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"Pay or not to pay?". Money in psychotherapy.

b2ap3_thumbnail_20140710-171756.jpgPsychotherapy - is on one hand a relationship, on the other, it’s a service. It is a job that has to be paid, the money included in the process of helping the client, and plays the role of psycho-therapeutic factor: even for the poor man, it is important to make the amount of money paid for each session substantial.

For effective therapeutic relationship, the question of money - as well as other issues of the psycho-therapeutic contract - should be clearly discussed at the outset: it sets limits (but in order to be successful psychotherapy it’s important to have optimal distance between a client and a psychologist who just creates the fact that the customer pays for psychotherapy; it sets the frame of work (it is a job, not a miracle, magic show, adoption or "something that will make me") and brings many other benefits to the client.

The answer to the question "what the psychologist takes the money for?" Is simple: for his professional work.

A psychologist is not someone who "loves people for money"; he gets paid for not "help" or "compassion" (this can come from friends or family), but for their professional work in which he applies the skills, techniques, and knowledge. For knowing what to do and the ability to do it.

If the psychologist did not have a clear understanding of the issue, he does not give complete information to the client and the client will not be helped.

Such a complication (like almost every complication of relations) harms the process of psychotherapy.

Among other things, the psycho-therapeutic space - a place where you can discuss any topic, also depends on the client. And since the subject of money (no matter how not or very important it felt) plays a significant role in our lives (and, regardless of whether we are focus on money, or have chosen the path of non-materialistic life ), it is something not only can be but have to be discussed in therapy.

It’s important to discuss this topic within psychotherapy to people for whom money is for one reason or another "sore spot." For example, for generally stingy people. Or - on the contrary - he is earning well, compulsively wasting money and lives much worse than he can because of that. Сlient is constantly afraid of being cheated, or maybe he really is regularly cheated. Or his favorite scenario - attempts to "buy relationships." Or people with high qualifications and extensive experience constantly earn less than is actually worth, and even works for the minimum amount or altogether free. Or the client believes that he cannot spend money on himself. Or one spends only to on the "necessary" (for example, health or education, but not on vacation, or quality of life improvement, or psychotherapy).

When discussing with the client payment of psychotherapy these topics usually come up. So first talk about the payment - this is the one thread, taking which you can unwind the tangle of internal problems of the client, it is a step towards customer’s benefit.

But if the subject of money is not understood by the psychologist, the client will not only benefit but also feels uncomfortable: he fears he will "appear greedy" or "poor", "gives a bad impression", "offends the psychologist." And not knowing how to properly ask questions regarding payment (and whether it is appropriate to ask them at all!)
Despite the fact that the initiative of the client in psychotherapy is very important, it is the case when the psychologist must at the outset very clearly tell us about your professional proposal and make sure that the client is clear.

The responsibility of the customer is that he has to decide whether he fits these monetary conditions or not.

Fear of paying psychotherapist comes from the fear to give money "for nothing». For “listening”, for simple «talk" or worse for the “manipulation of their own vulnerable psyche”.

This is not surprising. After all psychotherapy - a commodity that can neither be tasted nor felt; it is a service where we can’t request a free sample or refund.

Anxiety about being deceived is very high. Fear of giving money for something not as valuable due to the apparent simplicity of psychotherapy (often a reaction to the first meeting with a therapist or psychologist-consultant looks like "is that all? But where is the great miracle?") And its duration also frustrates. (Psychotherapy is frustrating because it cannot meet unrealistic expectations of fast success).

Usually, every second person believes that "he is well versed in psychology." Comparing his ability to manipulate, or the ability to give good advice to a psychologist, what has been received from books or on the half-year courses (but not the skills, equipment and other necessary base for psychological practice), people often refer to psychotherapy with words   "I can do it as well." And who would want to pay for skills that you already have?

With this “I can do it” attitude people do not believe in "special knowledge" that is, for example, doctors have (the ability to prescribe drugs, the use of sophisticated tools for the diagnosis and even the infamous white (green) robes which already hints at a kind of caste). I think no need to explain that I don’t want to underestimate the work of the doctor, but to say that only that in terms of credibility - the doctors are in a better position.

At the same time, psychologists have no external dress code, special procedures, and the promise of a miracle that will definitely help. People gladly pay all kinds of miracle makers that promise miracles, everybody wants results without doing anything.

 Why do you need a psychologist? What the psychologist takes money for?

There is a common opinion about psychotherapy (mostly people who have never worked with a psychologist) say "For what they are taking money? It's just a conversation! ".

Some clients say "Oh, you are making nice money per hour" "Maybe I should become psychologists too?"

Often, people who say this, do not take into account that psychologist really works every minute of that time (what is similar  to the interpreter, to my mind, every second he processes words, analyses various scenarios and gives feedback)

He cannot switch, have a smoke break, eat, play solitaire, read jokes, or talk on the phone. He cannot even just "think about something else, be lazy. This is truly an hourly fee.

And much more: all this time it should be fully involved in the other person's life, empathizing with him, and - often - at the same time, simultaneously do substantial analytical work.

Even such "just listening" - in itself is a work. Rarely people share nice stories of life, usually, people share bad things and bitter, negative feelings of very high intensity (affects, "overflowing" feelings), which staked life difficult: when we all face acute or prolonged grief, in pain, sickness, when it hurts people around, usually the natural reaction is to stay away from a person like that.

b2ap3_thumbnail_4e70284cf6398f80628ae2f70ddb284c.jpgWell, in the end, psychotherapy is a technical work, which uses specialized knowledge and skills. This work, among other things, includes special conversation skills and has certain rules.

The therapist has to work with the resistance and defenses, which is to circumvent the one hand protection (sometimes for years prevent changes), and on the other not to break them together with a man. In addition, a psychologist gives feedback; helps find a resource that offers experiments, exercises, and assignments.

It - it is work that requires great emotional and energetic contribution.

And yes, all the practical psychologists learn not to burn out from objective difficulties that exist in this work.

The customer pays for psychotherapy, first, in order to get the services of a good quality professional that is willing to work with him.

Secondly, in order to make the process of psychotherapy helpful to him.

Payment terms - an important factor affecting a number of parameters of the process of psychotherapy that can help or hinder, enhance, or reduce its effectiveness. The relationship between a client and a psychologist with well-built borders, bilateral responsibility is healing for most customers. And payment psychotherapy works for that kind of relationship.

Payment and symmetry

Psychotherapy - is an unusual relationship. Attention focuses on one person - the client. On his feelings, issues, history, goals, desires, and capabilities. Or on its contact with a psychologist on how exactly it contact works. This relationship is for the benefit of the client-focused on his benefits.

The therapist can say about himself, show his presence, communicate his feelings, reactions and experiences, but only if he believes that this will promotes client and be beneficial to him (not just to "share" or remember that "I also had something interesting" or "important").

And in such a situation of obvious asymmetry, relationships, in order to be healthy, have to be paid in different ways, to bring symmetry to them. If there is no payment - that is an unethical and unhealthy situation, and in such a situation, psychotherapy has no place. Payment in this case helps to set a balance.

Payment and responsibility for the process

Responsibility for the process of psychotherapy is on both sides. The responsibility of the psychologist is that he must be professional (know his business) and comply with the ethical principles in relation to his clients.

The customer assumes responsibility for the payment on time and attendance of meetings for his own development.

And the responsibility of the customer is a measure of his mental health. As said W. Glosser "Mental health – is a responsible and realistic perception of the world." The result of prolonged psychotherapy is, among other things, the adoption of human authorship of his life and is responsible for this authorship.

When the customer pays for his psychotherapy - he commits a responsible act. Constantly performed actions gradually accumulate a certain style of behavior - responsible in relation to himself: paid process, as practice shows, it is harder to sabotage and easier to integrate. And of course, responsibility in communication with the other person - in this case with a psychologist develops responsible character. This positive experience (and a liability to others) as part of the therapy competently will be transferred to other areas of life - that is, serve as a model for a healthy relationship with you and with others.

Payment and borders

in order psychotherapy to be successful it needs optimal distance between a client and a psychologist, which is set by payment for psychotherapy. It sets working relationships (its work, not a miracle, not "adoption" or "something that will make me better").

Payment and security

Man does not exist in isolation from the world, and being in a continuous process of exchange. And when two people are in relationships and interactions, each of them gives something and gets something. Even if a man says that he gets nothing, but only pays, it is not quite true: as a rule, if you ask in detail, he gets satisfaction, self-assertion, self-worth, or something else. However, practice shows that people of any profession who are constantly working for free or for an amount that does not compensate for their efforts, in most cases begin to accumulate stress, even if the work brings the joy of creativity and satisfaction. This accumulated tension significantly lowers motivation and performance.

Therefore, the most secure relationship for the client - this is when the psychologist loves his work (only the money for the quality work is also not enough) and gets decent payment for it.

There is another reason why the paid psychotherapy is safer for the customer. When a man does not work for the money. You do not know why he is working. What are their problems, he "acts out" or decides by working with you, what he aspires to? In fact, that's exactly what mothers warn their children not to take candy from a man on the street, yes, there is a chance that his man's uncle is just kind and loves children. But there is a chance that he is not. 

Payment and motivation

it’s not enough to show intention once. It should be supported all the time.

People are always more receptive to the knowledge and change, for which they had to pay. Time of paid consultation is usually used more efficiently than one that is free. And what has been discussed or realized for the money always harder displace and forget. That is the work of the client, the results that he paid for.


Decide to change their lives much harder than decide to go three times a week to the gym. Aching muscles, the banal "reluctance" and lack of habit do not go in any comparison with the fear of a deep restructuring of individual resistance and the sense that his familiar world is changing.

To change something in your life, you need to make an effort, including money. Therefore, psychotherapy should expect a tangible amount paid by client in proportion to the level of his wealth.

I can say that sometimes there are clients that I don’t want to take the money from - they give so much professionally or emotionally, but it must be done for their benefit.

Each psychologist has number clients with whom he works for symbolic amount of money. Usually these are most interesting from professional perspective cases or they are highly motivated people.

Why professionalism is worth so much?

Can I find a cheap and good specialist? Yes you can. But it happens very seldom. In my case – Skype sessions give you the opportunity to pay Ukrainian tariffs for good specialists, which can be substantially different from regular therapy prices in your country.

Usually, a good professional is expensive. Yes, there are exceptions, but the rule is costly.

First, money makes some qualification. For example, it prevents people to come from curiosity, and without real motivation.

It helps weed out low-motivated clients: those who were «persuaded to go"; who came to fix someone else (wife, husband, and children), and not to work on themselves. Or those who came to prove to themselves that "this does not help."

This requirement is often necessary also because the physical capability of the psychologist is often limited.

I’ve mentioned earlier what emotional and intellectual resources, which requires a process of concentration in psychotherapy.

Not every psychologist can (even if you really want to) take customers at home.

Therefore, the price often depends on the rental. (This is an obvious advantage of Skype sessions, by the way)

Finally, the maintenance of professional level and professional improvement also cost money.

In order to be a good psychologists not enough get a degree some years ago (even in the best school)

Personality of psychologist is a too in his work with the client. Like any other too lit needs to be kept in order.

In the work of psychologist there are objective difficulties (emotional overload from a collision with affects and strong negative feelings, "burnout" and others). We also need personal therapy,supervision, and intervisions (sessions with colleagues). All this costs money. A good psychologist has to use all of the above on a regular basis to be in good professional shape.

That is,not it “would be nice to have” but is a necessary part of the professional practice.

We have the entire time to look for good psychologist training: new forms of therapy, books, seminars, etc. Like any other professional, we have a need for professional growth. Professional growth.

After reading this article it’s up to you to decide if it’s cheap or expensive.Everyone defines their willingness to pay and how much one is willing to pay for someone's work hour. And, perhaps, be ready to pay means you are ready to receive.

sources:
©Samir Pavlova (blog in Russian)
http://budurada.livejournal.com/90516.html
http://budurada.livejournal.com/90923.html
http://budurada.livejournal.com/94901.html
http://budurada.livejournal.com/95076.html
http://budurada.livejournal.com/95332.html
http://budurada.livejournal.com/98558.html
http://budurada.livejournal.com/99161.html

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