i've done 8 weeks weekly because she said it works better for me but now that its reduced fee shes asking if every week is fine...

It definitely felt completely different than last week. I was thinking does she remember that she offered this... I didn't ask...she offered and now she is being so cold and mean about it... When she talked like that, I felt she definitely regretted her offer...

I should have know to expect this... my experience has always been that women change..... they suggest something and they make it seem fine and then make you feel bad.

I havent felt so shamed in a long time.

Would this have bothered you? Would you be able to work with this type of arrangement?

[granite1]

i think it would have bothered. maybe you should continue to see yt . it is all strange about T2

[anilam]

No, I wouldn't but that's me. This is definitely hard, I like my T but I'd find a different T covered by insurance if I couldn't afford it (not that my T would ever offer stg like that) just because I know myself and I wouldn't be able to work through it. In my screwed up way o thinking I can't accept "favours".
I think you two need a longer discussion about that- you should have the same rights as her other clients- have sessions weekly, ask for ER session if needed, be treated with the same respect...

[unlockingsanity]

Ugh, the pressure of proving you can't afford to pay? You're not allowed to live your life (take any trip) for the fear that you will be asked to pay more?

I would have felt terribly shamed as well.

It's hard. Do you value this relationship enough to have to deal with the money issues or would it be simpler to move on to someone else and know you're going to pay X regardless?

I pay a reduced fee, but I've never been shamed about it and T's never threatened to re-increase the fee. However, he also knows I struggle to pay the current fee and often have to miss weeks or breaks based on finances.

If I felt shamed, I'd probably space out my session and eventually stop going. Shaming really isn't a healthy part of a therapeutic relationship.

Do you think you can bring this up with her and maybe she could clarify that she didn't mean it the way it came out?

From an outside perspective, I think I might move on, but I'd be unsure. It's so hard being attached to someone.

[CantExplain]

Originally Posted by Readytostop

The follow up session was horrible....

I would have challenged her.

"It sounds to me like you regret your offer. If you are willing to go ahead, fine. But if it is going to change our relationship, if you are going to resent me, if you've lost respect for me, if you are going to keep lecturing me, I'd rather quit."

[CantExplain]

Also:

"I know you're doing me a favor, and I appreciate that. But if you are going to TREAT me like you're doing me a favor, rubbing my nose in it and regarding me as a poor relation, forget it."

[unlockingsanity]

I agree with Can'tExplain. Maybe you could approach her and tell her how you felt shamed and that if you're going to continue to see her, you need to know that you're not going to feel put down because you're not paying the full price or feel like you have to report to her your financial situation. Either she can offer the reduced rate or not, but you're not interested in being repeatedly shamed by having to report your financial situation.

.
Ironically I have heard this. Some Ts get pissed because they give sliding scales or reduced fee and then their clients take trips, have expensive cars, talk about buying things like big TVs, etc.

I think it is about making therapy a priority and being honest about what you spend your money on.

I once worked at a grocery store as a check-out. I was ringing someone up that had a FULL length fur coat and leather boots on. She was really dressed amazingly. This was in a state where a fur coat is not really needed. I asked her if it was real and what animal it was because it was so shiny.

The lady paid with food stamps.

I think it is the same with Ts. Here was someone supposedly needing assistance but dressed to kill...
Imagine a T hearing about a great trip to Hawaii and the T knows she is basically seeing you for peanuts. Remember this is their job...

She has probably been taken.... by clients getting reduced fees and talking about "material things" etc. If you can't afford the fee, why are you buying stuff thinking...

It was nice that she offered, but confusing about the other stuff..

[CantExplain]

Maybe she bought the coat and boots before she lost her job?

[MusicLover79]

I'm sorry she put so many rules in place and made you feel bad for the reduced pricing fee. I would feel bad in that situation too. I couldn't afford therapy and my T asked me what I could afford and that's what I pay him now, and I'll start paying more when I can. Did you decide to go back after everything she had said?

[unlockingsanity]

Originally Posted by Stringcheese

.
Ironically I have heard this. Some Ts get pissed because they give sliding scales or reduced fee and then their clients take trips, have expensive cars, talk about buying things like big TVs, etc.

I think it is about making therapy a priority and being honest about what you spend your money on.

I once worked at a grocery store as a check-out. I was ringing someone up that had a FULL length fur coat and leather boots on. She was really dressed amazingly. This was in a state where a fur coat is not really needed. I asked her if it was real and what animal it was because it was so shiny.

The lady paid with food stamps.

I think it is the same with Ts. Here was someone supposedly needing assistance but dressed to kill...
Imagine a T hearing about a great trip to Hawaii and the T knows she is basically seeing you for peanuts. Remember this is their job...

She has probably been taken.... by clients getting reduced fees and talking about "material things" etc. If you can't afford the fee, why are you buying stuff thinking...

It was nice that she offered, but confusing about the other stuff..

Unless you personally know someone though, there could be a LOT of reasons behind wearing nice clothes and using food stamps. They could have been donated clothes (hence wearing something more than needed if it was the only thing they had).

[Asiablue]

I totally understand how you feel, it's like she offered something really lovely and it really helped enhanced your trust in the relationship and then the next week she was all cold and businesslike. Yuck.

I wonder tho... my experience is a lot of therapists aren't comfortable with the money side of things, like they feel guilty when you hand over your session fee. I wonder if she was uncomfortable having that conversation and that's why she came across so matter of fact? Another reason could be your own discomfort of the subject matter made you view what she was saying as shaming, or it could be both things!! Or none of that. You'll only know if you speak to her.
I think she is right to be very clear about her expectations and the contract of reduced fees because it definitely makes things easier for both client and therapist to be on the same page. And she did say a lot of it she didn't think applied to you as in she had faith you'd be fair and honest about needing the reduced fee.

[stopdog]

I think I would have told the therapist if I thought it felt shaming and told her what I heard her saying and asked if it was what she meant. But this is not the area in which I struggle, so maybe it is different. This would not have been a big deal to me because I would have wanted it all clarified and possibly I would have wanted it written down. I like to make sure I know what I am agreeing to.
And I never tell the therapist about any of my vacations as it is.

Originally Posted by Asiablue

I totally understand how you feel, it's like she offered something really lovely and it really helped enhanced your trust in the relationship and then the next week she was all cold and businesslike. Yuck.

This...this is how I felt.

Originally Posted by Asiablue

And she did say a lot of it she didn't think applied to you as in she had faith you'd be fair and honest about needing the reduced fee.

And yet she said she was going to ask me for updates every two or three months... so its like she says she trusts me to tell her when I don't need the reduced fee any longer but then why does she need to ask every 2 or 3 months

I cant deal with conflict... I don't tell people how I feel or what I think about something if I think it will upset them. One of the reasons I'm in therapy....

She kept asking if I was okay with the every other week plan... I would say "whatever works" then she would say it again... and I would say "its fine"... but in my head I was so upset...I was almost in tears.... She kept saying whatever you want... but I couldn't bring myself to say I wanted weekly when I felt I didn't deserve it....

[unlockingsanity]

Originally Posted by Readytostop

I cant deal with conflict... I don't tell people how I feel or what I think about something if I think it will upset them. One of the reasons I'm in therapy....

She kept asking if I was okay with the every other week plan... I would say "whatever works" then she would say it again... and I would say "its fine"... but in my head I was so upset...I was almost in tears.... She kept saying whatever you want... but I couldn't bring myself to say I wanted weekly when I felt I didn't deserve it....

I bet you would feel a lot better if you could share all you've shared here with your therapist. Can you be honest with her, do you think?

[Asiablue]

Originally Posted by Readytostop

I cant deal with conflict... I don't tell people how I feel or what I think about something if I think it will upset them. One of the reasons I'm in therapy....

She kept asking if I was okay with the every other week plan... I would say "whatever works" then she would say it again... and I would say "its fine"... but in my head I was so upset...I was almost in tears.... She kept saying whatever you want... but I couldn't bring myself to say I wanted weekly when I felt I didn't deserve it....

That is true, why would she need to ask if she trusts you to be honest? But maybe that's all just part of the spiel she gives everyone, kinda rehearsed an not tailored for each person she speaks to. You're not okay with every week and she did give you several opportunities to say so. I totally get why you didn't ask for what you wanted cos it felt like you would be taking something more than what's being offered and worse don't deserve?
But in this instance you are going to have to tell her you want to see her every week. If all she was offering was every two weeks, she wouldn't have asked if it was ok with you or tell you that it's whatever you want.

[unaluna]

This T definitely messed up. That crack about Hawaii was out of line. Either she is comfortable with it or not, and she really does not seem comfortable with it. Plus she made this totally false assumption, totally on her own, that your financial situation would change. You said you needed a long term solution, she offered a short term solution without thinking it out, then backtracked. And hurt you. I wouldn't give her the cash. I would buy pizza for my boys.

Originally Posted by unlockingsanity

Unless you personally know someone though, there could be a LOT of reasons behind wearing nice clothes and using food stamps. They could have been donated clothes (hence wearing something more than needed if it was the only thing they had).

Actually, she wasn't wearing donated clothes. She bought it and she was more than happy to tell me what she paid and when she got it.

People scam.

I actually think the T did something really nice by offering to continue to see you at a really reduced rate. This is their job and when they get "scammed" it hurts them. They may have debt and lots of bills too.

The T said that she trusted that you would not scam her. She has faith in you.
But if you have money to travel, she might believe your priorities are not straight.

I don't think she meant to shame you.... she let you know what boundaries were associated with a really low fee.

The mix-up about session frequency is confusing and that deserves a discussion.

Have anyone ever asked or expected your surgeon to do a sliding scale?
Alot of therapist don't even, so the gesture alone shows she cares.

From the point of therapists....
http://ironshrink.com/2011/10/should...ng-fee-scales/
http://ct.counseling.org/2008/04/pri...ng-fee-scales/

Mentions resent therapist feel...
http://www.afterpsychotherapy.com/sl...scale-payment/

[CantExplain]

Originally Posted by unlockingsanity

I bet you would feel a lot better if you could share all you've shared here with your therapist. Can you be honest with her, do you think?

Yes. Can you print it out and take it in?

the thing is stringcheese is I didnt ask her or expect her to do sliding scale or reduced fee... I just told her I found a t who accept my insurance ...

I thought it was very nice at the time...

Right and she decided because she cares.

What she is doing now... is setting the boundaries around "the deal."

The session frequency is confusing, but I don't think the blah blah blah about the $$ is unusual, especially if a T has been "scammed."

She wants you to be aware that this is a temporary solution should you agree.
If your budget increases and you can pay $10 more, you should. This is not "for the next 5 years, you will pay only "x""....

Remember this is her job.... she is re-establishing a contract with you.

You don't know her financial situation. She might really only have "x" spots for reduced fees, so she has to make sure that they are used honestly.
I was trying to find the article on the number of people who do not tell their Ts that their situations change, but I can't find it now.

But she cares... because she offered.

[unlockingsanity]

Originally Posted by Readytostop

the thing is stringcheese is I didnt ask her or expect her to do sliding scale or reduced fee... I just told her I found a t who accept my insurance ...

I thought it was very nice at the time...

You are allowed to change your mind and back out.