For psychotherapy, I worked on a fee-for-service basis, which meant that I did not participate with insurance programs, for both practical and philosophical reasons. Practically, I wanted to protect the privacy of the people with whom I work, and the management of benefits by insurance providers can be inconsistent with the treatment goals and duration of care that my patients found most useful.
More importantly, awareness about money--how we think and feel about it--presents a very powerful opportunity to be and become conscious about our values and choices. How money comes into your life and where it goes is an important but often overlooked place to practice mindfulness.
I had a sliding fee for individual psychotherapy, and for psychotherapy groups, with a scale that allowed for a range of people to access care. I invite you as a client to be intentional about deciding what you will pay for your sessions that is consistent with your capacity to pay and that reflects how you value the care you want and need. It is important to choose to pay an amount that is low enough to be sustainable over a period of time, meaningful enough to esteem your work in session, and honest enough to allow you to feel good about your decision-making.
Conversations about money can be a useful clinical issue, but it does not need to be: I will not be evaluating or second-guessing your ability to pay and I will trust your judgment about what is fair and manageable for you.
Money is too often the deciding factor about the care that we receive. Here I review my philosophy and practice relating to a sliding payment scale. Though everyone must pay something, to be clear, my intention is to make working with me possible financially for a wide range of people. And yet that may not always be possible from a practical standpoint. At times, the lowest end may not be available.