It determines our ability to provide for our basic needs, like therapy.
Some people have a lot of money and are defensive or feel guilty about the role of money in their lives. Others blame themselves for not having enough.
As a result, we often respond with shame and avoid talking about money entirely. The truth is, money and class status is often inherited and is very rarely someone’s fault.
Our society encourages us to avoid talking about money, because simply by having that conversation we’re opening up new possibilities. I want to open up this possibility with you: transparency, flexibility, and humanity in a financial arrangement with a therapist.
I have created a system of five tiers that represent people in different types of financial situations. My availability for therapy sessions is tier by tier, so I can work with a good balance of folks while also meeting my own financial needs.
Yes, there is some wiggle room. Let’s chat and we’ll see if we can work something out if you’re feeling any uncertainty. You never know if you don’t ask!
These fees are representative of 50 minute session times. I spend the extra ten minutes in the hour preparing prior to our session. Session fees are pro-rated by quarter hour.
For instance, individual intake sessions are an hour and a half which would be 1.5 times our agreed fee. Group intakes are two hours which would be 2 times our agreed fee. Got it?
Our fee agreement is open to change as needed.
A good rule of thumb in determining what tier you might best fit into is to consider where your money worries fall along Maslow’s hierarchy of needs.
The higher on the pyramid you are, the higher you can expect your fee to be. And the lower on the pyramid you are, the lower fee you can expect.
Worth noting is that Maslow’s hierarchy is derived from the Blackfoot Nation’s relational well being model which is more holistic and community oriented. However, for our purposes, Maslow’s hierarchy is a good starting point in discussing our individual relationships with money.
Availability last updated: 8/26/2024
Without any further introduction, here are the tiers:
A: “I can use my financial resources to impact the world around me.”
Price: $161 – $500
Availability: Yes
Do you or your family have accumulated wealth?
Is so, this is the tier for you.
This tier might be a good fit for you if you/your family own more than one home, you travel regularly, you employ service workers in your home, you can drop a few hundred dollars on a shopping trip or night out and not worry about it, etc.
If this tier is a fit for you, you might have more identity, purpose, or existential concerns. You want to know if you’ll have a safe space to assess your values and priorities. You will.
B: “I have OON benefits and would like to seek insurance reimbursement.”
Price: $160
Availability: Yes
Are you able to pay up front for therapy and seek insurance reimbursement?
This might be the tier for you!
$160 represents my “standard fee.”
Standard fees are used by insurance companies to determine what they reimburse. That’s why:
- this number needs to stay reasonably high to ensure that myself and other therapists are reasonably reimbursed by insurance companies for the services we provide. If this number were lower, they would argue that the cost of therapy is lower, and use that as justification to pay all of us less.
- this is the same number for anyone I work with who wants to seek insurance reimbursement. If I were to charge two different people at two different rates and they were to both seek reimbursement from the same company, the insurance company might only reimburse at the lower rate. How do we solve that problem? We only give them one rate.
- C, D, and E are considered sliding scale for insurance purposes. But really, the whole system here is a sliding scale.
It might be a good idea to double check your benefits if you’re interested in exploring this option.
C: “I am able to regularly have pleasurable experiences due to my access to financial resources.”
Price: $110 – $159
Availability: Yes
Are you able to go on pleasurable outings and/or make notable purchases somewhat regularly?
If so, we might be looking at a fee somewhere in this range.
This tier might be a good fit for you if someone else is paying for our sessions, you are fairly compensated in your field of work, you supervise other people in your field of work, you take a vacation at least once a year, etc.
D: “I am reasonably comfortable in my day to day life.”
Price: $80 – $109
Availability: Yes
Everyone’s got some money worries, but are you reasonably comfortable most of the time?
This tier might be a good fit for you if you can comfortably pay your bills every month, you order takeout more than once a week, etc.
E: “I can meet my basic needs.”
Price: $50 – $79
Availability: No
If you can generally meet your basic needs, and sometimes have funds left over to do activities or save, this is the tier for you.
This tier might be a good fit for you if you rely on government benefits, sometimes have to go without things you need, are unable to work, make at or below $20 per hour, etc.
I know that life can sometimes feel hectic when you don’t have a lot of money. Therapy can be a space where you take a break from all that, recenter, make a plan, and mindfully engage with your world.
What if I don’t have enough fucking money?
If you don’t have enough money to fit somewhere in this fee system I’ve outlined, my advice to you would be to find a provider who will take your insurance. You probably will be eligible for Medicaid.
I know this might not be your first choice, but there are good therapists who accept Medicaid. I’ve met them.
Why don’t you take insurance?
Insurance companies demand that therapists practice in a way that runs counter to my values.
These demands include but are not limited to: utilization of a “bio-medical” framework of “mental illness,” accepting clients when we are not a good fit for each other, and interacting with extensive layers of bureaucracy.
I fully respect therapists who are committed to taking insurance as a means of making therapy accessible. We’re both working towards the same goal in that regard.