Why don't you work for insurance or EFAP/EAP programmes so I can get free therapy?

Our answer to this question is somewhat complicated. First, let me say, we are not opposed to insurance or EFAP/EAP programmes (per se) - in fact we are approved by several and they do have there place (sort of). What we wish is everyone had "adequate" medical coverage with appropriate mental health benefits which would cover the cost of mental health care. Not taking insurance or EFAP/EAP clients means that we limit our practice to those who can afford to pay on their own, and we are very ambivalent about this. Never-the less, there are three issues that have led us to make this decision.

1. Most insurance or EFAP/EAP plans are "managed care" programmes. There is a reason a lot of people call it "mangled care." We object strongly to a "case supervisor" in Toronto or Montreal or Philippines or India telling us how to support a client he or she has never and will never meet. Which includes the number of times we can see a client and the specific protocols we can use. Simply put, the client is not our client but the Programmes (Agency's) Client. It is our experience, many decisions made by these programmes are not based on client needs, but rather keeping costs down (after all the less the Agency spends the more they make).
   
   
2. Insurance records and EFAP/EAP records are NOT confidential. Even when only basic information (like your diagnosis and the number of sessions you attended) is reported, it can be damaging. Most of these programmes require extensive reporting be sent to the Agency. When you apply for life insurance, a government position, or health insurance, or executive positions, or are consider for any advancement - a "DSM" diagnosis (mental health) can be enough for you not to be considered. In addition, these confidential case records (mandatory in managed care programmes) do occasionally find their way into the wrong hands, and there is little or nothing you can do about it if that happens to you.
   
   
3. Certain mental health diagnoses are especially potentially harmful to clients. The more "serious" or "unusual" diagnoses, like eating disorders, sexuality concerns or disorders, drug or alcohol abuse, post-traumatic stress, personality disorders (like "borderline" or "narcissistic"), depressive disorders and anxiety disorders can cause great personal damage if they are known, even if they were years in your past.