Therapy is expensive and it takes up a valuable hour in a week. The desire for therapy always needs to be greater than its cost in order for it to feel worth it for the person footing the bill. This tension can be harnessed and used in therapy itself. In most cases, the person footing the bill is the client themselves. But, with young adults, the question of who pays can greatly impact the treatment.
Many young adults, who are in school or just starting out in their careers, have someone else foot the bill for therapy. This is incredibly useful because it allows the young adult client to get high-quality therapy without worrying about the financial stressor and logistics of trying to get help.
However, the one downside of this set-up is that it eliminates the aforementioned relationship between cost and need. This tension between cost and want actually serves the therapy and ensures that people, who are engaged in treatment, are invested and truly want to be there. This is a motivating factor for the client to tackle some harder material in therapy and really make the most of their therapy time.
Being the payee also empowers clients to be very much a consumer. They are more likely to shop around to find what they deem to be “good therapy.” Additionally, they will be focused on what they are getting out of the treatment to ensure that they are getting their money’s worth.
For many conscientious young adults who want of help, this financial motivation may not matter. Their drive to do hard, emotional work is still high and, in fact, having family or a caregiver pay for treatment often helps them to feel cared for by the adults in their life.
For other young adults, though, it is worth considering having them pay for part of the treatment in order to instill that healthy tension. If the young adult pays for part of their therapy, it can help them feel more ownership over their treatment as if it is truly theirs. Furthermore, it is important for young adults to be aware of how much therapy costs and how to budget for even a nominal contribution to their treatment. This will serve as preparation for their increased autonomy as they get further and further into adulthood.
It is solely the therapist’s responsibility to make recommendations of what they believe to be best for the treatment itself. If the therapy with a young adult feels stuck or stagnant or if there are many cancellations, a broader discussion about what is happening in the treatment is needed. Yet how the payment and fee is set up is often left out of this discussion.
Many families see the “who pays” conversation as something that will be decided privately amongst themselves. Furthermore, many people find talking about money uncomfortable, which can add to the avoidance of the topic. Having the therapist facilitate this conversation can bring this material to the surface and can model a positive relationship to money for the young adult. The financial agreement of treatment is just one of the many factors that is absolutely always up for inquiry and reassessment in therapy. Revisiting who is paying for the treatment can and should be a part of that conversation.