Why I’m a Private-Pay Therapist
What private-pay therapy means for cost, flexibility, privacy, and access to care
When someone is looking for a therapist, one of the first questions is often, “Do you take my insurance?”
That makes sense. Therapy is an investment, and cost matters.
At Rooted Counseling & Wellness, we are a private-pay practice. That means we are not contracted as in-network providers with insurance companies. But private pay is not about believing therapy should only be available to people who can afford full-fee care. In fact, I believe therapy should be accessible to as many people as possible.
For me, private pay is about creating more flexibility in how therapy is provided while also building in options for clients who may need financial support or want to use out-of-network insurance benefits.
Therapy Should Be Built Around the Person, Not Just the Diagnosis
When insurance is used for therapy, the insurance company typically requires a mental health diagnosis and documentation showing that treatment is medically necessary. That does not mean insurance-based therapy is bad or less effective. For many people, using insurance is what makes therapy financially possible.
But not everyone comes to therapy because they meet criteria for a specific diagnosis.
You may want support because you are repeating the same relationship patterns, struggling with perfectionism, grieving a loss, questioning your sense of self, feeling disconnected from your body, or realizing that experiences from childhood are still shaping how you respond today.
Private-pay therapy gives us more freedom to focus on what is actually bringing you into the room rather than organizing treatment primarily around what an insurance company requires for reimbursement.
More Flexibility in How We Do Therapy
Traditional weekly therapy is helpful for many people, but it is not the only way therapy can be structured. Private pay gives us more flexibility to determine together what format makes the most sense for your goals. That may include weekly therapy, extended sessions, Brainspotting, somatic therapy, or more immersive Brainspotting intensive work.
For some clients, having more time in a session allows us to move beyond checking in about the week and spend meaningful time processing what is happening beneath the surface. For others, consistent weekly therapy provides the safety and continuity needed for deeper trauma work.
The important part is that the structure of therapy can be based on your needs and our clinical work together rather than on what fits most neatly into an insurance billing model.
More Choice in Who You Work With
Finding the right therapist matters.
You may be looking for someone who specializes in complex trauma, attachment wounds, Brainspotting, somatic therapy, grief, or chronic patterns of people-pleasing and perfectionism. You may also care about a therapist’s personality, approach, training, or simply whether you feel comfortable with them.
Using insurance can sometimes narrow the search to clinicians who participate in a particular network. Private pay allows you to choose a therapist based more heavily on fit and specialization. It can also create more continuity. If your employer changes insurance companies or your benefits change, your therapeutic relationship does not automatically depend on whether your therapist participates in the new network.
A Little More Privacy
For some clients, privacy is an important part of choosing private-pay therapy. When you are fully self-pay, your therapy is kept separate from insurance claims and employer-sponsored benefits. That added separation can feel especially important for people in professions where mental health care may feel sensitive or highly personal.
This may include first responders, law enforcement professionals, healthcare workers, military personnel, executives, or others in high-responsibility or safety-sensitive roles who simply prefer more discretion around seeking therapy.
Private pay can offer an additional layer of privacy and autonomy by allowing you to receive care without involving an insurance company in the reimbursement process.
But What About the Cost?
This is an important part of the conversation. Private-pay therapy is not financially accessible to everyone, and I do not want to pretend otherwise. I believe quality mental health care should be available to people regardless of insurance status, income, or barriers they have experienced in accessing care.
That is why Rooted Counseling & Wellness offers a limited number of reduced-rate therapy spaces for clients who are uninsured, underinsured, or who face systemic barriers to receiving mental health care.
These spaces are limited because we also have to maintain a sustainable practice, but offering them is one way we work to make care more accessible. We also accept HSA and FSA funds, and clients can use CareCredit when appropriate.
Using Out-of-Network Insurance Benefits
Being private pay does not necessarily mean you cannot use insurance at all. Rooted Counseling & Wellness partners with Thrizer to help clients who have out-of-network mental health benefits use those benefits more easily.
Depending on your insurance plan, out-of-network benefits may reimburse a portion of your therapy costs after you meet your deductible. Thrizer can help you check your benefits, submit claims, and track reimbursement.
Insurance plans vary, so reimbursement is never guaranteed. However, this option can make private-pay therapy more manageable for clients whose plans include meaningful out-of-network coverage. For some clients, this provides a middle ground: the flexibility of working with an out-of-network therapist while still receiving some financial support from their insurance plan.
Therapy Should Still Feel Accessible
At Rooted Counseling & Wellness, we want therapy to feel personal, thoughtful, and responsive to the person sitting in front of us. That includes being transparent about cost.
If you are considering therapy but are unsure whether private pay is realistic for you, we can talk through available reduced-rate options, out-of-network benefits, and the different ways therapy can be structured.
The right therapy should not simply fit a billing system. It should fit the person receiving it.