Payment can be due the session after the bill, two weeks later or a month later. Sometimes there is an agreement to wait until the patient has collected from insurance. Whatever the arrangements, they need to be clearly agreed upon. Deviations from the agreement then can be focused on in the treatment hours, as they occur. Charging for missed sessions, guidelines for the patient, and interactions between therapist and patient outside the sessions will be discussed in the final three questions.
Some patients enter treatment with some urgency, in some state of crisis or regression.
They are preoccupied with their problems, and want to address them as soon as possible. For these patients, discussion of the above arrangements can be burdensome, seeming like a distraction. For patients in this category, I discuss the arrangements piecemeal, after some of the presenting issues have been addressed, and when the patient is in a calmer state. The patient is then able to approach the arrangements both with more interest and more cooperation. Not long ago, the usual rule regarding missed appointments was for the therapist to charge unless the time was filled.