Private pay therapy: what do I get when I opt out of insurance?

In a world where therapy is often tangled in bureaucracy (in-network, out of network, superbills, etc.), many people are starting to ask: What do I actually get when I pay for therapy out-of-pocket? It’s a valid question—and an important one. Choosing private-pay therapy means you’re not just paying for time on the calendar. You’re investing in care that’s spacious, ethical, and deeply personalized. And it can be the right choice for some people! Let’s explore whether it might work for you.

Here’s what opting out of insurance can offer:

Privacy Without Compromise

When you work with a therapist outside of the insurance system, your mental health records stay between the two of you. (Unless they’re subpoenaed, but that’s a different concern.) Insurance companies require a diagnosis, treatment plan, and access to notes in order to approve or reimburse services. Sometimes they still don’t approve services! This can feel like an uncomfortable intrusion—especially if the issue bringing them to therapy isn’t easily captured by a diagnostic label. Private-pay therapy allows you to keep your healing process confidential and free from unnecessary oversight.

No Diagnosis Required

Not everyone who seeks therapy fits neatly into a DSM category—and that’s okay. First of all, the DSM was created by the healthcare industrial complex. But beyond that, many clients come to therapy because they feel overwhelmed, disconnected, exhausted, lost in grief, healing attachment wounds, or stuck in long-standing patterns. These experiences are deeply human, but they don’t always warrant a medical diagnosis. When you pay privately, we can focus on your story and your goals rather than checking boxes on a form.

More Freedom and Maybe More Depth

Without insurance limitations, our work together isn’t governed by session caps, treatment timelines, or pre-approved goals. We go at the pace your nervous system needs—whether that means slowing down to build safety and trust, or diving deep into your personal history and relational dynamics. Private-pay therapy can be more holistic, intuitive, and client-led process.

For the record, I work really hard to make sure insurance-based clients can get all of these things too. But it’s not always in my control—and that’s the primary difference, isn’t it? Control.

Care Designed for Who You Are Now

Insurance models and pay rates often require providers to juggle high caseloads and fast session turnover to make ends meet. Private-pay therapy can allow your therapist (me!) to show up with more energy, creativity, and attention. It supports the therapist’s sustainability—which, in turn, supports the quality of your care.

At the same time, I offer both private pay and insurance-based care, because equity matters—and I believe healing should never be one-size-fits-all.

You Deserve Thoughtful, Personalized Support

Therapy isn’t just a service—it’s a relationship. When you opt out of insurance, you opt into a space that’s built entirely around you. If you’re someone who’s ready to do meaningful work, explore grief or identity, unpack relational patterns, or simply be held in a consistent and private space, private-pay therapy may be the most nourishing option.

Curious about what that could look like for you? Reach out here to learn more or schedule a consultation.