[scorpiosis37]

So the news is that my T has multiple sclerosis (which my biological mom has and which I myself am predisposed to, but do not currently have). She said that she is physically doing okay now but her diagnosis has made her reevaluate what is important in life and she has decided that she would prefer to write a book, do speaking engagements, and spend more time with her kids than to work full-time as a therapist. She has decided that she will continue to run her business, but she will not practice out of it. She is going to go on disability. However, she said that would still like to see a few of her clients (including me), but that she can no longer bill through insurance because of her disability claim. That would mean I would have to pay out of pocket. I am an academic; I make okay money but not enough to pay a huge therapy bill out of pocket, especially when my therapy co-pay to see her has always been $10. We have arranged a phone call for tomorrow evening to discuss the possibility of continuing to work together, but I'm extremely worried about the financial aspect of it. The truth is that I cannot afford her fee unless I get help from my dad. But something about that seems wrong to me. My dad had Parkinson's and is very much disabled, but he is still working. I would feel horrible taking money from my dad to pay for my therapy in an arrangement that feels a little... uncomfortable... given the insurance/disability claim issue. Do others think this situation sound a little...???

The fact that my 5-year-long relationship with my therapist rests on whether or not I can scrounge up enough money to pay out of pocket (due to her disability claim) makes me feel pretty lousy. It makes me feel like she was not genuine all of the times she said that I am not just a job/paycheck and, if my insurance ever changed, we would "work it out" because she cares more about me as a client than about the money. She has literally told me before "I don't care about the money." I also know for a fact that my T is not struggling financially; she makes well over 6 figures and had several streams of income other than her therapy practice. The money is a much bigger issue for me than it is for her. Of course, I feel for her regarding her diagnosis!!! I'm just hurt that it seems her diagnosis has so drastically changed our relationship-- or what I thought our relationship was. I would never expect her to work for free, of course, but I'm afraid that she won't compromise with me enough so that I can continue to see her. If she isn't willing to accept a reasonable fee (since that fee would be pocket money; no insurance or taxes involved), it will hurt so badly. In her email to me, she told me that if I can't pay out of pocket I can contact her new, merged practice at X number and find a new therapist. Really?? That makes it seem like she doesn't actually care about me or our relationship. Whether I pay $50 or $100/hr is not going to make a dent in her life but, for me, it's the difference of whether or not I lose one of the most important people in my life. Which, clearly, makes me realize that I need to re-evaluate how important my relationship with her is. I certainly feel misled though. I am questioning whether or not she meant it every time she said "I love you" and "I feel the maternal bond too" and "I don't care about the money" and "you're the reason I do what I do" (i.e. the therapeutic relationship we have makes my profession worthwhile), and "I will be in your life forever."

Honestly, I don't know what to do. Or how to feel. Last week, all I wanted was for her to come back! And I still do! But these terms make it a whole different can of worms...

[Leah123]

If it truly hinges on scrounging up enough money, then yes, I think something is seriously rotten. And I hope I'm wrong because it feels terrible to say that knowing your situation and your relationship with her.

BUT

More importantly, and more positively.... I think that phone call actually means working out a suitable fee, one that you can definitely afford, because that's her professional and personal obligation to you given the therapeutic relationship you two have.

I feel she's been thrown way off her base for a while due to the serious diagnosis, and to me that explains the recent uncomfortable interlude. (I'm not saying it's a non-issue or to "let it go" not at all, just that I can make a lot of sense of it given the news.)

And now I think, based on all your prior posts... that she should be there for you and that means in a *manageable* for you way.

Once I thought my therapist was letting me down/pushing away... and she and I have some history like you and yours...

and I said to her "I am NOT letting you off the hook." or along those lines, that I was holding her to her commitment and fighting for the relationship. Turns out I did not need to, but I was glad I realized it and said it - that we were on a journey together and it wasn't over yet.

P.S. I just read the part about you being referred to her practice if you couldn't pay out of pocket. That threw me for a loop. I hope there is a miscommunication there. I deeply hope it.

I'm sorry you're having to deal with all of that. Sounds like a difficult situation and I hope you're able to work something out that will be beneficial for you.

[ruh roh]

It bothers me that she's not being honest about her employment in order to claim disability. Would it be worth it to you to see her for a few sessions to talk about your feelings of being misled by her all these years?

[On a side note: It bothers me a lot that she is seeking to hide her income in order to claim disability.]

[unaluna]

Maybe she thinks you make a lot more than you actually do? Maybe just use this as an opportunity to have a really uncomfortable conversation, saying the things youre sharing here. Kindly, of course.

[Rive.]

I don’t get that. Why do people (worse for a T as they ought to know better) say such things e.g. i love you, money doesn’t matter, will be in your life forever etc... and then such discrepancy as, in your case: if you can’t afford me, bye-bye?! (esp if you say she isn't hurting for money)

I would feel the same as you re genuineness of the relationship and her supposed caring.

I really hope when you speak to her you can talk this out (politely) and come to a half-way compromise. Otherwise - if she is adamant this is her new policy, i wouldn’t feel too positively about her morals tbh.

[atisketatasket]

I would figure out what you can pay and be very upfront about it. The only reason I can afford as much as I pay for therapy is that I'm temporarily out of academia and in the private sector. When I return next year, one therapist has to go. If your therapist has an inkling about academia, she should understand this (acceptance is a different matter).

I hope it goes well.

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[LonesomeTonight]

I'm glad you heard from her. I hope you're able to work out an affordable fee. If she has plenty of money, I agree that charging you her regular rate seems wrong. Plus, technically, she shouldn't be making money on the side if she's collecting disability (at least that's the rule in my state--my aunt's on disability).

And what does it mean if she's continuing to run her business? Does she own the therapy practice and thus would be making money from it? Just wondering. I'd see what she says in the phone call before making a decision. Do you think she realizes that you can only afford a certain amount? Let us know how the call goes.

What a person can have as income varies depending on what type of disability they are falling under, so it is possible and legal to have a certain amount of income under certain types of disability. (I can never remember which is which.) As far as the insurance thing goes, that may also be tied into the type of disability she is working under which may be why she has to work under out-of-pocket now in order to be much more careful about what income is coming in.

Hopefully when you talk to her you will get more information about what the possibilities are for you. I know this is stressful for you and for her both. Having gone through helping my sister get onto disability and all the paperwork and rules surrounding it, it can be a bit stressful to go from full income to disability in a short amount of time. Definitely requires rethinking everything you thought you had figured out about your future.

[scorpiosis37]

Thank-you for all of the responses. I really hope that my T and I can figure everything out on the phone as well.

While I do not personally know the laws in my state regarding disability, I read her e-mail to my dad (who is a lawyer and who files my mom's claims as she also has MS), and his reaction was that it sounded a little fishy. He told me what questions he would like me to ask her, because he is troubled by the legality of the situation. And, quite frankly, it may ultimately be as much his decision as it is mine. I cannot afford her full fee on my own so, if I decide I want to see her and she won't budge on the price, asking my dad would be my only option. I would not do that indefinitely, but it is somthing I might consider temporarily because, if nothing else, I need closure.

Yes, my T does know my salary, down to the dollar. We talked about it a month before she went on leave because I took on an additional appointment, which raised my meager salary by a few thousand dollars. But even with that small raise, I do not make anywhere close to enough to afford her full fee.

[divine1966]

Well I don't expect anyone to work for free or for less money than they want regardless how much they love their job. I don't work for free so why should they?

Saying that if she intends to hide this income and not pay taxes then I'd move on to a different t. She will claim disability but will collect from you on the side?

I would ask your dad to help with a bill if your insurance wouldn't cover therapy. But if it does I would go see different t. The one that takes insurance. Not this one

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I'm so glad she got back to you, and I'm sorry she got the difficult news of MS. I know from what you've said about your mom's diagnosis and your own MS scare that it must be hard to absorb all of this.

It would be really nice if you were still able to see her, but I do understand the worries about the cost and not being able to use insurance. It does make me a bit skeptical when you mention that she's filing for disability and can't accept insurance because of how that will effect her disability. People are able to make a small amount of money when on SSDI, but I imagine that if she "owns" a business and also plans to see clients on the side, she'll probably be over the limit. Unless you live on disability or know someone on disability you won't believe how little the money is that a person is living on, although SSDI is better than SSI. It always makes me sad that people are willing to compromise their integrity and morals to get around the system, although perhaps she is not trying to do that and this is something else entirely. I hope so. Perhaps she realizes that she isn't going to have anywhere near her former income and she's trying to find ways around this. I hope you're able to have a productive conversation with her about the entire situation and that you're able to find a way to continue to see her, even if it's just to gain some closure.

I would feel horrible taking money from my dad to pay for my therapy in an arrangement that feels a little... uncomfortable... given the insurance/disability claim issue. Do others think this situation sound a little...???

Yep, absolutely. It smells fishy. Maybe she will give you more information when you talk to her, but from what you've said, it sounds like she's planning to see clients "under the table" and not report those earnings either to her disability insurance provider (Soc. Sec. or private disability or both) and probably not report them to the IRS either, since that information is available to Soc. Sec.

I don't know what her personal financial situation is; she may be having a cash flow crisis if she's going to be losing most of the income from seeing clients.

I imagine she will do what she thinks she needs to do to manage her finances. If that involves asking you to pay more than you can afford in order to see her, that puts you in a tough situation.

I would decide how much you can afford to pay her per session, even if it's only your $10 co-pay, and refuse to budge from that. It would then be up to her to accept or reject that offer.

My perspective is that of someone who's been dealing with spending and debt issues for years, though, and I know how easy it is to let emotional reasons lead you to spending more than you can really afford for something.

It stinks that she said things to you in the past like "the money doesn't matter". I would imagine that when she said that, she wasn't expecting to be diagnosed with a serious illness.

She very likely is seriously stressed about her finances and her future earning power and her cash flow during the time that it takes to be approved for disability benefits.

Once you get approved, you can work some, but it's very difficult to get approved if you're working. Advice on that varies from place to place in the US, depending on the mindset of the Soc. Sec. judges in that area, but when I was applying initially, my lawyer told me "no work while you're being evaluated", which can easily be a two-year period.

Almost anyone is going to get a little freaked out about how they're supposed to survive for two years without working if they have been working up to that point.

It's possible that your therapist has private disability insurance, too, and that has another set of rules.

Regular Social Security disability looks at your income from "work". For example, you can have investment income, and they don't care about that at all.

I hope I haven't repeated things you already know. I suppose I was motivated to leave a reply on this thread because I do hold therapists to a high standard of honesty and professional conduct, and what yours is proposing sets off alarm bells for me.

Best of luck for sorting out what you need to do.

[BonnieJean]

The fact that t put all that in writing about seeing clients off the books due to the disability status is not wise. Email travels across servers and thru venders and nothing in it can be presumed to be only between the writer and the recipient.

[missbella]

I was convinced by a music teacher to pay her untraceable cash for several years "because we were friends." She had a nice renovated house and lifestyle. It always felt kind dirty and I felt dirty being involved in it. I always pay my taxes.

It sounds like fraud, which means if you continue to see her for out of pocket money, you'll be involved with fraud also.

I'm glad for you that you've heard from her, though. And I feel for you regarding her inconsistencies - promising she'd be in your life forever and then.. this.

[SallyBrown]

I agree with those who say: figure out what you can afford, propose it to her and see what happens. I'm having a hard time figuring out, based on your description, whether she put forth her fee as take-it-or-leave-it, or if she put forth her fee but didn't say anything about reducing it if it was necessary. So, the *situation* may not be as dire as you think... but regardless of the actual situation, I can totally understand why you'd feel the way you feel about this. If money doesn't matter, then why not come to it from that place, instead of saying "You can pay a fee or see someone else"? And of course you're questioning the other stuff. At least with the "money doesn't matter" statement, you're in the (unfortunate) position of testing that now, but you can't really test love.

I hope there's some way through this that doesn't involve a painful unraveling of your relationship with her. I'd get why you'd do a few appointments for closure if it came down to it, but -- I am sure you know this -- don't try too too hard for it, because closure is extremely elusive. I do get why you wouldn't want your dad to pay for it. It definitely seems weird and not quite right.

To borrow from another thread, I'd send you a virtual (high-protein veggie-packed) lasagna if I could.

[stopdog]

I think sometimes people, even therapists, say things they may mean well enough in the moment but then the moment/circumstances change.
I hope you work it out with the therapist.

[scorpiosis37]

I talked to my T last night. She said that her standard few is $150, but now that she is going to be taking payment out of pocket she is charging clients who make above a certain amount $120 and clients who make under that amount $80. So, for me, the fee is $80. I expressed a little concern over this, and she said she might be able to come down to $75, but no lower than that. That was above the number I had in my head. In my head, the number I could afford was $50. However, in the moment, I agreed to the $75/$80. I don't want to lose my T over $25/week. So, after I hung up with her, I called my dad. We worked something out where he is going to help me for awhile, while I try to cut down on other expenses and come up with a way to work this amount into my budget. It definitely puts a strain on things-- and it sucks to know that there is a $ amount attached to my relationship with T-- but I made the decision that I am just going to move forward with the way it is. I want her back, and it's worth it to me to have that support and consistency. I've tried out other therapists and I don't want them; I want her. So, we are going to have a phone session next week and then, the week after, I will see her in person again for the first time!

I will, however, have to work through some of my hurt feelings with her. In order to move forward, I need to tell her how it made me feel that she didn't follow through on the referrals. My hope is that we can get through that in a session or two, and then just move on from there. I really want to get back to having the relationship we had before the break. I miss her!

[Cinnamon_Stick]

Originally Posted by scorpiosis37

I talked to my T last night. She said that her standard few is $150, but now that she is going to be taking payment out of pocket she is charging clients who make above a certain amount $120 and clients who make under that amount $80. So, for me, the fee is $80. I expressed a little concern over this, and she said she might be able to come down to $75, but no lower than that. That was above the number I had in my head. In my head, the number I could afford was $50. However, in the moment, I agreed to the $75/$80. I don't want to lose my T over $25/week. So, after I hung up with her, I called my dad. We worked something out where he is going to help me for awhile, while I try to cut down on other expenses and come up with a way to work this amount into my budget. It definitely puts a strain on things-- and it sucks to know that there is a $ amount attached to my relationship with T-- but I made the decision that I am just going to move forward with the way it is. I want her back, and it's worth it to me to have that support and consistency. I've tried out other therapists and I don't want them; I want her. So, we are going to have a phone session next week and then, the week after, I will see her in person again for the first time!

I will, however, have to work through some of my hurt feelings with her. In order to move forward, I need to tell her how it made me feel that she didn't follow through on the referrals. My hope is that we can get through that in a session or two, and then just move on from there. I really want to get back to having the relationship we had before the break. I miss her!

I was wondering how often you see her and how often you need to see her. Could you go every two or three weeks? It would save you some money, or could you do that until you work it into your budget?

I am so glad you can still see your T. My T also has MS and when she was diagnosed she was out of work for months. She is doing well now.

[stopdog]

I am glad you are able to work something out. I am surprised the therapist knows the income of the clients. I would never tell the therapist what my income is.

There's always plasma donation, if there's a facility for that in your city. If you go every week, it would cover your therapy expenses, and it has the added bonus of being a good metaphor for your situation.

[LonesomeTonight]

Could you maybe go just every other week, if finances become too tight? Not ideal, but then at least you could still see her.