I read this on your blog, and my first reaction was "I'd be pissed!" I think what would anger me the most is that it was an un"discussed" fee. The surprise like that would have very much annoyed me.

I am starting up with a behavioral therapist, and when I got the paperwork from her to fill out, I will admit that I was really annoyed by the fact that she charged for coaching sessions (though coaching is mandatory) and she charges for updating other treatment team members (beyond the two that are included) However, because it was set up in her paperwork from the get go, I can live with that. I know what I'm getting myself into.

I'm glad your T acknowledged that it would have been better to talk about it together first. I hope that when you meet tomorrow you can work something out that feels ok for both of you.

R2Gl

I think my T knows he made a mistake in not discussing the fee with me first. Thanks for letting me know that your T is charging for coaching and updating. Clearly it is something that varies from T to T and as long as I know about the charges in advance I can decide if I want him to do the consultation.

Thanks for validating my shock poppet. I think I will pay him because he is seeing him as a supervisor for his work with me and at my request. I need to be informed of any fees so I can okay them, like I authorize 4 hours of consultation or supervision so I won't be surprised by the bill.

((((COGS))))

Let us know how it goes!

(((Cogs)))

I keep thinking about your situation, and it really doesn’t seem like there is an easy answer. I think we can all agree that your T messed up by not talking with you about the fee first. I can imagine how shocking it must have felt seeing that on your bill. I think if it were me, either way (either me paying or T paying) would be hard to deal with. If my T paid, I would feel guilty, and like he was doing too much for me, but if my T just charged me without discussion, it would feel like he didn’t care about me, and that I had somehow embarrassed myself by imagining that he would pay.

As for who should pay for the supervision, I keep going round and round in my head. On the one hand, getting supervision when necessary is the T’s responsibility, and is already included as part of his normal fee. I know my T meets with a consulting group/supervisor, and has talked specifically about me many times, but paying for that group is his responsibility, not mine. On the other hand, I believe you mentioned that it was your idea to do the trauma assessment, and so meeting with this supervisor would be something that he is doing not because he thought he needed it, but at your request.

I think setting limits on the number of supervisory sessions is a good idea. I’m also wondering if you could have them take it slowly- at this point your T has talked to the supervisor once (and maybe read a written report? I’m not sure how it works) and should have some new ideas on working with you. Maybe have them wait a month or two to see how things are going before scheduling a supervisory session?

I’m also wondering if perhaps you and your T could share the cost of the sessions? It doesn’t have to be all or nothing. Anyway, regardless of who pays, I hope that the insight from the trauma assessment is helpful in your therapy.

Nannabee, thanks for your well balanced answer. I am the one who requested attending the trauma assessment clinic. I am grateful he is willing to attend supervisory sessions with a T that I picked for him through the clinic when he may not have felt it was necessary. I had planned to discuss payment for the sessions when they were set up but I wasn't prepared for the initial consult to be billed.

The update is that my session went well last night. I paid the bill at the start and he asked if I wanted to wait until after we had talked about it and I said no I'll pay and then we'll talk. He told me that he realized he hadn't discussed it with me but it was his standard operating practice to charge for that time. I think he was surprised that he hadn't charged me before. We discussed my concerns about not knowing about the charges and how they were difficult right now in particular.

He told me that he had to pay for the supervisory sessions and that they hadn't settled on a fee yet but he thought he would charge me his rate and he would pay the supervisor's fee (so we both would be paying something). I agreed but told him if the supervisory rate was different than he expected I was willing to pay a higher rate if he discussed it with me first. Then we discussed the number of sessions and he told me that they had planned two or three about three weeks apart so we could discuss if we wanted to continue after the first. I said that was acceptable to me. Then we moved on and I shared my interpretation of him charging or not charging for some non-session items (like consults or letters to other doctor's) as indicative of how much he liked his client's at any point during the therapy.

Thank you all for your advice. I feel a lot better after working through this.

Glad to hear it ended up working out well, and it sounds like it was a great conversation for both of you.

Nice work!