Yes. Many clients opt to pay for therapy privately, or “out of pocket,” rather than using any insurance benefits. There are several reasons why this can be a good idea. 1. Declining a diagnosis. Because using insurance benefits means meeting criteria for ‘medical necessity,’ therapists are required to provide a mental illness diagnosis for you and share it with your insurance company. This diagnosis can stay in your files and impact you throughout your life. Privately paying for therapy means skipping the pathological approach to your care and making diagnosis an optional treatment aid rather than a necessary fact. (Note: This is especially critical for couples therapy, for which insurance companies dictate that a single person in the couple is designated the “identified patient” with a diagnosable problem. Our therapists don’t work in that model of pointing fingers at one problematic partner; instead, the couple as a unit is seen as the client. Insurance rarely covers couples therapy.) 2. Protecting your privacy. Clients are often concerned about the level of privacy they can maintain over their information once it’s shared with a large managed care company. Maintaining a higher level of confidentiality and security around personal information is a common reason clients opt not to use their insurance benefits for therapy. 3. Maintaining your autonomy. Paying privately for therapy increases autonomy and choice by removing all requirements and limits related to therapy length, type, treatment, and approaches. For example, using insurance means the insurance company dictates how long you and your therapist can meet, both in terms of session length and the number of sessions you’re able to have. Out-of-pocket payment ensures you are in the driver’s seat of your own care. It also allows you to keep your therapist even if you happen to change jobs or insurance providers. 4. Focusing on therapy. Finally, privately paying for therapy allows therapists to dedicate more time to preparing for a client’s sessions, rather than using that time for administration and negotiation with the insurance company. This time is most often used to review notes related to your care, engage in consultation or clinical supervision, attend workshops, or read relevant books. The ultimate result is more focused and personalized therapy sessions that are better suited to your needs.   There are many reasons why clients prefer private pay therapy. If you’re curious about paying out of pocket, we encourage you to speak with your therapist about your options during your introductory phone consultation and see if this might be a good fit for you.