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Free psychotherapy: an inquiry into resistance

Published Online:https://doi.org/10.1176/ajp.133.9.1066

Psychotherapy for which the patient is not charged, such as that provided by the Veterans Administration system, can lead to unique conflicts and resistances within treatment. Patients may depreciate the value of therapy, feel obligated to the therapist, or expect him to make inappropriate nonfinancial demands. The authors present five cases illustrating that lack of a fee may become the focus of insoluble resistances to therapy, and suggest that, particularly in training situations, a token fee should be charged to obviate these difficulties.

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