When Therapy, Insurance, and the Workplace Collide

Because I’m a therapist in my own profession, I get to learn lots of interesting things about other lines of work, jobs, and careers through my clients. (For anyone who thinks that therapy is a one-way relationship, this is a case-in-point to the contrary!) The stresses of sales goals, the effect of long-term irritation (or attraction to…) coworkers and bosses, and also the particulars of a whole variety of jobs. One thing I don’t often hear about though, but that must be an issue for all of my clients, is what it’s like as an employee to start therapy on a company medical plan.

More Than Water Cooler Chat

From a friend of a friend, I heard that it’s not totally uncommon for information that’s interesting, or salacious, in people’s insurance records to get shared in offices. Now, I’ll preface this by saying that I have no idea how common it really is, or exactly what kind of information might get passed around. And not to mention, whenever it does happen, it’s completely unethical! But those considerations aside, it occurred to me that it could be pretty difficult to disguise a weekly therapy appointment from a boss or a small office of colleagues. After all, for most people, the appointment is at the same time each week, so you’d have to tell your boss you have some kind of appointment. And if you’re vague about it, and you work in the kind of place where HR isn’t exactly hermetically sealed from management, your boss or your coworkers may not have a hard time finding out exactly what your appointment is for.

Therapy: Your Dirty Little Secret

Of course no one should feel shame or embarrassment about working with a therapist, but it’s widely acknowledged, both anecdotally and statistically, that social stigmas associated with therapy are one of main explanations for why people delay seeking treatment. Those stigmas aren’t just beliefs that patients have, but indeed, are ways that they’re treated by their associates (friends, family, anyone!) who might know they’re seeking treatment.

Now, imagine that you’re struggling with depression. Suddenly, you face not only the difficult decision to seek help, but also the anxiety that a coworker or boss might find out and ‘think things’ (because that’s what a stigma is!) about you, or face the uncertainty that this might change how they perceive you. It’s so easy to imagine someone waiting even longer to seek help, and I can’t tell you how many traumas could’ve been eliminated, how much less pain my own clients might’ve experienced, if they would’ve sought help sooner.

Ways to Support Therapy in the Workplace

It should go without saying that we’ll all be luckier once the stigmas associated with therapy are weakened and disappear, and we can ‘normalize’ talk therapy the same way we’ve normalized physical therapy. But until then, we have to consider how to address these stigmas in ways that will allow people who need help to get it. So, if you’re in HR, or even a manager, you should be extra diligent in observing your ethical responsibilities with respect to your employees medical information. And if you do happen to learn that an employee has a regular therapy appointment, do you best to treat it like you would any other outside-of-work obligation. Tempting as it can be, don’t try to ‘offer a shoulder’ or let him or her know you’re there to talk—even if you’re friends! It’s difficult enough for many people to make the decision to seek out therapy, and many of the emotions we experience in therapy are new and uncertain. The last thing anyone wants, at least at first, is to feel forced to share those experiences, even when the offer is well-intentioned.

For therapists, I’m trying something in my own practice that works not only for workplace issues, but solves several insurance problems in one go. I made the decision to stop taking client insurance and allow clients to file reimbursement claims with their carrier. Clients can decide how they want to disclose medical information to their insurers, and when necessary, I work with clients to help assign them the most appropriate diagnostic codes to their situation. For clients who use workplace insurance, evening or even weekend sessions (if possible) may be an option for keeping out nosey colleagues.

I’ll be spending the next few posts writing about therapy and therapy-related issues in the workplace. If you have questions, comments, or topic suggestions, I’d love to hear what you have to say.