Why I Don’t Take Insurance or Offer Free Consult Calls (And Why That’s Better for YOU!)
If you've looked into working with me, you may have noticed two things: I don't accept insurance, and I don't offer free consultation calls. I know that can feel like an extra hurdle when you're already working up the courage to reach out for support. So I want to take a moment to explain why… not as a policy, but as a genuine reflection of what I believe helps you heal.
Why I No Longer Accept Insurance
A mutual investment in the therapeutic process right from the start benefits both parties and sets the stage for the therapeutic relationship.
I talk about this more at length here, but it’s SO much better for clients to pay out of pocket for mental health treatment. Oh the horror stories I could share from my own limited time accepting insurance, from my colleagues’ who are still in network with insurance, and from my experiences as a patient trying to use her own insurance benefits. Our insurance system is not a system that actually benefits patients or providers.
By not accepting insurance…
Your privacy comes first. To bill insurance, I'd be required to assign you a formal mental health diagnosis and document the details of our sessions in a way that becomes part of your permanent medical record - accessible to insurers and shared across systems neither of us controls. So much of the work I do touches on tender, private territory: intimacy, trauma, sexual health, the body. You deserve a space where that stays fully yours.
You get care shaped around you, not a policy. Insurance companies decide how many sessions you're "allowed," which approaches are covered, and whether your experience even qualifies as medically necessary. I never want a claims adjuster who has never met you making decisions about your healing. Working outside insurance means every choice we make together is based on what's actually helping you - nothing else.
You're never reduced to a diagnosis code. So many of the people I work with aren't in crisis and don't fit neatly into a diagnostic box; they're carrying something real and human that doesn't reduce to a billing category. I'd rather see and treat the whole person in front of me than the label insurance requires me to give you, and I’d rather protect your future from any stigmatized or systemic impact of having a mental health diagnosis on your permanent record. The impact of having a mental health diagnosis goes beyond whether or not insurance pays for that therapy hour. Even having a diagnosis of “generalized anxiety” can impact whether or not you’re approved for life insurance down the road. Furthermore, many of the clients I work with have treatable diagnoses. Which means, even if you do meet criteria for a formal diagnosis when we start working together, you might not still meet that criteria by the time we’re done. But does that diagnosis get wiped from your permanent medical record? Nope. And that’s messed up.
Our time together fits your needs, not a clock. Insurance reimbursement is built around a rigid 45- to 50-minute session. Some of the work we do deserves more room to breathe. Working outside of insurance limitations means I can give you the time your therapy goals actually call for, both inside of our scheduled appointment time and out. Instead of spending my time outside of our therapy sessions fighting with insurance to get them to cover treatment and chasing down payments, I’m able to spend that time collaborating with your other providers, consulting with experts on your care, reviewing your assessments, treatment planning, responding to your messages outside of session. That means a better patient experience and outcomes for you.
It lets me build a sustainable practice, which means better care for you. Insurance reimbursement rates are set by insurers, not by the actual cost or complexity of specialized care, and they're often held artificially low. Practices that rely on them are frequently forced to overbook, shorten sessions, or burn out trying to make the math work. By stepping outside that system, I can keep my caseload small and sustainable, stay well-rested and fully present, invest in ongoing training in specialized areas, and be here for the long run for all of my clients. A sustainable practice isn't just for my benefit. It's what lets me show up as the best possible therapist I can be, which means you get the best possible care from me.
Why I No Longer Offer Free Consultation Calls
Somewhere along the way, both clients and therapists came to expect the offer of “free good-fit calls.” Why is that? That’s not a service or marketing strategy used by any other healthcare provider that I’m aware of.
A real first session tells us so much more than a phone call ever could. Fifteen minutes of small talk doesn't give either of us a true sense of what it's like to work together. An actual first session, with real time, depth, and structure, is a far more honest way for us both to feel out whether this is a good fit. A real first session tells us so much more than a phone call ever could. And truth be told, it can take several sessions to get through the initial phase of therapy - building trust and rapport and feeling comfortable to work with your therapist.
Therapy is an ongoing relationship, with both parties evaluating “the fit” along the way. When I’ve been a client seeking a therapist, I never liked having to condense my story into a few minutes of time and hope that the therapist can make a quick decision about if she can help me. In reality, the therapeutic relationship requires ongoing “fit checks” from both parties. You should continue to assess whether you feel your therapist is a good fit and you’re making the progress you’d hoped for. Likewise, good therapists continually assess whether or not we’re clinically, legally, and ethically able to meet your needs, or if you need new, or different, support along the way. Something new may come up in your life that’s outside our scope of practice or area of expertise. You may need a different level of care than what we provide. Evaluating the therapeutic relationship is ongoing, not done in 15 minutes of small talk before any of the real work begins.
Investing in yourself is part of what makes this work. There's something powerful that happens when you pay for your own care from the very first moment: it signals, to yourself as much as to me, that this matters and that you're truly showing up for it. When clients have a financial stake in the therapy process, they tend to engage more fully, follow through more consistently, and get more out of the work. A free call, by contrast, can quietly set the tone that this is optional, low-stakes, or something to sample before committing. I'd rather we begin the way we mean to continue: with both of us fully invested.
It protects the quality of what I can offer you. If I gave away free time to every person who reached out, I'd need to see far more people to sustain my practice, which would mean less time, energy, and attention for the clients I do see, including you. Charging for our first session, just like every session after it, means you get my full presence and preparation from the very beginning, not a rushed or sales-oriented version of me.
It sets a foundation of mutual respect. Therapy works best as a partnership, each showing up fully, not as something one person sells and the other tries out for free. Starting that way, from session one, tends to carry through the whole relationship.
You still get everything you need to decide. I value transparency, and my website reflects that by sharing my approach, rates, and areas of focus in detail. I'm glad to answer brief, specific questions by email before you schedule. You should feel confident and informed going into working with any therapist, but you don’t necessarily need a free trial run to get there.
The Heart of It
None of this is about making care harder to reach. It's about protecting what matters most: your privacy, your investment in your own healing, and the sustainability of a practice that can actually be here for you - not just today, but for as long as you need it. When you book that first session, you're not testing the waters. You're beginning the real work, with someone who is just as invested in it as you are.
If that resonates with you, I'd love to discuss how we might work together.
