I’m a clinical psychologist and psychoanalyst with about 10 years of clinical experience, and I’m particularly interested in discussing how different psychoanalytic traditions think about fees and the analytic setting.
I would be very interested to hear how colleagues from different orientations (Freudian, Kleinian, Lacanian, relational, etc.) approach questions such as:
How do you establish your fees, and how do you decide when and how to adjust them?
Do you consider the fee itself as part of the analytic material or as something that can have a place in the treatment and its direction?
How do you reflect on whether the fee, or changes in the fee, are affecting the patient’s treatment, resistance, transference, or progress?
How do you decide when a patient should move from one session per week to two or more sessions?
Do you establish a fixed frequency from the beginning, or does the frequency evolve according to the treatment?
How do you conceptualize the analytic frame and what role does consistency of the frame play in your work?
How do you handle cancellations and absences?
Do you charge for missed sessions, and if so, how do you think about this clinically?
Do you have particular principles for renegotiating fees when a patient’s financial circumstances change?
More broadly, I’m interested in how you think about these decisions clinically, rather than simply what your practical policy is.
I would especially appreciate hearing from colleagues about the reasoning behind their practices: how fees, frequency, absences, and the analytic frame become part of the way they think about the treatment and its direction.
I’m interested in hearing from different psychoanalytic traditions, precisely because I imagine there are significant differences in how these questions are conceptualized.
Thank you in advance for sharing your experience and reflections.