I don’t accept insurance because of issues surrounding privacy, control and medical diagnosis. Insurance companies limit and monitor the number of sessions a client is able to have, dictate how a therapist is able to work with a client and require a medical diagnosis be made which becomes a permanent part of your medical record. Ethically, I have a hard time diagnosing someone with a mental disorder because most of my clients are not ill and deserving of such a label. Confidentiality is also weakened as they have access to your notes and records upon demand. For those reasons, I have chosen not to accept insurance.