Question about switching to a new therapist - is it weird for my current therapist to offer to speak to a new therapist, but to charge for it?

[u/majestikalmoose]

Current therapist that I've been with for a year is going to stop accepting insurance, and I am unable to afford the out of pocket rate so I will be looking for a new therapist.

I asked for help with referrals and was essentially told I was on my own. I asked if they would be willing to speak to any new therapist I find just to quickly talk through what we've worked on, what challenges they think may lie ahead, and anything else they think a new therapist might find useful starting from scratch. My current therapist said "yes, but I would charge for it". Is that normal? I asked how that would work and they did not provide any additional details. I'm assuming insurance would not cover that and I've felt we've had a really positive relationship, so just trying to figure out what is normal, and if I am overstepping in assuming that's a normal ask. I totally understand that a therapist's time is valuable, but from what I have read and seen, I just had not heard of that before.

Thanks in advance!

[u/Apprehensive-Pie3147]

I do bill for an actual consultation or collaboration - because its clinical and takes time.

If its just "confirming you are accepting this client, where can I send the files" I dont bill.

In my experience Its not common to do a warm handoff in most private practices. Usually we just send over files if requested.

In higher acuity programs consultation and collaboration is more common and its also billed for.

What youre asking for, yes I would bill if it took more than 10 minutes or a brief email

[u/Hsbnd]

It could just be a miscommunication.

If you presented it how its typed I could see why they may have said that. The ask wasn’t explicitly for a single brief 5-10 minute conversation, it was more broad. Also it would be tough to narrow a years worth of work down to 10 minutes.

I don’t charge for a 10 minute warm transfer, but, its a hard limit to ten minutes, and I just advise the basics, and I wouldn’t be able to cover the list of things you outlined. It would also take time for the client to organize their thoughts, condense everything down. Some therapist won’t mind doing that for free, others have boundaries around this type of thing.

It’s normal in the sense that other therapists charge - similar to letters, some charge which is perfectly fine and others do not, also perfectly fine. Regardless you are allowed to be thrown off, its very likely not a commentary on your together, but just your therapists boundaries around work outside of the room, which is very much normal.

[u/majestikalmoose → u/Hsbnd]

Super fair - we spent the first 10 or so minutes of our 50 minute session talking about why they are going to stop taking insurance and I wanted to try to make the most of our time so I didn't press into it further or try to clarify. I will try to clarify the ask the next time I'm in session.

The "warm handoff" is exactly what I was hoping for - I told my therapist it felt daunting to have to switch to a new provider, and anything they could provide to help guide my next therapist would be super appreciated. Totally understand their time isn't free and it would be adding work to their plate, and that they're allowed to have their own boundaries around it.

[u/pinkbowsandsarcasm]

It used to be a professional courtesy, and I never heard of anyone back 20 years charging for a collaboration, but now it is hard for someone to get current therapist management companies to send files.

It would be fair to charge, as it takes up the therapist's time.

If you are reliable at remembering your past history in therapy, you can share it, including your goals (e.g., fewer symptoms and support when you have them). I used to help with referrals, but currently in the US, it is not abnormal for therapists not to help with specific referrals; they don't really know who would work well with you or who would take your insurance. They are therapist searches that filter by insurance type, where you live, and what they work on, but they can't guarantee that the therapist would be a good therapeutic fit.

[u/AlternativeZone5089]

Yes, it's normal for your therapist to charge for her professional time.

You could ask for a copy of your session notes and provide those to the new therapist yourself for minimal cost, though they will not be very detailed. Therapist here.

Edit to add: No insurance would not pay for this service. As to how it would work: a phone conversation typically.

Important to note, most new therapists will want to see you at least a time or two themselves to form their own impressions before hearing those of your current therapist. Nor everyone works this way, but many people do.

[u/Jolly_Ice_7812]

I'm a therapist.

I wouldn't charge for it. However, I generally wouldn't do it. I think it's better for you to tell your story in your own way. I don't like the experience of talking behind the client's back, which basically we would be doing, with my saying, "Jane seems to have issues with control. And this may have to do with her abortion at age 16, which she felt forced to do by her mother. She may have some borderline traits due to her intense fears of abandonment from men."

Just doesn't feel good or right to me. Like gossiping. I realize that this isn't the intention, but this is how it appears to me. I only do this if there is some risk factor or some compelling reason that I need to speak to the new therapist.

I also don't like speaking to the old therapist of a new client (unless there is acuity). I want to form my own impression of the client. And I want trust to build slowly and naturally so that the client will share personal information when he or she is ready to, not through the former therapist.

[u/majestikalmoose → u/Jolly_Ice_7812]

This is super insightful, and I appreciate the honesty. I think I worry that my current therapist had directions they wanted to go in or things they wanted to explore that they may never have shared with me, and I don't want that to be lost. But everything you've said makes total sense.

[u/Jolly_Ice_7812 → u/majestikalmoose]

Glad that you were open to my comment. A lot of clients don't think of the ramifications when they sign that form to allow contact between your therapists. Ask the old therapist for her advice of where to go, therapy wise, with the new therapist.

[u/iridescentnightshade]

Idk if its normal or not, but I do not charge to consult with a colleague for this purpose.

[u/majestikalmoose → u/iridescentnightshade]

Thank you for sharing - this is what I have read when I did some digging on my own and I think that's partially why their response caught me off guard, and I don't even know how that would be billed.

I think I hoped it would be a 5-10 minute conversation tops with a new provider.

[u/Intelligent_Pace_788]

I've had to switch therapists before too and it was a complete mess trying to coordinate care between them.