Psycho-Babble Psychology Thread 362407

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How much does a good therapist charge?

Posted by Angela2 on July 1, 2004, at 20:34:18

I am just wondering because my therapist charges a lot. (200 dollars per visit). Sometimes I find myself thinking "all she cares about is the money" she isn't really trying to help me. I'm just trying to figure out if she does care about me or not.

 

Re: How much does a good therapist charge?

Posted by Dinah on July 1, 2004, at 21:29:09

In reply to How much does a good therapist charge?, posted by Angela2 on July 1, 2004, at 20:34:18

I think it depends on the credentials of the therapist, and the area of the country... a lot.

My own therapist is high for this area at $110 an hour, even for therapists with more prestigious credentials than he has. It looks like they're getting an average of $100 an hour around here, so I suppose they're catching up. It used to be a bigger difference.

I used to have a website that estimated treatment costs, including therapy, but it doesn't seem to be working.

 

Re: How much does a good therapist charge?

Posted by mair on July 1, 2004, at 22:46:24

In reply to Re: How much does a good therapist charge?, posted by Dinah on July 1, 2004, at 21:29:09

Mine charges $105 per session which is a little less than what she charges newer patients - I think she charges me a little less because I go 2x a week and I think she tries to keep people as close to the rate they started at as she can. My T has a PhD; I think my pdoc charges her therapy patients more - maybe $165.

Dinah is right - I think a lot of this is dictated by your location. I don't begrudge my T a penny of what she charges and frankly thought she should have raised the rate from where I started ($95) a lot sooner than she did. Also although she definitely needs the income, when I thought I might be losing my insurance coverage, she instantly offered to lower my rate to keep me in therapy. On the other hand, I think a T's overhead probably isn't all that huge in relation to some other professional services

mair

 

Re: How much does a good therapist charge? » mair

Posted by Pfinstegg on July 1, 2004, at 23:40:36

In reply to Re: How much does a good therapist charge?, posted by mair on July 1, 2004, at 22:46:24

I live in a large city. My analyst (an MD) charges $170 per session, as do nearly all of the therapists (psychologists and social workers) who have PhDs. There seems to be common going rate that they are all aware of. The psychopharmacologists here are even worse- they all charge $300 an hour! Luckily, you can go for a quarter or half of an hour every few months after the initial visit, but still!

 

Re: How much does a good therapist charge?

Posted by Elle2021 on July 2, 2004, at 3:43:02

In reply to How much does a good therapist charge?, posted by Angela2 on July 1, 2004, at 20:34:18

My psychiatrist, who has an MD and a PhD, charges $270/hour. My therapist, who is a masters level clinician (she's an LMHC), charges $104 per session.
Elle

 

Re: How much does a good therapist charge?

Posted by Miss Honeychurch on July 2, 2004, at 8:22:19

In reply to Re: How much does a good therapist charge?, posted by Elle2021 on July 2, 2004, at 3:43:02

My T is a clinical psychologist (PhD). He charges $120/hour.

 

Re: How much does a good therapist charge?

Posted by lucy stone on July 2, 2004, at 8:48:57

In reply to Re: How much does a good therapist charge?, posted by Miss Honeychurch on July 2, 2004, at 8:22:19

My PhD analyst also does less intense therapy. He charges new patients $120/hour. I paid $95/hour when I started 4 years ago. I pay $85/hour for my analysis but I go 4 times/week so it adds up for him and for me. I live in a medium sized city in the central part of the country.

 

Re: How much does a good therapist charge?

Posted by partlycloudy on July 2, 2004, at 9:57:17

In reply to How much does a good therapist charge?, posted by Angela2 on July 1, 2004, at 20:34:18

My T charges $90 for an hour session. The EMDR therapist (also an LMFT) charges me $95 an hour and a half. Sounds like I'm getting a deal, but the cost of living where I am is quite low, as are the wages.

 

Re: How much does a good therapist charge?

Posted by asya on July 2, 2004, at 11:47:36

In reply to Re: How much does a good therapist charge?, posted by partlycloudy on July 2, 2004, at 9:57:17

My T's actual rate is $130/hr (I go weekly), but it seems with the various insurance arrangements (PPO, HMOs etc),. they never actually GET that amount because of PPO discounts etc. Do you guys have your insurance covering 100% of your T's fees or like 80% or something?

 

Re: How much does a good therapist charge?

Posted by Angela2 on July 2, 2004, at 12:30:32

In reply to Re: How much does a good therapist charge?, posted by asya on July 2, 2004, at 11:47:36

Right now my insurance is covering none of my appointments because I was only covered for 20 visits per year and I have run out. Doctors appointments are always covered during the year and there is no limit for insurance. Congress has turned down the suggestion of treating mental health visits like doctors appointments many times.

 

Re: How much does a good therapist charge?

Posted by lucy stone on July 2, 2004, at 13:17:20

In reply to Re: How much does a good therapist charge?, posted by Angela2 on July 2, 2004, at 12:30:32

> Right now my insurance is covering none of my appointments because I was only covered for 20 visits per year and I have run out. Doctors appointments are always covered during the year and there is no limit for insurance. Congress has turned down the suggestion of treating mental health visits like doctors appointments many times.

This is something I can never understand. Mental health problems often cause or aggrevate physical problems. Insurance companies will pay to treat the physical problems but will not pay to treat the underlying mental problem. If your psychological problems cause you to overeat insurance will pay to treat the resulting heart attack, but they won't pay to address what made you overeat in the first place. My daughter had a brief period of anorexia a few years ago. The insurance paid for doctor visits to monitor her physical health but wouldn't pay for the therapist who saved her life. In addition, our insurance pays for 26 visits a year. Her T needed to see her twice a week for support as she started eating but didn't need to see her for a hour each time. He saw her for two 30 minute sessions a week and charged half of his usual session fee each time. The insurance counted each one as a visit so we ran out of coverage in 13 weeks rather than 26. She needed to be in treatment for longer than that and we paid for it out of pocket. Fortunately, we could cover the cost but many people can't.

 

Re: How much does a good therapist charge?

Posted by Jai Narayan on July 2, 2004, at 20:23:48

In reply to Re: How much does a good therapist charge?, posted by lucy stone on July 2, 2004, at 13:17:20

My EMDR therapist charges $120 for an hour and a 1/4. I like her work and see her weekly. I need to look into my insurance to see if it has a limit to my visits per year.
Thanks for the heads up.
Good mental health=good physical health.
What is this bias against mental health assistance?

 

Mental Health Insurance parity...what can you do?

Posted by gardenergirl on July 2, 2004, at 20:53:17

In reply to Re: How much does a good therapist charge?, posted by Jai Narayan on July 2, 2004, at 20:23:48

I've been working hard to advocate for federal and state mental health parity (meaning insurance coverage for mental health would be equal to coverage for physical health as long as mental health coverage is offered by the company.) The "Paul Wellstone Mental Health Equitable Treatment Act” (S. 486/H.R. 953) currently has more than enough sponsors to pass in the Senate, but Speaker Hastert in the House has refused to bring it to the floor for a vote. He has apparently been influenced by insurance lobbyists.

There is a website run by the American Psychological Association's Practice Division which has a link where you can easily send an email to your Senators and Representatives asking them to support this important legislation. You can access this site at http://www.apapractice.org/#
Just enter your zip code in the box in the right column labelled legislative action center and follow the instructions. It's very simple.

The only modification you need to make to the pre-written letter (although you can write your own or modify it as you wish) is to change the "I am writing as a constituent and a psychologist" part. You can leave it as constituent if that is true, and/or change it to your own profession. There is also the option to add your personal experiences, which is really helpful in getting your letter read. But please know that every letter counts. If a legislator gets ten letters on a topic, it puts it high on the list for attention.

Please consider taking five minutes to contact your legislators to impress on them the importance of this legislation. If anyone has any questions or would like some help with this, please feel free to email me at gardenergirl88 at yahoo dot com

Thanks for your support. Even if you disagree with the legislation, make your voice heard. That is what our forefathers and mothers fought so hard for more than 200 years ago.

Thanks, (stepping down from my soapbox now)

gg

 

Re: How much does a good therapist charge?

Posted by Rigby on July 3, 2004, at 14:12:24

In reply to How much does a good therapist charge?, posted by Angela2 on July 1, 2004, at 20:34:18

Mine was $85 an hour. I said I was quitting about a year into it--too much money, probably too scared. She begged me to come back--but I did at the rate I chose: $60/session. We stayed there for a year then she raised her rates overall ($85 for current clients, $100 for new) and I renegotiated to $75. All of it's out of pocket--she no longer accepts insurance.

I guess my thought about it is that they're usually negotiable--at least in this area where it seems like there is a therapist on every corner.
> I am just wondering because my therapist charges a lot. (200 dollars per visit). Sometimes I find myself thinking "all she cares about is the money" she isn't really trying to help me. I'm just trying to figure out if she does care about me or not.

 

Re: How much does a good therapist charge?

Posted by pegasus on July 4, 2004, at 14:12:34

In reply to How much does a good therapist charge?, posted by Angela2 on July 1, 2004, at 20:34:18

My current T, who is an MA LPC and board certified art therapist, charges $85 for an hour. I think the going rate for MA level Ts in my area is a little lower than that, but she has art supplies to fold in.

My old T, a Ph.D. psychologist, charged $90 when I was getting some money back from my insurance, and $72 when I wasn't. I think his new patients were paying more. I'd been with him for a couple of years. That's quite a deal, I think.

When I was looking for new Ts recently, it seemed that most PhDs were charging from $90 to $120 in this area (which is a medium sized town with very high cost of living and tons of Ts). Most had about a 20% discount if insurance wasn't involved, but some don't.

My pdoc charges $130 an hour, or $60 for a "half hour" (even if we only talk for 15 minutes or so, which she usually manages somehow).

My insurance covers 50% of 25 visits per year. I always pay my T directly, then file a claim with insurance afterwards.

Hope this info helps. It seems I've been getting quite a deal on therapy.

pegasus

 

Re: How much does a good therapist charge?

Posted by TexasChic on July 6, 2004, at 13:16:05

In reply to How much does a good therapist charge?, posted by Angela2 on July 1, 2004, at 20:34:18

Mine charges $165 per hour visit. With my insurance its $42.50, and the visits are limited (I can't remember how many). I've never been able to figure out how they came up with that figure ($42.50).
When I first started going and my insurance then didn't cover it, she gave me a discount and charged me $80 a visit.
Oh, and I live in a rather large metropolitan area.

 

Re: How much does a good therapist charge?

Posted by Angela2 on July 6, 2004, at 13:36:55

In reply to How much does a good therapist charge?, posted by Angela2 on July 1, 2004, at 20:34:18

I forgot to mention that my therapist is also my pdoc. I think thats one of the reasons why her rates are so high. Plus she's also a good one.

 

Re: Mental Health Insurance parity...what can you do? » gardenergirl

Posted by mair on July 6, 2004, at 18:06:32

In reply to Mental Health Insurance parity...what can you do?, posted by gardenergirl on July 2, 2004, at 20:53:17

Am I not mistaken that there is now some mandated parity, at least for employers of a certain size?

I quit therapy several years ago because I ran out of benefits. (I hit my lifetime cap) Sometime after that Congress passed a bill that I thought required parity, but it was of no use to me because my employer wasn't subject to the bill anyway. Fortunately, the state I live in passed its own parity legislation which offers no exemptions for smaller employers. Mental health care can still be heavily managed under some plans, but at least there is no cap on dollars spent, like there was before.

I know how important this is. My state's bill enabled me to go back into therapy and has enabled me to stay in therapy. Since I only partially respond to ADs, therapy is pretty important for my stability, and I get pretty panicked whenever I think I'm going to lose those benefits. My employer is a part of a larger group which has had enough negotiating clout to force the insurance company to make unmanaged care an option for its members, albeit a much more expensive option. My employer, mostly at my urging, has opted into the more expensive plan. So I'm ok for now, but I don't know how much longer I can convince my employer to do this. Insidiously (and probably deliberately), the plan that includes unmanaged mental health care, not only has far costlier premiums, but is actually worse in the co-pay requirements for services which are unrelated to mental health care. So I am not only disadvantaging my employer who picks up the cost of the premiums, but also each employee here whose co-pays are higher essentially because I need this plan. Also I worry that the association of which we are a part, can not continue to force the insurance company to make unmanaged care an option for every member.

It was interesting to me how the insurance company responded to the change in the law. Quite literally, for several years after the law changed, the statement of benefits all policy holders received continued to cite the old, outlawed caps, so if you were uninformed, you'd assume those limitations still applied to you. Also, when they started having to offer a choice, the printed material they sent around totally misrepresented the insurer's preferred managed option and if you didn't respond very quickly, you were defaulted into the managed care option. This happened to my employer. When I brought some of the misrepresentations to the attention of the insurer, they let us opt into the unmanaged plan immediately. I think I wasn't the first person who complained, because they put up absolutely no argument.

It's getting harder and harder to hold onto unmanaged care - our plan costs a few thousand dollars more than the managed variety, and I'm pretty sure I'm the only person here who benefits. I go through this continual range of emotions about it, ranging from guilt that I have it so better off than most of the people on this Board, guilt that I'm actually receiving more in benefits than I pay in premiums, guilt that my therapy progress is so interminably slow, and then also anger that I have to feel guilty. I've read some insurance industry stuff that claims that they don't want to write big checks for therapy because there is no evidence that therapy really works for people with chronic depression. Sometimes I think I'm the poster child for this theory. Of course, the insurance companies are talking about cures, and most of the rest of us are looking at long term maintenance.

I guess I need to get off my soapbox, but your post brought all of this to the fore for me.

Mair

 

Re: Mental Health Insurance parity...what can you do? » mair

Posted by tabitha on July 6, 2004, at 19:34:07

In reply to Re: Mental Health Insurance parity...what can you do? » gardenergirl, posted by mair on July 6, 2004, at 18:06:32

I admire you for getting your employer to buy a plan with good mental health benefits. I'm always afraid to have anyone at work know that I use mental health benefits at all. I'm afraid all my therapy billing will drive up their group rates and they'll trace it back to me personally.

My other quandary is, I don't fully accept that my therapy is medical treatment. I like to think of it as personal growth. So I feel a bit guilty about billing it all to insurance, even though I have the dx, and the parity laws, and the insurance coverage. I guess I just don't like thinking of myself as needing mental health care. Too hard on the ego.

 

Re: Mental Health Insurance parity...what can you do? » mair

Posted by gardenergirl on July 6, 2004, at 19:41:02

In reply to Re: Mental Health Insurance parity...what can you do? » gardenergirl, posted by mair on July 6, 2004, at 18:06:32

Hi Mair,
I understand feeling guilty. I get my therapy for free while I am in grad school. As long as I am considered actively registered, even if I have to take a year off to finish my dissertation (which would cost me 6 credit hours of additional "research hours" tuition), I can still see my T. So I feel guilty about that because I have a great T. It's hard for me to conceive of convincing my husband that we need to invest in therapy for me down the road.

There is a national parity law that passed in 1996. I believe it is for severe mental illness only (some define this as biologically based). Insurance companies have taken advantage of loopholes by limiting number of visits, charging a cap on total benefit, and charging increased co-pays. All of these are allowed in the federal law, although individual state laws may be more comprehensive and more tightly written. In addition, I think this law applies to companies of 50 employees or more. Again, state laws may be better, and would supercede the federal law.

The Wellstone Act would close these loopholes, so that if a company offers coverage for mental health services, it must be equal to medical coverage...in co-pays, number of visits, cap, etc. This would be a better bill altogether, although state law may still supercede this.

Thanks for your input. I hope some on this board are inspired to write. It really takes hearing from the people affected for change to happen.

I've sent many letters. So many to my state Senator (my state has a parity law pending in the Senate), that when I met him in person, he knew of me and my interests.

Take care,
gg

 

Re: Mental Health Insurance parity...what can you do? » tabitha

Posted by mair on July 6, 2004, at 21:38:17

In reply to Re: Mental Health Insurance parity...what can you do? » mair, posted by tabitha on July 6, 2004, at 19:34:07

Tabitha - I work in a pretty small office, and I fit more closely into the category of boss than employee. But it was hard because we had a couple of insurance brokers really trying to sell us on saving a bunch of money by switching to this other plan and EVERYTHING was better with the other plan except the mental health benefits. And I'd sit in these meetings where these people would talk in very specific terms about how there was no reason not to switch and save a ton of $$ unless someone was using the mental health benefits. There was only coverage if you used one of their providers comprised of some pretty underwelming therapists. I've just made too much of a commitment to this process with my own T to even think about going elsewhere.

I hated having to go to one of my colleagues to urge him not to support the switch, but I really had no choice and of course then each of the brokers we dealt with knew exactly why the switch wasn't made.

I am woefully underpaid for my background, education, skills, length of employment etc etc etc. I've allowed this to persist mostly because I've been so down on myself for so long that the prospect of advocating for myself is seems too daunting, and I can't imagine getting it together to change my employment. I've been trying to build myself up to forcing the issue of my compensation, but the whole deal with the insurance set me back in that process because I know, although no one would probably say it, that my colleagues probably would argue that I shouldn't get a raise because of the excess costs of this policy.

I also know what you mean about not looking at therapy as medical treatment. I have the same hang-up and I'm sure the insurance companies want all of us to think that way. It's not like I couldn't survive without therapy.

mair

 

Re: Mental Health Insurance parity...what can you do?

Posted by rs on July 7, 2004, at 9:40:31

In reply to Re: Mental Health Insurance parity...what can you do? » gardenergirl, posted by mair on July 6, 2004, at 18:06:32

Just would like to say the state I live in the insurance carrier that you have must pay for therapy if it is medically necessary. My T said that as long as he uses what he does they must cover. They were covering two visits a week since September but now do just one. I pay 10 co payment. The other visit T has came down much on fee for me to continue. He said what ever I felt I could afford. Yes feel guilty about it but I need it. So I guess I am fourtanate to have this coverage. He did not know about this till someone told him in his officce. Some people might not even know that they must cover if medically necessary. I am sorry for people that cannot afford therapy. I know there was one time with old T that worked in a clinice I had not reduce rate and I ended paying thousands of dollars.


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