How often do you see your T?

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WinterRose said:
How do you manage seeing a therapist so regularly with healthcare? Is it very expensive for those of you who do? My plan only allows 30 visits a year.

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My therapist is not on my insurance plan, but my insurance does have some out-of-network coverage. It ends up being that insurance pays for about 43% of the cost of my visit each week. I think they pay that much through 48 visits, then they pay less, but I haven't figured out the percentage. (What they're actually paying is 75% of their Usual Customary Rate which is a lot lower than what my therapist charges). I end up paying several hundred dollars per month out-of-pocket. It's hard since I'm single, but I have no dependents so that does give me more disposable income. I also recently started group therapy which I'm paying for without help from insurance. The therapist offered to not charge me for group, but I'll wait and see if I can afford it first. If I start having financial problems, I'll ask him for a discount on the group part of it.

Definitely ask about sliding scales! I bet quite a few therapists take on clients for lower fees sometimes.

I would have never thought that I would spend so much on anything (I'm too cheap to even get high-speed Internet at home -- here I am on my 56k modem connection), but it has been totally worth it to me. I will never regret one penny of it.

Sidony

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WinterRose said:
How do you manage seeing a therapist so regularly with healthcare? Is it very expensive for those of you who do? My plan only allows 30 visits a year.

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Winterrose, yes, it is very expensive. My health insurance pays for ZERO visits a year to my T because he is not part of their provider network. But he's worth it. I just put it in my budget. I don't think I could ever ask him for a reduced rate. I would think that an unreasonable request of him and would be scared of rejection. If I got short on cash, I guess I would cut the frequency of my visits to once every other week. I know he is completely booked up every day and has a waiting list, so I would expect him to take on only clients who can pay.

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WinterRose said:
How do you manage seeing a therapist so regularly with healthcare? Is it very expensive for those of you who do? My plan only allows 30 visits a year.

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My T has a sliding scale so I don't use insurance with him at all.

But I remember when I lived in NY, my insurance plan only allowed a certain amount of visits with my T and I had to end up paying out of pocket for extra visits that I needed. She was very nice and we tried to work out a fee that was fair for both of us.

I paid my therapist out of pocket and got a full-time job so I'd have enough to do so (was only working part-time before) and I saw her once a week but for a back-to-back session (so 100 minutes at a time). I really liked that setup as I had enough time to introduce and work things through in a session and see what was going on from session to session.

"How do you manage seeing a therapist so regularly with healthcare? Is it very expensive for those of you who do? My plan only allows 30 visits a year."

My T is working with the case worker at the insurance company to get more visits approved. My therapist said that there was a law passed last June or July that said if an employer has more than 50 employees, the insurance must allow 60 therapy visits per year. I don't know if this is right or not; maybe you want to ask your T.

Muffy

I see him once a week. This is a great question because last session we talked about how I thought he was trying to get rid of me as a client...irrational I know.

Anyway, he said most of patients are 10-12 sessions and then there is a smaller subset and then he paused and said "who have more to deal with and are more long term".

It's been a year now...giggle. Guess I'm part of that smaller subset.

Ya know, I can't see how anyone can get anything done in 10 visits. Do I have more problems than the average person who goes for therapy? If I had a problem that could be solved in only 10 visits, I probably wouldn't even seek therapy because I wouldn't consider it "big" enough to require the help of a professional.

specific phobias can be treated in a fairly shortish time via systematic desensitisation or flooding.

people can also do a 'crash course' in anxiey management covering such things as the role of diet, exercise, sleep, and specific skills like progressive muscle relaxation.

similarly for sleep difficulties.

sometimes brief educationally focused therapy is useful for people while their meds kick in too...

depends on the nature of the problem (life time traits / habitual ways of coping vs typically very good functioning but specific problem now)

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muffyvanderbear said:
My T is working with the case worker at the insurance company to get more visits approved. My therapist said that there was a law passed last June or July that said if an employer has more than 50 employees, the insurance must allow 60 therapy visits per year. I don't know if this is right or not; maybe you want to ask your T.

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There's a loophole in the law that allows my company an out because they're self funded.

I see my T one to three times a month. I view her more as a consultant than anything else. Never have experienced the transference, negative or positive so can't speak to that.

This is a really good question and one that I have been thinking a lot about. I see my T twice a week and have been for the last 6 months. It really has been helping but my insurance only covers 10 sessions so obviously that doesn't last long. I know that my T said that when my insurance ran out that if I was having trouble financially, we could talk about a sliding scale and even not charge me until my insurance kicked in again. He said that if I was willing to make the committment to therapy and to him then he was willing to make the committment to me and not the money. I have been paying out of my pocket for most of the sessions (which is putting me financially further and further backwards) but I am so scared to say anything to him for fear that he will be upset or cut my sessions to once per week and given the nature of the topic that I am working on, I don't see once a week being enough. I have no other support in my life besides my T. Anyway, I kind of feel stuck between a rock and a hard place. If I do ask him to reduce his fee then that is not really fair because he is a professional that needs to survive and make a living too...how can I expect him to keep seeing me for so little but then on the other hand, how can I keep going at this rate while all my other financial obligations are getting put to the wayside so that I can continue with therapy? Anyway, thanks for letting me vent this out.

Sunshine, your t has already told you that he would work out sliding scale with you if need be, and if you are committed to the therapy. I would trust him on that one. I would also tell him about my fear of hime reducing the sessions to once weekly.
If I was in your sich I'd say something like, ''I am gaining a lot here, I so appreciate your expertise. You had once mentioned to me that when my insurance runs out and I'm unable to pay you'd work out a sliding scale fee. I have been afraid to bring it up for fear that you would cut my sessions to once a week. However, I feel that I need the support of twice weekly, and yet it is so hard for me to swing it financially. Are you able to work out a financial arrangement without cutting down on my sessions?"
When I felt the need for twice a week I told my t that I feel I need to see her more often and would she be able to make it financially possible for me?
Let us know what happens.
Take care,

Thanks Withit,

I know that I should speak to him but I know that it won't be this week for sure as I am pretty angry at him and will need to deal with that first. I do think that at the end of the session tomorrow I will tell him that I need to talk to him next Monday about it thought so that way I can't get out of it. I do that often tell him about what I need to talk about or send him an email (which he likes me to do) and tell him what I want to discuss so that I don't back out when I see him.

Anyway, bottom line, I am still freaked out about talking to him and admitting that financially I can't do it. I don't want to admit that I am in financial ruins to him and the reasons why but I know that I have come a crossroads and need to say something. I know that he will probably be understanding but to me it is just embarrassing to admit.

Thanks again Withit and I will let you know when I talk to him.

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WinterRose said:
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muffyvanderbear said:
My T is working with the case worker at the insurance company to get more visits approved. My therapist said that there was a law passed last June or July that said if an employer has more than 50 employees, the insurance must allow 60 therapy visits per year. I don't know if this is right or not; maybe you want to ask your T.

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There's a loophole in the law that allows my company an out because they're self funded.

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Whatever State you live in is actually "in charge" ultimately; the 1996 HIPPA and Mental Health Parity Act don't say anything about number of visits; only lifetime $$$$ amount limits.

http://www.cms.hhs.gov/HealthInsRefo...hParityAct.asp

Sunshine, you said you don't have any other support besides your T; you probably should work on developing some? Riding a unicycle over a road strewn with glass and "hoping" you don't get a flat tire is not a great plan :-)

Do you have any friends, relatives you like, interests, job(s), hobbies, activities? Does your mental health plan have anything for group therapy? Maybe you could supplement your individual with (usually) less expensive group therapy and alternate/save some up for your individual sessions? Who do you "practice" what you learn in therapy on (besides us :-)?

I do work a full time job and a seasonal second job in the summers and play sports one night a week but other than that I have no real friends or family that I am open with about my mental health or issues in my life. I am closed off and put a fake smile on for all. As for group therapy, I have been in one long time ago and it didn't go very well. Other than two forums (one being this one) and my T, I do not have any other support. Pretty sad eh?

I used my job relationships with other women to help me with my therapy issues. I kind of used my job like I use these mental health groups only as face-to-face opportunities to help me with my GAD. Since I had to leave work to go to my therapy sessions, I told "everyone" at work (starting with the group of women I worked with) I was going to therapy (and was very surprised at the number who were curious/wanted to know more about therapy, etc.) and had a good time with my best friend in the group "arguing" about therapy, she couldn't see telling someone about one's self unless the other/therapist would talk about themselves :-) I was able to get a better understanding of my own beliefs and rationale, etc. I got to practice with my feelings as I had a boss who would gently tease me if I snapped at him the next day at work, "Oh, therapy must not have gone so well last night?" It was actually extremely helpful in getting me to see my effect on others and associate my feelings with what was actually going on in my life, etc.

You don't have any friends in the sports group or go out afterwards to celebrate or anything?

I can relate to what you are talking about with the people at work because a few of them at work do know about my therapy and I am becoming more open slowly with it. I can actually say that I am leaving for therapy now instead of shyly saying an appt. It does help too that I have a lot of different personalities to work with which is helps me practice my patience and coping skills. I work with a narcissistic, a bipolar, an ADHD and a person that suffers from depression and ADHD. It really is quite a mixture of people. These 4 are actually the head bosses of the place I work -

Anyway, to say the least, our place is never boring

As for sports friends, no we don't go out afterwards or anything but we do have an end of the year banquet which is a blast. I am just more of an introvert that likes to stay home and hybernate.

These employers can find more ways to get out of taking care of their employees - it's sickening.

Muffy

OT Sunrise, try and view the situation this way: Your therapist's deep desire to help others, get the education to do so and go through having an office for accessibility and continuity...caused him to be a therapist. He would be a therapist anyway, but there's no way to do that and pay his bills so he could continue to help. You are helping him pay his bills so he can do what he loves and does best: help you.

OR

You have hired a consultant who is expert in the matters of the mind, emotions and "heart." Just like any other consultant (banker, CPA, lawyer, engineer) his resulting experience with you is not based upon what you pay, it doesn't change if you don't pay much or alot, the information he (they) give is based upon their expertise and that you have hired them to tell you what they know, and guide you along the way of the project you asked them to help with.

You aren't paying him to be a friend, or to care. He does that because of who he is. You pay him so he can have time to show you he cares.

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_Sky said:

You aren't paying him to be a friend, or to care. He does that because of who he is. You pay him so he can have time to show you he cares.

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wow sky, never thought of it that way. great words.

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_Sky said:
You pay him so he can have time to show you he cares.

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Love that.

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_Sky said:
You aren't paying him to be a friend, or to care. He does that because of who he is. You pay him so he can have time to show you he cares.

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Sky, I love that (especially the part I bolded). Thank you.

It was funny at T yesterday... I pay on a sliding fee scale and I'm seeing him twice this week so he asked me if that would be a problem financially, and if so, I could pay him at a later time for the extra session. So I go, "No way-- I'm loaded." And he raises his eyebrows and says, "Really? Then maybe we should spend the session talking about re-evaluating your fee." And we started to laugh because we both know I'm far from loaded.

Hmm, there's a little pizza guy on here.
He's eating. I'm not.
I ordered a pizza one hour and five minutes ago...
Now the question is.... WHERE IS IT?

That was pretty funny about being loaded

About your pizza, do you not have a 40 minutes or its free offer?