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ees In Therapy: Forms, Self-Assessment and Resources

By Ofer Zur, Ph.D.
 

This Page Is Composed Of The Following Three Sections:

    I. Clinical Forms Regarding Fees
    II. Therapists’ Self-Assessment Regarding Their General Attitude Towards Money
    III. References

 

 
I. Clinical Forms Regarding Fees

Following are sample sections in the Office Policies that pertain to fee issues:

HEALTH INSURANCE & CONFIDENTIALITY OF RECORDS: Disclosure of confidential information may be required by your health insurance carrier or HMO/PPO/MCO/EAP in order to process the claims. If you instruct Dr. Zur, only the minimum necessary information will be communicated to the carrier. Dr. Zur has no control or knowledge over what insurance companies do with the information he submits or who has access to this information. You must be aware that submitting a mental health invoice for reimbursement carries a certain amount of risk to confidentiality, privacy or to future capacity to obtain health or life insurance or even a job. The risk stems from the fact that mental health information is likely to be entered into big insurance companies’ computers and is likely to be reported to the National Medical Data Bank. Accessibility to companies’ computers or to the National Medical Data Bank database is always in question as computers are inherently vulnerable to break in’s and unauthorized access. Medical data has been also reported to be legally accessed by enforcement and other agencies, which also puts you in a vulnerable position.

PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay the standard fee of $XXX.00 per 45 minute, $XXX.00 per hour session at the end of each session or at the end of the month unless other arrangements have been made. Telephone conversations, site visits, report writing and reading, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Dr. Zur if any problems arise during the course of therapy regarding your ability to make timely payments. Clients who carry insurance should remember that professional services are rendered and charged to the clients and not to the insurance companies. Unless agreed upon differently, Dr. XXXX will provide you with a copy of your receipt on a monthly basis, which you can then submit to your insurance company for reimbursement if you so choose. As was indicated in the section Health Insurance & confidentiality of records, you must be aware that submitting a mental health invoice for reimbursement carries a certain amount of risk. Not all issues/conditions/problems, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Dr. Zur can use legal or other means (courts, collection agencies, etc.) to obtain payment.

CANCELLATION: Since the scheduling of an appointment involves the reservation of time specifically for you, a minimum of 72 hours (3 days) notice is required for re-scheduling or canceling an appointment. Unless we reach a different agreement, the full fee will be charged for sessions missed without such notification. Most insurance companies do not reimburse for missed sessions.

To obtain the full Office Policies and other important clinical forms, click here.

 
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II. Therapists’ Self-Assessment Regarding Their General Attitude Towards Money

Following are series of questions that may help therapists clarify their relationship to money and hopefully will aid them in dealing more effectively with money issues with their clients. Many therapists have not consciously articulated the meaning of money for themselves and as a result sometimes they do not handle money matters well. Take a few minutes to answer these questions.

  • Do you feel deserving of being paid for providing psychotherapy service?
  • How are you in regard to setting realistically high fees?
  • How are you in regard to earning “a lot” of money?
  • What are your feelings about rich people?
  • Is your relationship to money similar in any way to your relationships to time and/or sex?
  • How would you define the meaning of money for you?
  • Do you vacillate in your attention to money matters and, if so, to what do you attribute this?
  • How are you in regard to expecting to be paid on time?
  • Many authors, therapists and clients have likened therapy clients paying for love to prostitution clients paying for love. What are your thoughts and feelings about this analogy?
  • Do you know what the average charge is for therapy in your area, for therapists with similar credentials and a similar type of setting and clientele? Do you know how to obtain such information?
  • Have you clearly defined criteria by which to set your fees, such as full fee, sliding scale, bartering, pro-bono?
  • Do you feel comfortable talking to your clients about money?
  • Do you have clear office policies regarding fees?
  • Are you, your assistant or the person who sends out bills good about billing clients consistently and on time?
  • Have you looked for education or consultations regarding money concerns?
  • Do you keep count of your total earnings and the average fee you have charged throughout your psychotherapy career?
  • Would you feel better about yourself if you changed your attitude and management practices regarding money issues in therapy?
  • Reflecting on the above answers, how would you define the challenges and obstacles to successfully dealing with money in your practice?

 
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III. References

Bishop, D. R. and Eppolito, J. M. (1992). The clinical management of client dynamics and fees for psychotherapy: Implications for research and practice. Psychotherapy: Theory, Research, Practice, Training. 29(4), 545-553.

Blackmon W. D. (1993). Are psychoanalytic billing practices ethical? American Journal of Psychotherapy. 47(4), 613-620.

Corbett, A. (2000). Psychotherapy for those who do not pay -understanding money in the therapeutic relationship. https://www.respond.org.uk/business/confertalk.html.

Cummings, N. A. (1995). Unconscious fiscal convenience. Psychotherapy in Private Practice.. 14(2), 23-28.

Erle, J. B.(1993). On the setting of analytic fees. Psychoanalytic Quarterly. 61, 106-10

Fay, A. (1995). Ethical implications of charging for missed sessions. Psychological Reports. 77, 1251-1259.

Fenichel, O. (1954). The drive to amass wealth, in The Collected Papers of Otto Fenichel:.Second Series. New York, Norton, pp 89-108.

Friedman, R. (1991). Psychotherapy without fee, in Money and Mind,. edited by Klebanow S, Lowenkopf EL. New York, Plenum, pp 207-221.

Geistwhite, R. (2000). Inadequacy and Indebtedness: No-Fee Psychotherapy in County Training Programs. Journal of Psychotherapy Practice and Research,. 9, 142-148. Retrieved from https://vuir.vu.edu.au/19368/30/00jpr142.pdf

Gedo, J. (1963). A note on non-payment of psychiatric fees. Int J Psychoanal,. 44, 368-371.

Gutheil, T, Gabbard G. (1993). The concept of boundaries in clinical practice: theoretical and risk-management dimensions. Am J Psychiatry;. 150, 188-192.

Herrell, J. M. (1993). The therapeutic value of fees: what do practitioners believe? Journal of Mental Health Administration,. 20, 270-277.

Herron, W. G. (1995). Visible and invisible psychotherapy fees. Psychotherapy in Private Practice. 14(2), 7-17.

Herron W.G., Rouslin Welt S. (1992). Money Matters: The Fee in Psychotherapy and Psychoanalysis.. New York, Guilford.

Herron, W.G., and Sitkowski, S. (1986). Effects of fees on psychotherapy: what is the evidence? Professional Psychology: Research and Practice,. 17, 347-351.

Hill, Marcia. (1999). Fee in Feminist Therapy,. Haworth Press 1999. Originally published in For Love or Money: The Fee in Feminist Therapy. Women & Therapy,. 22, Number 3. (Table of Contents and Abstracts are available at: https://www.tandf.co.uk/journals/WWAT)

  • Psychotherapists’ Ambivalence About Fees: Male-Female Differences
  • What Are We Worth? Fee Decisions of Psychologists in Private Practice
  • Women, Mental Health, and Managed Care: A Disparate System
  • The Function of the Frame and the Role of Fee in the Therapeutic Situation
  • Payment for Missed Sessions: Policy, Countertransference and Other Challenges
  • Client and Her Therapist
  • Barter: Ethical Considerations in Psychotherapy
  • The Price of Talk in Jail: Letters Across the Walls
  • Private Practice with a Social Conscience

Inman, D. J. & Bascue, L. O. (1984) Fee policies of psychologists in private practice. Psychotherapy in Private Practice,.2, 3-12.

Lorand, S. and Console, W. A. (1958). : Therapeutic results in psycho-analytic treatment without fee: observation on therapeutic results. Int J Psychoanal,. 39, 59-64.

Manos, N, (1982). Free psychotherapy: the therapist’s and the patient’s view. Psychother Psychosom;. 37, 137-143.

Mellan, O. (1994) Money Harmony: Resolving Money Conflicts In your Life and Relationships,. Walker and Co.: New York.

Mellan, O. (1995) Overcoming Overspending: A Winning Plan for Spenders and their Partners,. Walker and Co.: New York

Meyers, B. (1976). Attitudes of psychiatric residents toward payment of psychotherapy fees. Am J Psychiatry,.133, 1460-1462.

Nash, J.L. and Cavenar, J. O. (1976). Free psychotherapy: an inquiry into resistance. Am J Psychiatry,. 133, 1066-1069.

Needleman, J. (1994) Money and the Meaning of Life, New York Doubleday Books, 1994

Pasternack, S. A. (1977). The psychotherapy fee: an issue in residency training. Diseases of the Nervous System,. 38, 913-916.

Pasternack, S. A. and Treiger, P. (1976). Psychotherapy fees and residency training. Am J Psychiatry,. 133, 1064-1066.

Pope, K.S., Geller, J. D., and Wilkinson, L. (1975) Fee Assessment and Outpatient Psychotherapy, Journal of Consulting and Clinical Psychology. 43, 835-841.

Power, L. C. & Pilgrim, D. (1990) The fee in psychotherapy: Practitioners’ accounts. Counseling Psychology Quarterly,. 3, 157-170.

Psychotherapy Financ. 2000 Survey: https://www.psyfin.com/Survey2000/PsyFin2000.pdf

Soderlund, J. A century of fees. New Therapy,. Retrieved from https://www.newtherapist.com/18fees.html.

Trautt GM, Bloom L. J. (1982). Therapeugenic factors in psychotherapy: the effects of fee and title on credibility and attraction. J Clin Psychol,.

38:274-279.

Wood, W. D. (1982). Do fees help heal? J Clin Psychol;. 38, 669-673.

Wortman, R. J. (1984) The relationship of psycho-analytically oriented psychologists’ fee policies to personality, training and experience. Psychotherapy in Private Practice,. 2, 25-38.

Yoken, C. and Berman J. S. (1984). Does paying a fee for psychotherapy alter the effectiveness of treatment? J Consult Clin Psychol. 52, 254-260.

 
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