The Risks of Using Insurance for Therapy

Part of my job as a therapist is to protect my client’s confidentiality and privacy. The requirements dictated by the insurance companies, jeopardizes this potential. If therapy is paid for through insurance, the insurance company requires the therapist to provide a diagnosis from the DSM IV (Diagnostic and Statistical Manual for Mental Health Disorders). Not all DSM diagnosis qualifies for insurance coverage. They usually only pay for therapy if you qualify for a mental disorder diagnosis, such as Major Depressive Disorder, Bipolar Disorder or an Anxiety Disorder. Couples counseling, communication skills or pre-marital counseling is normally not covered.

We are required to provide a DSM Code to the insurance companies, which stay in the client’s medical records for an unspecified time. This can have an effect on obtaining insurance or life insurance in the future, as well as become available to employers.

Insurance also requires the therapist to share information from the sessions on a weekly basis in order to maintain coverage and in determining the number of sessions allowed. In addition, it is common for insurance companies to request copies of the therapist’s notes, which may reveal detailed information discussed during the sessions. This also becomes a part of the client’s permanent medical record, therefore compromises confidentiality. In a court proceeding, medical records could get subpoenaed, including your mental health records.

For these reasons, I have chosen not to work with insurance companies in order to continue to provide a safe environment where my clients can feel secure about their privacy.