The Therapy Transaction – How the Financials of Therapy Impact the Therapeutic Process.

This post was a submission by Joel Schmidt, Licensed Mental Health Counselor. See below for information on how to get scheduled with him for individual or couples work. 

Money can be a bit taboo to talk about….and a complex topic when it comes to the financials of therapy for both clients and therapists. If you know me well enough, you know I like talking about things that people often don’t talk about….mysterious dynamics of therapy…and what it’s like to be on both sides of the therapy room. I, myself, have been on both which gives me a unique take and the ability to speak to certain things about therapy that probably wouldn’t be possible if I hadn’t been a therapist and a client in the past.  

Why talk about the financial element of therapy? Well, money tends to bring up feelings…and feelings tend to bring up questions.  The helper (therapist in this case) we assume cares a lot about people - but also have some conditions placed on their willingness to help.  The client (and person in need of some sort of help) wants to work with someone who genuinely cares - and sometimes wonder how money factors into the equation.  

Money From the Therapist Angle:

Therapists often struggle to set their fees, to talk about money with clients, to raise their rates, or to have a conversation about past-due fees. How much is fair to charge for therapy? How much am I “worth”? How much money do I need to make to take care of myself while also being in the business of helping and caring for other people?  How do I reach as many people as possible but also maintain my own sanity and well-being? How can I establish a genuine and authentic relationship that clients believe is sincere when one of the conditions of being available is that my clients must pay me? There’s an interesting balance that has to be maintained to ensure the financial and emotional health of the therapist while also doing the best work possible. 

Money From the Client Angle: 

Clients sometimes struggle with the financial aspects of therapy as well. Does my therapist only listen and care because I am paying them to? What happens if I can no longer pay? Is this worth the financial investment and am I getting the full value? How authentic is my therapist being in the way they act towards me? They seem really concerned about me, but am I really just “a number” or contributing to a bottom-line? 

Validity of the Questions - From both angles

I didn’t cover the full complexity of the financial element of therapy, but questions from both the therapist’s and client’s ends are valid and worth having some transparent conversations around.  Just laying them out there like I did, I believe, is a good start.  

Again, I talk a lot about the interesting dynamics of the therapy relationship and how it’s different from other relationships…and money is probably one of the things that impacts it most and in some cases “muddies the water” if all considerations around money haven’t been made.

For the sake of this conversation, I’ll simply speak to the value of money being a part of the therapeutic relationship.  Why it’s good - not only for the therapist but for the client.  

For the Therapist: 

Money is the only way that therapists get the opportunity to do what they chose to do for a living - and that they hopefully love doing.  When I thank clients, I often make it clear that I’m thanking them for the opportunity to do what I’m passionate about.  I like helping people, I like working with people to solve problems and puzzles, and I genuinely look forward to meeting with my clients. I wouldn’t have the time or energy to do this as a hobby.  I might even build resentment towards people who were taking all of my time with nothing to offer towards me.  In this sense, money is the great equalizer.  Generally speaking (aside from having a certain level of openness to the process and being willing to do some of the work between sessions), a client only owes their therapist one thing: an agreed upon amount of money for the time they will be spending with their therapist.  This fulfillment from the client’s end opens up the therapist to be everything else the client might need from a therapeutic perspective.  It also creates an obligation for the therapist to be COMPLETELY present for their clients - something that you can’t find many other places in this world.

For the Client:

Paying for therapy takes away the sense of burden that a client might otherwise feel they are imposing. Knowing they have done their part in the “contractual” agreement, frees them up to feel okay making therapy about them alone…for having the expectation that the therapist show up when they have agreed to meet…for getting to be in full control of the topic and the work that’s being done. The money, then, is the part that really makes it all possible.  It’s the power to create the dedicated space, to have expectations of the helper, and to work with someone truly specialized in what they might be struggling with. Another consideration not yet mentioned speaks to the power of “investing” in something.  People who have paid money for something are more likely to get the most out of their investment - and to do the work.  Hiring a personal trainer, for example, makes someone more likely to show up to the gym, to feel accountable to something, and to do the work between sessions to improve their physical condition.  It’s no different with mental health.

This post was written by Joel Schmidt, a Licensed Mental Health Counselor in the State of Florida. Joel specializes in Anxiety Disorders (General Anxiety, Social Anxiety, Panic Attacks, Phobias), but can also help with Depression, Low Motivation, Moderation and more. To schedule an appointment to work with Joel, you can click here to schedule online, email him at joel@floatoncounseling.com, or call 813-515-9602.  

 

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