6 Ways Private Pay Therapy Can Improve Your Care
TLDR: Everyone should have access to quality therapy, full stop. Our current healthcare system imposes several challenges to receiving quality care. Private-pay therapists can typically offer higher-quality care because they are far less burned out, and the client and therapist decide what is needed, not the insurance companies. While more expensive, there are often sliding-scale or free options.
In an ideal world, everyone would have access to high-quality therapy. Every person who wants this deserves it.
Unfortunately, we do not live in that world. The US healthcare system places significant burdens on both patients and providers, with provider burdens trickling down to further impact patients. While there are both excellent and terrible therapists in the private pay and insurance-based therapy spaces, private pay therapy can be a way to get around these negative impacts and receive higher quality care.
How does insurance negatively impact therapy?
Insurance companies harm therapy care by interfering in patient care decisions, limiting who can access therapy, and failing to pay therapists a livable wage.
Many patients want to use their insurance to minimize costs, and who can blame them? Yet, they do not realize that this can often negatively impact the care they receive. Health insurance companies are not in the business of health; they are in the business of extracting maximum profit for their shareholders and executives.
Insurance companies can and do deny claims or stop covering treatment, often abruptly, causing harmful interruptions to care. This has even more of an impact when it comes at a particularly stressful time, such as postpartum, after a trauma, when escaping an abusive relationship, during job transitions, etc. Further, this can generate surprise bills which patients didn’t know they needed to budget for.
Insurance companies also determine which “problems” are worthy of therapy. If you don’t meet criteria for a mental health diagnosis, even if you are experiencing distress or are at risk for developing one, insurance companies will not pay for therapy. They also don’t care if you need specialty care or a particular approach, or someone that you don’t have to drive an hour each way to see - if there is even one provider in network that says they work in the general topic you need treatment in, they will not cover it.
They also grossly underpay therapists. This means that therapists who accept insurance often have to see MANY more patients just to make ends meet, to the detriment of patient care.
Therapy may just seem like sitting and talking, but it requires the therapist to intensely listen, while at the same time identifying unhelpful thoughts, behaviors, or patterns, noticing emotional shifts in the client, and delivering therapeutic interventions. This is mentally energy-intensive work, and there’s simply only so much any one person can do each day.
Think about how drained you feel after doing intensive listening with no breaks or distractions. Therapists who must see way more clients than is reasonable can lose their ability to do this with all their clients, and they become burned out, less patient, miss things, are less attuned, and have little to no time outside of therapy to prepare for your work together - doing readings, thoughtful preparation, or extra training or consultation.
How can Private Pay Therapy Improve Care?
A therapist that’s not burned out is a better therapist: When a therapist has worked past their capacity, they can’t listen deeply, are zoned out and distracted, and they miss things. They miss you. When a therapist can charge a living wage so they don’t have to overwork themselves, they can show up as their best self, giving you the best care.
The only people making treatment decisions are you and your therapist together: You and your therapist alone decide what’s right for you and your treatment, without having to worry about what will be “approved” or if your treatment will suddenly stop being covered.
Your therapist will have time to thoughtfully prepare: If your therapist doesn’t have to overload themselves with patients, they have time to learn and prepare by reading, learning, doing advanced trainings, and consulting on topics that will add to your care. For example, I would not have been able to do all the in-depth trainings I’ve done on EMDR, perinatal mental health, trauma, etc., if I had been seeing 35+ clients a week.
No billing surprises = less stress. It is not helpful to anyone’s mental health to suddenly receive a large bill because something you thought was covered by your insurance is now being denied after the fact, full stop.
Treatment won’t be abruptly terminated: You don’t have to worry about therapy suddenly stopping at a critical moment. If you are dealing with a life challenge, the last thing you need is your support being cut off in the middle of it.
You can get truly specialized care: Rather than being forced to see someone who says they work with trauma regardless of if they actually have specialized expertise in it or not, you can see someone whose exact niche is someone like you! There is a therapist out there for every type of person. For example, I work with trauma, sexuality, perinatal/postpartum concerns, relationships, and body acceptance from a Health at Every Size lens. The clients who see me have chosen me because of my areas of specialty, not because I was a random person in-network who may or may not have the experience they need. The more specialized care you can receive, the better fit it will be, and decades of research on the effectiveness of psychotherapy point to fit as one of the most important factors determining how helpful someone is.
Is private pay therapy affordable?
Private pay therapy is, in general, more expensive than seeing an in-network provider. This is especially true in high-cost-of-living cities like Los Angeles and Manhattan Beach.
But it also might be more affordable than you think.
If you have a PPO insurance plan, they will reimburse you for part of the expense after your deductible is met. My clients have anywhere from most to some of their session fee covered. Check out my FAQ to learn which questions to ask your insurance company to find out how much they will reimburse you.
Additionally, most private pay therapists are able to offer sliding scale and pro bono (free) therapy slots BECAUSE they are able to charge what they need to. If I accepted insurance, there is no way I would be able to do this. This allows me to reserve a few slots to make therapy more accessible. Open Path Collective is a directory of private pay therapists who offer sliding scale therapy. You can also search for sliding scale options on Inclusive Therapists.
Some people truly can’t afford private pay therapy, and this is a shame - our country should pay people livable wages and provide universal healthcare that pays providers livable wages. But more and more clients are choosing to go the private pay route because it does tend to provide higher quality, more individually tailored treatment, and it is often more affordable than you might think at first.
Start Therapy Focused on Women’s Issues in Los Angeles:
If you are a sensitive, smart woman who pours herself into relationships and/or career and puts on a strong face (and IS strong), but inside you are struggling with anxiety, guilt, or shame, you aren’t alone. Our culture places impossible standards and stresses on women. Working with a therapist who specializes in women and understands can help. Start by following these steps:
Reach out for a consultation at Well Woman Psychology.
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About the Author:
Dr. Linda Baggett is a licensed psychologist and founder of Well Woman Psychology, a virtual trauma-informed therapy practice supporting anxious and people-pleasing women in California, Colorado, Illinois, New York, and Washington. Dr. Baggett helps women manage anxiety and relationship challenges so they can build the healthy, fulfilling relationships they deserve with less stress. She also works with clients around body image, relationship issues, perimenopause and menopause, perinatal and postpartum challenges, pregnancy loss and miscarriage, and infertility.
Disclaimer: This blog is for educational and informational purposes only, is not a substitute for individual medical or mental health advice, and does not constitute a client-therapist relationship.