Sliding scale

[Crow]

I'm having some financial challenges and T has offered to do sliding scale. I figured we'd talk about it in today's session and set a fee but I got so disregulated that we ended up focusing on my reactions and not the practical stuff.

Does anyone have issues with feeling like you owe someone or are indebted? Doesn't feel safe to me.

 

[UnicornSightings]

I do a sliding scale. It's awesome!!! I felt guilty for forever and felt like I could never talk about buying something, you know? Have thought about bringing it up but it doesn't really bother me so much anymore. She wouldn't offer if she wasn't ok with it so I don't stress. Some therapists will absolutely not do it. Cool that you have one that will.

 

[Briellewannabe]

I've only ever done sliding scale (with interns needing hours and being supervised) or pro bono. It's hard. I often feel guilty, like I'm taking advantage of them, especially the pro bono (my EMDR T and my psychiatrist are both pro bono). I don't have a job currently, so it's not like I am lying to them, but I still feel bad, however, I believe they genuinely want to help me. They have had several opportunities to be done with me and they haven't.

 

[scout86]

Does anyone have issues with feeling like you owe someone or are indebted?

Yes. And I did the sliding scale thing the first year I worked with my T. The way I looked at it, he had a choice. It was something he chose to do so he could work with people who didn't have insurance and couldn't afford his normal rates. He could quit doing it any time he chose. He could not do it at all. As long as he was getting paid what he wanted to get paid, I didn't feel guilty.

 

[Crow]

Weird thing is she doesn't do sliding anymore. When I first started working with her (years ago) I was on sliding. I think it's bugging me so much because she doesn't accept sliding anymore and so this is like special to me. She really wants to help me. These two week intervals has totally screwed things up.

 

[scout86]

She really wants to help me

Then maybe you should let her.

I have a hard time taking a compliment. A good friend once said, "A compliment is like a present. Someone gives it to you because they want to. By arguing with them, you deprive them of the pleasure of doing something nice. When someone pays you a compliment, the appropriate thing to do is say 'thank you', then shut up."

I think you could look at this the same way. It probably makes her feel good to be able to help you out. In a way, if that's her true feeling, you're 'giving' her something by letting her do this. If that's not her true feeling, if she feels put upon, or like you owe her, well then, she should probably consider therapy herself because that's kind of passive aggressive, at best.

 

[UnicornSightings]

Then maybe you should let her.

I have a hard time taking a compliment. A good friend once said, "A com...

I love your reply!!!! :)

Weird thing is she doesn't do sliding anymore. When I first started working with her (years ago) I was on...

People make exceptions. She's making an exception for you. That's awesome! Don't let thoughts of "I don't deserve this" ruin it. You are you to NOT deserve it?

 

[Rose White]

I fired a therapist when he went pro bono for me when my insurance stopped covering therapy. The power dynamic ate away at me and I felt like a prostitute. I didn't even fire him I just put him off with scheduling until he closed my case. Then when I finally got over myself I started mailing him checks to pay for the free sessions he gave me last year. I never mailed him all the checks that I said I would because I feel stupid, conflicted, and poor.

My new T has no sliding scale. I have to pay her the full price. At first I felt good about that because of how the pro bono messed with me. Last week she forgot to charge me. This week I paid her for two sessions and ran out of money until next Friday. When I told her that I forgot to pay her last week she acted surprised.

I'm telling myself I deserve it, I deserve to pay the therapist to deal with my trauma. But I also deserve to have money for food and gas and not have to beg my mom for cash.

Intensive outpatient services are free, while therapy costs me a day's worth of wages. I'm thinking of trying to go intensive outpatient to save money. Talking about the money triggers a cascade of inner and outer criticisms.

 

[snowangel35]

I would accept her offer especially if she brings it up again but totally understand your hesitation. She wouldn't offer if she didn't want to.
I'm in a similar situation but find it difficult to follow my own advice. My T also offered me a sliding scale fee in order to be able to come bi-weekly. I am only able to come once a month right now and I am finding it very difficult dealing with my intense feelings for him and everything else between sessions. I would like to go more often to do deeper work as I often spend much of the time recalling the previous weeks than getting into the deep things I need to get into. I am conflicted about accepting his offer which I didn't ask for it although did share my desire to go more often. I have issues with accepting the offer of help/care from others (which is what I see this as). I know he obviously can afford and the reduced fee is still a lot of money but it would allow me to come more often. I don't know what to do....

 

[Suzetig]

My T has always seen me for 90 minutes and charged me for an hour - and her rate for me hasn't changed in the four years I've been seeing her so she effectively works for 50% of her usual fee with me. Its not something we've really discussed other than for her to say it's her choice, she isn't in it for the money and she enjoys working with me. The thing is we both know I could easily afford her full fee but she won't charge me that.

I don't feel guilty to be honest, I feel very fortunate and it's been good for me to accept her generosity towards me. I pay it forward in other ways and am grateful to her. I think of it as me learning to accept kindness from others, which is very hard for me to do.

 

[Deleted member 12723]

I did a sliding scale with a therapist and was always grateful because I could not have afforded the full cost. It was the only way I could afford therapy and now have a co pay of seventy dollars. Which really is so expensive for me so I will not be able to go for more than once a month. Take it if she offers.

 

[Crow]

She offered me $150 for 60 minutes or $200 for 90 minutes. That's $80 off her normal rate. So a huge discount. Unfortunately, with the cats' emergencies the past month, and me not being quite as frugal as I could be with food, I can't see her for a few more weeks. But hoping when things get settled financially I'll be able to see her at least twice a month. Our goal is for me to see her every week. Every other week and we have to do the whole do I trust her thing over again. Gotta love attachment issues. Same thing over and over so at least I'm really good at it now :)

I was looking at this as a gift and said so to her. She countered that it wasn't a gift. It's simply a business decision. She enjoys the work we do together and I'm to the core of my trauma work and she doesn't want that disrupted. And she can afford it. So that takes away any feelings (seemingly) of obligation. And I'll work on the other danger kind of feelings as they come up. But feels like those are pretty much resolved somehow.