Should I have taken back my check?

Not always and my contract states I don't guarantee an outcome. But this discussion is not whether the therapy the OP is engaging in is useful to her - it is whether the billing for this time was proper. I can't bill one client for time spent working on another file or if I did not do the work - which is what this therapist failed to do in this instance -her job - the thing therapists claim they paid for doing.
Perhaps therapists need a K with clients that says they get paid for just renting out the space (which is how I have always seen it) - in my opinion, and this is not that of OP based on her responses to me - they don't do anything to begin with. But they claim they do - so I expect them to do that which they claim they do - appear to pay attention.

I am fascinated at how many rush in to defend therapists and give them leeway not given to others on a regular basis. I suppose it is no wonder they have god complexes

It's about my feeling of wishing I didn't have to pay, never having a career, and feeling that my T wasn't paying attention to me. A lot of stuff. Resentful of being old enough for Medicare and not having insurance like I used to have. Medicare is fine for medical claims but most Ts don't accept it and it probably wouldn't cover social workers anyway. Jealousy of T though I could travel too if I felt better and if I weren't afraid. She's going to an exotic country in a few weeks.

Thanks, stopdog. My T has always been there for me. She messed up this once. I don't like that she did, but I don't think I should have taken my check back. If I had done so, I would feel guilty. But she did offer when I complained. I'm not good with decisions.

Thanks for your input. My T has always been reliable and wonderful. I have to let it go. It's not the money like others said. I'm just very depressed right now.

She gave me the reduced rate when I went on Medicare. My husband wouldn't let me see her otherwise. He hated my being in therapy. It was okay for $25 a session but not $100. He was sick and I needed therapy. She let me pay $60 or $75. After he passed away, I decided to pay $100. She didn't tell me it was $165. Maybe I should paint to $165 now. I don't care. I want to die anyway.

Thank you. That makes sense but I am in pain from sciatica or something like that, and am depressed. It wasn't a good time for my T not to be present. You're right. Afterwards I thought I'm pathetic to pay her to listen to me sing on my phone. I resented her looking at the clock so much. I thought I was important to her. It made me feel I'm not. I'm just a paycheck. She denied that yesterday.

I don't disagree with you for the most part. But T said we had an agreement about the fee so she didn't raise it. She never told me: this is my fee, you have to pay it. I have more money now but I don't work. I have to live on what my husband had plus social security and pension. It's good but you never know what could happen. Maybe I will discuss it with her. I think she charges too much for a social worker. I know I'm jealous. I hate myself anyway.

[QUOTE=Mouse_62;59388
I agree.(sorry didn't want to use the like button. I find it repulsive in its use/abuse )[/QUOTE]

Thanks, mouse. I agree about the like button. It's hurtful and is like taking sides. Thanks for saying that!! I do agree with feileacan mostly.

I just emailed my T that I will pay her full fee from now on until I die, that I don't deserve a discount. I'm just like any of her clients and she's just my T. That's it. I said if she wants to we can discuss what that means emotionally. Thanks for all the input. Maybe I should have taken my check back but I have to be honest and pay her fee, and discuss how that tears me apart.

I think you may be out of touch with licensed clinical social worker fees which are usually not much lower than PhD/PsyD fees. My LCSW T charges $165 per hour and I'm in a small town in the southern US. The closest city is St. Louis, where fees are closer to $200/hr. In NYC over this is not unusual.

I think that sometimes jealousy and resentment can make people feel bad about themselves. I should say that this has been true for me, not trying to make it some kind of universal. I wish you could see your own value as independent from how much you earned when you worked or that not having a career doesn't diminish you as a person.

I think it's a positive step for you to pay what every other client pays to your T. That was very brave and probably very fair of you to do so. I hope you continue talking to her about what money means and what you value and why.

The other thing I would add to this is that a therapist being paid $165 an hour is not the same as an hourly paid worker in a company being paid that much. People in private practice have to pay for their own health insurance, sick leave, vacation time, personal time, etc., and have to pay the rent and utilities for the space they are renting, as well as office supplies and any items that she uses in therapy. Plus all the education and fees associated with paying for their license and liability insurance. It adds up to a lot. The therapist ends up not taking home anywhere close to that $165.

Also, it takes us a long time to get to a point where we can have a private practice. In order to be a social worker with a private practice, you need to get a masters in social work, pass a licensing exam, have two years of experience and many hours of supervision after that exam, and then pass another exam. That is a lot of years and hours.

Rather than focusing on the specifics of how much you are charged (besides sorting out what you can afford), it might be useful to talk with your T about what comes up for you emotionally. Why do you think she is paid too much (do you feel like you are not getting as much out of your sessions as you want to?)? What did you notice feeling when you saw her being distracted? What were you hoping that she would say when you brought it up the following session? Continue to look at the question behind the question, as it seems that you and others are doing.

Therapists are no different from other professions in this and other professions actually do something

I'm not trying to say that we are different from other professions in terms of value, etc. Just that you cannot easily compare the pay of someone in private practice to someone who is not (even someone in the same field). I work in a clinic and get paid a small fraction of what someone in private practice gets paid. But my office space is free. I get free supervision. Just comparing hourly rates says very little.

I am an independent contractor/consultant. I pay for my own supplies, my own insurance, full social security taxes, etc. I also charge a lot for my time to compensate for this - so I do get it. However, I don't charge my clients for time spent surfing the internet, getting lunch, daydreaming, etc. And, if I make a mistake (because "I'm only human"), I fix it - free of charge.

If I am paying a therapist for one hour of his or her time, I expect that to be my time. I actually set the bar pretty low - I don't expect them to fawn on me or to agree with everything I say - but I do expect them to be on time and to be fully present for that one hour.

"If I am paying a therapist for one hour of his or her time, I expect that to be my time. I actually set the bar pretty low - I don't expect them to fawn on me or to agree with everything I say - but I do expect them to be on time and to be fully present for that one hour."

I agree with this, and I hope what I said above doesn't sound like I don't. My point is that your time should be yours and focused on you, AND that the therapist should be paid for it.

If your therapist consistently is late or not paying attention, it is definitely time for a new one. You should not have to pay for time that is not being used exclusively for you.
I'm realizing that my post may have come across as more inflammatory than I meant it to be. My tone was meant to be patient and explanatory, not angry. I think people who are not independent contractors do not realize how much expenses add up when your company is not the one paying for them.

Rainbow, it sounds like this might have been a unique instance for your therapist? If so, hopefully it does not happen again and this one instance can be used for material in your sessions.

I am a solo practitioner - a lawyer

I'm sorry about your health issues, rainbow. That makes it hard to cope.

I personally don't really understand why the fee thing has to be a topic of analysis. I don't care what expenses a T has behind the hour when they mostly just sit there and converse with me, and I am willing to pay only so much. Not because I could not afford more based on my financial situation, but because I don't think the service is worth more - in my opinion, anything above $100 for 45-50 mins with a therapist is way too much for what they actually do/provide (I actually paid twice that already). And I don't care what goes on in their life - we all need to perform at work while also having personal challenges. If they cannot focus and participate even the pretty low amount they typically do, it's not the client who should be analyzed for being upset about the charges that are not earned. Being careful about what we spend our money on is not a pathology, at all. Just my opinion.

Just so you know, there are social worker T's who take Medicare. I see it listed under my T's accepted insurances.

Thanks, Catlovers. Yes, my T has never been distracted like this before. She has always been 100% present with me.

Thank you. I appreciate your understanding.

Thanks for your viewpoint. My T sees everyone for the full 60 minutes. She has someone before and after me! I can see how that leaves no time for anything personal. Sometimes she has to run to the bathroom before we start. I think $165 is too much but it is probably the average rate in my area.

I assumed that some Ts accept Medicare but I never thought of it when I started seeing my T.

Thanks, Wheeler. Those are insightful comments. I tend to be critical towards everyone in my life, not just Ts. I expect a lot, and end up disappointed. I have been through a lot with my T, and feel more comfortable with her than anyone in my life. I'm not looking to move forward in therapy anymore. I just need my T to be there for me as I struggle with my daily life and challenges of aging. She's my safe place.

Thank you! T emailed back that we'll talk about the money issue when I see her next. She said maybe "something in between." ( $100 and 165). So, not sure why she seems to still want to give me a discount after telling me what her fee is and that many of her clients pay out-of-pocket! She only said that after I said " most people have insurance and don't pay you all that". Maybe because most of her clients are younger than I am, are working, and are physically healthier. Or haven't seen her for almost 8 years!

Thanks. I do feel that often my sessions aren't so helpful, and that $100 is a lot of money. T and I had discussed cutting down sessions, but then stuff came up in my life, and I really need her as my anchor. The money reminds me of my being a failure, having been underpaid despite having a master's degree. I've discussed that with her in the past. I think her inattention last week triggered those feelings.

I think fees and the worth of a person's time (on both sides) is such a strange concept to begin with. There isn't enough money to compensate me for listening to someone complain about me for hours at a time, or to complain about paying me to listen to them complain about me. I realize you don't spend every session complaining about her, or even whole sessions, but man...I would find that taxing. Same as if I had to sit and listen to someone who told me not to speak for the hour. There just isn't enough money to be debased like that if the end result is that the other person is still dissatisfied. But that's me. Apparently there are those who will do that.

I have to say I am really struck by how kind and compassionate your therapist is, Rainbow. I think you have a lot to be grateful for. Maybe you would feel better by tapping into what is going right/well for you?

I think therapists pride themselves way too much about doing anything but I also think they mostly don't take clients all that personally. I know, as a lawyer who was a public defender for a good number of years, that my clients (and the world in general) did not love me for the most part. I did not take it personally. A good friend of mine had his eye socket broken when his own client punched him in court because the client thought it would get him a continuance - and he did not take it personally and he negotiated a good plea for the client. I also believe 100 is a lot of money.

I find it is good when clients stand up for themselves to a therapist. The idea of being grateful that a therapist is not terrible all time is not one I would embrace or encourage. I think that leads to someone accepting sub par treatment and says they are not worth better treatment from the professional they hired.

I think there are therapists who take Medicare, but you probably want to stick with your current T think so that is not an option. I do think it is reasonable to ask for a reduced fee that matches your finances or even just what you personally feel it is worth for you - it is a fair negotiation, like with any professional or seller. The thing though is that the T may also have their own idea and cutoff, and perfectly has the right to say no to a request or offer. Negotiation is usually a two-way compromise and, realistically, if the parties cannot arrive at an agreement, one can express any amount of dissatisfaction, it won't resolve it.

One thing that I wonder... you said that your T suggested cutting back on sessions but "stuff came up in your life" - do you feel that you use your therapy efficiently to discuss all that stuff? I also have the feeling from your posts that you spend a lot of your mental and therapy time talking about whatever your T does or does not do, and how it is not satisfying for you in the moment. Isn't that a bit of distraction from dealing with your own actual issues? Is it helpful to you to ruminate so much over the Ts life and behavior, either by yourself or with her? I don't know... just wondering. Many Ts do like to spend a lot of time discussing what goes on between them and the client, but from your posts it often sounds like your T is gently trying to push you to focus on you more, or to reduce your interactions and engage in your own life more, probably because the other things have been going in a circle for a while? You do say here that you are not looking to progress or change much, so perhaps that is okay. You bring up your age as a point where you don't expect big changes. But those things you often talk about here, dealing with your child wishes and how you want to experience the T as a mom figure, family substitute etc... maybe after a certain age, those things become a bit unrealistic and really not malleable? And your T knows this and tries to steer your to move on from it somehow?

I hope this does not come across as critical, just some speculation I thought to share.

I'm not sure if this is in response to my post or not, but if it is, it totally mischaracterizes what I said. I would never suggest anyone accept subpar treatment.

Rainbow, it sounds like you have negotiating room here with your therapist. Hope you figure out what works for you in this.

Just to add, Rainbow, when I said you have a lot to be grateful for, I was speaking in global terms about your life--you are financially stable, have a family, your art, a home, friends. Sometimes, when I'm in a rut of depression, it helps to see the things that are working well. Not saying that's easy, but it does help to try to get out of that rutted track of seeing everything as dire and disappointing.

There you go; nice job! Money itself is always an issue because it is limited for everyone, but usually there is something else behind the question or the issue someone has with it, and it looks like you are starting to identify that. If you feel like you are not getting what you need from your therapist, it is natural to feel like you are overpaying her. And of course feeling like a failure plays a role too. I hope that these are issues that you can continue to address.

About the first point: this is only in my experience, but I used to feel more disappointed in a lot of people, probably nearly everyone, including my wife and kids and therapist and coworkers and . . . . I think it is simplistic to say things like oh you can only get what you need from yourself and being disappointed in others is just about the emptiness you feel inside, and no one can fill it but you. I made a conscious choice to stop being critical as much as I could. Instead I tried to be a better listener and understand as opposed to pass judgment and impose criticism. My relationships with other people were improved and it had the attendant effect of me getting more of what I needed. It's also been true of me when I am disappointed in others because it still happens, to remember that most people can only do what they can do, and everyone including me has the right to refuse, scale back, etc. At the same time I try to accept what people offer me rather than "oh no, I couldn't possibly . . . " which irritates the hell out of a lot of people.

On the second point, I think it's good that your T didn't just decide to take the money and not discuss it. I'm not sure what you mean by "most people don't pay you that." I have insurance and I have a copay, but between the two she earns $165/hr. So she is paid $165 per hour. When I was uninsured over the summer, I paid $165 out of pocket. It's not just about what you pay, but what she gets paid per session. I think it's fine if she offers you less and you can feel free to accept it. This would be one example of accepting what people offer you and I think that would be a good thing. I take people at face value when they offer me something, even if I think it's not 100% fair.

On the third point, isn't part of valuing a service about what you get out of it? It feels like there is some internal inconsistency between "my sessions aren't all that helpful" and "I need her as my anchor". It seems like you focus on the negative and discount the positive in terms of the value of T for you. That's probably an example of being hyper critical.

I believe you, stopdog, that while working on a case you never stop to get a cup of coffee, or check your email, or take a phone call, or get distracted by something you just realized about another case, but that's obviously not the case with other lawyers. And let's face it, there are pretty many awful lawyers getting paid high fees for sub par work.

As for fees, I haven't found $165 to be out of line where I live. My psychiatrist/therapist charged (not me) about $285 an hour, though he was very good about taking all kinds of insurance. I do realize that's not at all the same thing given his training and his purview, but those one-on-one private sessions normally do not run cheap.