Money Talks: Becoming More Comfortable With Understanding a Family's Finances

Abstract

Child and adolescent psychiatrists are taught to ask a broad range of questions during clinical evaluations. We routinely gather quite sensitive information about a family history of mental illness, secrets that could be influencing family members, reasons for divorce including affairs, use of substances, and concerns about physical or sexual abuse. During training, we learn how to build a trusting relationship, ensure confidentiality, and phrase questions in an empathic manner that facilitates discussing the intimate details of such varied conditions as eating disorders, obsessions and other anxieties, self-destructive behavior, and the like. However, questioning in one area of family life gives many child and adolescent psychiatrists great pause-asking about money and the family's financial status. There is similar ambivalence regarding setting and collecting fees. Fee setting may be considered in supervision or in transition to practice seminars, but, given the use of clinic settings to teach psychotherapy, few training programs have the opportunity to teach residents systematically how to determine fees, take responsibility for their collection, or explore the meaning of paying for treatment as part of their core curriculum. 1 Bishop DR Eppolito JM The clinical management of client dynamics and fees for psychotherapy: implications for research and practice. Psychotherapy. 1992; 29: 545-553 Crossref Scopus (6) Google Scholar 2 Newman SS Considering fees in psychodynamic psychotherapy: opportunities for residents. Acad Psychiatry. 2005; 29: 21-28 Crossref PubMed Scopus (4) Google Scholar