The payment of fees for psychotherapy

Several specific effects of third party payment of fees for psychoanalysis and psychotherapy are demonstrated. Using some of the criteria for listening that have been set out by Langs (1981, 1982), case illustrations from several sources are reviewed and discussed. Some of the examples have been selected from detailed accounts found in the psychotherapeutic literature, which should permit the reader to turn to the original source for verification and review in greater detail. Others have considered the effects of third party payment or reduced fees on the course and outcome of psychoanalysis and psychotherapy (Eissler 1974, Gray 1973, Halpert 1972a, Langs 1979, Lorand and Console 1958). With the exception of Langs, none of these has looked at how the therapist's compensation or activity around the fee payment is represented in the derivative material of the patient. In Langs' assessment of the derivatives in a case where insurance was used, the effects appeared detrimental to the therapeutic course.