A Guide to Psychology and its Practice

Questions
and Answers

 

I was diagnosed with PTSD. I applied for and was originally told I was awarded $10,000 in counseling costs. I saw until recently a psychologist; I have had sessions regularly for the past year. Recently, well a couple of months ago, a letter was sent to me from the state office of Victims of Crimes (Victim witness assistance). This informed me that the therapist I have seen was last paid in February 2002. This office would not pay beyond this date. I now am in serious debt for 15 or so additional sessions. I will and have begun to pay this therapist. He also informed me that he would have to stop our sessions. I am in a haze of dismay as to what to do. I have no counselor and no financial means to see one, as I will be paying the previous psychologist, for the next 2 years. I am not angry at him of course, but I feel sort of like I am hanging out to dry and heal myself.

 
Your story, sad as it is, points to two principles about psychotherapy. First, it illustrates quite graphically that whenever you invite a third party—such as insurance or managed care—to pay for your psychotherapy, that same third party will not only determine whether you really deserve treatment in the first place, but it will also tell you when you should be cured. And when you reach that point, that’s it. Period. Treatment is over whether you like it or not. And if you complain, they will just refer you to what is written in the fine print to which you agreed when you signed the treatment authorization form.

Still, you should read the small print in the Victims of Crimes contract to determine who really is liable for any sessions that Victims of Crimes disallows. Sometimes, when a psychotherapist accepts such cases he also accepts personal liability for providing any treatment beyond what is authorized.

Moreover, a psychologist is ethically bound not to abandon a client. It may be too late for this, but you might ask this psychologist to offer you some free help in finding treatment somewhere else.

The second principle is no more pretty than the first, and I emphasize it throughout this website: No matter what happens to you, you—and you alone—must take personal responsibility for your own healing. Your mental health must be more important to you than any other material aspect of your life. And if you understand this point, then you will see that you have a few more options available to you right now than you think.

On the one hand, in order to pay for continuing treatment, you may be able to reduce expenses elsewhere. How much money do you spend on cigarettes and alcohol—or other drugs? How much money do you spend on your cell phone, that, if you’re like most people, you don’t really need? How much money do you spend on movie rentals and theatre tickets? How much money do you spend on eating meat, when you could eat vegetarian foods? How much money do you spend on restaurant dining when you could eat vegetarian food at home? How much money do you spend on car payments, when you could be driving a smaller, cheaper car? The fact is, many persons could save hundreds of dollars a month by paring away frivolous expenses. And all that money could be used to pay for psychotherapy.

On the other hand, you may be able to increase your income by taking a second job just to pay for psychotherapy, even if the psychotherapy has to be in a low-fee clinic with a student intern.

Now, you may sneer at all these suggestions. And I don’t really know your particular circumstances, so my suggestions may not be practical for you. But think about it a bit. If you did any of these things, it would prove to you that you’re not as much a victim as you think. And that’s what psychotherapy is all about.

 


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