How to tell counselor you are done...

[Cheryl in NM]

I know we have several therapists on this board. I've looking for advice from them as well as those who have done this.

 

I don't feel like my counselor is really helping me. I also feel like my depression is currently "at bay". Those 2 things combined with the fact that I haven't reached my deductible and am paying for the visits are causing me to determine that I really don't need counseling right now.

 

Here are my "issues":

1. She's allowing me pay on a sliding scale, but billing my insurance full price, which, they, of course, discount, but that discounted price is more than she's charging me. That is fraudulent in my mind and I plan to pay her what my insurance has attributed towards my deductible.

2. The things she recommends are things that I've already thought of. She hasn't offered me anything new, just validation.

3. I currently don't feel depressed. I'm not medicated. I've solve hormonal issues and am dealing with sleep issues and am physically feeling better.

4. She's been late to about half of my appointments and then became confused during a text conversation with me as to who she was talking about and told me that I didn't have an appointment for another 2 weeks. As a result I didn't go to an appt., she called wondering where I was, which is how we discovered the mistake.

5. I was attending counseling due to grief issues and depression. The grief is still there, but I'm dealing and she hasn't focused any counseling on this issue anyway.

 

 

So, do I go to my next appointment or cancel now? What is more courteous, to cancel my appt. next week or go and explain in person? What is the best way to tell her that I won't be returning? Also, does it sound like I'm making a good decision?

 

Thanks so much!

[Little Nyssa]

The lateness and billing questions make me wonder if this is a quality counselor. But that's a separate issue from whether you are done for now because of your own situation being improved.

I would just call and leave a message cancelling the appt and saying you are done with therapy for now but you will call her another time if you want to meet again. You don't have to pay for an appt just to say Bye.

And then watch yourself and don't be reluctant to seek out a different counselor in future if you need it.

I think sometimes people need a several visits to work through saying goodbye, but it sounds like you are pretty much done from what you describe.If you feel like you are spinning your wheels with her.

:001_smile:

ETA i ought to say I am not a therapist, but I am an RN with experince in the mental health field.

Edited July 21, 2011 by Little Nyssa

[Joanne]

I'm not sure what you mean with regard to the billing issues. In general, though, just because she agrees to "sliding scale" for you, it doesn't mean she should not accept or bill for a professionally acceptable rate if your insurance pays. Is she sliding scale the co-pay?

 

In any case, your list comingles issues you have with HER specifically with some indicating you don't feel the need for counseling at all right now.

 

The lateness/possible slips in professionalism concern me.

[LarlaB]

You can just cancel your next appointment. :) No need to explain unless YOU would like to...

 

Disclaimer: I am not a licensed counselor, although I hold the degree/training. :)

[Cheryl in NM]

I'm not sure what you mean with regard to the billing issues. In general, though, just because she agrees to "sliding scale" for you, it doesn't mean she should not accept or bill for a professionally acceptable rate if your insurance pays. Is she sliding scale the co-pay?

 

In any case, your list comingles issues you have with HER specifically with some indicating you don't feel the need for counseling at all right now.

 

The lateness/possible slips in professionalism concern me.

 

I have a high deductible insurance plan so I have to pay 100% of all medical costs up to $3000 before my insurance starts paying. So when she bills my insurance company they adjust it down to what they allow to be paid for that service, then they attribute that amount to my deductible as if I have paid it. So she billed them $150, insurance discounted it to $70, I paid her $45. Insurance thinks I paid $70 and so $70 counted towards my deductible. I only paid $45 so I "made" $25 on the deal. Not acceptable in my book. I think it might be fraudulent as well and against IRS rules regarding HSA's. But I'm just going to send her the amount the insurance thinks I paid. In my mind billing the insurance company a different amount than charging me is fraudulent and immoral.

[Cheryl in NM]

The lateness and billing questions make me wonder if this is a quality counselor. But that's a separate issue from whether you are done for now because of your own situation being improved.

I would just call and leave a message cancelling the appt and saying you are done with therapy for now but you will call her another time if you want to meet again. You don't have to pay for an appt just to say Bye.

And then watch yourself and don't be reluctant to seek out a different counselor in future if you need it.

I think sometimes people need a several visits to work through saying goodbye, but it sounds like you are pretty much done from what you describe.If you feel like you are spinning your wheels with her.

:001_smile:

ETA i ought to say I am not a therapist, but I am an RN with experince in the mental health field.

 

The lateness and the billing issues have been bothering me as well. That and communicating with clients via text and then not knowing who she is actually "talking" to.

 

You can just cancel your next appointment. :) No need to explain unless YOU would like to...

 

Disclaimer: I am not a licensed counselor, although I hold the degree/training. :)

 

 

I really don't want to but in the past, when I was in counseling in my teens, and I felt I wasn't getting anything from counseling the counselor told me that I needed to keep attending because I was only trying to run away from my problems. I've really had a bad run of counselors before and that has made me unsure of myself. I thought I wasn't getting anything out of it but the "professional" said I was running away so I must not know what's going on in my own mind. I've struggled with that for years. But with this counselor, she just hasn't had anything to offer. I'm just paying her to vent at her. I can do that in a journal.

 

Thanks for the input!

[Joanne]

I have a high deductible insurance plan so I have to pay 100% of all medical costs up to $3000 before my insurance starts paying. So when she bills my insurance company they adjust it down to what they allow to be paid for that service, then they attribute that amount to my deductible as if I have paid it. So she billed them $150, insurance discounted it to $70, I paid her $45. Insurance thinks I paid $70 and so $70 counted towards my deductible. I only paid $45 so I "made" $25 on the deal. Not acceptable in my book. I think it might be fraudulent as well and against IRS rules regarding HSA's. But I'm just going to send her the amount the insurance thinks I paid. In my mind billing the insurance company a different amount than charging me is fraudulent and immoral.

 

So you benefit, and she still gets less than a standard hourly rate. It it is against the law, I am with you. If not, I understand her getting as close to a professional hourly rate as possible.

 

I really don't want to but in the past, when I was in counseling in my teens, and I felt I wasn't getting anything from counseling the counselor told me that I needed to keep attending because I was only trying to run away from my problems. I've really had a bad run of counselors before and that has made me unsure of myself. I thought I wasn't getting anything out of it but the "professional" said I was running away so I must not know what's going on in my own mind. I've struggled with that for years. But with this counselor, she just hasn't had anything to offer. I'm just paying her to vent at her. I can do that in a journal.

 

Edited to add that you are an adult woman, aware of your needs and preferences. I'm sorry you have a history of less than stellar interactions with mental health professionals. But if you feel she is not benefitting you, just stop going.

Edited July 22, 2011 by Joanne

[Tap]

I would probably let her know you would like to take a one month break. Try that first, then if things are stable let her know you are going to try a 2-3mth break, with the idea that if you are still in a good place emotionally, then you may quit.

 

It puts a built in baby step into your treatment plan so you can have a check in in a few months to get a small bit of advice, but also lets her know your intentions.

 

If she says that she feels you need to continue therapy, ask her to consider just going once monthly for the next few months. (I assume you are on a weekly/bi-monthly appt schedule now).

 

There have been times that I have taken a month or so off of dd4s therapy for various reasons. The therapists were always happy to comply and easy to work with when we were ready to return. The one therapist that we 'graduated' out of, was happy that we no longer needed her at the moment, but left the door open for us to return.

[texasmama]

You don't want to continue counseling. That is fine. Your #4 on the list bothers me the most, but truly, the issue is that you have received maximum benefit from this therapist at this time. Just cancel your next appointment unless you feel the need to deliver this news in person. (There is nothing right or wrong about either decision. It is truly a personal one.) Rules of polite society don't apply here. It sounds like you have made a well thought out decision to stop counseling at this time. In the future, if you want to continue with counseling, I would suggest not going back to this particular therapist. (but I think you have already figured that out...)

 

I am a therapist.:001_smile:

[Cheryl in NM]

Thank you all. This is what I already thought, but wanted a reality check.

 

I'm going to call and cancel my next appointment. I went 3 weeks between the last 2 appt. because of the mix up in #4. Dh and I had 2 rough weekends and came through it. I feel I've inadvertently baby-stepped my way out the door anyway. I've been contemplating this since about the 4th visit and I've had 8 visits so I think I've given it plenty of time; I've kept an open mind, but it's time to close this door.

 

I will be looking for another counselor if I need one in future, she really didn't work out. FWIW, I don't think it's her fault; she didn't do anything wrong in therapy. By the time I called the insurance and got the referral I was already taking other steps to help myself. It's amazing what a hormone adjustment and a few good night's sleep in a row can do! :D I think I'd rather just go through life and be able to ignore the fact that my step-son died and my husband is still destroyed over it and then something happens and it jumps up and smacks me in the face. I think that's just grief and the facts of life after losing a child. I imagine this will always happen. I just need to remember that it's a temporary situation when that happens. Until now, I've found that unacceptable.

 

Anyway, thanks so much ladies!

[Cheryl in NM]

No one was at the office during business hours so I left a message canceling my appt.

 

Then I texted the counselor, that is how she's communicated with me in the past, stating my name and that I was canceling my appt and that I was feeling good and would let her know if I needed her.

 

Well, she called back and left a message saying she was glad I was doing good but to call her tonight because she'd like to visit me and get some closure.

 

What is she looking for? I'm debating not calling her back. It seems like a flashback to my past. I can't really quit going, because I don't know what's good for me type of thing.

 

What do you think?

[EKS]

No one was at the office during business hours so I left a message canceling my appt.

 

Then I texted the counselor, that is how she's communicated with me in the past, stating my name and that I was canceling my appt and that I was feeling good and would let her know if I needed her.

 

Well, she called back and left a message saying she was glad I was doing good but to call her tonight because she'd like to visit me and get some closure.

 

What is she looking for? I'm debating not calling her back. It seems like a flashback to my past. I can't really quit going, because I don't know what's good for me type of thing.

 

What do you think?

 

I wouldn't call her back. This is a business relationship. You canceled the appointment, end of story.

[Cheryl in NM]

Thanks, that's what I was thinking. I also wrote the office a letter describing the billing issue and included a check so that my payments to them match what my insurance thinks I paid.

[Jean in Newcastle]

Who needs closure? You don't seem to. And if she needs closure, she can agree to talk to you without billing you!

[texasmama]

Closure is for you, not her. You can feel free to not call her back. If I had a client who was suicidal, I would probably follow up by phone, but clients are free to drop out and never return without giving any explanation. Many, many people do this for many reasons, including the fact that it is hard to say goodbye and easier to just stop coming. However, in your case, it doesn't sound like you need anything further from her so it is just fine to not contact her again. She should let it lie and not continue to contact you.

[Cheryl in NM]

Closure is for you, not her. You can feel free to not call her back. If I had a client who was suicidal, I would probably follow up by phone, but clients are free to drop out and never return without giving any explanation. Many, many people do this for many reasons, including the fact that it is hard to say goodbye and easier to just stop coming. However, in your case, it doesn't sound like you need anything further from her so it is just fine to not contact her again. She should let it lie and not continue to contact you.

 

I'm definitely NOT suicidal and she has no reason to think I might be. I agree about the good bye thing. It's easier to just move on and it's not like we have a long-term relationship. I've only had 8 sessions!

[Cheryl in NM]

Or she can go see her own shrink...;)

 

:lol:

 

Who needs closure? You don't seem to. And if she needs closure, she can agree to talk to you without billing you!

 

She wanted me to call her tonight. So I'm assuming since she wants a phone call after hours that she wouldn't charge me. It never even occurred to me that I would be charged if I called her back! :001_huh:

[gardenmom5]

So, do I go to my next appointment or cancel now? What is more courteous, to cancel my appt. next week or go and explain in person? What is the best way to tell her that I won't be returning?

 

cancel now, and when you cancel merely state you do not wish to reschedule. you do not need to explain anything to her.

[gardenmom5]

:lol:

 

 

 

She wanted me to call her tonight. So I'm assuming since she wants a phone call after hours that she wouldn't charge me. It never even occurred to me that I would be charged if I called her back! :001_huh:

 

If you call, the very first question you should ask is if you're being charged for a phone call. Keep in mind, she wants you to call to 1) determine why you canceld, and 2) probably get you to reschedule.