chapter  Chapter Eleven
The first session and fees
WithRobert Langs
Pages 15

The ground rules related to the fees for psychotherapy are, in principle, stated in the first session. This chapter discusses the initial contact before turning to the ever problematic area of managing the fees for psychotherapy. The therapist’s handling of the first telephone call and the consultation session sets the tone for the entire psychotherapy. Managing the fee of a psychotherapy is a difficult responsibility for the private psychotherapist and a source of endless problems for clinic therapists and their patients. In the private therapy situation, the very fact that a therapist is dependent on the patient for part of his or her income is a burdensome reality for both parties to treatment. Managing the relatively fixed frame is part of the real and substantial context and holding environment of a patient’s psychotherapy. Frame modifications beget frame modifications; frame breaking soon becomes the preferred mode of adaptation.