Dear Therapist:

A year ago, my 20-year-old daughter told me she wants to speak to psychologist because she’s feeling anxiety. She insisted on speaking only to the top and most expensive ones....We don’t have an extra dollar but I don’t let money get in the way of necessities and over the past year and a half shelled out over 10 grand. My daughter never had any trauma and she doesn’t discuss her problems with me. The psychologist told me she has low self-esteem which causes her distress. The thing is that I didn’t notice any changes for the better since she started and I don’t even know if she appreciates my sacrifice as she is always asking me for more money to spend with her friends. My question is do you think that it would be beneficial if I ask my daughter to start helping pay for her sessions? She does have some of her own money. Would that help her take responsibility for herself? I don’t want her to feel like I’m not there for her but it could help her grab control over her life instead of staying in her misery comfort zone. Thank you.



I certainly understand your daughter’s desire to see someone whom she views as a top therapist. Anxiety is disconcerting at the very least, and it can be debilitating. She probably felt that in order to appropriately deal with her issues, she needed to be sure that she would be treated by the person who could best help her. It seems that you agreed at the time.

Your daughter’s decision may have been an easy one for her. Her primary (and perhaps only) concern was her need for relief from anxiety. It seems like concern over the financial cost and the sense of responsibility that accompanies this concern were largely ignored. If she was required to pay, would she have researched various therapists, weighing reputation, experience and other factors against the cost?

As parents, our job is to help our children achieve success in the best way possible. Mental health care can be one of the tools that we use to help our children reach the happiness that they deserve. However, there are usually other goals that we need to bear in mind when tending to our children’s needs. In each circumstance, we need to identify the specific, pressing need. We also, however, should try and maintain focus on other general goals, and on the ways in which we can help our kids to achieve them.

In order for children to become happy, healthy, independent adults, they need to learn how to become responsible for their actions and decisions. Although we may want to do everything for our kids, from a broader perspective this can hamper their ability to become independent. In addition to the obvious practical consequences, this can add to feelings of low self-esteem. When someone feels little or no sense of control over their life, this can lead to feelings of low self-worth.

I cannot tell you what it is that your daughter most needs. You mentioned that you want her to help take responsibility for herself, and that you want her to take control of her life. Since I do not know your daughter, I don’t know whether having her chip in for therapy costs will help her feel more responsible and in control.

There are many factors involved. Generally speaking, there are a few reasons that paying for one’s own therapy can be beneficial. As discussed, it can help the person to feel more responsible and in control. It can also help them to make better choices with regard to seeing the appropriate therapist, rather than simply seeing the most expensive one.

Within the therapy process, someone paying their own way might be more likely to be concise and focused on their specific goals. This, in turn, can help them to achieve their goals more quickly, rather than remaining in therapy longer than necessary. Of course a therapist should focus on helping their clients to achieve their stated goals. However, what is sometimes left unstated is the goal of no longer needing therapy to deal with issues.

There are people who become habitual therapy clients. Sometimes it is the relationship between the therapist and the client that steers them in this direction. People can develop a pattern in which the only way that they know how to deal with emotional distress is to schedule an appointment. Although this may help them with the immediate problem, it ignores the larger issue.

Your decision with regard to having your daughter pay toward her therapy should be based on your understanding of what she needs, and on what it is that you want her to learn about life. Often the easier decision is to simply fix the current problem. (If you had all the money in the world, would you be more likely to simply continue paying for your daughter’s therapy?) However, the easier decision is not always the best one. The best decision is the one that takes everything into account, and that recognizes both the immediate issue and far-reaching effects.

-Yehuda Lieberman, LCSW

  psychotherapist in private practice

 Brooklyn, NY   |   Far Rockaway, NY

 author of Self-Esteem: A Primer / 718-258-5317