I recently came across this quote by Andras Angyal in his book “Neurosis and Treatment, a Holistic Theory that really struck me as being one of the most well articulated passages on this point around the therapist/client relationship.
“To react to the healthy aspect of the patient rather than to his neurosis is one of the many ways available to the therapist for stimulating and furthering the patient’s growth without falling into didacticism.”
Years ago, I remember being frustrated and angry when my analyst raised his rates to $139 per session. I wasn’t making anywhere close to that as my hourly wage and felt that the high cost of therapy was turning the process into something that was too heavily focused on immediate results and taking focus away from process and relationship which are really the keys to successful therapy. I wish my analyst had explained to me the business model of the field as I think it would have relieved a lot of the pressure and, frankly, the resentment I was feeling at the time.
Much like my analyst, I plan on raising my rates in the near future to keep up with the ever rising cost of living in this city which is increasingly pushing out talent and choice in a variety of fields. It’s something I have to do in order to maintain any kind of reasonable lifestyle that will allow me to care for myself in a way that allows me to care for my clients.
The article below does a pretty good job of explaining the monetization of therapy. (If it were up to me, we would live in a society where 1. Therapy and the exchange of money were not intertwined or 2. We lived in a society where people were getting their needs met in their social and cultural circles and we didn’t need specialized individuals to perform the type of work western therapists undertake.)
The two main costs of doing business this article seems to overlook are the fact that we have to pay for own health insurance and that we also have no paid sick or vacation time. Cancellations are also a factor unless we choose to charge a client each time they miss a scheduled appointment and we are not able to rebook that time slot. That, however, is the topic of much debate. Unlike other medical providers or even lawyers, we have an ongoing relationship with clients that often necessitates weekly sessions for long periods of time. That’s a game changer, in my mind, when it comes to the way we structure our fees and ways of doing business. That’s a lot of money and time invested on the part of our clients and it’s reasonable to assume they will need to cancel from time to time, sometimes last minute. I think it’s a personal decision and a business practice decision each individual needs to assess for themselves based on their working model as to whether they charge for cancellations and under what circumstances. In my opinion, sometimes it’s best not to do so for the sake of the relationship, the therapeutic process, and client retention. Sometimes, if the problem is chronic and one is consistently losing revenue and not making therapeutic process during a very sought after time slot, charging for cancellations may be necessary.
One thing to keep in mind, even when working with therapists out of your network (I choose to remain so, mostly for the sake of my clients), is that your provider will likely cover some of the cost of your session. I have clients who pay as little as $37 per session to see me weekly in spite of my not being on any insurance panels.
Here is the Talk Space blog post entitled How Much Does Therapy Cost and Why Is It So Expensive, in it’s entirety. At the end, I’ll provide a link to the article’s location on the Talk Space site. Continue reading
I am pretty comfortable with self-disclosure so the information in this New York Times article isn’t one of my main concerns (knock on wood) but it’s interesting nonetheless. I can see the pros and cons of clients having access to more information about their therapist but I’m wondering what effect this will have on more traditional practitioners or those who are not comfortable with this level of transparency. The internet is definitely changing the nature of the therapeutic relationship.
I knew my psychiatric practice was forever changed the day a patient arrived with a manila folder stuffed with printouts and announced that it contained the contents of a Google search that he had done on me. He pulled out a photo of my mother and me, age 7, that had been published in my hometown newspaper; architectural plans for an addition to my house that was never built but apparently was registered locally by the architect; an announcement about my great-grandfather’s becoming editor of Amazing Stories magazine in his old age; and my brother’s history as a college activist. (See below for a link to the full article.)
Even when working with the best of therapists, the process of therapy can, at times, be very uncomfortable. It requires vulnerability and the exposure of weakness when most of us would like to see ourselves as strong, autonomous, and confident. Disclosing personal information to a relative stranger is never easy but, taking the time to find the right person with whom to work can make all the difference in the world when it comes to your personal growth. Continue reading