Irritation with my therapist-advice/opinion
 

I am highly irritated at the current time with my counselor for my individual therapy. I had an appointment with him yesterday. This is a man that I have had a professional relationship with for over twenty years, and had considered a friend. After I had sat in his office for close to an hour bearing my soul to him, he announced to me that he expected his total amount due to him for my last appointment. I had accidentally missed my prior appointment with him. The prior missed appointment had been scheduled during the time my DDH and I were having our last major argument. My DDH had gone to Motel 6 for the night, accidentally? fell in the shower, and fractured vertebrates in his neck. I was having trouble sleeping and had taken sleeping medicine in order to fall asleep. Once I fell asleep, I over slept the appointment time. God, I knew I needed to have made that appointment if I had been able to!

Here I was in his office yesterday, and had beared my soul to him; he decided to summarize the session by his announcement that I would be expected to pay for the missed appointment. After everything that I had just told him, he made me feel so invalidated! I feel like it was an inappropriate time to tell me about my missed appointment. I feel like it could have been made in a lot more tactful manner.

All I could do after his announcement was to state I understood him and agree to pay him the money. He owns and operates his own office, so it wasn't a policy issue. As I grabbed my two walking canes to leave I announced I felt the counseling was over, and that I had just gone through HELL! And I left! (My son paid the office manager.)

Now this morning I woke up, and feel like I want to make a personalized poster, and mail it to him as a Christmas gift. The poster would say "Poor is the counselor that places his own self worth above that of his client's!"

What is your opinion?

yea, a jerk for sure. I'd dump him as a friend and "mainly" as a therapist. send him a dollar bill with poop smell on it for Christmas.

I can see how you'd be aggravated, but, having a family member who is a therapist, I can see the other side of it too.

Lots of people--I wouldn't have believed how many--make appointments and then never show up, no phone call, nothing.

If you'd be happier with someone else, by all means look for another therapist.

Thank you for your responses. :thanks

What do you think about the saying "Poor is the counselor that places his own self worth above that of his client's!"? This saying just popped into my head this morning. I'm not sure if there is a similiar saying like this, but it kind of has a double sword meaning to it. On one side we do need a counselor who does have self-esteem, and, yet, we don't need a counselor that acts like mine did yesterday. :riphair

or maybe "poor is the counselor who has a friend for a client."
i, personally would not want friends and family as clients, just because it would make me extremely uncomfortable to ask for my fee.
it will always be a bad time to ask me for money.

phoenix, i do understand how you feel though.
it is so hard for me to "expose" myself, and then feel like he was sitting there thinking about his fee from last week.
i am sorry for that, and that you felt your soul baring was invalidated.

i know i am not in a position, or have the skillset to ask this, but when i am having trouble with my counseling, or the counselor (thank god no transference! :)) it could be i was making progress and sometimes progress is painful.
just something to consider, i appreciate the knowledge you share here.

Beth

Since you asked, I think it would be a poor counselor working from his car that didn't protect his business interests.

I view medical professionals as business people first. They are in business to support themselves.

Appointments are made with the intent of managing income to support the business.

My professional and personal time is valuable. I try to manage my time with a schedule and appointments. If an appointment fails to show or I fail to make my appointment, time has been lost. Time is a precious commodity.

Well, as noble a profession as it may seem.. it's a way to make a living. It's a job. He needs his paycheck. You owed the fee.. he had to request payment on services rendered, I'm sure he has a policy about missed appointments. When would have been better?

Maybe not the best and most loving approach, but it's a business, hun..

There is another perspective to be had here.

Perhaps he listened to your story in order to determine if the appointment was missed due to "circumstances beyond your control." Perhaps, after listening to your story, he decided that the missed appointment was caused by a series of choices, not beyond your control, and therefore payment for the appointment is a consequence of your actions.

I believe my therapist would have probably done the same, and come to the same conclusion.

JMHO,

L

I am supervised by a therapist and work very closely with them. The first thing I will say is although you may feel like he is a friend, he isn't, he is a therapist. He cares about his clients for sure but he is also a professional. That is why professionals have strict boundaries and although it is jarring and upsetting, he isn't doing anything untowards or unprofessional at all.

Transeference and counter transference is when the client's emotinal needs are being met by a therapist and possibly vice versa. This can be harmful so if he is acting like a friend and then decides not to be, that may be counter transference on his part. After such a long established relationship, there is bound to be some of that happening.

If I were you I would definately talk about this. It would be a good time to reestablish boundaries after such a long client/therapist relationship. The therapist is human too but the only troubling part is if he makes you think he is a 'friend' when he isn't. So what happens is something like this where you suddenly feel 'betrayed' by his 'friendship'. That is an area the therapist needs to work on for himself and his relationship with you.

I would not say what you came up with this morning because he really didn't do anything any other counselor/therapist would not do. When you began therapy, I'm sure he made you sign something about cancellation/payment policy. If he did not you can use that angle. He needs to be very specific with you in writing about his payment/missed appointment policy.

I agree with this. I'm guessing if your car had broken down and you'd called him at the time he'd have waived it. But I can see why he charged you under the circumstances.

Something doesn't sound right, here.

Mental health professionals do not take on longstanding "friends" as clients. They would refer a friend to a third party professional.

Is his perception of your base relationship different from yours (i.e. he considers himself a friendly aquaintance but you considered yourself a "friend")?

It is usually the policy that missed scheduled appointments are charged, unless notice is made within a time frame that the appointment will not be upheld (normally 24 hours).

CLMI

I agree with this. I thought the whole point of seeing a therapist is to talk to someone that has NO interaction/relationship/knowledge of anyone we know? Otherwise how can they be impartial to understanding you if they know you personally and know your family?

The note seems so, I'm not finding the right word, but like playing games. Will he even know what you are talking about?

If you want to continue with this counselor how about going to the next session and simply state "I felt very invalidated when you addressed payment matters at the end of my appt. after I shared xyz. In the future, please address these matters at the beginning of my appt." See what he says.

If you don't want to continue with him as a therapist and you have a grievance write a grievance letter. Simple and to the point. "I do not think addressing payment issues at the end of an appt. is appropriate or professional. I felt invalidated. I will be looking for services elsewhere." If he is part of a network/office then they probably have a written policy on grievance procedures they'll show you if you ask. If he is in private practice - maybe not.

I think it was very bad timing too btw. I would have felt invalidated too. If this is his only 'mistake' and you like him in general maybe he just had a very bad day. If there are other things it is OK to look for a better match in therapists. Just because you've known him for so long doesn't mean he is the counselor for you. I've only seen two counselors in my life so I'm not expert but they both said that if I felt it wasn't working or wasn't a good match to speak up and they'd refer me to someone else. It happens. It is expected. There are a lot of different styles of counselors out there - lots of different people. The person before you may have had a grievance for mentioning payment issues at the beginning of the appt. instead of the end - She might feel like it was starting the appt. off on the wrong foot and how can she bear her soul to someone that is worried about his payment!!

Who knows but I just think you'll have a better chance at feeling like there was some resolution if you are more upfront.

Hi Phoenix, I am sorry you have had a hard time during the DDH accident and now with the therapist. My mom was in therapy 10 years and I do not think she has recovered from codependency (IMHO).. when I mentioned this to my current therapist she said currently the field has improved and her therapies last 2-3 years max... perhaps, this therapist was no longer able to help you and all this is a gift from HP so you find someone else who is a better fit for you and perhaps has other techniques and approaches that will help you heal faster? Hugs!!

Of course it hurts! I think he should have brought the issue up at the start of the session. That way you get the business over and move on to your issues. But you do owe him the money.

When we're angry it can feel great to get revenge. But my experience is that we pay for it later, sometimes years later when we look back at our actions and feel ashamed of them.

I practice the opposite today and feel a lot better....

I forgot about my appt back in May, totally slipped my mind. I had to pay more than the copay for the missed appt because it keeps the counselor from booking another appt. Yes it seems unfair to pay for services not rendered but it is business. I can understand truly.
I personally would not say much to the counselor about it because this is standard practice in that world. You will find this in every practice, maybe he has bad timing but it is standard. My daughter was seeing a therapist and I decided to treat her as an adult and let her make her own appts since she was 18. She never told me when they were but missed two and we had to pay for both appts and yes the therapist was not very happy about not getting a call or an apology for the missed appt.
Also if he's been a good therapist all these years and this was the only instance of a communication breakdown maybe it's the time to overlook it or if you're unhappy with the therapy maybe it's time to shop around.

Hi Phoenix,

I understand your frustration and your irritation. The therapist / client relationship is a strange one...I often feel like my therapist is my "friend", but in reality, he is not: he is a professional with whom I have entered into a contract. That said, he is a caring person who I genuinely believe has my best interests at heart, but he is first and foremost a professional who is running a business.
That said, perhaps your therapist could have handled it in a way that didn't sound so harsh, but...
JMHO....Google "therapist patient relationship". I found a lot of helpful advice on understanding the dynamic that goes on in the therapist's office.
Sending you kind thoughts and hugs.

It was appropriate for your therapist to solicit his payment. However, I question his timing. He is in a profession that deals with people's mental health. I don't know "how" he asked b ut the manner in which he asked is also important given the context (you just poured your heart out.) . I would question his lack of sensitivity & sensibility.

Now that I have allowed enough time for me to reflect on my exchange yesterday between my therapist and me, I believe he did this on purpose. I have used him as my therapist off-and-again for the last twenty years. Over this period of time we have gotten to know each other pretty good. When I describe him as one of my friends I'm referring to the definition of friend by the Merriam-Webster Dictionary; one attached to another by affection or esteem. I didn't call him my "querido".

Over this period of time he has gotten to know that I consider him rather "money hungry", and he has gotten to know I don't like to "waste money". He knows that he can get me off my "pity potty" and get me motivated in order for me to "save money".

The question was not whether or not I owed him the money, but how he approached the subject with me. His front desk could have told me that I needed to pay the amount due for my prior missed appointment. His front office is operated by his son, and his daughter, also, suffering from schizo-effective disorder. My daughter, also, suffered from schizo-effective disorder.

Well, if that was his deliberate plan, it worked! He managed to get me off my "pity potty", got me motivated, and I actually had a productive day!

When I chose to go into therapy with him this time, I knew what I was getting. He's a straight-shooter, without any sugar and honey added to his advice. I think he feels like he has done enough talking......now it's my time to put his advice into action!

Love and Peace,
Phoenix