[Rive.]

How do you feel, or how would you feel, knowing that your T's care for you was dependent on your ability to pay them? Knowing that if you were not able to pay their rates, they would have no hesitation in dropping you.

Has this happened to you? Did it impact the way you believe your T cares about you or do you view it as 'paid caring' (i.e. fake)? Did it change your relationship?

Do you have any thoughts or feelings you would care to share?

PS: I am not talking about those Ts who are willing to accommodate you or lower their rates, I am talking about those Ts who are like: 'these are my rates, take it or leave it'

[Etcetera1]

Originally Posted by Rive.

How do you feel, or how would you feel, knowing that your T's care for you was dependent on your ability to pay them? Knowing that if you were not able to pay their rates, they would have no hesitation in dropping you.

Has this happened to you? Did it impact the way you believe your T cares about you or do you view it as 'paid caring' (i.e. fake)? Did it change your relationship?

Do you have any thoughts or feelings you would care to share?

PS: I am not talking about those Ts who are willing to accommodate you or lower their rates, I am talking about those Ts who are like: 'these are my rates, take it or leave it'

Well the way I always looked at it was, even the therapist with the most passion for caring about and helping people and the best possible, purest intentions would need to earn a living to not starve to death and to put the bread on the table for the family. So to me, it seems like a fair arrangement to pay for their time. Don't really have any feelings about it beyond that.

[AliceKate]

I live in communist Germany - the insurance pays for me Theough if they decided (with reason) that I was no longer eligable, I'm pretty sure T would drop me. I agree with Etc though, it's fair. He has bills, too.

[ScarletPimpernel]

T would do sliding scale, but if I couldn't even afford her sliding scale, she wouldn't see me.

I don't think that means she cares about me any less. She still cares, but there has to be the transaction of fees in order to keep boundaries. And, I feel, I'm not paying for their care. I'm paying for their knowledge, skills, experience, and education. Plus, like the others said, they do have to pay their bills.

L is will to go very low with her sliding scale with me. However, she says she'll never do $0. There has to be a fee, even $5, again for boundaries.

I don't mind. I feel it's the one way I can give back to them.

[ArtleyWilkins]

I've seen therapists who charged absolutely nothing, therapists who charged very nominal fees, and therapists with standard fees but who were on my insurance.

Honestly, I would have never been able to go to a therapist if I had to pay their full rate. It just would have never even been an option while raising kids, running a household, paying medical bills, etc. So, I HAD to have a therapist on my insurance so that I only had to pay the insurance copay. I never would have gone into therapy with a therapist I could not afford. But even then, sometimes the copay itself was even out of my reach, particularly if I was in crisis and needed to see the therapist more often than usual (which was about a week to 10 days). My last therapist would work with me in those times which didn't happen all that often, but he wouldn't let me go without care if it was an emergency. But the fee one way or another had to be paid eventually - I wouldn't expect any differently.

But I guess my answer is that I couldn't have seen a therapist I couldn't afford and wouldn't have even sought them out in the first place. Had my therapist for some reason dropped my insurance, I would have had no option but to find a new therapist that I could afford.

But I don't think that would be an indication of a lack of care on the therapist's part. It's just reality. I know enough about insurance that if they drop a carrier, it is because they aren't getting paid well or in a timely manner by the company. If the have multiple clients on that insurance, they simply cannot continue to do business that way. I wouldn't see that as the therapist dropping "me". (I've been through this with some very excellent doctors and as frustrating as it is, I know it isn't personal).

[Etcetera1]

Originally Posted by Rive.

PS: I am not talking about those Ts who are willing to accommodate you or lower their rates, I am talking about those Ts who are like: 'these are my rates, take it or leave it'

I didn't address the PS directly. So I still would see that as a fair arrangement to pay for their time if they can offer enough expertise in return for the payment. I am always free to either agree to it or simply refuse to pay it, I can pick another therapist that's cheaper if need be.

(That is, if I was still looking for therapy.)

If the issue is that temporarily I cannot pay the rate, due to some unexpected problem coming up, I would expect them to be flexible in negotiating a payment schedule. As far as that would be realistic. Depending on circumstances and all that.

If it's clear that I cannot ever afford to pay that rate again in the foreseeable future, well I don't know about that from experience, but I would probably put that in the "bad luck" category.

I would not expect them to keep seeing me at some much cheaper rate out of sympathy or pity or compassion or any of that. It would feel like the wrong boundaries.

As in, I would feel too obligated for their making an exception for me, I would feel a risk for too much enmeshment, unsaid expectations, resentment or other messy personal drama or whatever. I want none of that in my life, let alone in therapy (if I were to still go to therapy).

[Lostislost]

I feel like it totally sucks. My T is great when it comes to letting me pay whatever I can afford, but I still feel inadequate that I can't just pay him his proper fee. I don't remember the last time and I feel like I don't deserve him.

When I was younger I had to see a therapist for a set number of sessions because of something that happened to me. I hated that, I mean it was free but their 'care' for me was completely absent, I felt nothing towards them. I didn't get to choose them and they would be rid of me when our number of sessions were over no matter what.

[susannahsays]

In the past I had a therapist who did not charge me for a whole year and then when I was well enough to get a job, I paid her a much lower fee.

I understand why other people would be uncomfortable with this or feel it wasn't the right boundaries. I for one didn't suffer any repercussions. This therapist never mistreated me in 12 years. It didn't cause any issues that I can think of.

I think it depends on how your mind works, at least a little bit. In a previous job I did a significant amount of pro bono work. Not because I'm a very nice person or even generous, but because I saw an opportunity to help people out who would find it really difficult to pay and because I could do so without much inconvenience and no direct cost to myself. It felt good to do this and I only ever had an issue with one person. That person was uncomfortable with their inability to pay and projected it onto me. I had to get quite "real" with them to disabuse them of their fantasy that I looked down on them or was anything other than happy to help. I also explained that I got something out of it too - experience with a wide variety of hardware and software. If I had the opportunity to do something similar in my current position, I wouldn't hesitate.

I think that therapist saw charging me the same way I did with my clients. I didn't have a problem accepting what she gave me, and she didn't have a problem giving it. I didn't begrudge her for helping me and she didn't begrudge me for accepting that help. I assume she benefitted similarly to how I did with my pro bono work - primarily that she felt good about making a difference for someone who needed it. I very much doubt she was deprived due to not getting money from me.

What to her was a little was a lot to me. Of course, doing this for me necessarily meant she could not do it for someone else. Or she might have helped other people in the same way but the point is there's a limit.

I get the impression based on how I always hear other people talk about this topic that this is unusual and somehow wrong. I just don't think it's such a simple yes/no answer except per individual.

That said, this is never an expectation I have. I had to stop seeing my psychiatrist of 12 years because I couldn't afford her when I was in school. It sucked, but I certainly didn't hold it against her. As soon as I graduated and got a job, I went right back to her.

[Omers]

When I was struggling with employment awesome T offered to discount his rate bu $10 for every hour I volunteered. It totally flipped me out to have him define the monetary value of my work so I declined and reduced the frequency of sessions until I had a good job again.Awesome T, I believe would totally drop me as a client. However I also totally believe it would not change how much he cares about me. Depending on if it was temporary or permanent I know he would allow me to stay in touch to a degree. If it were permanent he would attempt to connect me to community based services, I would blow a gasket, we might rupture… but I could still call or email on occasion and expect a reply.

[Rive.]

Thank you all. Much appreciate your responses..

[Mountaindewed]

The therapist I had before I moved said if my insurance got cut I could always see a student.

When I was 13 my parents had to pay totally out of pocket for a therapist my insurance wouldn't cover because they thought she would really help me. Which she sort of did and I tried going back to her as an adult but my medicare wouldn't cover her and I really couldn't afford to pay out of pocket.

My current therapist has helped me out these last 3 months but I may have to go to every other week soon if my finacial situation doesn't improve. She says I need therapy every week but theres only so much they can do and I am the one procrastinating at this point.

[divine1966]

I don’t think it has anything to do with caring or not caring. Very few people can afford to not charge for their services. Someone else must be paying their bills if they work for free and it’s a luxury.

Most people have to get paid for the job performed or they’ll end up on the street and starving. I can’t expect my dentist to fix my teeth and my plumber to fix my toilet for free so why would I expect a therapist to see me for free.

Of course on occasion they might see clients for free to help them out, but as a rule it’s just not affordable and not sustainable no matter how much they care

[Rive.]

What if your therapist had another regular source of income that paid handsomely so they're not dependent on therapy money, per se. Then they upped their rate (significant increase) & would not budge on that.

Would that change in terms of your belief(s) regarding their caring or not caring and/or how you may feel about them?

[susannahsays]

I'd like to say I would have no opinion and that's their business. But I think that's dishonest. I would probably be judgemental about it.

I'm not sure how a client can actually know everything about a therapist's finances, though. What if they have massive debt? Or some other factor in their life means they need to make more money than you think they need?

[Rive.]

Thank you for your honesty, susannahsays. And for offering a different perspective. Appreciate it.

[Etcetera1]

Originally Posted by Rive.

What if your therapist had another regular source of income that paid handsomely so they're not dependent on therapy money, per se. Then they upped their rate (significant increase) & would not budge on that.

Would that change in terms of your belief(s) regarding their caring or not caring and/or how you may feel about them?

I would assume that they've changed their rate for all of their clients. So I would not take it personally. So I would not have any changed feelings or beliefs about their level of caring.

Without knowing their exact reason for changing their rates, I would not have any further opinions or feelings on the whole. Who on earth would know anyway what the reason is. The actual reason may be a private matter, as well. And definitely not to do with me.

I would ignore it completely as far as the personal relationship itself and related feelings, really. I would just decide if I'm able & willing to pay the extra rate.

A couple of things I thought of that would make the situation realistic enough (& also ofc assuming that the new rates are not out of touch with the market):

- Adjusting very outdated rates to inflation
- Having acquired new qualification, with better services and expertise offered
- God knows what private reasons

A (rhetorical) question too. How would I know so much about their additional source of income? If I somehow know so much about the financial situation of the therapist, that already sounds like a "relationship" that I would run from far and fast. There is a reason why I do not involve myself in therapy much now.

[Rive.]

Good points Etcetera1, thank you.

And yep, you have the right idea.. therapy can definitely do more harm than good.

[waterlogged]

I just did the opposite. We switched insurance companies and now my therapist is getting half of what I had been paying them because they are in network with the new insurance company. The therapist can’t just drop me because I have new insurance, but they sure got screwed over in the deal.

[Favorite Jeans]

Maybe I’m in the minority here but I really want to pay my therapist. It’s what keeps the relationship clean. Otherwise I’d owe her in other ways. I do not want emotional reciprocity or guilt in that relationship. And you cannot pay someone to care. They either care or they don’t. You pay for their time and their skill set.

Whether and to what extent they need the money doesn’t figure into my calculation (though I might have feelings about it). If I couldn’t pay and my T wouldn’t accommodate me I’d feel devastated. But that doesn’t mean the T is doing something wrong.