WESTCHESTER RELATIONAL THERAPY
CONSIDERATIONS WHEN CONSIDERING COUPLES, RELATIONSHIP, OR FAMILY THERAPY
Couples, Relationship, or Family Therapy – Self-Pay
As marriage and family therapists, we approach challenges through a systemic lens — understanding that distress often lives within relational patterns rather than within one individual. One of the services offered by Westchester Relational Therapy is couples, relationship, and/or family therapy. In relationship therapy, the identified “client” for purposes of treatment is the couple and/or family system as a whole, rather than any individual member. Treatment is directed toward improving relational functioning and system-level dynamics. No single individual is designated as the identified patient, and services are not focused on diagnosing or treating a specific mental health disorder of one person unless separately agreed upon.
An individual mental health diagnosis is not assigned in the ordinary course of couples, relationship, or family therapy. Because most insurance plans require a covered mental health diagnosis assigned to an individual insured member, couples and family therapy services are generally not eligible for insurance reimbursement. Therefore, true couples and family therapy is provided on a self-pay basis only.
Family Therapy with an Identified Client -Potential Insurance Reimbursement
Under some circumstances, if relationship stress contributes to a mental health condition for one partner — such as anxiety, depression, or trauma-related symptoms — therapy may be structured as individual treatment with conjoint sessions, where a partner or family member participates in support of the identified client’s goals. When the therapy is structured in this manner, the partner or family member participates as a collateral to the treatment rather than as a client, and the therapy is coded as “family therapy with patient present.” The “patient” refers to the identified client who receives a diagnosis and whose treatment will be the focus of the therapy. Westchester Relational Therapy’s informed consent for collaterals participating in the therapy of an identified client, provides more of the specifics regarding the legal ramifications of structuring a therapy in this manner for the partner or family supporting the identified client’s therapy. Some insurance plans do provide reimbursement for family therapy structured in this manner so long as there is an identified patient with a diagnosis, and the required medical necessity is met.
Following the intake session, your clinician will recommend which structure is most appropriate given the issues presented during the intake. In not all instances will Family Therapy with an Identified Patient/Client be appropriate.
Appropriateness of Couples and Family Therapy; Safety Considerations
Regardless of how a therapy involving two or more participants is structured, couples, relationship, and/or family therapy is appropriate only when all participating members feel emotionally and physically safe within the relationship and are able to engage in the therapeutic process without fear of harm, coercion, or intimidation. The effectiveness of relational therapy depends upon each participant’s ability to speak openly and participate voluntarily.
If, at any time, the therapist has reason to believe that there is ongoing emotional abuse, coercive control, intimidation, or risk of physical harm between participants, the therapist may determine, in their professional clinical judgment, that couples or family therapy is not appropriate to continue at that time. In such circumstances, the therapist may recommend that one or more participants engage in individual therapy or other appropriate services before resuming relational therapy.
The therapist reserves the right to suspend or terminate couples, family, or conjoint sessions if continuing would compromise the safety, wellbeing, or therapeutic integrity of the process. Decisions regarding continuation of treatment are made in accordance with professional standards of care and applicable New York laws and ethical guidelines.