Question about fees

I see my T once per week for a double session and my T also gives me extra time each week because she has no one after me. I pay the full amount for the double session each week. Now my T wants to see me twice per week but has said that she wants to make it two regular sessions, no double session and no extra time. I'd be paying the same amount but getting less time. I feel like I can't be upset about this and say anything because she was giving me extra time, but I'm very hurt. Because she knows that I'm in the middle of an emergency right now and how much her support means to me, so it upsets me that she's choosing now to take it away, especially since she knows I can't afford to pay anymore than I already do. I think I'm not being fair to her but I feel terribly, terribly hurt.

This kind of change can be REALLY hard ... the best thing I can suggest is to reframe it: yes, the session time will be shorter; however, you will have to wait less time until you see her again.

Otherwise, yeah, I think the fee situation is fair. But, of course I can understand the hurt. It's hard to make these changes... you should definitely discuss these feelings with her.

Like you, I was seeing my T once a week for a double session.
Due to some issues I was having she suggested we meet twice a week for a regular session. I was a little nervous but I actually like it much better. As it was stated earlier I didn't have to wait so long to see her and I think I've made more progress.

Did your T tell you why she wants to make the change?

Your feeling hurt is appropriate and valid in this kind of situation.

Your T screwed up by not maintaining professional boundary from the beginning by giving you extra time after your double session. This way she has set a routine you have gotten used to and changing this routine now understandably makes you unstable, and, if you are in crisis, it only exacerbates it. As a therapist, she has to understand the importance of consistency when working with highly traumatized people. If she had to make changes for whatever reason, this had to be run by you, discussed with you in advance, not just imposed on you like that. So, yeah, I am sorry, but that's a screw up on her part. Sorry you are hurting. Your pain is completely understandable.

Thanks so much everyone. I would really like to add the regular session and keep the double session (no extra time). But to do that I would need her to give me a price break (half) for the new session. She hasn't offered that. And I don't think it would be fair for me ask considering that she's given me so much extra time in the past. I'm really upset.

It seems clear to me that your t wants to help. Perhaps she would be able to do the price break. It seems to me that it would be ok for you to say that is what you want-unless her saying no would be devastating. She may not know that you can afford the half-session fee.

Did she say why she wants to do the switch?

It'd be perfectly appropriate for you to ask for fee reduction. Just because she made a choice in the past to give you some extra time doesn't mean you owe her something. You don't. As I said, it was her choice to give you some extra time. You didn't ask for it so you owe her nothing. And if you DID ask for it you'd still owe her nothing

1. because when someone does you a favor that doesn't put any obligation on you to "return" the favor by not daring to ask for what you need. They did what they did by choice. You didn't force it on them.

2. because she screwed up when she let sessions go over time, which is why you are hurting now, so the "favor" she did turned out not to be a good thing for you at all

3. because she is still getting paid well so it's not like she is seeing you for a low fee or pro bono.

Please, don't feel ashamed or guilty about asking for fee reduction when you struggle financially. There is nothing wrong with asking to cut the price. She is not obligated to fulfill your request, but it's still okay for you to ask.

People don't realize that often times therapists WILL reduce their fees, often significantly, if you ask them. People are just afraid to ask. It's also not in the American culture to bargain. I've come from a different culture, so it's much easier for me to ask to cut the price from the get go with no guilt or shame. I did that on the very first session and most of the time they'd cut the fee about 30%.

Thank you so much everyone. I've decided to ask her in my session today. I'm so SO nervous but know I won't be able to continue being real with her unless I at least ask and we talk about it. I am worried that I'll be heartbroken if she says no.

Sarah - she wants to do the switch because she thinks it would be better for me to have less time between sessions so I wouldn't struggle as much with waiting.

This makes perfect sense to me for the switch. It seems that you know the "extra" time was just extra time. Did you expect it to last forever? Maybe she felt this extra time wasn't helping you, so she decided to switch things up. Or maybe she needs that extra time for herself?

ScarletPimpernel - I love your name! No, I didn't expect the extra time to last forever. But I loved it and was thankful for it. I think what's so hard for me is that I shared with her how much our sessions have been helping me and then about three weeks later, she suggested making this change. It also hurts that she wants to make a change right now when I'm in the middle of an emergency and she knows that. I don't know. I know I'm not being fair to her, but I'm just really hurt. It reminds me that in the end it's all about money and somehow that hurts a lot.

I don't know. It almost sounds like she's trying to help you. Maybe I'm misreading something. I understand that you're in a crisis/emergency, but I would think that having sessions twice a week would be more beneficial than having a double session once a week. That's just me of course.

I see my T once every four weeks now. It's really hard. But she allows me to check in via email at least once a week, and if I need to, I can make a sooner appointment.

The biggest problem in this situation, as I see it, is this. The therapist may be acting out of good intentions, but the change she is imposing on you was decided without your participation. There was no prior discussion with you about the upcoming change. No one cared to ask you if it would be okay with you and what your preferences would be. You were basically told "this is how we will do it from now on because this is for your own good and because I said so". Do you know who is treated like that? Children. So, the biggest problem for me in this situation is that you are being treated like a child.

You are an adult. This is YOUR therapy and YOU are paying for it. You have the right to voice your preferences and to take part in deciding how your therapy will proceed.

No therapist can have intimate knowledge of your emotional process. Only you have that knowledge. Only you know what helps you become stable and what makes you unstable, what works for you and what doesn't.

If the therapist can't give you what you need for whatever reason, that's okay, as long as the therapist acknowledges it as their limitation instead of presenting it as something that needs to be done for "your own good".

It pisses me off when therapists treat their clients like stupid children who are supposed to obey and who have no right to make decisions in regards to how their therapy should be conducted while, at the same time, charging them an arm and a leg.

Just wanted to share that she said no to the reduction in fees. I'm extremely hurt.

I am really sorry to hear that. This is very unfair to you. Personally, I would confront her about her unprofessional behavior and then would look for a new therapist. I know it's stressful to search for someone else when you have worked with someone for some time already, but at this point the trust is broken. I don't see how your therapy can be effective from now on when there is no trust and when you feel betrayed. In the sense, you are without a therapist now anyway..May be it'd be a good idea to take a short break, sort out all you are feeling right now and then make a decision with the cool head.