If cost is not an issue a person may choose the professional they believe will be most effective in treating them and agree to self-pay and not submit for insurance reimbursement. I have found that there are many agencies across the country that provide excellent services to people coping with depression as it relates to chronic illness. These agencies are usually a mixture of private and public funding and have a sliding-fee scale. That is, the amount the patient pays is based upon income and is not a flat fee. Even individuals in private practice may be willing to consider a fee lower than their established rate, but you will not know unless you ask.
Similar resources exist in other countries.
Dan Kavanaugh, LCSW-C, BCD, is a clinical social worker at the National Institutes of Health Clinical Center, Bethesda, Maryland. Return to index for this issue. Go to the table of contents for this issue.