Leaving The Land of Insurance: A Therapist’s Story

Once upon a time, there was a brave therapist starting a private practice. Having worked previously in an agency, she was used to having clients use their health insurance to pay for therapy sessions. So she contracted with health insurance companies to provide psychotherapy for clients and set up her practice in the Land of Health Insurance.

What she did not know, however, was that in that land there were dragons.

The first dragon she encountered was the Administrative Paperwork dragon. In order to defeat this dragon, the therapist needed to keep track of what different insurance companies needed, submit bills to them within a small window of time, and follow up with the companies when she didn’t get paid due to an error (which happened frequently). While the therapist was unable to defeat this dragon, she tamed it a little bit, so it just lumbered along behind her all the time and occasionally scorched her with fire.

Soon, she encountered another dragon: the Medical Model Dragon. This dragon battled with the therapist to label her clients as sick with a mental illness. This dragon said with a booming voice, “Is this treatment Medically Necessary?” The Medical Model dragon would not allow the therapist to escape the dragon’s lair which was littered with words like Measurable Behavioral Goals and Biologically-Based and Symptoms and Diagnosis and Medication and Psychopathology. The therapist did not like it in the dragon’s lair. But she stayed in there and kept battling in order to help her clients.

While weary from battling the other two dragons, the therapist was disheartened that a third dragon joined the fight: the We Know What Is Best dragon. This was the most dangerous dragon of all because he had hypnotic powers. The dragon kept repeating “Short-Term Therapy Is Best” and “Cognitive Behavioral Therapy Is Supported By Research” and “The Goal Is Symptom Reduction” and “This Client Isn’t Motivated To Get Better” and “Don’t You Think Your Client Should Be Done With Therapy By Now?” The therapist started to question her therapy approach and forget who she was and what she believed was healing.

Constantly harassed by the Administrative Paperwork dragon, trapped in the Medical Model dragon’s lair, and lulled into numbness by the We Know What Is Best dragon, the embattled therapist realized that in the Land of Health Insurance, she would always be fighting these dragons. She feared not only for her own well-being but also for how her constant battle with the dragons would affect her clients. So she ran, far and fast, and escaped the dragons and the Land of Health Insurance.

Some of her clients were still trapped in that land, so she figured out a way to keep working with them from outside. The therapist was saddened that some people living in the Land of Health Insurance who were looking for a therapist would not be able to work with her because she had left the Land. The therapist knew that there were many therapists still battling the dragons and others who had found a way to live with the dragons in peace. Yet she knew that, for her, she had made the right choice.

Outside of the Land of Health Insurance, away from the dragons, the therapist could do her work. The therapist could help clients in the ways that she and her clients thought would be best. She did not feel pressured to be the kind of therapist that the dragons wanted her to be. She had new challenges to be financially accessible and to find new clients, but those challenges were not as taxing and they did not make her forget who she was as a therapist.

Today, the therapist lives in the Land of Healing. She continues in her quest to help her clients. It’s not easy, but the land is free of dragons.

And the therapist and her clients lived happily ever after.

THE END

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