breaking up with your therapist

In ALL, HE SAID SHE SAID by Stephanie Klein47 Comments

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Thank you for taking the time to meet with Stephanie and me yesterday.  You seem like a very nice person and your studies are consistent with Stephanie’s desired counseling techniques as well.  Upon leaving we did have some questions.

The fee of $175 seems un customarily high from our research and wonder the basis for it as it is something we never discussed. Is this a consistent fee per 50 minutes?

It is our intent to have individual goals for each session as well as overall goals for the counseling.  Unfortunately, I did not feel any advancement following our meeting other than fact finding. Being our first session it is understandable however, it is still imperative to know there will be value/insight in each visit.

When I asked you if you would ever tackle a specific issue by providing your thoughts your response was "The only thing I might say is if you continue with that path there is an 86% chance of divorce."  Did I hear you correctly?  It sounds as if the method of using fear as a motivation is counter to my goals.

In addition, you had stated a large part of your practice is knowing when our heart rate is over 100BPM as it is then we think irrationally.  I wonder how you will know our heart rate but more importantly that is assuming we don’t have the faculties to think rationally and be animated at the same time.  I guess i just didn’t understand beyond a general portent what your goal is with our heart rate.

Couples counseling is a big commitment in time, emotion and money.  The counselor/couple dynamic is a conflict of interest as there is always a financial incentive for continued/more frequent sessions which is not necessarily dependent on the progress of the counseling.  As we walk into this relationship I thought it important to voice concerns and hopefully get your feedback.

Again, thank you for your time.

_________________________

I wonder if she’ll contact Phil in response to the letter he sent her above. We do have another appointment scheduled with a different therapist, as well as a second appointment with this counselor. We’ll see what comes of it. I don’t know what you can expect of a first meeting, really.

I think the problem is that she wouldn’t let us get into the actual problems. Instead she asked us questions about the day we met, what we loved about each other, to tell her about our wedding day. And although she didn’t say as much to us, I TOTALLY GET why she asked us these things: to assess how bad our situation is. That is to say, if all a couple can remember are the bad memories, that’s how bad it has become, but if they still light up about their courtship, about their wedding day, etc. then you know there’s still love there. We both went on and on about all the things we love about each other, but at the end of the day, you can also have some deal breakers. You can still feel more unhappy than happy in your life, and then you either make changes or you make bigger changes.

I think Phil was hoping that we’d discuss an issue and get a chance to see her style, to see how she’d coach, when she’d interrupt, see how she could add value. I understand what she wanted to see in us. But also spending $175 to reminisce for 50 minutes seems pricey, no?

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Comments

  1. Definitely pricey. I guess there has to be some time for information collection and you don't know exactly what insights she was trying to gain from asking you about those different situations. It sounds like Phil wants to have the answers straight away but that would be difficult. What theoretical background is she working from?

  2. Very expensive; 86% chance of divorce based on what? All previous Phils & Stephanaies w/b&g twins?; regarding heart rate business, Phil should have assured her he has competent cardiologist. She sounds like a waste of money. Find someone else. Preferably psychologist with strong background in couples counseling.

  3. Me again. Also, find someone who understands jew speak; i'm referring to this: "to think rationally and be animated at the same time." Someone familiar with italian speak would also be acceptable. You apparently chose a practitioner only familiar w/prim southern speak.

  4. Yeah, that is pricey. But it is your money to spend and your marriage to counsel. I saw that letter coming yesterday after your video post. Maybe not the letter itself, but everything Phil said in it. My guess is that the therapist will use this letter to help Phil see himself more clearly. He's a little like the Doubting Thomas from the Bible, and Lost, lol. Yeah, I do somehow link everything back to Lost. He has to stick his fingers in the wound to believe. He seems to have problems trusting people because he is smart. Smart people don't like to be told things, operated on, diagnosed, fixed by someone else. They are perfectly capable of doing all of that themselves. I know cause I'm like this too. I took the quiz on Facebook, which Lost character are you. I am a Jack. This did not surpise me as I would be the type to take out my own appendix. Phil seems like this to me, but I am just a blog buddy who has an opinion. I'm excited to hear about the follow-up and progress! I like you guys as a couple and family! And Phil is great to be so involved and want to work on being better together. There are a lot of guys out there who would never go to therapy, they would go to a bar.

  5. I remembered one of the painful counseling moments last night when I was wondering how it went for you. Leaving the counselor's office, torn skin flapping in the breeze, wondering how the hell I'd ever get back in bed with the sonuvabitch who would charm the pants off of the therapist, subtly twisting the knife further into me with each condescending, patronizing innuendo. And I hated her for looking at me like *I* was the one with the problem, when my biggest problem was being treated with disdain, disrespect and basically like dogshit. Ewwwwww. Makes my stomach hurt to think about it.

    On a happier note – sweet son and I were talking last night – and I was reminded and validated again why I left his dad all those years ago. Our home is a haven. Only nice words are accepted. Sure – the darlings are ridiculous sometimes, but hurtful, unthinkable and unforgivable words are not uttered there…and if they are in a moment of yuck…they are discussed, apologized for, and not uttered again. Thank god.

    I wonder if my signature will have the random number and letters in it again – I've retyped it 3 teens' mom – let's see!

  6. Definitely pricey! Considering you and Phil can jolly well counsel yourself writing letters to each other. Phil is funny, so are you. I have said it before, but I think you guys make a cute couple.

    Also the internets have bloody killed the counselling market, have they not? When the counseller asks us something, we already know WHY its being asked and HOW she/ he wil use it to treat us.

  7. Obviously the first time is testing the waters (and/or reminiscing) and can be different than future sessions. So she shouldn't have charged you. Grrr. Go Phil for writing the note. (My BFF is a therapist.)

  8. that is way too much per hour. i live in SF and paid much less per hour for a great couples counselor here

  9. I'm the Office Manager for a PhD psychologist in Southern Oregon. His initial consultation fee is $180, then $140 for all subsequent. At the last clinic I worked at in the Twin Cities, initials were as much as $400, depending on what was being evaluated, and then about $100 as session after that. So I suspect her $175 is an initial fee.

  10. I agree, way too much to charge for non-specific counseling.

    Interview her/him first before you make an appointment to find their counseling style and importantly, do they have experience working with couples who have similar issues as yours? And the first appt is usually a data gathering appointment with ANY counselor, so don't expect much on the first visit.

    The types of questions Phil is asking needs to be done BEFORE you step into his/her office and pay money. Fee, methods of counseling, intervention style, goals, etc., figure this out over the phone.

    Also, you both should be on the same page as to what you want from the therapy and counselor, otherwise one of you will always have some sort of complaint that can eventually lead to, "Why are we doing this? This is a waste of time/money!"

  11. First of all, $175 sounds about right for here, Bergen County, NJ. It is not true, however, that "nobody good takes insurance." Might be worth the additional effort to find someone who does.

    Also, in my experience finding the best therapist for you is kind of like lobbying for the "best" teachers for your kids. I too have twins and it's not necessarily about who has good word of mouth with the yentas — it's as much about the teacher's fit, personality-wise, with your child as about his/her skill in the classroom. One of my kids is a good student, happy and easygoing; the other has developmental, health and behavior problems. The best teacher for one might be a nightmare for the other. And so it goes with therapists — he or she has to be a good fit for you and/or Phil.

    Finding the right person to help you is worth all the work!

  12. Pricey? I've been in and out of therapists and psychiatrists for over 15 years. $175 is about right, in my experience. Some insurance plans will cover that, with a copay of around $35 or so. Have you looked into whether or not insurance will cover? If you have an actual condition, they'll cover unlimited visits, but for something like couples counseling, you can usually get about 30 or so out of them.

  13. PS Just be glad you don't live in California. The good therapists out here range upward of $300.

  14. I may not believe in love-at-first-sight…but I definitely believe in clicking with a therapist right off the bat. Life is too short and there are too many qualified therapists to stay with one that isn't for you. The process is challenging enough, neither of you should have to feel uncomfortable with the facilitator.

  15. Are you seeing a Gottman therapist? I do understand their use of the heartrate monitoring – I think it has some validity.

  16. We paid $150/50 min. for marriage counseling in Chicago. We had to pay upfront and then submit the invoice to our insurers for reimbursement, but it was worth every penny.

    Something that occurred to me as I was ready Phil's letter was that the therapist might not have meant the statements concerning divorce rate or heart rate literally. If that is indeed the case, I hope she will clarify what she meant.

  17. Hm, $175 seems about right to me. I've paid from $80-100 for myself, with up to $150 for a first session. And both of those therapists were licensed clinical social workers, not PhDs, so education/creds can affect rates. Plus there's just one of me and two of you, so I would expect it to be a bit higher for two.

    As for the background/info gathering stuff, I understand Phil's perspective – and he's a guy, so wanting to "fix" right out of the gate. The first appt is pretty routinely a general fact-finding discussion. It's a bit frustrating, but pretty hard to assess the issues you want to discuss without some background – I wouldn't want a doctor to start treating me without having examined me first. That first session lays a foundation for her to draw from. All that said, I firmly believe if you're not both comfortable with the therapist after a couple sessions, it's worth moving on to someone else. Wish you two luck. Hope you can better understand each other and yourselves, and gain some communication tools.

  18. While her methods seems a little weird, $175 doesn't seem overly pricey to me. I paid $140/45 mins. five years ago. Not sure if there was a higher initial fee or not. Yes, from my experience, there was much fact finding in not only the first visit, but the first three (just let me fill out a questionnaire instead of wasting time/money talking about my sibling in our couples couselling!). I can sympathize with your frustration, but I think Phil is being overly optimistic in expecting anything out of the first appointment; it truly is just a time of assessment–on both your parts. Then again, if you don't get a sense of the therapist's counselling style, then how can you figure out if she's right for you? (My guess is that they don't care about what you think of them.)

    Although I thought our stint in counselling was helpful, it is often pricey for what you get out of it. I think you have to go into couples counselling expecting to pay a lot for a little and be fine with it because in the end, if the counselling saves or rights a sinking relationship, that's not something "little" at all. It's a lot of time and a lot of money no doubt (and keeping track of it will only pressure and frustrate you), and counselling is always a leap of faith to some extent, but I believe it's worth it even if only a small corner of your relationship is improved as a result. Think of how much energy, time, effort, and anger you'll save from fewer arguments. Even just one less heated argument is worth the $175 session fee alone (in my opinion, at least).

    I'd give this therapist another session before you make any decisions. (Provided she responds to Phil's letter.)

  19. This is a process. The first time my BF and I tried couples therapy it was very frustrating. Both of us wanted to cut to the chase and fix the issues or walk away from the relationship. We ended up walking away from the therapist, floundered for a year at least and then returned to therapy at a severe breaking point. Ready to be "bare," open to criticism and self examination, we started working slowly, both as individuals and as a couple. Now things are great, but it took a lot of time.
    Have you read the John Gottman books yet? A $15 book investment that really was eye opening.

  20. I'll probably get some hate replies for this comment (and I'm by no means a therapist)… but Stephanie, have you ever thought that maybe you're blowing all of this out of proportion and are maybe a little over-sensitive? What if you try concentrating on the good things you have in your life rather than looking for the negatives? You have multiple successful books, a blooming series deal, two gorgeous and healthy children and a husband who loves you very very much (albeit a little rough with his words). I'm not saying that things aren't hard sometimes, but see the forest for the trees here and spend more time on the good. I think it will make the hard much easier to handle.

  21. When Phil wrote, "your studies are consistent with Stephanie's desired counseling techniques" he was indeed referring to Gottman. I've read his first book and LOVE that he believes some shit you just can't work out. That you agree to disagree and move on or out. Yes, she is a Gottman therapist, which is why I knew exactly what she was looking for when she asked us the questions she did in the session.

  22. I think the danger of couples therapy is that typically, when both people are willing to go, it means they both think that the other one is the problem, and are just waiting for a third party to confirm what they've been trying to convince their partner of all along: "I'm right, you're a jerk, and even the therapist agrees with me". Very few people can go into something like this really willing to commit to it. If you've really got marriage-threatening issues, I think it's a little naive to expect results after 50 minutes, regardless of the price. Honestly, if a stranger claims they can fix anything about your marriage within less than an hour of meeting you for the first time, they've probably also got a bridge to sell you.

  23. Doesn't the 86% correspond to something in Gottman? I think what she meant was that if what you really want out of therapy was voiced by Phil's desire for her to judge a specific incident that occurred and give her assessment of who was "right" and who was "wrong" you wouldn't be "getting" what Gottman is about and would be stuck on the wrong path according to Gottman's diagnostic tools.

  24. PS Doesn't Gottman focus on the underlying stuff and feelings about each other that causes these specific incidents, blow ups, ways of (mis)treating each other?

  25. To be fair, she didn't give US a percentage or any statistics about ourselves. She was addressing his question. When he asked how she worked, she said that if she spotted certain behavior, she'd likely say, "If you continue with that behavior, the research shows you'll have an %86 chance of divorce… so we'd work together on changing that behavior."

  26. based on some of the thing Phil said in his letter, it sounds like he's seriously question the validity of *any* counseling, not just this counselor. $175 being a reasonable fee or not, it's a lot to spend on something that half of you are always going to regard at hooey.

  27. She'll probably quit you guys first–the letter was so nit picky. Then again maybe it will give her a clue of why you are so unhappy.

    Anyway, the first session is just an intro….his letter seems premature.

  28. Wow. Hmm. I agree and disagree with a lot said above me. Phil's desire for the therapist's personal thoughts/judgments is not a good idea, as Rebecca said. And his need to meet goals at each session is also pretty much an expression of a need for control (let alone his letter!). I can understand feeling out of control when your health is unpredictable and you're starting therapy – it's a lot to handle. It's going to take some major trust.

    Therapy isn't for figuring out who's wrong. It is, among other things, for teaching each of you to pay attention to whether you (not the other person, you yourself) are acting for good reason or out of fear, hurt, anxiety, etc.

  29. Price is around what we paid in SF. Our first session sounded very similar — talking about how we met and other background. I thought it was critically important to do this. Beyond giving the therapist context for how you ended up in therapy, it reminded my husband and I about why we were together in the first place and how much we have invested in making the marriage work. Phil wants instant results, which is one of the problems he seems to have in your relationship, too. You can't expect it to be better overnight and you must be willing to trust and have faith in your therapist.

  30. that's actually pretty normal rate wise ( though you can def get cheaper and still get quality). ultimately though, it sounds like neither of you felt the *click* thats really important to have with your therapist. i think Phil writing that letter was good-have you two really discussed and compared what you want out of therapy, what kinds of approaches and techniques you can imagine being better or worse? this is info to also share with your therapist. many can approach problems from dynamic and also cognitive and behavioral aspects, and the more they know about how you work, how you relate and problem solve ( and what differences there are in these areas between you tow) the better. also, while i totally understand the fear that $175 a session is a real financial incentive for a therapist to be perhaps not as productive as he or she should, and def. there are ones that do that, doing so is patently unethical. as in violating, at least for psychologists, the APA ethics. an ethical therapist wants to do thier best job, get the most out of each session, see and facillitate the most growth from thier clients. $175 may seem (and is) a lot of money, but being a therapist, listening to the suffering and problems of people day in and day out is very very stressful, and in that way $175 is not alot. on the whole most therapists go into the field not for the $$ but to help people function at thier best, and thier goal is to do that.a therapist should also be very comfortable discussing the busisness end of therapy–what you want, what they do, how they approach problems, and what you can expect from therapy. the first few sessions will be for them to get to know you, to gather info, to formulate your case, but hopefully if you want some concrete problem solving as part of your therapy they can offer some of that. (and if you want that, ask for it.) if they can't provide what you want, hopefully they can provide referrals.

    good luc!

  31. I agree with Anna's point that therapists are not supposed to be judges, and I don't think mandating a particular goal per session is as productive as Phil thinks- some issues take longer than 50 minutes to figure out, and it's likely the two of you don't even have a full grasp of the goals you need to accomplish. What I mean is, it's not that you two don't know and aren't entitled to opinions about what needs to be fixed, but the whole idea of therapy is that the therapist sees things you don't, has training you don't, and leads the two of you accordingly. I can imaging you two being exhausting to a therapist because you won't just sit back and let her do her job. That being said, I know the both of you are intelligent and are doing your best to be informed, not just swallow everything someone with a degree says to you. But how are you ever going to grow and move forward if you second guess and question to the point of break-up-letters everything you don't agree with? I really think you should take a previous poster's advice about interviewing potential therapists before starting actual sessions. Though I'm not so sure you won't get charged, I think it sounds like an excellent idea. If you find someone you feel confident in, then the both of you should make a commitment to x number of sessions with that person, regardless of how your feel going forward.

  32. I think some of the issues you have in your marriage might also be contained in the letter. $175 is expensive, but it will hopefully be time limited, perhaps you could discuss that. You won't get something out of every session, and if you do, it might not be what Phil expected. Choosing a good match is essential when selecting any counsellor but the demand may be premature and are almost certainly provocative, nothing wrong with that, seeing how the counsellor responds may make up your minds?

  33. Phil is an articulate guy and he took time to write a letter and follow up. That's way more than most husbands would do so go Phil.

    I agree with a comment that you either click with a therapist or you don't. And you both have to click. Go with your gut and keep looking.Rarely does someone get lucky on the first meet and greet and find a keeper. It's an unscientific process.

    The price seems on par with what most therapists charge. Insurance should some of that. Not sure what carrier you have but ours was partially covered. Sometimes I would wonder if we would just be better off taking the money and going on a trip without the baby but it's easy to get along when you're on vacation!

    Good luck. Now I am reading about Gottman and might need to hop on Amazon to check out his books. Sounds pretty interesting.

  34. dump her. i'm a therapist, and i've also been a patient. this interview that she did with you is not a requirement of couple's therapy. she sounds analytical, not intuitive. intuitive people don't respond with "there's an 86% chance of divorce if you do x,y,z." she does not sound gifted. why go to anyone that isn't, even if you're spending $5 on it? it IS an investment of your time, your emotions and the quality of your relationship. you both could have walked out of there with a feeling of hope and having gained some insight, and you didn't. i say cancel the 2nd session & go to the 2nd therapist on your list.

  35. I'd see if you could find someone who does 1.5 hour sessions for about $150-200. I hardly see what can be accomplished in 50 minutes.

  36. I live in Austin and because of my work I am familiar with the prices that private therapists charge here and $175 is an average rate and somewhat on the lower end especially if she accepts insurance.

  37. it does seem like a waste of a session. Maybe some people like that soft fuzzy intro to the process, but IMHO she should have just asked for a video of your wedding and not wasted your time!

  38. Firstly – congratulations on walking in the door. Period. Second – coming from a long line of therapists – and those who need therapists and feeling like one of each on any given day…the best advice I can give is…get a referral. It may not be possible but if you find someone, who helped someone you know…it's a good starting point.

  39. The weird characters you are seeing is because of the ' you are using in your name. That is the way the html code reads it and it does not rectify it. If you don't want the you will have to take out the apostrophe! I hope this helps!!!

    Jen

  40. I went for couples therapy over ten years ago and back then it was $150 an hour in NYC, so that seems fair to me. I know NYC is more costly but remember, I am talking 1999…

  41. As a Licensed Professional Counselor, I can tell you that $175 for the first session is no where in the ballpark of going rates for therapy. Was she a Psychiatrist? If she was doing a psychosocial/background session with you, she basically charged you for two sessions but then the appointment should have been twice as long. I think that you need to shop around…it sounds like she is ripping you off. (From: Your military spouse friend who argued with you about the USO in San Antonio/ you using it when preggers.)

  42. Well, my husband and I are in therapy (we're separated but trying to work it out) and I think it's pretty par for the course for them to ask background questions in the first therapy session. That's true for both individual and couples therapy and it's the only way they can really start to know the situation. And you'll do some type of "story telling" every session because it's through the stories that the therapist determines how you interact and communicate.

    $175 doesn't seem that pricey to me. My step-mother is a psychologist and that's her fee. She's on the Jersey shore, so maybe it's high for Austin? I'm in Madison, WI, and pay $125/session with my personal therapist and $100/session with our couples therapist. My husband's personal therapist is $115/session. So it would definitely be high for this part of the country.

    Has Phil ever done therapy before? If not, then I think the above letter just shows that he had unduly high expectations for the first 50-minute session. Sometimes the first session is more expensive because they'll do a diagnostic, but that doesn't sound like what happened here.

    Good luck. Our marriage is still up in the air, but I think we can save it. On the other hand, sometimes I wonder if I want to. It's a terrible time, and I wish you the best.

  43. Oh dear. That was quite a letter. He was basically insulting the therapist's ethical basis with that crack about a financial incentive for continuing. It's been my experience that a good therapist wants you to get done, not continue so s/he can cash in. If he's uncomfortable with the idea of therapy, and compensating someone for such a thing, which it seems he is, then he shouldn't go. He's not going to enter into it with the right spirit.

    I think the price is right, standard for an experienced therapist in today's market.

    I think the letter was way out of line and shows that Phil doesn't really understand couples therapy. A first meeting is where the therapist gets a feel for the relationship, not a time to see results or "make progress" from the patient's standpoint. I'm sure the heartbeat comment was a metaphor.

    Regardless of the therapist you end up with, he should chill, let the process go fwd and avoid judging/second guessing everything. Or not go at all.

  44. I recommend you try Linda Scott here in Austin. Her rates are lower and she is amazing. 327-3408. 1007 MoPac Suite 102.

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