Do I have to spend my college fund on therapy?

November 7, 2007 11:09 PM

Would it be inappropriate for me to ask for a reduced fee from the therapist I'd like to start seeing, considering my unique financial circumstances?

I’ve been thinking of starting therapy for a while, and just this week I found a therapist I want to meet. His website says he charges $85 an hour and he doesn’t take insurance (not that I have any.) I want to ask him if he can slide his scale for me a bit, but I’m having some ethical trouble with this.

There is no clear answer to the question of whether I can afford the fee. I earn (and live on!) only about $10,000 per year, but I also have a trust fund (it’s not technically a trust fund, but effectively it’s the same thing: a large gift of money from a relative.) I live my young-broke life unhypocritically, and not as some sort of socioeconomic tourism. I’m not what anyone would think of as a trustafarian. In fact, almost no one knows I have this money at all.

I don’t touch my “trust fund” because it was given to me with the intent that I spend it on an education, and that’s precisely what I want to do with it. Some families just straight-out pay for their children’s education; in my case, I was given a large lump sum and expected to write the tuition checks myself- same net result…Except I still have all this money at the age of 25 because I was too depressed to succeed in my attempts at college.

There is nothing concrete preventing me from spending my college fund on therapy- the account is completely under my control. I am extremely reluctant to deplete it, but I wouldn’t be able to afford therapy otherwise. Seeing a therapist once a week would cost me more than what I’m paying for rent!

I am not acutely depressed right now and in theory don't NEED therapy, but I really liked this guy’s website, and he specializes in something I could really use some help with at this point in time.

So, in light of what I’ve just explained, would it be inappropriate to ask for a lower fee from this therapist? I don’t want to lie about my financial situation, and I’m sure the fact that I have a trust fund will come up in therapy, seeing as it’s been such a blessing/curse.

PS. Please don’t suggest that I look for other ways to get therapy- any programs specifically for low-income folks would still subject me to the “am I poor or not?” question (uh, I do have a low income!) and there are conflicts of interest that prevent me from going to the local school of professional psychology and getting therapised by a student. Paying a private therapist either his/her full rate or a reduced rate is really my only option.

posted by anonymous to Human Relations (18 answers total)

Of course you can ask for a reduced fee. The worst that can happen is that the therapist says "No." Then you have to decide whether to pay the full fee or look elsewhere. But, best-case scenario, the therapist might be willing to work with you on a fee that you feel is more affordable to you.
posted by amyms at 11:14 PM on November 7, 2007

I'm with amyms, I can't see how it could hurt to ask. But don't lie about your funds.
posted by knave at 11:21 PM on November 7, 2007

Corollary to knave's advice: don't lie about your funds, but tell him what you just told us.
posted by awesomebrad at 12:47 AM on November 8, 2007

I was once in your exact position. Trust fund that was only for education and my job paid a pittance. I was completely up front with my therapist and she had no problem sliding her pay scale wayyyyy down for me. Good luck.
posted by meerkatty at 12:51 AM on November 8, 2007

What would you do if there were no therapists to take your money?
posted by denishowe at 1:08 AM on November 8, 2007

look, I have never been in therapy but simple math tells us that 85 bucks a pop x 2 appointments a week x 50 weeks in a year = 8,500 dollars

I'd seriously go back to the wealthy relative who generously chose to finance your education and tell her/him, look, I love you but the education you so generously tried to buy me is not going to happen because I'm too sick: I make only 10K a year so the 8,500 dollars for the therapy are impossible for me to pay, where does that leave us?

if the relative gave us, say, 100K or more to give you an education and I don't see why they couldn't give you 8,500 more

if the relative is dead/not paying, then try to get a discount. if not, pay full price, your health is more important even than anything else, even than your education
posted by matteo at 1:22 AM on November 8, 2007

I know you said "not that I have any", but just to clarify: the therapist won't _file_ insurance for you, but if you had insurance, you could theoretically file it yourself, provided that sessions with this guy are covered, and provided that he's willing to give you the necessary documentation.

There might be delays, you'd be on your own if things got sticky, but you _could_ get insurance to reimburse you. I think this is the 'old-fashioned' way.
posted by amtho at 4:22 AM on November 8, 2007 [1 favorite]

As an addendum to amtho above - I'm in the middle of this situation right now. I file a claim, but it still required that the therapist sent her license to the insurers and we had on one occasion to spend an entire session to resolve a particular insurance problem. So, you will file, yes, but the therapist still might have to do some things which he/she will have to agree to - which mine did as an exception to her normal practice.

Regarding the fee, my experience has been that most therapists adjust to financial circumstances (talking to friends, etc). And, of course, it's of the utmost importance that you are honest with them.

However, for what my opinion's worth, I respectfully disagree with sonrialiac. I think that you should reserve money for education for education directly. I understand that the depression gets in the way and prevents you from doing it, but the two things are separate.
posted by blindsam at 5:01 AM on November 8, 2007

I have seen many therapists with sliding-scale payments. Ask.
posted by VeniceGlass at 5:01 AM on November 8, 2007

Ditto VeniceGlass. Do it.
posted by zenpop at 5:24 AM on November 8, 2007

Therapists have seen it all. If they can't handle being asked stuff like this, how good of a therapist could they be?
posted by hermitosis at 6:12 AM on November 8, 2007 [1 favorite]

You should ask for a lower rate with a clear conscience.

Your 'trust fund' is no more relevant than the income of your parents.
posted by desuetude at 6:22 AM on November 8, 2007

desuetude is right, just be sure you're not hiding anything from the therapist. And that you don't _feel_ like you're hiding anything.
posted by amtho at 7:06 AM on November 8, 2007

You realize you're going to print out this AskMe for your therapist, right?

Yes it is appropriate to ask about a reduced rate. Even if you don't get it, consider: You might not require a full year of weekly therapy. You might not like the demeanor of the therapist so you're just out 85$. The therapist might suggest other methods of payment that you haven't considered. The therapist might consider bartering for payment if you have a useful skillset. The therapist might refer you to a less expensive therapist, or one covered by your insurance.

It will work out. Good luck.
posted by enfa at 7:48 AM on November 8, 2007 [1 favorite]

sure, ask. explain that you have some funds that are earmarked for education, but you don't want to commit those elsewhere without exploring your options. if he's willing to slide his fee, great. if not, then you have to decide whether he's worth it.
posted by thinkingwoman at 10:17 AM on November 8, 2007

Yes, you should ask for a reduced rate. Your college fund shouldn't factor in at all when it comes to the therapist determining whether or not you qualify for a discount.

I know you said that you weren't interested in programs for low income people, but it is something to keep in mind if the therapist thinks that a medical approach might help you out. Psychiatrists are considerably more expensive than therapists. Low-income mental health programs, generally, will ask for your proof of income, not proof of net worth. Not disclosing your fund won't be a lie of omission, it simply won't come up.

Finally, since school is not in your immediate future, are you able to invest your college fund and spend the interest on things like therapy that will make it easier for you to successfully complete college?
posted by necessitas at 10:27 AM on November 8, 2007

I don't understand why so many other posters think you need to discuss this block of money with the therapist at all. It was given to you with the understanding that it was for something else and that's what you want to use it for. If you had money in a retirement fund would you feel like you had to mention it and that you don't want to deplete it?

There's nothing wrong with asking if he'll take a different rate. He may or may not, depending on their workload. It's in his interest to make a deal if he has the free time since once that hour in time slips into the past the ability to make money on it is gone.
posted by phearlez at 2:39 PM on November 8, 2007

This question is so similar to what I just went through that I'm almost sure I must have asked this in my sleep.

I'm in pretty much the exact same situation, quasi trust fund, limited funds otherwise, and a therapist that I think would be a good match. Heck, their normal going rate is even $85.

Like desuetude said though, the trust fund is irrelevant, I explained my financial situation and the therapist said they could go as low as $60. Only a $25 savings, but it at least helps make the economics of getting help a little more workable.

I think if you just explain your situation, there's a good chance you'll get some good news. It's good you're working to get the help you need.
posted by mindless progress at 10:26 PM on November 8, 2007