In order to use insurance benefits with a therapist, insurance companies require that the client have a diagnosis of a mental disorder as specified in the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) on the claim and that treatment is medically necessary. Additionally, insurance claims are not as private as I prefer because the insurance company can view and audit records. Often this doesn’t create a problem, however, there are cases where this information could be used against an individual for custody or divorce claims, health coverage rate increases or even security clearances.
The truth of the matter is that most of my clients are very normal individuals just struggling with abnormal situations in their lives. Some are struggling with addictions, which are acquired quite normally while others are going through normal developmental stages but are struggling because they have never taken this journey before. Some individuals tend to be stuck in their relationship, want to learn how to love again as a couple; others are grieving the loss of a significant relationship.
I do not view my clients as having a disease or disorder and I do not want them to have this view of self or others. These negative labels often promote feelings of helplessness and the need for external controls. I believe change is possible and we are the master’s of our own future.
I prefer not to use insurance for this reason.
I accept insurance plans as a convenience to my clients only.
Requiring a mental health diagnosis for every client can be an ethical dilemma for a counselor. A diagnosis will often only loosely fit a client in order to collect insurance reimbursement. While doing so can be a convenience for the client, it can also be somewhat of a disservice to them as well.
My clients seek help to take the necessary steps toward goal realization. They might need support, direction, information or new skills to change patterns of behaviors that hold them back. Undoubtedly some of my clients experience stress, anxiety or mild depression because of circumstances in their life or relationship, nevertheless I believe that my clients can successfully move forward and find ways of significantly reducing or eliminating most of the causes of distress in their life or relationships without the labels of disease or disorders.
If you use your insurance for services, I want you to understand that as your therapist, I work for you and will guard your privacy with vigor. However, I also want you to understand the risks and concerns with using insurance coverage.