Psycho-Babble Medication Thread 6789

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Am I paying too much for therapy?

Posted by mila on May 29, 1999, at 2:15:12

I recently started therapy. As i have no insurance, I am forced to borrow money from my parents to pay for it. We are paying $175.00 per 45 min session. I have decided to go with this expensive psychdoctor/psychotherapist because he was recommended to me as being very good and necessary for myself given my history of 5 years of bad treatment. The person who made the recommendation is a highly regarded high profile psychiatrist so I trusted his judgement.

So far I have had two sessions which were both rather uneventful and seemingly unhelpful. I feel terrible for paying someone that kind of money after simply talking about whatever comes to mind at the time, and getting little feedback. Are the first few sessions of therapy supposed to be like this? Am I just wasting my money? Or is this an investment that will pay off in the longterm?

 

Re: Am I paying too much for therapy?

Posted by JD on May 29, 1999, at 7:47:40

In reply to Am I paying too much for therapy?, posted by mila on May 29, 1999, at 2:15:12

Unfortunately, highly regarded M.D. psychotherapists tend to cost around what your paying in my experience. As to whether it's "worth it", that can be hard to judge: it really depends upon the particular doctor, the particular patient, and the kind of treatment you are seeking and/or needing ... I would go with your instincts after a few more sessions as to whether you think a good working relationship can develop with this person. The lack of feedback you mention is often deliberate and can end up being surprisingly productive in the long run, but it has to occur in the right kind of neutral-but-supportive context--otherwise you will just end up frustrated and, yes, even ripped off!

My general advice to other people (based on the kinds of things I regret not having always done myelf) is mainly to avoid being passive about choosing a doctor--give due credit to referrals and experts, but also do what you can to actively shop around for a situation that really "feels right" for you. It's true that the price issue can be hard to get around when you're seeking a top professional... One possible way to get around this (not that I ever have) is to go into therapy with a therapist who's just completing their training, as the prices for such people can be greatly reduced--you're obviously trading off on experience and professional stature, but some of these people can apparently be very good if chosen with care.
Good luck,
JD

> I recently started therapy. As i have no insurance, I am forced to borrow money from my parents to pay for it. We are paying $175.00 per 45 min session. I have decided to go with this expensive psychdoctor/psychotherapist because he was recommended to me as being very good and necessary for myself given my history of 5 years of bad treatment. The person who made the recommendation is a highly regarded high profile psychiatrist so I trusted his judgement.
>
> So far I have had two sessions which were both rather uneventful and seemingly unhelpful. I feel terrible for paying someone that kind of money after simply talking about whatever comes to mind at the time, and getting little feedback. Are the first few sessions of therapy supposed to be like this? Am I just wasting my money? Or is this an investment that will pay off in the longterm?

 

Re: Am I paying too much for therapy?

Posted by Elaine on May 30, 1999, at 1:25:19

In reply to Am I paying too much for therapy?, posted by mila on May 29, 1999, at 2:15:12

Without insurance, $175 for 45 minutes seems a bit spendy to me. And even highly regarded M.D. psychotherapists may not be a right "fit" for you personally. However, a "breaking in" or "getting to know you" (on both sides) period does occur, so you may wish to try a few more times, as JD suggests. I believe, though, that there are many excellent therapists at about half that price who could do very well for you. But, it may take some searching. Some therapists do give an introductory session without charge. Such a big part of therapy is how you relate to the therapist and whether you can trust him or her. If you need medication, you can go to a psychiatrist and, after a few times, only pay for short medication visits - much cheaper than basically paying for a therapist AND a psychiatrist in one person, every week. I would hate to see you spend your loan money quickly and then feel you can't afford to go to anyone, rather than spending much less and still seeing an experienced and qualified therapist. This is, of course, only my opinion. In terms of your $175 psydoc therapist, again, no matter how highly recommended he is or how high profile, you need to determine if his personality and professional styles are compatible with you. Also, what kind of therapy approach does he use and is that agreeable with you? (Is he Freudian, cognitive, behavioral, existential, etc?) Why don't you interview a couple of others while you're still trying him out? That way, you might see how you relate to other therapists compared to him and better be able to decide how you feel about him.

Good luck to you.

 

Re: Am I paying too much for therapy?

Posted by Phil on May 30, 1999, at 9:31:15

In reply to Am I paying too much for therapy?, posted by mila on May 29, 1999, at 2:15:12

> I recently started therapy. As i have no insurance, I am forced to borrow money from my parents to pay for it. We are paying $175.00 per 45 min session. >
>
>>That is the going rate for the best.
Therapy often does seem and is just talking-you will never get immediate results. It took me years to develop mistaken perceptions and knee jerk reactions and it can take years to sort those out.
Since I grew up in a alcoholic environment, trust is a very big issue. My therapist asked me to complete,"Love equals..... Still after 45 years of life and a lot of therapy, I still complete the sentence the same. "Love equals pain."
Like Scott Peck said-life is difficult. Some of my issues will never go away but I will continue to try.
Anyway, if you have special issues(most of us do)try working with someone who has been there
and is not there anymore. They can see thru BS
really well. Just an opinion.

Phil

 

Re: Am I paying too much for therapy?

Posted by Alison on May 31, 1999, at 3:03:35

In reply to Am I paying too much for therapy?, posted by mila on May 29, 1999, at 2:15:12

Mila,
I am assuming that you are in the USA, and therefore I am not up to date with how much that is in Australian dollars. But to give you an idea of what I would have to pay here to see a Cognitive Psychologist is about AUS$125 per 50 mins. I don't know what it is for a Psychiatrist, as most people here see Psychologists. I am very, very fortunate as I can see the Psychologist at university for 1hr. absolutely FREE !!! I was so shocked to find out that I could go as long and howevermany times and not pay! So you may want to try something like that. Also in Australia if you are a low income earner then the government will either subsidise it or it's free. If I go to the public hospital for anything then I don't have to pay a cent either no matter how long I stay.
I don't mean to get you down, but I was shocked that you have to have insurance or pay heaps over there. Sometimes we really don't know how good we've got it, and I am very grateful for the opportunities.
Alison

 

Re: Am I paying too much for therapy?

Posted by John on May 31, 1999, at 8:29:02

In reply to Am I paying too much for therapy?, posted by mila on May 29, 1999, at 2:15:12

> I recently started therapy. As i have no insurance, I am forced to borrow money from my parents to pay for it. We are paying $175.00 per 45 min session. I have decided to go with this expensive psychdoctor/psychotherapist because he was recommended to me as being very good and necessary for myself given my history of 5 years of bad treatment. The person who made the recommendation is a highly regarded high profile psychiatrist so I trusted his judgement.
>
> So far I have had two sessions which were both rather uneventful and seemingly unhelpful. I feel terrible for paying someone that kind of money after simply talking about whatever comes to mind at the time, and getting little feedback. Are the first few sessions of therapy supposed to be like this? Am I just wasting my money? Or is this an investment that will pay off in the longterm?

Mila, for that kind of money you are entitled to no less than superb treatment. A good doc can, and should, help you feel like a million dollars in one meeting. I have had good ones and mediocre ones, and I know. Kind of like a real good coach on a team giving a winning pep talk. If you haven't left the docs office on your first two visits without feeling like you have a new chance, a new hope, I personally would move on. A good doc will display so much wisdom and pack so much into an hour as to seem almost godly or magical. These mental conditions we deal with are too delibilitating and potentially deadly to be wasting time with someone who isn't going to come out swinging for a home run immediately. Sure, good counsel does take time, but good counsel also makes itself known and obvious on the first meeting. And when you know you have good counsel, the cost no longer seems important. The cost is only an issue when you feel you aren't getting relief. If you don't walk out of that office feeling 50 pounds lighter, twice as happy, twice as strong, and twice as wise, the doc isn't even worth $20. Maybe to someone else, but not you. John.

 

Re: Am I paying too much for therapy?

Posted by JohnL on June 1, 1999, at 4:43:09

In reply to Am I paying too much for therapy?, posted by mila on May 29, 1999, at 2:15:12

> I recently started therapy. As i have no insurance, I am forced to borrow money from my parents to pay for it. We are paying $175.00 per 45 min session. I have decided to go with this expensive psychdoctor/psychotherapist because he was recommended to me as being very good and necessary for myself given my history of 5 years of bad treatment. The person who made the recommendation is a highly regarded high profile psychiatrist so I trusted his judgement.
>
> So far I have had two sessions which were both rather uneventful and seemingly unhelpful. I feel terrible for paying someone that kind of money after simply talking about whatever comes to mind at the time, and getting little feedback. Are the first few sessions of therapy supposed to be like this? Am I just wasting my money? Or is this an investment that will pay off in the longterm?

Mila, let's assume for discussion you decide to find another doc. How to do it? Here's an experiment I tried. I called local hospitals, mental organizations, got referals. Also went through the yellow pages. Though credentials, location, referral, etc., can make a difference, it's that doc who really LOVES the work you want. Someone with a passion for what they do. The best in any professin are those that are in love with their work. I sent a duplicate one-page letter to my list of names, describing my problem, medicine failures, current status, etc., and asked if I sounded like a tough case that would add spark to their daily routine to please call me for a meeting. My family doc laughed at this idea claiming no one would answer because they are already too busy with problem patients and aren't going to purposefully take on a pre-advertised difficult case. Well, I got a response from almost half the names I mailed out to. That tells me those who responded love their work. They certainly have no shortage of work don't need me as a client. Then the process begins of an initial meeting to find that special "chemistry". This is just one way to find a good doc, but the money will seem irrelevent when you find the right one. JohnL.

 

Re: Am I paying too much for therapy?

Posted by Tom on June 1, 1999, at 11:49:43

In reply to Am I paying too much for therapy?, posted by mila on May 29, 1999, at 2:15:12

> I recently started therapy. As i have no insurance, I am forced to borrow money from my parents to pay for it. We are paying $175.00 per 45 min session. I have decided to go with this expensive psychdoctor/psychotherapist because he was recommended to me as being very good and necessary for myself given my history of 5 years of bad treatment. The person who made the recommendation is a highly regarded high profile psychiatrist so I trusted his judgement.
>
> So far I have had two sessions which were both rather uneventful and seemingly unhelpful. I feel terrible for paying someone that kind of money after simply talking about whatever comes to mind at the time, and getting little feedback. Are the first few sessions of therapy supposed to be like this? Am I just wasting my money? Or is this an investment that will pay off in the longterm?
Everything everyone said in the thread responding to your initial posting is entirely correct, but there is one thing I would like to add. ALL THINGS IN LIFE ARE NEGOTIABLE!! I went to a highly regarded M.D. to handle both my meds and psychotherapy, and really felt his $150 per 45 minute cost to be a little too pricey. What I said to him was that I really liked him but I absolutely couldn't afford
his price. I then offered him $110 per hour. He gladly accepted. It seemed to me that the doctor would rather avoid a negotiation of his fee and gladly accept a reasonable amount for his services. I might add that I submit this fee to my health insurance and get a partial reimbursement (60%) for the session. Now it doesn't freak me out about the amount of money I spend on "mental health". Wouldn't
it be great to just walk away from all this care and just feel better on our own....!!!!
Good luck

 

Re: Am I paying too much for therapy?

Posted by kerridc on June 3, 1999, at 20:03:56

In reply to Re: Am I paying too much for therapy?, posted by Tom on June 1, 1999, at 11:49:43

Pay what you feel the therapy is worth. If it is worth nothing to you, then as little as $1 is too much. If it keeps you from feeling horrible and enables you to make progress, it is invaluable.

What's interesting is that you have globalized an entire 5 years therapy experience as being "all bad." If I were your therapist, my first question to you would be; "what do you expect me to do that [potentially] several others in the past five years could not?" Next I would point out how you managed to completely engage and de-focus an entire group of people away from any therapeutic issues, since it doesn't appear that obtaining the money is actually a problem.

If your highly reputed doc is not suggesting you be involved in group treatment, you are paying too much. Based on what little you have revealed, group would definitely be the treatment of choice.

I charge $45 a session because I think that is "fair" and I am able to provide services for that fee. I pay $95 a session for my own therapy, and though I would hate to pay more, it is an inadequate reimbursement for what I gain.

Others in this thread have offered excellent points to consider when the actual issue at hand is the dollar amount paid for therapy.


> > I recently started therapy. As i have no insurance, I am forced to borrow money from my parents to pay for it. We are paying $175.00 per 45 min session. I have decided to go with this expensive psychdoctor/psychotherapist because he was recommended to me as being very good and necessary for myself given my history of 5 years of bad treatment..."


 

Re: Am I paying too much for therapy?

Posted by Elaine on June 6, 1999, at 12:13:23

In reply to Am I paying too much for therapy?, posted by mila on May 29, 1999, at 2:15:12

What Tom says is true - many therapists will negotiate their fee, either on a long term basis or depending on current financial status. There are also individuals and clinics who have a sliding fee scale, and that doesn't mean they are sub-standard therapists, either.

Again, good luck

 

Re: Am I paying too much for therapy?

Posted by alan on June 6, 1999, at 22:43:17

In reply to Re: Am I paying too much for therapy?, posted by Elaine on May 30, 1999, at 1:25:19

i am seeing a psychologist for talk therapy thru a county supported program that charges on a sliding scale. The therapist impresses me as very intelligent, knowledgeable, and conscientious. I have never been able to fathom why MD's are considered especially qualifieed to do this kind of work; seems to me a terrible waste of an expensive and deemanding medical education. I also see an MD psychopharmacologist for medication once a month for 15 minutes. Anyhow, I pay $14 per session for the talk therapy. I suspect you could find similar resources in your community.
Studies done some years ago showed no correlation between the formal education and the effectiveness of psychotherapists. There may be some advantage in having therapists follow well defined protocols for cetain types of therapy (IPT, CBT), as specified by researchers; but very few therapists do. The kind of degree makes no difference. (Freud thought a medical education was bad training for a psychoanalyst, but I don't think he had any evidence for that either.)
I have no idea of how to tell if a therapist is good (for you!) or if you are making progress because of therapy. That is why we need controlled studies, but they won't tell you much about YOU.
I hate to give advice, knowing how wrong anyone could be, and especially non-experts like me, but I would certainly look for less expensive therapy.
We all have enough problems without poverty too.
Alan

 

Re: Am I paying too much for therapy?

Posted by Jay on June 7, 1999, at 20:08:23

In reply to Re: Am I paying too much for therapy?, posted by Elaine on May 30, 1999, at 1:25:19

My fiancee's psychiatrist is also rather pricey, and without insurance, the talk therapy seem disproportionately expensive but the woman is a damn genius with the meds. She refuses to work with another therapist and supply only the pharmaceuticals. May I assume this is a rather standard practice at her level of training or is this unusual. We highly value her expertise, but this is an unisured expense and between the meds and twice-monthly sessions we are spending a huge sum. A former therapist is willing to work with my fiancee, and they enjoy a great rapport, but the doctor is resolute in being the exclusive resource for meds and therapy. Any suggestions on how to approach the issue with the psychiatrist?

 

Re: Am I paying too much for therapy?

Posted by claudeah on June 18, 1999, at 23:39:28

In reply to Re: Am I paying too much for therapy?, posted by Jay on June 7, 1999, at 20:08:23

My therapist is quite pricey too---$125 for 50 mins, but I would not trade him for the world. He and my psychiatrist get together every other week or so to discuss mutual patients. My therapist also calls my doc if he senses that I am having problems with meds and has checked on me at home and work if things are kinda weird. As I had told Dr. Bob once before when asking for advice--if it weren't for my 'team' as they call themselves I wouldn't be here to type this.

As for feeling good everytime you come out of a session----I don't think you are getting your money's worth if you do. I mean, come on, we are all good actor's and can pretend we are feeling great when we are actually feeling like midnight has set in----it takes a good therapist to get past that darkness into the ugly stuff, and that hurts worse but is necessary.

Sorry for babbling........

Claudea

>
>
>
>
> My fiancee's psychiatrist is also rather pricey, and without insurance, the talk therapy seem disproportionately expensive but the woman is a damn genius with the meds. She refuses to work with another therapist and supply only the pharmaceuticals. May I assume this is a rather standard practice at her level of training or is this unusual. We highly value her expertise, but this is an unisured expense and between the meds and twice-monthly sessions we are spending a huge sum. A former therapist is willing to work with my fiancee, and they enjoy a great rapport, but the doctor is resolute in being the exclusive resource for meds and therapy. Any suggestions on how to approach the issue with the psychiatrist?


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