Practical Issues

Insurance

There are several important things to know about insurance before you start mental health treatment. For detailed information about insurance issues, please visit our Insurance section.

Make sure you have insurance coverage.
Before coming to the University, make sure that you have insurance that covers mental health treatment in Ann Arbor, Michigan. You can do this by calling your insurance company.

Know your session limits.
Typically insurance plans limit the number of mental health visits they will cover in a given year. Knowing ahead of time the number of sessions covered can help you and your therapist plan accordingly. If you are unsure about session limits, contact your insurance company.

Free Counseling is Available.
Counseling & Psychological Services provides free counseling to University of Michigan students who are currently enrolled in courses. So you can make an appointment at CAPS regardless of whether or not you have insurance that covers mental health services.

Confidentiality

Psychotherapists, like all healthcare providers, are required to keep all information related to treatment confidential. There are, however, limits to confidentiality that you should talk with your therapist about. Here are some situations in which your therapist will share information with someone else:

If you are under the age of 18, your parents or legal guardians have the right to access your health records (including psychotherapy records) without your permission.
If therapists have reason to believe that you are an immediate threat to yourself or someone else (e.g., if the therapist believes you may physically harm yourself or someone else), they are obligated to intervene by contacting law authorities and/or the person they believe to be in danger.
If therapists have reason to suspect that a child, an elderly person, or a person with a disability is being abused or neglected, they are obligated to contact authorities.
If you are seeing a therapist in training, the therapist will share information for treatment purposes with his/her supervisor who will be a licensed care provider.
If a court orders the release of your health records, the therapist (or clinic) may have to comply.
If you are 18 years of age or older, you have the right to determine how much you would like your parents to be involved in your treatment, if at all. Your care providers cannot talk to your parents about your treatment unless you give formal permission. In some situations, it may be very helpful for your parents to have some information about your treatment. You will always have the final word on this, but we recommend talking about this issue with your care provider.
- **If you decide to bill your therapy sessions to your parents’ insurance plan, they will be able to see that you are attending psychotherapy and possibly your mental health diagnosis, but your care provider will still not be permitted to talk with your parents about your treatment without your permission.**

Transferring Mental Health Records

If you have received mental health services in the past and you are over the age of 18, your therapist will likely ask you to sign a release of information form that would allow him/her to contact your previous care provider to talk about your prior care or to ask for records. If you are under 18, you will not have the authority to sign a release of your medical records; your parents/legal guardians will have to sign the release of information form to transfer medical records. Your previous care providers cannot release information about you (or even acknowledge that you are/were a patient) without your permission (or your parents’ permission if you are under 18) except when ordered by law. Your therapist should be able to provide you with a release of information form. If you receive treatment off-campus during breaks, you should transfer your records from your campus care-provider to the off-campus care provider before going on break.

Allowing your therapist access to your mental health records is very important. Imagine going to see a new medical doctor who has no access to your medical history (e.g., your medical allergies, immunizations, previous operations, etc.). Your quality of care could greatly improve if the doctor had all of the necessary information to guide the treatment. The same is true for psychotherapists.

Seeing More Than One Care Provider

It is common for people with mental health disorders to see multiple care providers at the same time (e.g., a psychiatrist for medication and a psychologist for psychotherapy). It is important that these care providers communicate with each other to make sure that their treatments are compatible. Sometimes activities you do with one care provider—such as taking a certain psychiatric medication—can interfere with the strategies being used by the other care provider—such as exposure to anxiety-provoking situations. If you are seeing multiple mental health care providers, be sure to let them know so that they can provide you with a release of information form allowing them to communicate with each other about your treatment.

Ending Therapy

There are many reasons people end therapy. Ideally, therapy ends when clients and their clinicians feel they have accomplished the goals they set out to achieve. However, therapy sometimes ends for practical reasons, for example, when the patient moves away or graduates. Finally, therapy can end when the patient or therapist feels that they are making little progress. Whatever the reason, there are important steps to take when ending therapy:

Consider whether you gave the therapy a fair chance to be helpful. Keep in mind that progress is not usually immediate. If you have been attending therapy regularly and following through with all of the procedures (e.g., homework assignments or talking about difficult topics) and you are not making progress toward your goals, you should feel justified in ending the therapy.
If your goals have not been met, consider seeking therapy somewhere else or with a different therapist within the same clinic. Remember, just because therapy didn’t work out the first time doesn’t mean that it won’t work out under different circumstances.
If you choose to end therapy, try to tell your therapist at least a couple of sessions in advance. This can help the therapist prepare and provide you with the most helpful final sessions.
If you feel comfortable, provide your therapist with feedback on your experiences and why you think the therapy might not have been successful. This can be very helpful learning experience for the therapist.
If you have a chronic mental health disorder and therapy was your primary form of treatment, it will be important for you to find treatment or support elsewhere. You can use the Resource section of this webpage or ask your therapist for recommendations.
If you are seeing multiple care providers, let the provider(s) who you are still seeing know that you are no longer seeing the therapist with whom you ended treatment.

Ending a therapeutic relationship can be difficult for many reasons. Here are a few common ones:

You had a successful therapy and you are worried that the progress you made will go away once you stop attending therapy sessions.
- Most therapists, when possible, are open to having patients who have ended therapy come back if they begin to experience problems again.
- Even if you cannot see the same therapist in the future, you will likely be able to see a different therapist if needed.
- If the therapy ended successfully, you will likely find that you are better able to cope with problems on your own than you were before therapy.
You did not find the therapy helpful and you are worried about hurting the therapists’ feelings.
- Remember, therapists are trained to be able to deal with these situations.
- No therapists are successful in helping to meet all of their clients’ goals. Their primary concern is helping their clients. If they cannot effectively do so, they may recommend that another therapist could be a better fit.
- Therapists often learn things from unsuccessful therapies that can help them do their job better in the future.
You have a good relationship with your therapist and you don’t want that supportive relationship to end.
- It is important to talk about this directly with your therapist. This often indicates that the kind of support you are getting from your therapist is very important to you, and you and the therapist can talk about ways to find that in your day-to-day life.
- Therapy often generates relationships based on mutual respect and admiration between clients and their therapists. Ending these relationships can be difficult for both clients and therapists.
- Successful therapy often helps clients develop supportive relationships outside of therapy that help serve part of the purpose of therapy.
- Although ending may be difficult, it is important to remember that therapy often equips you with coping mechanisms to get through tough transitions.
- If you know in advance when therapy will end, you and your therapist can spend time preparing for therapy to end. Sometimes it is possible to end therapy gradually by having less frequent sessions rather than having an abrupt end.

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