The below information is for educational purposes. I will support you in whatever path you choose, but I want your choice to be an informed decision.  

 

Client’s who opt to be private pay are in total control of who their protected health information (PHI) gets disclosed to - if anyone. I believe in your right to self-determination and in collaborating together to determine the length of treatment, interventions used, and focus of treatment. We will regularly check-in to discuss how treatment is progressing, any shifts that need to be made, potential referrals, pausing or ceasing treatment, and how treatment feels overall for the client.

 

I believe my clients have the right to pace their treatment to what feels comfortable for them individually and not be determined by external sources or driven by quantitative value. I believe it is best to not overwhelm my clients and slowly build their window of tolerance as opposed to rushing into processing certain issues with the potential for retraumatizing my client or flooding their nervous system. This is not to say that I think my clients can’t “handle it,” in fact I KNOW they can, but just because they can doesn’t mean they should. 

 

Unfortunately the insurance world operates from the lens of the medical model and they (insurance companies) are trained to make treatment the most cost effective possible (i.e. the shortest possible). In order for insurance to pay for any portion of services you must have a diagnosis and this diagnosis must be deemed medically necessary, which on the surface may not seem like a big deal. However, many diagnoses can unfortunately be used against people. How you may ask?

• By raising life insurance policy costs or denying coverage

• Potentially barring a person from certain careers or licensure (e.g. law enforcement, medical, aviation, firefighters, military, etc.)

• Potentially impacting security clearances

• Denying insurance coverage due to pre-existing conditions

• Higher premiums

• Limiting the number of sessions per year

• Limiting what treatments will be covered among others

 

Additionally, once a diagnosis is made it remains a virtually permanent resident in your personal medical record, regardless if the issue has been resolved or not. Insurance also has the right to audit my charts at any point in time, including having access to my notes of what is discussed in session and treatment plans. These audits are often not conducted by clinical personnel, but by insurance company employees or third party auditors. These *often* non-clinical personnel will determine if your treatment is warranted and medically necessary.

 

Furthermore, important issues such as a desire for self-growth, struggles with life transition(s), or couples therapy are often not covered by insurance carriers (these tend to be coded as a “V code” and are not deemed medically necessary). However, these issues, in my opinion, are no less important. Sure there are technically ways around these, but that would require me bending the truth a bit to fit a diagnosis (an F code), which is insurance fraud and ethically and legally I will not do this.

 

At the end of the day it is completely your choice as the client as to what path feels best for you and I will support you in that decision.