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Considering Fees in Psychodynamic Psychotherapy: Opportunities for Residents

Dr. Newman is with the Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan. Address correspondence to Dr. Newman, Department of Psychiatry, University of Michigan Health System, 1500 E. Medical Center Dr., Ann Arbor, MI 48109-0118; stewartn{at}umich.edu (E-mail).

OBJECTIVE: The topic of money is ubiquitous to psychodynamic therapy work, yet often neglected in residency training programs. Residency allows a unique opportunity to address issues pertaining to money and their impact on therapy. METHOD: Through the experience of the author, the need for a more explicit and systematic consideration within residency training of financial issues is explored. Perspectives from the relevant literature, therapeutic principles, and their impact on resident training are discussed for several topics. These topics include the difficulties encountered in discussing fees, the negotiation of fees, impact on the stability of the frame, expectations of patients and residents, payment of fees, and handling missed appointments. The applicability of these skills to other venues of practice is highlighted. CONCLUSIONS: By addressing the topic of money and fees in residency training, a richer educational experience can be realized.

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