Finding Freedom:

One of the things I love most about being a mental health therapist is that it challenges me to practice what I preach. Everyday, I witness our clients taking courageous action in the face of their biggest fears and it’s hard not to be inspired by this! As I was building the business model for Unbound Counseling Services and contemplating what it really means to be “unbound,” I made the difficult (and bold) decision to stop accepting insurance in my practice.

I want to make it abundantly clear that I am not against insurance. I wholeheartedly support clients in making the best decisions for themselves and their families when it comes to their health– which includes finances. This said, I recognized early on that insurance was not working for me in my practice, so I decided to lean into discomfort and end the relationship. 

Dealing with insurance companies is challenging and time-consuming, leading to frustration and dread. Insurance companies often dictate treatment decisions like how often you can go to therapy, for how long, and what types of therapy treatment are approved, which I believe are decisions that should be made by the client and their therapist. I believe every human can benefit from therapy, but insurance only covers services with a mental health diagnosis (and not everyone who seeks therapy qualifies for a diagnosis or would benefit from receiving a diagnosis). Insurance is all about preventative care for physical diseases such as cancer and heart disease, but when it comes to mental health, you would think they are staunchly against it. 

In addition, insurance companies are notorious for underpaying mental health therapists. In a field in which women make up a disproportionately large percentage of the therapist workforce (75.6% at the time of this writing), current insurance practices exploit women’s labor via underpayment, overwork, and gatekeeping of services. The heavy administrative burdens placed on therapists, coupled with low reimbursement rates and months-long delays in payments, contribute to financial strain and burnout as therapists often take on more clients than they can emotionally support to make a livable wage. This, in turn, compromises client outcomes. Not to mention, insurance companies can “claw back” treatment fees paid years after service was provided even if treatment was successful! 

Confidentiality is one of my biggest concerns when it comes to working with insurance. Insurance companies have the right to request your therapy records at any time. When you apply for life insurance, or even certain jobs, they have the right to request your medical records which includes access to mental health records and diagnosis. As a therapist, it pains me greatly that this practice could result in negative and/or undesired outcomes for my clients. 

And lastly, the degree to which insurance companies have continued to profit and flourish despite limiting access to life-saving mental health services for their members infuriates me to my core. I no longer want to be part of a broken system. 

When it comes to setting fees for our services, I strive to provide transparency in the manner in which our clients’ investments are reflected in their treatment:

• Several hours of thorough documentation and treatment planning 

• Advanced-level trainings

• Masters-level education (in fact, I have two!) 

• Research

• Consultations with other therapists and/or medical professionals 

• State licensure fees 

• Professional organization/continuing education fees 

• HIPAA compliant processes, communication systems, and medical records keeping software 

• Completing reports and assessments 

Caring deeply for your wellbeing and rooting for you to succeed are free!

I set the rates at Unbound Counseling Services with great intention and strategy to ensure that therapists can invest in themselves and their self-care. Therapists who aren’t burned out are able to deliver their best work each and every session, improving client outcomes. I know this, because I’ve been a burned-out therapist. 

Advocacy and giving back to the community are also very important. When therapist fees are in alignment with their experience, education, and credentials, they have increased capacity to offer low cost and free services in order to amplify awareness and support for mental health issues in the community.

All this to say, I want each and every one of my clients to know their worth and stand confidently in it. I realized that I needed to do this too. 

I fully recognize and honor that this is a complex topic and that there are very personal pros and cons to using insurance. I would never try to talk anyone out of using insurance if that is what’s best for them. I also wanted to take the opportunity to inform readers and potential clients of some of the lesser known aspects of using insurance pertaining to mental health benefits. It’s my hope that reading about my journey has inspired clarity in yours.