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So, I guess I have mentioned elsewhere on the forums that my pregnancy is making me really sick. Like, "I'm not going to leave my house unless it's an emergency cuz I feel like I have the flu" sick.

I called my T and suggested that we take a break from therapy until I feel better, unless she is willing to do phone sessions. She agreed to phone sessions, even though she said that is not something she normally does.

Well, our first phone session went pretty well, I thought. At the end of it, I mentioned to my T that I had had a harder time focusing than normal and asked if she noticed. She said she had, and that that can be a symptom of pregnancy, and was probably made worse by the fact that I wasn't feeling well. So I asked her if she thought there was much point in continuing therapy at all while I was feeling this way.

She seemed a little uncertain about how to respond (maybe she thought I was trying to terminate?) but what she said was, "I'd feel better if I could at least call you every week to see how you're doing, then if you want to talk, we can, but if you don't, we don't have to. What are your thoughts?"

So I said I wanted to continue with therapy as usual, just over the phone instead of her office until I'm feeling better. However, her suggestion confused me a bit. These friendly little phone calls to check on me whether or not I want to talk-- surely she'd be billing me for them? I mean, if I wanted to talk, she should be paid for her time, and even if I didn't presumably she would have set time for talking aside for me and should be paid for that? It's just the way that she phrased it seemed so casual and vague-- like a concerned friend wanting to check in because she cares about me or something. And I'm sure she does care about me, but I felt that the line was getting a bit blurry-- not in a bad way, necessarily, but I felt confused.

Does this seem confusing to anyone else or is it just me?
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I think that is a really nice offer, actually. But, it does need clarification on how it will be billed. Will she check up on you (for free) and then if you say you need a full session, then you continue talking and then she will bill you?

My T checked up on me the last week of November when I was in crisis, and home alone with 4 kids (H out of town), with 5 minute phone conversations in the evening, and she did not bill me, except for my one full session on Wednesday evening. Then I went inpatient and talked to her one time while I was in there, but I was warned by the hospital staff that she couldn't bill it as therapy....well, she never billed me or that either. When I finally talked to her on the phone again in late December, I told her I wanted to pay her for her time, and she said it was okay, that a full session is different from her checking in on me.
Hey Ninn,

That is interesting. Maybe what my T was getting at was that she'd like to plan on having (phone) sessions as usual, but that if I'm feeling particularly icky and unable to talk much she'll be understanding and just consider it as a check in and not billable as a session. This actually makes a certain amount of sense in context.

It was hard to ask for clarification at the moment because she was being so kind and helpful-- obviously concerned and trying to be considerate. I hated to start nickel and diming everything at that moment. *rolls eyes* It's so weird that therapy is a business relationship and a personal relationship at the same time. Occasionally that makes discussing the financial ins and outs of things awkward.

Additionally, I suspect that my T thinks I am rather less stable and safe than I consider myself to be. I can easily imagine that in her mind, I am a client somewhat in crisis that she is committed to helping as best she can, and that financial considerations are secondary. I believe at the time we had that conversation, she really was thinking how best to keep in touch with me and not about how she'd go about billing for this, exactly. Which is noble and all of that, but from my point of view I have a budget and like to know what I am getting into, lol.
Hi, my impression after reading your first post was that your T was trying to strike a balance of not imposing her will upon you and honoring your right to make your own decisions, while wanting to let you know that she thought you should continue therapy. She probably is worried that its not in your best interests to quit altogether, but she is mindful of it being counterproductive to control you that way, and also recognizing that physically you feel like crap right now. I agree that she probably didn't think about the billing question, but that is understandable because she was kind of put on the spot if she wasn't anticipating your suggestion of a possible termination.

It sounds like what she suggested is something you might like, if only you didn't have to worry about how last minute canceling would affect her as far as billing & scheduling. But if I were in your shoes, I think I would have to decide ahead of time whether I wanted to schedule a full phone session or schedule a 5 minute phone call. Because its not fair to T if I were always scheduling a full session and then changing my mind after 5 minutes into it that I was too sick or unfocused to talk. I think you are worried about that too, and yet you would also hate to have to pay for full sessions which you didn't utilize. But if you can predict that likely you are going to be sick for awhile, then I'd plan accordingly. Ask if you can have 5-minute check-ups, or possibly even 20-30 minute sessions if you think you could tolerate them, and ask what she would bill for that arrangement.

Sorry you are feeling so yucky. I've been there! No fun at all. Good luck to you.
quote:
But if I were in your shoes, I think I would have to decide ahead of time whether I wanted to schedule a full phone session or schedule a 5 minute phone call. Because its not fair to T if I were always scheduling a full session and then changing my mind after 5 minutes into it that I was too sick or unfocused to talk.


Yes, this is exactly how I feel. So I'm going to be scheduling full sessions with the idea in mind that I'll just force myself to stay on the phone no matter how sick and unfocused I feel, lol. I do think it will be good for me to have full sessions if I can manage it, and I believe I'll be able to most of the time. If I absolutely have to get off the phone early, I'll still plan on paying as usual.

Deciding all this-- what I think I need, what I think I'm up to committing to, and what is most fair to T-- required some pondering, lol. It's nice to be able to sort these things out on this forum and get some input. Thanks, y'all. Smiler
Hi HIC,
I just wanted to comment on the money aspect. My T allows both phone calls and emails between sessions and has never charged me for either. He considers it part of the service. My usual phone calls are around 2-3 minutes. A really long call runs 10 and my longest ever was 15. When I stopped going regularly (I 'ended' evidently didn't take too well Wink) I asked about his contact policy and he told me that nothing would change, he was still my therapist and I could call or email anytime. I was so surprised I actually looked at him and said "but you won't be getting paid!" to which he smiled and responded "I didn't say that if you were calling a lot I wouldn't ask you to come in." So I think more than likely your T wanted to make sure that therapy was available despite your physical ailments but she also didn't want to pressure you to carry through with a session that you are too ill to focus in. My guess would be that because she offered this, you would only be charged if you carry through. I know it's uncomfortable to talk about but it's not unreasonable to ask her about the finances. I would present it as the concern that it is: your need to plan your budgeting, especially with a little one on the way. Smiler

I also think it would be good to discuss because it's kicking up a lot of feelings. You're T has offered her boundaries and in a way your decision to stay on the line no matter what and pay if you have to cancel is an attempt to take care of your T and keep yourself safe from a boundary violation instead of trusting her to set and stick to her own boundaries. Discussing your motivation for that is a really good thing to examine in therapy.

On an encouraging note, I had morning sickness with both of the my pregnancies but only for the first trimester for both. About the time I hit 12-13 weeks the "morning" sickness (I had it all day) faded. After that I was only sensitive to particular smells. Oddly enough, coffee was one of them.

AG

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