The short answer is no, I do not accept insurance. The explanation is below if you are interested in why.
Many couples ask me if I can accept they can use their insurance for couples counseling. I would like to explain how insurance works and why I work in the way that I do.
Insurance companies have requirements for clients to bill them.
· One person needs to be the identified client.
· That person needs to have a clinical diagnosis that explains why they need care.
· The insurance company may require proof that what is discussed in session is clinically necessary and working to address the diagnosis.
When I help a couple, the relationship is the client, not one person in the relationship. I do not subscribe to the idea that one person’s anxiety, depression, reactivity, etc. is the problem. I believe that the reaction between partners is the real issue and what needs to be addressed.
In some cases, having a clinical diagnosis can affect you in the future. If you ever want to work in the military or other government positions, they may check your mental health record. If you want to move to a foreign country, the same may be true. If you ever get into a future court case with your partner, this diagnosis could be used against you in court.
Insurance companies can request copies of clinical notes from sessions in order to have proof that what is being discussed is related to the diagnosis. And they will only reimburse for certain modalities, so the clinician is not free to treat you in the way that they best feel you are suited. They are not being limited by what the insurance companies will reimburse.
Even if you pay the clinician directly then submit an out of network statement and receive your reimbursement from the insurance company, they can decide at a future date that the session should not have been covered and they can “clawback” the money from you months later.
For all these reasons, I do not accept insurance for couples counseling and I do not provide an out of network statement for services.
Yes, if you are lucky enough to have an amazing friend or family member who is a patient, empathetic listener who is educated on therapeutic techniques, can non-judgmentally hold space, and will keep your secrets confidential, then that person is a great resource in your life.
For the rest of us, it is important to remember that most people have their own opinions of what you should do based on their experiences. They may feel you should do things in the same way. If you discuss an issue but don't act accordingly, they may judge you. They may not be able to listen to you vent without providing you with the “right” solution.
They may not keep things confidential between the two of you. They tell their partner or one friend, who then tells one friend, etc. Some things feel personal and you don't want these things spread around in your community. Some issues around sexual health or relationship dynamics may feel too private to share with even your closest friends.
Generally, friends and family will remember the information on your latest relationship conflict. They may start to form a negative view of your partner. From there, they may start to encourage you to leave your relationship because it seems like a bad choice to them.
A skilled therapist is constantly focused on learning effective techniques and the newest information in their area of expertise. Your friends and family may have a more shallow or narrow focus of study in pop psychology.
While therapy is not cheap, it is still much cheaper than divorce. In Washington state the average divorce costs $10,500 - $12,000; with kids this jumps to $15,000 per a local divorce attorney. Relative to divorce, couples therapy is much cheaper financially as well as mental much healthier for your children to experience an intact family.