[Leah123]

I have been struggling with overspending in therapy. The money's been well worth it, but I was spending more than was really affordable and decided to cut back. Cutting back has been hard, but I've made some progress. Been trying to cut back about 2/3, and have managed to cut back about 1/2.

It got harder to manage when she raised her rates 25% in January, but I've been working hard on it.

My therapist and I made a plan to make this manageable and have been fine-tuning as we go. I plan on a Monday session and a Friday session and to get to do an email session at a reduced rate in between. She volunteered a fixed rate for that email starting two weeks ago.

But last week, the first week of the fixed rate email, I thought I'd written too much, so offered to pay a higher amount, and she said she appreciated my offer and sent back an invoice for a midpoint, between what she originally offered and what I offered.

I did not give myself a chance to take the lower rate because I did not want to take advantage of her time.

The thing is, I feel so inhibited knowing she agreed to a lower rate, because then I feel I shouldn't write as much as usual, which just makes it much harder for me to be open with her.

This week I decided not too worry too much about writing, but I am writing a lot again, and feel like the rate she offered me is unfair to her. But I'm torn because I want to be able to trust her.... I want to let her do this for me, but... I don't want her to resent me or regret her offer and I don't want to take advantage of her time, sigh.

(Yes, I know I should just let her do it, and not raise the issue of fees, just pay the agreed upon amount, sigh... I know it, and I've read about others having this problem like 20 times on this board, jeeze.)

So, I've been dealing with a bit of awkwardness about fees, and tonight I noticed...

she raised her rate AGAIN!

That's the 3rd time she's messed around with it in the last five months.

I'm sure it's for other clients, and she'll continue seeing me at the January rate, which was already 25% higher than what I paid last year,

but it's SO awkward. I don't like thinking I can't afford her. I don't like feeling... inferior, like I can't just pay whatever she charges. I don't like feeling that if I want to add an extra session, it'd be at the higher rate, which is what she'd said in January when we discussed this.

I LOVE my therapist. She's highly experienced (20+) years. She understands me. She's reliable. She's committed. She's versatile. She's caring. She's giving. She's a good therapist, and she knows ALL about me.

But when I feel stress about the finances and feel unsure about her rates... I just wanna quit. I wanna go find someone who takes my insurance, pay them the $30 an hour copay and hope for the best, that they'll let me email between sessions and I won't struggle to pay for them out of pocket as I do with her. I just finally told her all about my financial circumstances recently- took me a long time to get open and trusting enough w/her to talk about that.

Sigh. It's temporary insanity to think of seeing someone else, but I hate the financial complications.

She would see me for free if I could not pay. She has said so. But I don't feel sure of things seeing that she just raised her rates again today. They're up 20%+ more than what I'm paying.

Just had to rant. Seems like I can't get clear about anything lately.... just muddled, and money muddles too.

I did already email her all my thoughts about this. I don't know why I waste my time telling her this stuff- I already know for a fact that she'll see me at my regular rate and even if I wanted to add a session and asked her to maintain that rate for the added session... well, she probably would. I want to trust her to be consistent with me, but it's so hard to trust. I hope she'll charge me the offered rate for the email this week: I just want to see if we can really stick to our plan, if she'll keep her part of the bargain, sigh.

[HazelGirl]

I relate SO much! My T is seeing me for free for May and June, and it has been so difficult both leading up to this and then actually dealing with this month. I have guilt living in the back of my mind that I need to talk about, but haven't yet.

No real solutions. Just wanted you to know I understand.

[tinyrabbit]

I'm surprised extra sessions are at the new rate - does she not just have a fixed price for each client?

Does she not take your insurance? Are there Ts who do? If so, I'm not so sure it is temporary insanity.

By the way I do two sessions a week and find it helps to have them more easily spaced (Tuesday and Friday)

[Ambra]

Hi Leah, I only have some words of comfort for you. I relate too. My therapist is not going to get anything at our next session, it will be the first time. I feel like you, I've always paid for everything and now I feel uncomfortable. T said she is fine and there's nothing to discuss if I'm worried about her, but it was difficult to text her my schedule for an appointment as I didn't feel entitled to do that. I wrote her late after a lot of thinking, I decided that not writing at all would have been an insult since she was waiting for news from me.

So I guess the best thing we can do to honor out T's kindness (defer payment, free sessions, reduced fees or whatever) is just to accept what they offer to us as long as we need to and they are willing to do it and let them know how grateful we are.

Hugs!

[AllyIsHopeful]

That's great that you are so close to your goal! I know it has been tough. Maybe more people are beginning to contact her so she needs to raise them to avoid having to turn anyone away. So it could just be a supply and demand type of situation. You're not inferior for not being able to afford her new rates, because those new rates are not directed toward you. She probably wants to be consistent and does not feel it is fair to repeat clients to raise rates so frequently, but needs to do something to control her work load.

It's good that you are able to talk about all of this with her. I know how tough it is to discuss financial matters with a therapist or anyone for that matter. I struggle with it myself and try to avoid that topic.

You really love this therapist and feel she is competent, has great qualities, and most importantly she knows and understands you very well by now; but the financial stress weighs on you so much, even after finding a middle ground with her or being reassured there is no problem. So the best way to decide if you would like to look for a new Therapist that accepts your insurance is by a cost/benefit analysis. It will be hard to transition to a new Therapist but maybe it would be worth it in the end.

Did you go with the online therapy because it is more flexible and works better with your schedule? Or are there any other reasons in particular you chose it instead of going through insurance?

[coolibrarian]

Money is always a hard thing to talk about, especially in therapy.

[Leah123]

Originally Posted by tinyrabbit

I'm surprised extra sessions are at the new rate - does she not just have a fixed price for each client?

Does she not take your insurance? Are there Ts who do? If so, I'm not so sure it is temporary insanity.

By the way I do two sessions a week and find it helps to have them more easily spaced (Tuesday and Friday)

Well, thinking about this question, I guess to be more specific, she said that if I contacted her between sessions, she wouldn't have advance notice and the rate would be higher. I guess if I pre-scheduled a session instead of just initiating one when I saw her online, maybe she would lower her fee. I'm not quite sure, but yes, it makes sense to me that my sessions should all be at the same rate.

She doesn't take my insurance and there are Ts that do, however, I have a great deal more flexibility and convenience with her, being able to do therapy from home and not just the one 50 minute session a week my insurance would mostly cover. Of course, now I've also been seeing her about 15 months and we've connected so deeply, I'd hate to stop seeing her. It's been a difficult but very productive process and she's made a commitment to me that I'd like to enjoy for a while, to just have that stability in my life of her consistent therapeutic presence.

Also, we did do Monday and Thursday sessions for a long time too, like you said to space things out evenly, but it was more expensive. The issue was then I'd do an email session between Monday and Thursday and another one between Thursday and Monday. By seeing her Friday and Monday, it's easier to avoid doing an email session on the weekend, which saves hopefully $200 a month.

[Leah123]

Originally Posted by AllyIsHopeful

That's great that you are so close to your goal! I know it has been tough. Maybe more people are beginning to contact her so she needs to raise them to avoid having to turn anyone away. So it could just be a supply and demand type of situation. You're not inferior for not being able to afford her new rates, because those new rates are not directed toward you. She probably wants to be consistent and does not feel it is fair to repeat clients to raise rates so frequently, but needs to do something to control her work load.

It's good that you are able to talk about all of this with her. I know how tough it is to discuss financial matters with a therapist or anyone for that matter. I struggle with it myself and try to avoid that topic.

You really love this therapist and feel she is competent, has great qualities, and most importantly she knows and understands you very well by now; but the financial stress weighs on you so much, even after finding a middle ground with her or being reassured there is no problem. So the best way to decide if you would like to look for a new Therapist that accepts your insurance is by a cost/benefit analysis. It will be hard to transition to a new Therapist but maybe it would be worth it in the end.

Did you go with the online therapy because it is more flexible and works better with your schedule? Or are there any other reasons in particular you chose it instead of going through insurance?

Thank you. I think she actually has not been as busy as she would like- it's hard to find regular therapy clients online where the billing is by the minute, I think it tends to draw more clients in brief crises than those looking for weekly therapy. It's different for me because I work at home online, so meeting online is convenient, comfortable, and offers a lot of flexibility, not to mention my Ts availability for email sessions and in general.

I like having a relationship with her, I deeply appreciate her ability and offer to be there for me long term, so I can rely on her presence. I wouldn't want to give that up. The money is significant, but well spent, and it helps to know that I'm choosing to pay, that if I did indeed have a financial crisis she would see me pro bono. And then of course, we've gotten to a very intimate place and have done great work together, so... I don't want to consider leaving at this point, am just hoping that we settle into the new routine and I can stop worrying.

[Leah123]

Well, she just replied to my lengthy set of three emails I wrote her last night about all this and about how worried and insecure I feel lately, as well as the one I wrote this morning saying I wish I hadn't written all that, worrying a lot over a little:

"Good morning, Leah, I just scanned over your e-mail thread and was pleased that you are feeling more centered this morning. Don't worry about the fee; your rate will stay the same; and I am totally comfortable with that. I am not going anywhere; I am here for you! Right now I am off to get ready for lunch with my colleague/friend. Hope you are having a good morning, XXXXX"

It's a little odd to have said so much and gotten such a brief reply, but I suppose it's understandable as I told her this morning I'd let my worries get away with me and wanted to wrap up the email. I guess my thing is that... I know when my feelings are illogical, I can typically see that, but... I guess I'd still like more insight and reassurance from her. However... she did sum it all up... no fee increase, and she's fine with it.

But am I fine with it, and am I fine with feeling so... anxious. I guess having brought up how hard a topic finances are for me, this is bound to be a little complicated for a while along with the other hard topic we're dealing with. Time, right, maybe if I just give it time to settle. But I wish she'd written more and not 'scanned.' Oh well. I'm really short on sleep, this will probably seem fine later. Things are actually going alright, maybe I should dwell on that for a while.

[HazelGirl]

This is something to bring up in session with her, I think.

[Asiablue]

ugh, the money thing in therapy is a minefield. Both for therapist and client, it carries so much weight in it.
She obviously cares about you to have even read your email and replied, even tho she's just about to go out for lunch. Her reply was short but I'm positive she'll talk to you more about it when you both have time to attend to it.

She was on her way out the door from the sounds of it and just wanted to give you a reply quickly before she left.

[Leah123]

Yes, I agree with you both, but she didn't say she'd reply later, and I'm not sure she will. I'm not positive what I want further from her anyway... guess I just want to know she's okay with the midweek email rate, because that would be helpful to me and objectively, it's not unreasonable given how much I've spent on her services during the past 15 months and that I'm paying for two sessions a week, offering her some stability in a format where regular clients are notoriously hard to come by. And I'm having a bit of a larger issue w/feeling inconsolable and disconnected lately, mirrored a little in this, so... that's one to probably address more tomorrow in session.

Thanks for the input, it helps to get to discuss this.

[sweepy62]

Could she be raising rates because the online company takes a part of the fee? Just asking because I don't know how I works, but I hope u get the rate you discussed, I understand how it could make the relationship uncomfortable .

Sent from my iPhone using Tapatalk

[Leah123]

Originally Posted by sweepy62

Could she be raising rates because the online company takes a part of the fee? Just asking because I don't know how I works, but I hope u get the rate you discussed, I understand how it could make the relationship uncomfortable .

Sent from my iPhone using Tapatalk

Thanks Sweepy. They do take about 50% of the fee. I wish she'd use another company, almost all the others charge a lot less, but they are a big one, better established, and I think she hopes she'll get more business with them. I have asked her to see me privately before, but she said no, I do understand, just wish it worked out better- if I saw her somewhere else, she could charge me less and *still* make more.

She did tell me not to worry about the fee: I sincerely hope that means she'll stick to her offer to just charge me a flat rate for the one midweek email session.... part of it is because I *must* watch my budget, but part of it is because I really want to know that she'll keep her word.

[sweepy62]

Wow that's a big chunk, I hope she keeps you a flat rate too, I can understand your anxiety, sometimes I think we need therapy just to deal with therapeutic issues.

We should all be required to take a 3 month intensive course in therapy that will prepare us for the actual THERAPY lol like transference 101 attachment issues , fees, anger with t, crushing on t, ect....

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[Leah123]

Well, I am feeling sad and disappointed. I just received this note from my therapist:

"Hi Leah, hope you had a good day and that you love your new carpet. I forgot the invoice earlier."

*And she sent me an invoice for the same amount as last week, which is higher than what she offered me.*

I wrote her back this message, sigh:

"Hi XXXXX. I hoped when you said you scanned my emails this morning and were on your way out, that meant you'd actually read them later.

I also hoped when you told me you wanted to offer a flat rate for a midweek email, that you would follow through.

I'm not disputing the amount. I already struggle with feeling like I'm taking advantage and my discomfiture at seeing you've increased your rates. I'm not disputing the amount, just telling you that having you fall through on your offer, I feel.... let down."

[Asiablue]

Originally Posted by Leah123

Well, I am feeling sad and disappointed. I just received this note from my therapist:

"Hi Leah, hope you had a good day and that you love your new carpet. I forgot the invoice earlier."

*And she sent me an invoice for the same amount as last week, which is higher than what she offered me.*

I wrote her back this message, sigh:

"Hi XXXXX. I hoped when you said you scanned my emails this morning and were on your way out, that meant you'd actually read them later.

I also hoped when you told me you wanted to offer a flat rate for a midweek email, that you would follow through.

I'm not disputing the amount. I already struggle with feeling like I'm taking advantage and my discomfiture at seeing you've increased your rates. I'm not disputing the amount, just telling you that having you fall through on your offer, I feel.... let down."

oh dear I hope it's just a mistake on her part....

[sweepy62]

Wow, I would feel let down as well, and I hope that it was an oversight on her part. I'm hoping you get a reply soon and don't feel bad about sending the email remember she did offer.

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[brillskep]

What you wrote here sounds like it's about more than just financial issues an I am glad to hear you've raised these issues with your therapist.

I just wanted to add a couple of my thoughts about this:

1. Very important. Extremely important. She offered and agreed on a certain fee. That means (or it should mean) that she is okay with it. A therapist needs to take care of her/himself, rather than the client taking care of him/her. It's important in every way. Especially so the client won't feel obliged to take care of the therapist's unexpressed needs and try to read their mind (as it may have been the case in the family of origin for example) and so that the therapist will be modeling good self-care practice to the client. If your therapist is as good as you say, she has probably taken into consideration her needs and what you can afford. The fact that she's raised her regular fee twice in half a year also tells you she will ask for what she needs. So you don't need to worry, she knows what she's got to do.

2. If you really, really want not to write so much to her, you could do so without censoring yourself. Think of it this way: if you were in a face to face session, you might need to talk to her for two hours but the session may only last one hour, so you won't get to say everything you want in that one session, but that doesn't mean you haven't been open. You could possibly ask her what is an acceptable length of writing in her view and stick to that. One thing which could help (or at least it does in my case) would be to first write everything you wish you could say. That will allow you to express yourself as you feel. Then you could slowly combine sentences (for example if your thinking process while writing led you to a conclusion after 3 or 4 lines, you could write the conclusion more directly the second time). Cut back on anything that doesn't seem necessary. It can be difficult, I know. To me it's a good therapeutic process in itself and helps me to calm down if I do it in a particularly distressing moment. I do this when I text my therapist because he has an old phone which can only receive very short messages. It actually helps me to clear my head and realize what's most important to me.

Leah, my heart goes out to you, because money is not an easy subject for many of us. I'm just curious, does your therapist punch in the actual numbers you are charged herself? Is it automatically computer generated? Or possibly done by the service she works for?

Best of luck in resolving this issue in a manor that is somewhat satisfactory to both of you. I know you have been working real hard to stay within the goals you've set.

[Leah123]

Originally Posted by Goingtogetthere

Leah, my heart goes out to you, because money is not an easy subject for many of us. I'm just curious, does your therapist punch in the actual numbers you are charged herself? Is it automatically computer generated? Or possibly done by the service she works for?

Best of luck in resolving this issue in a manor that is somewhat satisfactory to both of you. I know you have been working real hard to stay within the goals you've set.

Aww, thank you. She does set the rate herself, manually, for each email session and she sets her per minute rate directly as well, and the service just takes a flat percentage of that as she bills.

I feel I sent her a clear, honest message earlier... and I hope she responds productively. I will say that 95% of the time, she does, but I am still concerned, hope it will work out in the am when I have a session or she replies to my message prior.

[Leah123]

Originally Posted by brillskep

What you wrote here sounds like it's about more than just financial issues an I am glad to hear you've raised these issues with your therapist.

I just wanted to add a couple of my thoughts about this:

1. Very important. Extremely important. She offered and agreed on a certain fee. That means (or it should mean) that she is okay with it. A therapist needs to take care of her/himself, rather than the client taking care of him/her. It's important in every way. Especially so the client won't feel obliged to take care of the therapist's unexpressed needs and try to read their mind (as it may have been the case in the family of origin for example) and so that the therapist will be modeling good self-care practice to the client. If your therapist is as good as you say, she has probably taken into consideration her needs and what you can afford. The fact that she's raised her regular fee twice in half a year also tells you she will ask for what she needs. So you don't need to worry, she knows what she's got to do.

2. If you really, really want not to write so much to her, you could do so without censoring yourself. Think of it this way: if you were in a face to face session, you might need to talk to her for two hours but the session may only last one hour, so you won't get to say everything you want in that one session, but that doesn't mean you haven't been open. You could possibly ask her what is an acceptable length of writing in her view and stick to that. One thing which could help (or at least it does in my case) would be to first write everything you wish you could say. That will allow you to express yourself as you feel. Then you could slowly combine sentences (for example if your thinking process while writing led you to a conclusion after 3 or 4 lines, you could write the conclusion more directly the second time). Cut back on anything that doesn't seem necessary. It can be difficult, I know. To me it's a good therapeutic process in itself and helps me to calm down if I do it in a particularly distressing moment. I do this when I text my therapist because he has an old phone which can only receive very short messages. It actually helps me to clear my head and realize what's most important to me.

1. Yes, you're right, and I recognize I should have accepted her offer last week and *not* sabotaged myself a little by offering her more. She *did* say she might charge more for extremely long or complex threads, however, she said she would always discuss it with me first, and she did not do that. (I wonder if she might have thought my offer last week was a standing/permanent one. I did not phrase it that way, but it is somewhat possible we had that misunderstanding.)

2. She has always encouraged me to write at length and not edit, so in terms of the amount she's comfortable with, there is no limit, and she's proved that for more than a year. I do consolidate and revise though, yes, though not always, depends on if I have the time or inclination. The issue now is that I feel constrained by the lower fee she's offered. I would like her to stick to that offer, but not really sure if she's certain of it right now, so I think I'll find out tomorrow. I truly hope she is: I want the consistency.

[Leah123]

I haven't heard back, it's noon her time, session in 45. Time to play the "what's the worst that could happen game" as I'm feeling anxious.

The absolute worst scenario is that she gets fed up with how much I expect of her, time and moneywise and she terminates.

Okay, well, that probably won't happen. She's only told me dozens of times she's in it for the long haul and would never terminate me for being too much or anything else once we had established our relationship.

The absolute best scenario would be that she apologizes for being inconsistent, says this was just a misunderstanding from a convo last week, and she meant her offer and wants to honor it, that she's totally comfortable with it.

The middle of the road scenario (see, this is the one hard to anticipate) would be that she felt this was a really long email this week and worth the higher rate, and I would point out that she told me she'd discuss it with me first before charging a higher rate, and she would acknowledge that and say she'll be clearer going forward. Then I'd have to tell her the inconsistency would bother me: I want a reliable plan, and we'd have to negotiate what would be included in a flat rate email, such as maybe one or two posts a day or something. (In fact, I just popped her a note to that effect, about me just writing one main post a day, letting her reply, and then me posting a second, final reply for that day.)

I am not liking that she offered me something completely of her own volition (I never asked or hinted for this) and that it's gotten complicated. I don't need complications in my already hectic life.

[Leah123]

It's 10:05, our session was supposed to start at 10 (1 her time) and she's not online. Even as I know it's not a catastrophe, I am shaking. Come on, nervous system, take a break.

I sent one email to let her know she was not showing online: there have been glitches a time or two in the past.

I will NOT send her more. I am worried she's too angry to talk to me, that I brought up the email and she thinks I expect too much. It's harder than it should be to remember that *she* offered the email, I never asked for it, and this is just a relatively simple situation to work out.

---------------
It's 10:15. She is not online and did not reply to my email about her offline status. I have her home phone number. I am NOT going to call it.

Anything could have happened.... traffic, computer update issue, emergency (hope not), lost track of time...

This paying for email should NOT be a big enough deal to her to make her upset enough to skip a session.... I'm afraid she thought my tone in that last email about hoping for her to read what I wrote and honor the fee was sarcastic/angry, but it wasn't. Even still... this is only a big deal to me right? It shouldn't be ahuge issue to her, to her, it's just something to renegotiate if anything.

Unless... she feels she got too entangled with me and worries about her boundaries.