• You have to be diagnosed with a mental disorder in order for your insurance (managed care) company to reimburse for sessions.
• Your diagnosis is part of your medical record that stays in your health files permanently, and is viewable by every medical professional who sees your file (including your managed care company).
• Your insurance company determines how many sessions you get (NOT you or your therapist).
• Your managed care company determines the therapist you see (even if you found a great one on your own!).
• Your managed care company determines the type of therapy you receive.
• Employers have been known to access your insurance information (particularly police, fireman, and pilots) to determine continued job eligibility.
• On occasion, your co-pay may be high enough for you to have paid for your sessions on your own.

• Confidentiality - Access to your records is usually limited to you and your therapist.
• Flexibility - There are no restrictions placed on how you choose your therapist and what services you design in partnership with that person. The plan of care, and the payment of services, are discussed and set by mutual agreement.
• Autonomy - The length of care, frequency of sessions and other aspects of work you do together are entirely up to you and your therapist.
• Privacy - Some managed care companies require not only a diagnosis but to review notes from treatment sessions, thereby limiting the confidentiality of your care.
• Choice - The number and types of professionals from which you can select to receive care and the forms and extent of the care that will be provided are broader.
• Quality - Because you and your therapist are not burdened by managed care issues (such as predetermined length of therapy, types of therapy provided), you are guaranteed a quality therapeutic relationship.
• Criteria - Managed care companies may set guidelines for the types of treatment they are willing to reimburse, which in some cases may seriously limit access to services you may need and want.