[Asiablue]

I don't have health insurance, in the UK we don't really use it since we have free healthcare. But that means that i have to pay out of pocket for a therapist.
It's really a big expenditure in my household every month. But i really think it will be worth it in the long run.

I have wondered tho, if an insurance company was paying for unlimited sessions would i be as motivated to attend all my sessions? Often i don't want to turn up, but what makes me go is the thought of being charged for the missed appointment. Would i be more inclined to f@Ck around and game play and stall if i wasn't paying out of pocket? Would i be less inclined to push thru the intense discomfort of certain subjects if i knew i wasn't paying for the session directly. When i don't answer something in therapy or my first reaction is to stall and put up protective walls i am also very aware of how much this is costing financially and time is ticking by and i don't want to waste any of it, so i push thru the discomfort very often, when if insurance was paying for it, i think i personally would be less likely to work as hard.
Because i have to pay for it out of pocket, therapy is really precious to me and not something i intend sitting in for any longer than i need to. And i try not to waste sessions.

I guess i'm asking if you think having to pay out of pocket would affect how hard you work in therapy? I'm not being judgemental and i know everyone is different and everyone works differently in therapy but i'm curious if anyone is aware of how their behaviour in therapy would change if they had to literally pay out of pocket for it, because i know my behaviour would most likely change if insurance paid for my sessions, i probably wouldn't be in such a rush to get better, i probably would ocassionally not turn up for a session, i probably would allow those barriers to stay up for longer rather than pushing thru.

[archipelago]

I pay out of pocket and it is a major expense because I see an analyst who is also a doctor. They are not cheap. But it is totally worth it. And that wouldn't change if someone else paid. I would work just as hard and value it just as much. I tend to not think of the money, not that I'm well off, but I just don't like thinking about things in terms of money. My therapy is sacred. There is no way to put a monetary value to it.

[BlueSoup]

I started paying out of pocket and then switched to using my insurance. For me, nothing has changed. I still show up to every session and try to be present and cooperative the whole time.

When I was paying out of pocket, I did pay more attention to the money I was spending. I realized very quickly that my money was being wasted on the therapist I had chosen and ended up terminating with her after about 10 sessions. (she had no training in the issues I am dealing with, yet continued to see me) I've been with the new one for about 2 months. I'm still not sure if she can help me but I'm not so worried about the money part of it because I pay nothing until the end of the year.

So I guess money does play into my therapy but I view it a little different.

[Daeva]

I tend to think differently, since my college pays for my T. So I get my T for free. I think it's based more on the individual, what they are dealing with in therapy, how motivated they are, why they are there. I was paying for a T before and got no where's cause I was being forced to go to her by my family. However a year later I find Angela for free and see her and I'm doing much better.

So for me, money isn't involved in my motivation at all. I cherish my time with my T because I have lived without anyone to listen or care for me my entire life. I had a very abusive childhood and no one gave a **** so I think that may also play a role on why I'm so attached to my T and willing to work with her, and not **** around

[lrt1978]

I'm having therapy on the NHS, so not paying for it and it hasn't affected my therapy, I still go even when I don't want to, I work hard and try to do what I am supposed to, if I had to pay for it I would still be the same. I feel extremely lucky not having to pay for therapy.

Sent from my iPhone using Tapatalk

[stopdog]

I pay for it. It has no effect on my going or canceling or how I do it. Right now, I can afford it. If I have something happen where I cannot pay for it, I will stop going.

[Hope-Full]

I pay out of pocket until I reach my sizable deductible, then insurance takes over. As others have mentioned, I work hard no matter what, and really feel that my work with T is truly priceless. If I didn't have insurance, and were paying out of pocket, I'd be canceling my TV, tightening up my budget, and cutting costs wherever I could so that I could continue with T. Yes, it's that worth it. So is my T.

[tohelpafriend]

I highly value my T, as I've stayed with it for about 6 years!! However, when it came to my asking them for all my clinic notes, although I did get them, I realized the town keeps these records. Be careful about exactly who has access to your records and the laws in your state. Also, the prescribing m.d. for our counseling center gave up and decided he would not prescribe for me, as I was 'treatment resistant'. Again, my .02 is if I could find a good T in private practice, it would be weekly again. Now I'm at 1 T session per month.
After so much time invested, I'm seriously thinking of starting post grad work in counseling with a lot of experience already.

[anilam]

I pay out of pocket (have insurance but don't want to use it cause then it's part of your medical record and could be used against you in the job market).

However, I think I'll be more pressed knowing someone else is paying for my therapy- like I'm wasting their money? I've never canceled just because but that's out of the respect I have for my T not because of his cancellation policy.

I used to pay for it, but now it's covered by the health care system because my T is also a psychiatrist. (I pay a maximum fee, approximately £100, per year for all health care that's covered by the system.) So I can actually compare, and I can confidently say that I feel more compelled to work hard and not skip any sessions or avoid uncomfortable issues, etc, now that my therapy is paid for by the tax payers' kronor. When I paid out of pocket I skipped a couple of sessions with flimsy excuses, because I would have to pay anyway - I would feel rather guilty if I did that now. Of course, my current T is much better for me than my previous T and that factors in as well. I don't want to skip even a single session.

One thing that's potentially different is that now that I have (almost) free therapy for as long as I need it (or until T retires), I feel more motivated to work on difficult stuff, because I don't have to feel guilty about working long-term and squandering our money on that. Plus, when I don't pay it means H doesn't have to know I'm going, which also makes it possible for me to work much more effectively.

I've had therapy that was free, therapy I paid for out of pocket, and therapy paid for (mostly) by insurance. Can't say that has ever had anything to do with how hard I worked in therapy.

When I began therapy with this T 3 1/2 years ago-insurance was paying for it. All I had to pay was $25.00 (US dollars) and insurance paid the rest. I will say back then that I did take advantage of it-often asking for additional sessions and things of that nature. Now for the past 1 1/2 years, I been paying my T out of pocket. I don't necessarily know if it effects how hard I work. I'm in psychodynamic therapy so it's mostly based on healing through the relationship. For that reason, even sessions where I don't work on difficult past stuff and just do general chit chat- "healing" is supposed to be happening. That being said-after those general chit chat sessions I do tend to feel guilty and like I wasted the money. But, going there and just having that safe place and having someone who has my back-has a lot of value to it.

[Nightlight]

We have subsidised health care here and so a large number of people, including me, don't have health insurance—though, all of the health insurance policies that I know of here don't cover therapy anyway. So I pay out of pocket, but I've had a series of sessions paid for through a certain scheme before, and currently I'm having a limited number of sessions through the public health system, which are fully funded. I value therapy just the same regardless of what I'm paying. I once said to my T that it was good that I paid so much because it meant that if I was still coming to see her, then I really needed to see her, and that it made sure I really valued it. Honestly, I realised soon afterwards that I was saying that because it was easier to think that than the alternative, that people like me should have access to the sort of help that is provided through therapy without such an enormous financial struggle.

[Mactastic]

I am VERY lucky and I know it. My T is a Board Certified Psy.D. who charges $165/hr. He charges me only $50 and my insurance reimburses me $30 of that. I am extremely thankful for my circumstances. There's no way I could afford therapy any other way. Even though I pay very little I value it very much.

[granite1]

interesting question. I was actually thinking about this the other day regarding my unwillingness to talk sometimes in T. although I am doing a lot better with this in the last 6 months ar so ( im proud) I spent years not saying a word .(god my poor T) I think I would have just left T if I was paying out of pocket and not just a copay. thank god for insurance . I don't think for me paying out of pocket would have been an incentive to work any harder then I do on being able to talk.

[doyoutrustme]

I get reimbursed in full, after paying out of pocket. I rarely miss a session.

[Asiablue]

You're all better than me then lol, i do very much value therapy and would regardless of insurance paying it or me paying it but i know myself and on days i was dreading going or if i was feeling angry or in a huff with T i might cancel if insurance was paying whereas just now i drag myself there because i'd rather get something out of the fee i'd have to pay regardless of turning up or not.

[granite1]

my T told me once the only expectation she has of me is that I show up. there have been a few times I have cancelled do to upset . but if this really is her only expectation I do show up. but I have insurance .I think again I would have stopped years ago if I paid out of pocket.

[learning1]

I've always used insurance. I've never strongly not wanted to go to a session, but if I did cancel, I could be charged. If the t decided to charge for that session even though I cancelled, they couldn't bill insurance, so they'd have to bill me. That would be a strong motivation not to cancel if it was a situation where I thought the t would charge.

If I had to pay entirely out of pocket, I'd be less inclined to go to therapy at all. My t offered to reduce or cancel my copay, and I decided to pay half of it, which motivates me to go more often. I'm not confident I can get much other than immediate support out of therapy, and I strongly doubt the full cost would be worth it to me for that. The full cost would be roughly half of what I pay for housing per month, so it would be a really really significant expense.

I don't know what to do to "work hard" in therapy- I think there probably isn't anything I could do. So the cost doesn't affect that.

[archipelago]

Asia, at least you asked the question and got responses and were honest about how you might be different. May I ask you why you would not want to go to a session besides being angry with your therapist?

[Asiablue]

Originally Posted by archipelago

Asia, at least you asked the question and got responses and were honest about how you might be different. May I ask you why you would not want to go to a session besides being angry with your therapist?

umm lots of reasons, laziness, illness, avoidance is a big one lol if i know we're going to tackle something hard then i really feel like not going. But i'm proud to say i've always turned up to sessions and never ever just not turned up or canceled short notice.

[archipelago]

Cool. Sorry that sometimes it is hard to go though. I have phone sessions when that is the case just to have a little more distance.

[healingme4me]

I don't know if I'd go, as much, paying out of pocket. Insurance covers, all but a copay. There's ways around, 'cancellation fees', when rescheduling.
I do, put effort, into my therapy. Managing stress, seeing things, reality based, are just as important to my physical health, as emotional health, if not more important.
If, I had, all, the money I could ever need, would I go?

Sent from my LG-MS910 using Tapatalk 2

[A Red Panda]

We have free healthcare here. I'm pretty sure you can get private therapists and stuff, but I go to see a mental health worker. I sort of just ended up put into it as I wanted to see the psychiatrist. I wasn't wanting councelling.

So found myself in it without wanting to be, and it's free. I still do all of the work that my T asks me to do, and I'd never just cancel or not show up.

But that's just how I am as a person. As it is I already feel like I'm a huge waste of his time - there's no way that I could cancel and waste his time even more.

[archipelago]

I guess I have to admit now that I think about it that money is a factor in the sense that if I had more of it, I would go more often and do real analysis like 3 times a week, but I can't afford that and don't really have the time or energy. What we do already takes up enough.