I've had this happen to me, my T kept it from me for the "sake of my well being" at the time, but charged my insurance company more and that is how I found out before she had a chance to tell me herself. Then I had to pay her my individual percentage of that. I was in an emergency (and at the hospital, not for inpatient mental health though) at the time and she had to coordinate things very much outside of my session time. We have an arrangement now about out of session contact for severe emergencies (if she has time to give, she will and does but monetarily speaking it's not free - she doesn't do it for the money as far as my heart can tell). T did give me paperwork at the beginning that additional contact above/beyond may cost, etc, etc. So in this scenario, it made sense to me I wouldn't have had any mental ability to deal with my finances. She has never charged me for going over time inside of a session (aside from once... 3 years ago). I do not think you're wrong in wondering wtf is going on... your T should be watching the clock, or at least after the first time letting you know or something.... it does depend on the crisis though. Not discussing it with you before billing you is ridiculous. Does he have a "person" who bills for them? My T says she wishes she had someone else to write up the bills because it sucks to deal w/ the money part (my other T has a secretary, but she's messed up before).

Money is a trigger for me too... I go off the deep end when my financial situation changes in any way.

Sorry to ramble... I hope you can get it sorted out because.... yes he is the clock keeper and should, IMHO, let you have a choice if at all a viable possibility. What if he just let you go for hours or something?

Yes, I have had this happen once as well. Once I started telling T the details of some childhood abuse and when I looked up it was a couple minutes to the end of the session. I said "we don't have time and I wanted to tell you". He looked at me and said keep talking we can go long which is very unusual because he is fully booked most of the time. It was a snow day and most people had cancelled but I was his last session of the day. He called me and asked me if I could come in earlier and I did so I knew there was no one after me. We went for about 25 minutes more and when I got my bill he had charged me for half a session. I was surprised he hadn't said anything but did think it was completely valid so I didn't discuss it and it has never happened again. The most he has ever gone longer in a session except for that day is about 7 minutes which he hasn't charged me for.

I hope you can ask him what the rules are because I agree you should know what to expect. Does he charge in 5 minute intervals or 15 minute? or does he prorate the session minute for minute? I think he should tell you so it is clear but I think during the session they don't want to interrupt what you are talking about to say "if we go past x time then I will be charging you". That would probably change your focus and make it difficult to finish talking. Then later they are doing their billing/time records and forget they haven't been clear on the costs. At least that is my giving the therapist the benefit of the doubt theory.

Hey CD,

My T has let me run over several times and has never charged extra for it. Yes, I would find it triggering if she did and I also agree that is poor manners and bad business practice to have done so without telling you. Maybe if he felt you were at a sensitive moment with whatever you were discussing that introducing the topic of money would seem insensitive? But still.

Maybe it is a T's responsibility to end a session, but relinquishing that control is very difficult for me. I clock watch obsessively and am the one to wrap things up and end, probably 90% of the time. I think if I didn't she'd end up letting me run over more often than I'd be comfortable with.

Hi CD,
A few thoughts on this as I see this a little bit differently, plus I have a question or two.

When you started seeing this T. did he give you his contract stating his charges and rules for going over in session? Perhaps he covered himself in this way which would prevent him from interrupting the moment of you being able to continue with the difficult stuff. This information was given to me when I first started seeing T so I know what to expect.

I also look at this a bit differently but then I am not triggered by the money thing. In addition, I have insurance that after my deductible, I pay very little for each session.

Also, my T and I frequently run over. If it is a few minutes I'm not charged, but if it is longer, than I do. I fully expect this since this is her time, it is how she makes a living. However, I am aware since this was disclosed upfront in her contract.

Rebuilding Me

Personally I think Ts need to be upfront about this sort of thing and, even if it is in the T&Cs if a session runs over they need to still be upfront and have a conversation with the client so the client has the opportunity to make a decision about something that involves them. It is the therapist's responsibility to keep to time not the client's. Unspoken stuff around money never works out well in my opinion.

Therapy is a transaction but it is very much a negotiation between two human beings where one party wields a lot of power. It is not similar to other paid-for services.

CD, I would definitely speak to T about this. Running over by a significant amount of time shouldn't just happen IMO without the client being part of the decision making process.

Hi Closed doors,
My T very rarely goes over time. She currently only works one day a week, so has a tight schedule. She says she watches the time carefully because she is very aware how anxious people get coming to therapy and does not want to make anyone wait.
I ws once extremly upset, when she was working in the hospital, she had someone else coming so she said I could wait in another room until I felt better and she came to check on me when she was free.
Last week we had a double session, but it was arranged 2 weeks in advance because she wanted to try an excercies which needed extra time. When she suggested it she asked would it be too much financialy as it would cost double. So I had the oppurtunity to decide myself.
T also freely replies to e-mails and text message without any charge. I don't ever phone, but that is purely because she is at home with a 2 month baby and a 3 year old and really cannot talk.
I think it is reasonable for your T to charge for his extra time, but he should have discussed it first. If he could not do this I think he should not have charged for the first time, but then discussed it before it happened again.

Hi CD, I have been charged extra before by a T, but I was told ahead of time that this would be the case and it involved the T reading long letters that I would write to her, so it wasn't running long on a session, all of the T's I've seen have been very precise about ending on time +/- a few minutes.

If your T hadn't specified the rules regarding being charged outside of time, then it doesn't seem professional that they did this. Hopefully, he thought he had discussed this issue previously and this would be the only reasonable excuse for this. I'd be upset too.

Talking about money issues with a T is awkward, but hopefully you'll be able to bring it up the next time.

On the flip side, I once had a T kick me out of a session halfway through because I was escalating the tone of a debate (but not being threatening--just a butthead). I ended up using that as an excuse to leave, but years later when I thought about going back to see her, I insisted that she pay me back for the half session. She resisted initially, but I convinced her that she never presented me with a policy or warned me that said she could unilaterally kick me out, and she didn't fulfill her obligation to the time I had paid for. I had told her I might take her to small claims court (we met a few years later as I considered going back to her.)She was flabbergasted. She ended up deciding to pay me back as she put it "to lay this issue to rest." I never did go back to see her as a T.

It was a huge victory. I thought about framing the check, since the money wasn't the issue. Its about fairness. Rules should be made clear and followed by T's. They shouldn't be "above the law." They already have so much more power than us. I think they should be scrupulous and consistent in their therapeutic actions and business actions.

thanks for your responses, everybody.

cat, he has a billing agency that sends out the bill, and the return address is directlyl to T. yeah, i think he should have definitely mentioned it after the first time. he knows this stuff is difficult to impossible for me. i know this is all part of the therapy, but it doesn't make it easier. you didn't ramble at all, and i appreciate your input, cat ... seriously could have let me go for hours and i would have loved it in my deluded state. sigh.

cogs, i suspect he charges in 15 minute increments ... but i don't know. i'll find out when we meet on Thursday. we regularly go over, not more than 3 or 4 minutes, but he's never billed me for that. i guess if it happened once it would be a big deal, but twice in a row .... plus, historically my regular session was Friday mornings at 8:00 ... these sessions since i've started again moved to 5:00 pm which is his last slot for the day. i don't know if that plays into it or not ... nobody is scheduled afterwards so there's some flexibility there.

thanks for the advise, muffaletta. i do that all the time ... pay in increments i can actually afford. an extra $30 isn't so bad, but two in a row? that starts to get a little more difficult. i'm divorced in a house i can barely afford, raising two daughters. times are tough.

thanks for the hugs (((draggers))). i think that's my biggest beef, is that he decided that's what i needed, when, even though it WAS an emotional session, i didn't feel like there was a need to go over-time in either session, which tells me it was more about him and his needs than mine. if i can muster the courage in the moment i'll tell him so. it would have been nice to be given the opportunity to make my own grown-up choice as to whether i wanted/needed to go over-time. now i'm afraid i'll be obsessed with the clock, which i do have view of. ugh. early in therapy, i did call him on a couple of instances that we were going over. i cut it off! maybe i'll have to start being the clock-police again.

hi, hic. like cat said, it would have been good if he had talked abouut it after the first episode, but he didn't. he didn't have to do it during a sensitive moment, but he could have done it at the beginning of the second long session. see my comment in the above para ... i have ended sessions due to going over-time and being uncomfortable with it ... might have to start doing that again. thanks for your input

RM, i read through the stuff (almost 3 years ago now), but i don't recall this issue being mentioned in the literature. for sure i will revisit it, but i am 98% sure this is not discussed. i do remember at one point him saying that if i sent a long email that i could be billed for that, but other than that i am pretty sure there isn't any reference to going over and how that is handled. i don't, incidentally, have an issue with him charging for overtime ... i realize that he is trying to make a living like the rest of us. i have utmost respect for that. it's just that we went over, i was aware we were going over, thought it was to cover my needs at the time (my mistake that i take full responsibility for), but then finding out via billing statement that it cost me. and he didn't discuuss it, and did it again the next session without consulting me. again, i'll go through the literature, maybe i just don't remember it being mentioned. but i doubt it. we frequently go over by a few minutes as well, and i am not billed for that.

mallard, you're right ... unspoken stuff around money NEVER works out well. thank you for the affirmation. and thanks for affirming that this decision of going over-time shouldn't happent without the clients consent. i fully agree. i truly thing T meant well, but now the uglies are coming out...which is probably just as well, as these uglies are part of what i want/need to deal with. i will talk with him about this, thanks for your input.

starlight, since it was the last session of the day, nobody had to wait. if i knew somebody was waiting i would definitely say something about the time. T is also pretty open to emails and answering them (his answers are pretty short, but i'm okay with that). i have never texted him ... somehow that seems too personal. i have phoned on very rare occassion, and only to reschecule, etc. i agree with you that it's reasonable to charge for extra time, buut that it's also important to discuss before this actually happens. thanks for your input, starlight.

hey, ellyincal ... i'm the one-fruited avitar, and SD is the three-fruited avitar. don't worry about it, it's a common mistake
T actually has told me that if i were to write a long email/letter, that he perhaps would have to bill me for it. i've written some emails to him, but apparently nothing worth billing me for. that's an awesome story, and i think you should have framed that check!

so, i did it! i confronted him on this! in opening the session he took a directive approach, which he NEVER does (he even said "i don't want to confuse you, but ..." and started talking about my drinking. i told him that i wasn't dodging it, but that i wanted to talk about something else, and that if we finished that we could come back to the drinking. i told him that this is hard, but that i noticed that he either raised his rates or charged me more than usual because of going over-time (we went over-time a couple of sessions in a row, and he didn't say/ask anything about it, but ended up billing me an extra $30 for each session. i don't have a problem with him charging me more for going over, but i also think that i should be a part of this decision of whether we're going to go over or not). so i told him all this! this is huge for me, as confrontation is NOT a strong point for me. he didn't apologize (do T's ever apologize? or is is ALWAYS about us?) but he did say that he would go back and knock the $60 off the two sessions. actually, he ASKED if that's what i would like him to do. it was hard, but i said "yeah. thanks." and he said "you're welcome. that was hard for you".
and we talked about some other money things that have recently emerged with my FOO and it was a very emotional session for me, but at the end of the session he actually THANKED me for bringing the over-time stuff up, that he didn't want that stuff to remain unsaid and as a result affect the relationship in a negative way. i still have a hard time with that word ... "relationship" ... but his rescinding the $60 and then actually thanking me for bringing it up ... priceless. and scary and confusing and scary and confusing and scary and confusing, but also, he's getting my attention, slowyly. he's got the patience of a saint!

Hurray CD!
I'm in awe of your courage. Stuff like that would scare the sh** out of me too.
So congrats again.
P.S. My T has apologised to me on occasion, so some of them do, yes.

Yay CD! And CD's T! Glad that went well. It's always good to read a positive update.

I am in awe of your bravery CD. Great job!!

Jillann

That's fantastic. I'm really glad you were able to raise this with him and that you got a successful resolution. Brilliant how you phrased it too - that you needed to be part of the decision.

I've had Ts apologise to me on occasion, usually when we've recognised that they were reacting to their own stuff, not mine. Like you, learning to be assertive has been a massive thing so I recognise what an achievement this is. Nice one