Page 19 - Mar2019_BarJournal

HEALTH CARE LAW

maladaptive behavior. CBT techniques are designed he is observing another person in a neutral fashion, preferred providers. This varies among insurance
to get the patient to look directly at those cognitive without judgement. The therapist and the patient companies. Some insurers provide no benefits for
distortions and reframe them in a more realistic then identify a measurable behavior to change. An these “out-of-network” providers. For patients who
way. The patient then adjusts behavior based on example of a measurable goal is making it through do not have insurance or choose to go to an out-of-
rational thought. The following are examples of at least three meetings in a week without having network therapist who is not covered at all, it may
thought patterns which are cognitive distortions: to leave due to symptoms of anxiety. be possible to negotiate a lower out-of-pocket fee,
• All or Nothing – Everything that happens is CBT has additional characteristics: but this is solely in the therapist’s discretion.
either excellent or awful. Any outcome less • Sessions are limited, intensive and goal-oriented It is normal to use health insurance for a gym
than 100% equates to 0% (e.g., “If I don’t get • The focus is on current behavior membership, a doctor’s visit or a therapy session.
this job, I’ll never be happy.”). • In line with non-judgmental observation, there Like any appointment, sometimes we just need
• Mind Reading – Assuming the negative without are no “shoulds” or “musts” and behavior is a reminder.
relevant information. (e.g., “He didn’t say good not referred to as “good” or “bad”
morning so that means he’s mad at me.”). While this is the structured, fundamental
• Labeling – Using negative labels to describe approach, in practice therapists usually combine Rita Bryce was a federal prosecutor
oneself or others. (e.g., “I’m so stupid.” “He’s some aspects of CBT and psychotherapy or other with the U.S. Department of Justice
so useless.”). therapies to address the patient’s unique situation. in the Cleveland field office of the
One of the most difficult things for a patient The Mental Health Assessment (initial visit) and Antitrust Division for 23 years until
to understand and acknowledge is that these are periodic therapy sessions, whether psychotherapy, she retired in 2013. She obtained a
not fully rational thoughts. A deeply ingrained, CBT, or some other treatment, are usually covered by Masters degree in 2015 and is an independently
automatic response to a trigger is hard to give up. health insurance plans, much like visits to doctors’ licensed Social Worker. She works as an individual
In addition to getting patients to make realistic offices, after deductibles and co-pays are met. therapist with adults and children at The Centers
assessments of their behaviors, CBT seeks to help Additionally, visits to a psychiatrist for medication for Families and Children, a non-profit with a
patients understand that they have control over are covered on par with those of other specialists. focus on providing access to physical and mental
their responses to the trigger. This is accomplished If the psychiatrist or therapist is not one of the health care to disadvantaged individuals. She also
by helping patients engage in non-judgmental self- insurer’s listed providers, you may be reimbursed has a private therapy practice. She has been a
observation. When a triggering event occurs, the after paying the provider, but will probably have to CMBA member since 2017. She can be reached
patient will learn to observe his reaction as though pay more out of pocket than for one of the insurer’s at (216) 272-697 or her website is ritabryce.com.

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March 2019 Cleveland Metropolitan Bar Journal | 19