MyTherapistNewYork

We do not accept insurance for therapy-  And here is why.

People don’t generally expect therapy when making out their budgets.  They really don’t expect it when they have insurance coverage that covers medically necessary treatments.  For these treatments to be covered, the clinician must give you a medical diagnosis, which becomes part of an elaborate trail of paperwork (sometimes electronic) that includes any number of people involved in getting your insurance claim from the clinician to the insurance panel, and getting payment from the insurance panel back to the clinician.   While the system has its flaws that are too many to discuss here, it does generally work if you are lucky enough to have great medical coverage, and have something like strep throat.  It does not, however, have your best interest in mind when working with mental health clinicians like marriage and family therapists and mental health counselors.

I am an outspoken critic of the book that we in the mental health profession are expected to use in our work with clients called the DSM (The Diagnostic and Statistical Manual of Mental Disorders) put out every ten or fifteen years by the American Psychiatric Association.  (Interestingly, there are no statistics included in this book, despite its name.)  In it, are lists of what psychiatrists have voted to define (based on research?) as mental illness.  Nevermind that psychiatrists are medical doctors trained in biological brain diseases, not usually  psychotherapy, sexuality, couples therapy, substance abuse, eating disorders, autism, or any other topic included in the wide field of psychology.  Yet the entire field of psychology is forced to use codes from this book, to diagnose you with a mental illness, if you want to have insurance pay for part of your therapy, even if your therapy does not include treatment by a psychiatrist/physician.

Let me make it a little more clear to you by giving some real life examples.  You know all those gay kids killing themselves because they are getting bullied?  Well, if they come to therapy, I have to give them a diagnosis, probably related to depression or something called “adjustment disorder”.  So it’s not the little shits DOING the bullying that get the diagnosis, but the victim. Interested in couples therapy because your partner cheats on you?  Are you the one that calls the office to set up the sessions?  Then you are called “the identified patient” (or IP), and the “medical chart” at your therapist’s office will be opened in your name.  If you are the one with the insurance, then you are the one who will receive the mental illness diagnosis.

If you are hearing voices, or know someone who is severely depressed and fear for your safety or theirs, by all means, call 911 or check our your nearest psychiatric emergency room.  But by and large, these aren’t the folks who are going to therapy, many of whom just have problems coping with all the obstacles that come with being alive, and it is unfair for everyone involved to make them fit into a psychiatric/medical model.

Instead of using insurance for therapy, my solution has been to offer psychotherapy/counseling/coaching (whatever you want to call it) on a sliding scale.  This means that I accept a range up to what I consider to be ethically acceptable as the maximum fee (in NYC, my fee is $150, and if you do a bit of searching, you’ll find that some other professionals charge rates that are much higher).   Your rate is calculated based on the number of people in your household and your annual income, and starts at $40.

This is my calling, and my passion, and if I could do it for free, I would.  But I went to school for a long time to be able to practice my profession, and have to pay my bills, too. ( I do not want to be part of a system that emphasizes illness and not wellness, and truth be told, the amount that I would get paid from any given insurance company is not worth the hassle, anyway.) So to make my living (and pay back those student loans), I offer realistic therapy with results.  You track your progress.  You see if you are getting better at dealing with what you came in to deal with.  If you’re not getting better, why would you stay with the same therapist for years on end?  If your therapist can’t tell you exactly their plan for helping you, what are you paying them for?  If you ARE getting better, then why do you need to stay in therapy forever?  I believe so much in what I do, I have developed my practice as a training practice to offer therapists-in-training experience in offering effective, ethical, solution-focused and evidence -based counseling.  (And since 2005 have supervised no less than 30 new therapists, many of whom are now my competition.)

Chances are if you are reading this, you are not mentally ill.  Maybe no one has ever told you that before, even.  I do hope this series sheds some light on the subject of using insurance coverage for therapy, and I hope that you will want to read more about my practice and how we can help you be who you are.

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