Many people ask why I don’t take their insurance. And the reason is surprising – it’s for their own good!
My clients are young, without history in any database, and often just struggling to figure out the world around them. They are vulnerable in so many ways. Once I agree to take your insurance I am agreeing to some things that I do not think are in the best interests of my clients.
I am agreeing to provide the insurance company with a diagnosis. In fact, the insurance company requires that I provide them diagnosis in order to approve treatment. What’s the big deal, you may be wondering? The big deal is that, unfortunately, there still exists a stigma associated with mental health diagnosis in this country. If I diagnose a child with anxiety and depression today, how will that impact them in the future? Will this be considered when they are seeking to join the armed forces? How about when obtaining life and/or medical insurance in the future? Will they be asked to explain a depression diagnosis that happened at age 12 in order to apply for a gun permit or become a police officer? We simply don’t know, in this age of computers and vast databases, where this will pop up in the future. Will these records be considered for future employment? I hate to think that by helping a child, I’m hurting them down the road.
Insurance companies determine the amount of treatment a child should receive. They have never sat down with this child, they have never talked with the family, yet they are the ones to determine if the child need to have 10 sessions or 20. My goal with every client is to have them “graduate” from needing my services. I want them to be able to act as their own counselor and not need me! However, sometimes this takes more than the allotted amount of counseling. Sometimes deeper problems surface that need to be explored. Sometimes the family unit itself needs some attention, in order to best support the child. There is no way for someone sitting in a sterile office to accurately judge the amount of help a child needs.
Insurance companies are nosy. They want to know everything about you and your child. When I am participating with an insurance plan, my first contract is between myself and the company. They can demand that I provide them with detailed notes of in-session conversations, and copies of the records that I keep for your child. This creates a huge conflict of interest for me! I would rather tell nobody about what happens between myself and my clients. The details of my client’s & their family’s lives are not anybody’s business. However, the insurance company’s contracts (that my clients and I are both required to agree to) specify otherwise.
I firmly believe that counseling is intended to benefit my clients and their families and should never be a cause for difficulty. I also take confidentiality very seriously. Hence, I have decided to limit the risk of inadvertently causing future pain to my clients by stepping out of this system. Clients can access their out-of-network benefits and the amount of information I have to provide the insurance company is seriously limited. If you have questions about this feel free to ask! It’s complicated stuff.