Dialectical Behavior Therapy: Ask the Therapist

Dialectical Behavior Therapy and Insurance

Question:  My therapist told me that my insurance company said that "I MUST" have Dialectical Behavior Therapy" or they won't pay for anymore visits with my current doctor. I asked him what DBT is and he said "I don't know" you have to call you insurance company.

To me that didn't make much sense. If he is a therapist, shouldn't he know what it is? Then he said he wasn't going to start looking on the internet for the answer. He told me to call my insurance company and they will explain the details.

Oh, I have been with him for 5 years and I have the top New York City health coverage! He told me he would be able to continue administering my medication only, but not therapy. It doesn't make any sense to me. Perhaps you can help me understand. I will call my insurance company today and hopefully they will tell me if he put the request in. If he did, then he is lying to his patient. Thank you and hope to hear from you as soon as possible.

My two questions are:

1. Does the doctor have to recommend this treatment upon his diagnosis?
2. Do you think he was avoiding my above question because he recommended the treatment?

Answer:  Thanks for your question. I can't speak to the motives or intentions of your therapist, but I will say that it is becoming more common for insurance companies - who may have been footing the bill for long-term individual psychotherapy - to mandate that additional, or other, treatments be tried. In combination with individual counseling, DBT (which is a cognitive-behavioral, skills-based approach to BPD) is widely believed to be the treatment of choice (meaning, the most effective treatment) for BPD. It's unfortunate that your doctor does not know of Dialectical Behavior Therapy and apparently, isn't willing to educate himself about it, but you should pursue this option to see if it helps you. That's the most important thing in the long run.