My therapist can be a fraudster.

Dear forum members.

Please excuse my bad english - I live in Russia, but strongly need your advice. Russia is backward country, really is, so I can’t find answer on my question here.

I get psychotherapy from licensed specialist (diploma from a small univercity) with short work experience (2 years) who work in Psychodynamic psychotherapy.

She tells me that I must constantly increase the price for my consultations. With no upper limit. She says that it is a part of treatment. As she say price adds value to the treatment process, so it became more effective and I will recover quickly. She acknowledge that it is beneficial to her, but strongly insists that I need this in the first place. If I don’t want to pay more she tells that it is a "resistance" and I’m "resisting my success". Price always must be high for me and I must earn more to be able to raise the price.

With every new client she chooses price individually - it may be low at first, but will increase afterwards.

I’m a patient, vulnerable in many sides. And she puts me in the situation where I must raise the price (with no changes in treatment plan or her qualification). It seems like a manipulation to me. I think that my benefit from it will be much less than my loss of money (I have low income now and need money for food, clothes etc. - really basic needs).
I can see results after 3 months of a therapy, I’m feeling better, so I don’t know what to do!

Whether this method is acceptable? Is it ethical to do so? Or maybe it is a sort of fraud?
Dear forum members, please tell me your opinion on this situation.

I will really appreciate your help!

Hi,

It is slightly difficult to comment on this as I don't know how the healthcare system in Russia works and the healthcare system in a country usually has an impact on how pricing structures work.

I wouldn't however think it would be typical to raise the price for a patient without it being uniformly applied across all of her patients. This seems suspicious to me that she wants you to pay more as you go through treatment.

In my country, we have a gap payment and the rest of the fee is paid by medical benefits. Some therapists set a sliding scale on their gap payments, so if you are poor you might pay less but this would be negotiated at the beginning of treatment and remain the same for the duration of treatment barring perhaps the cost of inflation, which is not very much, or maybe if you suddenly get an high-paying job and no longer need the negotiated discount. But other therapists might just get all of their patients to pay the same gap fee and this fee would not go up other than small amount for inflation, but often this small inflation price is absorbed into the amount paid by medical benefits.

What you might find it worth doing is to call a few other therapists and ask how much they charge. Then you will get a more typical idea of what is normal practise in your country and be able to better tell if your therapist is behaving in line with industry standards or not.

Personally I'd expect there to be a set price and the price to stay at that price. If you start out with a discount maybe you'd pay more when your financial situation improves but I would have expected this to be agreed upon before you start treatment, not for her to be randomly deciding to increase the price arbitrarily as you go along.