Can't afford T

Has anyone not been able to afford their T anymore? If so, what happened? Did you have to terminate? Or did they let you pay a very reduced rate?

If my H doesn't get a job soon, we'll run out of money within a few months. I'm afraid I'm going to lose my T. I don't know what to do!

I would ask her about it. I recently asked my T, since they’re doing some layoffs at Hs job. He said that if a clients financial situation changes, he’s willing to negotiate with them on a lower fee. He said he even saw a guy for $5 a session for a few months. So I’d ask. Or if she’s not willing to negotiate on price, maybe she’d be willing to, say, just keep a balance that you could pay off once he does find a job.

Talk to your T about it! See what solutions she can offer!

I have talked about this hypothetical situation with my T and he has told me that we have gone too far to just stop because of money. Of course, I would always have to pay what I can but if it would happen that I can't pay anything then so it's going to be.

I'd be okay with keeping a balance. That would be fair. I just don't think it's fair to pay a reduced rate. It's the nature of a therapeutical relationship. She needs money too so she can help support her family. I'll hate it whether she accepts a reduced rate or will keep a balance. I want to pay her the full amount. But keeping her is most important to me. I can't lose her!

It is completely ok to discuss reduced rate and other options with her, but I think it is very manipulative to suggest that no means suicide.

So you want to control how much money she should take from you? Why not let her decide for herself how to handle this situation?

The nature of the therapeutic relationship is to negotiate an agreement, not that the patient will decide what the therapist has to charge.

Anyway I can see how impossible this situation might feel when neither of the black and white options are suitable or possible but the gray tones are out of the reach.

I hope you will talk to her and are able to postpone these suicidal thoughts for a moment because the situation is still quite hypothetical.

My employment situation changed and then I lost my job and my T offered a reduced rate. It was hard to discuss and accept, but I knew that I would slide back if I was left without support. As soon as my situation improves I plan on not only going back to her regular rate, but also pay her back (even though that’s not an expectation, and I haven’t told her that).

If you feel that strongly about your work with her, talk to her about it. You might be surprised.

Good luck.

The other thing is, you only see her in person monthly, right? So her taking a reduced rate/carrying a balance wouldn't have as much of an effect on her income as if you saw her weekly or more.

That's very judgemental. OP said she doesn't want that to influence her T's decision. She is saying that because it is how she feels. I very much hope she reconsiders that stance, but to judge it as something manipulative rather than just a genuine expression of her feelings is really unfair.

I don't like this idea. My therapist has suggested similar to me, but the concept of "owing" your therapist anything (including their fee) is riddled with issues.

Well, it still seems preferable to suicide...

I hope you will be honest with your therapist about your financial predicament. I'm assuming she's already aware anyway that your husband has lost his job so I doubt it will be surprising to her, and if she isn't yet aware of your financial situation, it's time to have that discussion because it IS affecting your well-being and state of mind right now.

My experience is that a reduced fee for a period of time is not particularly unusual and is often preferable to maintaining a balance (consistency of payment of fee, even reduced, helps maintain a professional boundary), but you need to talk this through with your therapist and allow her to offer up suggestions on how to handle this situation.

And yes, you need to tell her about your black and white thinking concerning suicide as the only alternative. That is an issue unto itself at this point that you need to be honest about simply because it is an issue that makes you unsafe and that is what she's there for.

I lost my job a while back and could not afford my therapy. I suggested having less frequent sessions, T suggested dropping my fee to half what I had been paying. Like you say, I felt bad about not paying the full fee, but since it was T's idea I figured it was okay. So I would suggest explaining your situation to your T and seeing what she says.

I suppose there is also a question of finding ways to bring in more on the side, stuff you can sell online or a side job or something like that.

I think I know what it's like, or at least my version of what it's like, to worry about financial matters. It made me very panicked and scared when I was going through it a few years ago. For me worrying about money makes me unhinged like nothing else, in terms of just feeling unsafe, all the time. The stress can be very terrible and I'm sorry you're going through it.

It's possible that you may not be able to continue therapy paying private pay if you can't afford it. I wasn't insured for much of the past year and had to pay out of pocket when I needed to. I worked more and I reduced my discretionary spending in other ways. I did not ask my T for a reduced fee and it really rubbed me the wrong way because his practice has a higher private pay rate than rate they've "negotiated" with my insurance company. I'm not saying it's wrong to ask for a lower rate, I just felt like I could swing it and didn't need other options.

Perhaps your T can help point you towards resources that might help you in your financial struggles, such as people (we have these folks in our community that work for nonprofits that help people figure out if they can refinance or take out loans or otherwise respond to a financial crisis).

Sorry to hear you and your H are having financial problems. If your T is unwilling or unable to continue sessions at a reduced rate - due to a temporary or other situation, then possibly ask your T to recommend someone who could. Seeing her less often may also be a temporary answer. Another type of counseling to consider is group counseling. That may benefit both you and your H together.

I hope your t can still work with you regardless of what you can pay with your husband not working. It's important to let her know your struggiling with the suicidal thoughts. Hugs. I hope things do work out

he let me pay a very reduced rate

talking about the financial aspects of psychotherapy is difficult for me but it's important to be on the same page..... I would talk with her about all of your options

Although others have said it already, I also think it's a good idea to discuss this with your T. I've heard of a lot of Ts who accept reduced rates for a while or similar setups.

This seems like black and white thinking, there are more options than death or free therapy. Most strategies would be preferable to suicide, it doesn't mean they are appropriate roads to follow.

Talk to your T about it. Your T knows what she can afford to charge. I'd bet there would be some arrangement that could be made. ((hugs))

My old t let me carry a balance when I was laid off. Once working again I paid him back. Talk to t and try not to jump to conclusions. I know that’s hard to keep ones mind from going there

When i had $8 in my bank account last year, she let me come without paying for a few months, and then i slowly paid her back.

I emailed my T telling her about my thoughts and feelings. She said she appreciated letting her know, but of course we can't discuss it over email. She said that next session (in 2-3 weeks) we'll go over scenarios.

I am not trying to manipulate my T. I never have. I respect her and her boundaries. I am just having a hard time justifying paying her less. I feel bad to put her in this situation. I was just being honest about my thoughts and feelings. And I think my T understands that.

I will not see another T. This is my last T. I hope to stay with her until she moves, retires, or dies whichever comes first.T and I have already discussed this. Of course the goal is to taper down, but she said she'll be there when I need her. As for tapering down more, that will be really hard. You have to understand my situation. First, all my unhealthy coping skills are being taken away: no SH, no smoking, no binge eating carbs. Then there's the reduction of Lamotrigine. On top of that, a huge fear of people. If H doesn't find a job that could possibly mean losing my house, some dogs, my T, and postponing IVF. I could lose pretty much everything. I've already been homeless. I'm not going to do that again especially without my T! I'll need her more if all that happens. T says it's tapes running through my head of my past. So reducing sessions even more will really be hard.

And yes my T knows my situation. It's been a probability for a few months now.

I want to pay my T her rate. She just got her own office and is raising her rates by 10%. I like the idea that I'm helping her out by paying her. She knows I like feeling like that. I'm always willing to adjust my time when she needs it even though I hate change.

I will follow whatever my T feels is right: reduced fee, keeping a balance, or termination. I trust her that she'll be okay with whatever she decides. It's just really hard to have to talk about this, but I know it's necessary. I don't want to get to the point where I can't afford her and not know what to expect.

Scarlet, I think you are so brave. I hope (and I really believe) that you can work something out with T that will work for both of you.