Original Post
Replies sorted oldest to newest
Hello Cat.
I haven't had any experience of being on the receiving end of a sliding fee scale, but I do know that I would feel very similarly to how you are decsribing your fears here.
For me, even knowing that a T is responsible for their own feelings, I'd still be anticipating hidden resentment on their part towards me. Which is very obviously my projections, so maybe you can find a way of not expecting your T to think the worst as well?
I did have a T who raised her fees from when I was on a lower scale because I was unemployed, and then got myself a job and I remember REALLY resenting HER for it - which is where I get my projections from.
Hm sorry this has been all about me in a way that isn't addressing what you asked in your thread in the first place. Sorry
I hope you will be able to accept remaining on a lower fee scale without it making you feel unmanageably guilty and beholden (though that would all be 'grist to the therapeutic mill' as well, wouldn't it?)
Hugs to you (((( Cat ))))
LL
I haven't had any experience of being on the receiving end of a sliding fee scale, but I do know that I would feel very similarly to how you are decsribing your fears here.
For me, even knowing that a T is responsible for their own feelings, I'd still be anticipating hidden resentment on their part towards me. Which is very obviously my projections, so maybe you can find a way of not expecting your T to think the worst as well?
I did have a T who raised her fees from when I was on a lower scale because I was unemployed, and then got myself a job and I remember REALLY resenting HER for it - which is where I get my projections from.
Hm sorry this has been all about me in a way that isn't addressing what you asked in your thread in the first place. Sorry
I hope you will be able to accept remaining on a lower fee scale without it making you feel unmanageably guilty and beholden (though that would all be 'grist to the therapeutic mill' as well, wouldn't it?)
Hugs to you (((( Cat ))))
LL
I can totally relate, Cat. My T raised his fee shortly after I started working with him. He is very explicit about not operating on sliding scales, but he never told me that he raised his fee. When I found out, I panicked and had the same reaction -- that he would be prone to resenting this low-fee client, that it would affect my access to him outside of session, etc. He assured me that it's his place to set his fee as he sees fit, and he is fully capable of working with me if/when he thinks the rate I pay him needs to change. Yet another area where I have had to learn to trust him... 
Yep, I know I pay a lower fee cos I always have done 
but in a way I wish I payed full price cos then I think I mightn't be cancelled so bloomin often and might not feel guilty for getting it on the cheap (still costs me an arm and a leg a month 
)
Moan over, hope this might make you feel not on your own with this one
starfishy
but in a way I wish I payed full price cos then I think I mightn't be cancelled so bloomin often and might not feel guilty for getting it on the cheap (still costs me an arm and a leg a month )Moan over, hope this might make you feel not on your own with this one
starfishy
My T gave us a slightly lower rate when we were out of pocket, then started doing doubles for no extra charge (in addition to all the outside contact stuff he does with no extra charge). It freaks me out...like all the time...and there were times before insurance prevented it that I would pay extra when I could for some of that stuff. But, my T has proven to be safe and never resentful. I am a little freaked out because of a few recent comments about how we are all working to allow me to grow (including him doing all the extra time and H trying to support me and me working my butt off to learn to be safe feeling things rather than dissociate all the time). I know he didn't mean it that way, like, "You owe me to get better, because I'm doing so much for you," because it was in the context of me feeling like I should just dissociate to make everyone's life easier (avoid crises). He was just trying to encourage me that learning to tolerate feeling these things is why we're working so hard and he is offering the extra support. Still, ouch.
I guess, I just give where I have a choice. My insurance's single case agreement dictates how much they will cover and pay for. I'm not allowed to pay extra above and beyond that and the max they will cover is 75 minute sessions and at a rate that is lower than what he usually charges full-price for 60 minutes (though the same amount he had us paying out-of-pocket). So, I always pay on time, track it meticulously. I express my appreciation on a regular basis in multiple ways (like the stuff I've made for him, verbalizing it in person and in writing, and working my tail off outside of session to put into practice the things we're working on together). If I had any other choice, I would be paying him his full rate for every single hour he spends working on anything for me. Between my insurance's rules, my family's finances, and T's own moral compass (i.e. refusing to use session time to work on disability or insurance matters as I've offered), the reality is just that it's how it has to be if I'm serious about getting help. It will set me back to not take advantage of it and that would not be honoring all the work that everybody (myself, my T, my family, my support system) is doing right now. The choice I have is between taking help and healing or imposing boundaries that my T does not feel necessary and at least severely restricting my own opportunities to progress.
That said, do I stress about it? Worry about it? Hate and detest it at times? Yes.
I guess, I just give where I have a choice. My insurance's single case agreement dictates how much they will cover and pay for. I'm not allowed to pay extra above and beyond that and the max they will cover is 75 minute sessions and at a rate that is lower than what he usually charges full-price for 60 minutes (though the same amount he had us paying out-of-pocket). So, I always pay on time, track it meticulously. I express my appreciation on a regular basis in multiple ways (like the stuff I've made for him, verbalizing it in person and in writing, and working my tail off outside of session to put into practice the things we're working on together). If I had any other choice, I would be paying him his full rate for every single hour he spends working on anything for me. Between my insurance's rules, my family's finances, and T's own moral compass (i.e. refusing to use session time to work on disability or insurance matters as I've offered), the reality is just that it's how it has to be if I'm serious about getting help. It will set me back to not take advantage of it and that would not be honoring all the work that everybody (myself, my T, my family, my support system) is doing right now. The choice I have is between taking help and healing or imposing boundaries that my T does not feel necessary and at least severely restricting my own opportunities to progress.
That said, do I stress about it? Worry about it? Hate and detest it at times? Yes.
I kind of know what you mean. My T's clinic does sliding scales. When I went on state funded health care due to my divorce and me not having any health benefits through work, T was fine with it. She was explaining why some clinics won't except state funded health care insurance though. Basically, T doesn't make as much money per session as other insurance companies or out-of-pocket would pay her. I felt guilty. I knew that I needed her and she was willing to work with me though. I've been working hard and trying to be a good client.
There was a time when I asked T to fill out extra forms, so I could get an exemption to see her. Her clinic ended affiliation with my HMO. Anyway, on that particular day T seemed annoyed (maybe a bad day for her in addition to my stuff). It's a lot extra paperwork for her, so I felt guilty again. I know that's why I don't want to have extra contact with her and work hard during sessions. Due to not asking for another exemption and other things going on, T and I are working on ending.
ok..gotta run to school now....
I wish you all the best and kind of know where you are as feeling funny about paying less for sessions.
Don't know anything about sliding scales, but when I started my counsellor told me a rate and I have been on that rate for more than 2 years. When I looked up the website I am not paying the full whack. It bothers me a little bit, he was doing a favour for a mutual friend, but I cannot afford the price they say on the site.
I feel the same way Cat. I"ve been seeing my T for four years and his rate for me hasn't changed. I pay completely out of pocket for 2 sessions a week so it is a huge expense for me and my family. I didn't think about it until one day about 1.5 years after I started that I saw a cheque someone had left in his outer office and the rate was $10 higher. I felt bad but never talked to T about it. I think he deserves a highter rate but I know if he asked me to pay more I might have to decrease the number of sessions I have in a month. So I feel bad but don't say anything.