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WHY: Cash Only

For both of us at Cascadia Family Therapy, 2017 is about making our practice and philosophy known. This is the first of many blogs, and in the future videos, about what we do and more importantly, why we do what we do.

You may have already read our webpage about why we are a cash only practice. On that page we list some consumer benefits of paying cash for psychotherapy like confidentiality and mental illness diagnosis.

Many health insurance plans do not pay for family sessions or couples therapy sessions. The way the system frequently operates is that one person in the family or couple gets diagnosed with a mental illness from the Diagnostic and Statistical Manual for Mental Disorders (or DSM) and then sessions are billed to their insurance through that information. (I could go on at great length about the faults of the DSM, how it was created, and it’s bias but I think I will save that for a future blog post….)

We believe that the act of diagnosing someone with a mental illness shapes the therapy process even if it is “just for billing purposes.” We believe in our client’s innate strengths that they bring to therapy with them. We actively choose to not see our clients, even just for billing, as having mental illnesses. Instead, we see our clients as strong capable people that are caught in strong patterns of interaction, behavior, or relationship dynamics. We simply offer another perspective, the tools needed, and the direction to help our clients break the patterns that are negatively impacting their life.

Family and couples therapy is a lost art and more work for the therapist. If you were to look at psychotherapy on a timeline; we have moved from the extreme individual perspective from the Freudian days, to a more family centered approach, back to the individual perspective over the past 100 years. Family and couples therapy often gets picked on in the media and misrepresented in movies and TV shows (except Hope Springs… but who’s counting 🙂 )

Family and couples therapy offers the power of multiple perspectives to approach problems, break patterns, and find solutions. More people in the therapy room equals more information for the therapist about the key components and potential benefit or function of a pattern.

For example:

A teenager is brought into therapy for smoking weed. His parents, understandably so, are worried about him and just want him to stop. After a few family sessions, the therapist can clearly see that the parents argue frequently in front of the teen. The therapist starts to identify a family pattern that has developed. When the teen smokes weed he gets a break or to check out from the stress at home. When he gets into trouble for smoking weed, his parents come into agreement and are able to work together for the goal of getting the teen to stop smoking weed. A marriage and family therapist could highlight this pattern for the family and identify the ways in which everyone is participating in the pattern. When each family member sees the way they participate it opens the door to new ways of interacting. Therapy then could move toward  just the couple to restore the parents relationship so that the teen would not feel the same need to smoke weed to check out from the arguing at home which would stop the pattern of getting caught and bringing his parents together.

That is a super simplistic example, but it highlights the way in which all family members regardless of age participate in family patterns.

It can be hard to face how you contribute to a pattern that hurts others or is destructive, but once you know, it makes it clear how to change. In society today, we are quick to label people with mental illnesses which can absolve people from the consequence of their actions and mask the behaviors or interactions contributing to the problem which disempowers people from taking action.

These hard to face truths are what empower people to make necessary change and have the life they have always wanted. We believe in those moments so much we have built our practice around them. And those moments are why we take cash only.

And in case anyone is wondering… we live our lives around these philosophies too so we are a cash operated business. Cascadia Family Therapy has not and will not take out business loans.


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