Master Your Money by Ron Blue | Christian Finance Book Review

Should Christian Therapists Bill Insurance? A Closer Look at the Cost of Being Paid As a Christian therapist, I’ve long heard the debate: Do you bill insurance or go cash-pay? The conversations swirl around two major ideas — accessibility for clients, and fair compensation for therapists. And while I used to think the answer was complicated, the more I experience the system firsthand, the more I wonder if the conversation isn’t so muddied after all. ⸻ The Case for Billing Insurance Let’s be honest — taking insurance can make it easier to get clients in the door. Many people search specifically for in-network providers, and in certain areas, especially where income levels are lower, that’s the only financially realistic option for clients. But here’s the other side: billing insurance doesn’t mean financial stability. Payments are often delayed — sometimes by months. When the reimbursement does arrive, it’s often much less than expected. And once you factor in the cut taken by group practices (typically 20–40% to cover overhead, admin, and billing), it’s not uncommon to walk away with $50 per client hour. Now add in taxes, documentation, unpaid admin time, and cancellations, and it can feel like you’re earning $25/hour with a Master’s or Doctorate degree. Many therapists in these situations end up making around $50,000/year. That’s not just disheartening. It’s devaluing. This reality isn’t just true for therapists — it extends to psychologists, psychiatrists, social workers, and other mental health professionals to a large degree. It’s especially hard to swallow for those of us with terminal degrees, who have spent years in rigorous training only to be reimbursed at rates that fail to reflect that investment. While some specialists may receive higher rates, many still face the same reimbursement delays, administrative burdens, and undervaluation by insurance companies. ⸻ Real Stories: $400 for 20 Sessions and a 65% Squeeze Let me share a story that captures this tension in a real, personal way. I once supervised a clinician who worked in an office that took 65% of her production. That meant she wasn’t just being squeezed by the insurance companies — she was also being squeezed by her own practice. The system was stacked against her from both sides, leaving little room for financial stability or long-term sustainability. A friend of mine — a master’s-level therapist — sees around 7 to 10 clients a week, almost every week. On paper, that’s 20 hours of face-to-face client time across two weeks. But here’s the reality: after the group practice took its cut, and after waiting on delayed and partial insurance reimbursements, their paycheck for that period came out to just $400. That’s $20 an hour — before taxes, before paying an accountant, before contributing to a health savings account or retirement, and before covering any business expenses. This isn’t just about one week. It’s about the fact that this can happen at all — and does happen, unpredictably. It’s nearly impossible to create a consistent budget when you’re dependent on payments that are delayed by insurance processing times, inconsistent billing cycles, and client no-shows. Now, I realize medical doctors also face bureaucratic frustrations with insurance. But there’s a key difference: even their “low end” of reimbursement is far higher than our “high end.” When a physician gets paid late, they’re still being reimbursed at rates that honor their training and the value our society places on their work. Therapists, by contrast, are expected to deliver deep, transformative care — and are often paid less than a high school tutor or barista for doing so. ⸻ The Case for Cash Pay With private pay, you set your rate. You don’t have to wait three months for a claim to be processed. You don’t have to argue over whether your note justifies the session. You don’t have to worry about clawbacks. If you charge $150 an hour, you earn $150 an hour. You’re in control. Critics of the cash-pay model often say, “You won’t be able to fill a practice that way.” And yes, it can be harder depending on your location or population served. But increasingly, therapists — especially those in niches like trauma recovery, testing, or faith-based care — are doing exactly that. They’re building thriving practices by setting fair rates and helping clients access reimbursement through superbills, where clients pay upfront and submit claims themselves. Recently, I looked into billing insurance for ADHD testing — a highly specialized service. Even with doctoral-level credentials, after my office’s cut, I’d be making around $75/hour. That doesn’t include the cost of tests, taxes, or the expensive training required just to offer assessments. At some point, it starts to feel absurd. And wrong. ⸻ A Word of Balance: Not All Insurance Experiences Are Equal That said, not all insurance experiences are created equal. Some therapists do very well with insurance. Reimbursement rates vary significantly by state, insurer, and negotiation. I’ve spoken with colleagues who consistently receive $100–$140 per session through insurance, and their systems are smooth and sustainable. Practices with effective billing departments and lower overhead can make insurance work in a way that feels fair and even profitable. So this isn’t a blanket indictment of insurance-based work. It’s not “cash-pay good, insurance bad.” There are plenty of therapists who’ve found the insurance model to be the best fit for their calling and business. And that’s valid. But the larger issue is this: Why are so many of us okay with allowing insurance companies — not clients, not therapists, not the free market — to decide what our work is worth? ⸻ Therapy Is Not Just a Service — It’s a Healing Relationship Yesterday, five out of five clients left my office lighter. Each one had a breakthrough. Each one left with a deeper understanding of themselves and their story. I don’t know how to assign a dollar amount to that — but I do know it’s not $50. And this is where the value conversation becomes personal. When I go to the doctor, I often get 10 minutes and a prescription. That’s considered worth $300. But an hour of deeply attuned, transformative therapy? Often reimbursed at a fraction of that. This isn’t about arrogance. It’s about integrity — asking the honest question: Is the current system valuing our work in a way that aligns with what it actually takes to do it well? ⸻ What About Access? Of course, we care about access. That’s part of why many of us became therapists. We’re helpers by nature. But I don’t believe the solution to the problems in the healthcare system is for therapists to simply accept being underpaid. That’s not the answer. Yes, the system has major flaws — opaque billing, inconsistent reimbursement, and a clear imbalance in how mental health is valued compared to other forms of care. But undervaluing clinicians only worsens those issues. It leads to burnout, turnover, and a system where quality care becomes harder to maintain. There are better ways to promote access while still honoring the value of our work. We can offer superbills to help clients get reimbursed. We can provide sliding scale options on a case-by-case basis. We can partner with churches or nonprofits to subsidize sessions for those in need. And perhaps most meaningfully, as Christian therapists, we can tithe a portion of our time — offering free or reduced-cost sessions to a limited number of clients as a form of ministry and generosity. That doesn’t mean devaluing our work across the board. It means freely giving as God leads us, while still maintaining sustainable practices that allow us to thrive and continue serving long term. ⸻ Final Thoughts: Let the Market Decide This isn’t capitalism or socialism. It’s something stranger — a system where a few massive companies set the prices for millions of therapists, regardless of training, expertise, or outcomes. Or maybe it is a form of socialism — but who knows? Either way, it isn’t working. Medical doctors have had decades of advocacy, established professional valuation, and strong reimbursement structures. Mental health, though essential, has lagged behind. But maybe the solution isn’t waiting for insurance companies to come around. Maybe the answer is: We set the price. We offer the value. We let the market respond. This is a moment for courage. For those of us who have labored under unrealistic reimbursement models, who’ve invested in advanced education and sacrificed time and income to serve faithfully — now is the time to reclaim the dignity of our work. Not with arrogance, but with clarity and integrity. We can create practices that are sustainable, ethical, and deeply honoring to both the client and the clinician. We can build models that reflect the true cost and worth of healing relationships. And we can do it in a way that still serves the underserved — through thoughtful generosity, strategic partnerships, and Spirit-led discernment. Whether you choose to take insurance or not, don’t let someone else’s reimbursement schedule define your worth. Charge fairly. Work ethically. Rest in the knowledge that your calling is sacred — and act like it.

Can Secular Counseling Theories Align with Biblical Integrity? A Christian Counselor’s Perspective on Foundational Truth and Therapeutic Technique A common question that arises for Christians working in helping professions, such as counseling, is whether they must make an exclusive choice between secular theories and the foundational truths of the Bible. Many practitioners and lay helpers alike grapple with the perceived need to either strictly adhere to a biblical counseling model or fully adopt secular psychological frameworks. However, the notion that these two approaches are mutually exclusive overlooks the possibility of a more nuanced and biblically sound perspective. This exploration argues that while biblical truth must serve as the primary and unwavering framework for Christian counseling, specific techniques from secular theories can be selectively employed, provided they are carefully evaluated and filtered through the lens of Scripture. Christians need not adopt secular theories wholesale but can engage with them through discernment and a commitment to biblical integrity (Jones & Butman, 2011; Johnson, 2017). The context in which this question is posed is significantly shaped by the increasing secularization of Western societies. Charles Taylor’s (2007) (Buy on Amazon) analysis in A Secular Age provides valuable insight into this transformation, moving beyond a simplistic understanding of secularism as merely the decline of religious belief. Taylor (Buy on Amazon) identifies a condition he terms “Secularity 3,” where belief in God is one option among many, contested and lacking the status of foundational truth. Within this secular landscape, the “Immanent Frame” prevails—a worldview that confines reality to the natural order, marginalizing or excluding religious perspectives on the complexities of human nature and well-being. Additionally, Taylor (Buy on Amazon) describes the rise of the “Buffered Self,” a modern individual defined by an internal sense of identity insulated from supernatural influences (Taylor, 2007). These concepts underscore how secular theories are often shaped by philosophical assumptions that may conflict with a biblical worldview. Nevertheless, Taylor (2007) (Buy on Amazon) warns against the “subtraction theory”—the belief that secularism is merely the absence of religion. Instead, he describes the “Nova Effect,” where secularism reimagines and proliferates belief systems. This implies that even within secular counseling theories, remnants of theological ideas may remain—although these often require biblical critique to determine their alignment with truth. The moral stance of “exclusive humanism” embedded in secular ideologies can implicitly challenge theism, further necessitating caution for Christian counselors. In navigating this secular environment, Christians can find a firm anchor in the authority of Scripture. Christopher Watkin’s (Buy on Amazon) Biblical Critical Theory offers a model for understanding culture and critiquing secular ideologies through the lens of the Bible’s unfolding narrative. Watkin (Buy on Amazon) introduces the method of “diagonalization,” where biblical truth transcends binary cultural dilemmas by offering a third, redemptive alternative. This framework equips Christians to evaluate counseling theories based on Scripture, rather than attempting to conform Scripture to secular paradigms. It highlights the importance of “out-narrating” rather than simply “out-arguing” secular worldviews, pointing to the power of Scripture’s redemptive storyline—creation, fall, redemption, and consummation—as a deeper explanation of the human condition (Watkin, 2022) (Buy on Amazon). Personal Reflection as a Christian Counselor and Professor As a professor with over thirteen years of experience—particularly in my time at Colorado Christian University—I have encountered this tension regularly among students. Many of them, especially those newly immersed in the field, ask, “If these theories that we're being taught and expected to implement are secular, how do I maintain my fidelity to the Christian faith and my obedience to Jesus Christ?” My response is often seen as controversial: You don’t need a theory. That statement surprises even some of my closest friends and colleagues, because it challenges a dominant paradigm in counseling education—that everyone must work from a specific theoretical orientation. But I see it differently. Though the Christian faith is not a theory, I believe we’ve become so disintegrated in our thinking that many struggle to see the faith itself as a sufficient foundation for the work of counseling. However, I would argue that the Christian faith—rooted in Scripture, guided by the Spirit, and centered on the gospel—is more than sufficient as both a foundation and a framework for therapeutic work. Consider the nature of secular counseling theories: psychoanalysis, Adlerian therapy, dialectical behavioral therapy (DBT), cognitive behavioral therapy (CBT), motivational interviewing (MI), eye movement desensitization and reprocessing (EMDR), internal family systems (IFS), emotion-focused therapy (EFT), Gottman method, and rational emotive behavioral therapy (REBT). Each of these presents an interpretation of how the world works, what is wrong with people, where suffering originates, and what the path to healing entails. Is this not exactly what the Christian faith also does—but with divine authority and eternal truth? Christianity teaches the truth about sin and its devastating impact on our lives, our relationships, and the entire world. It also proclaims the ultimate solution: the life, death, burial, and resurrection of Jesus Christ. Yes, the implications of the gospel are profound and require theological depth and pastoral wisdom, but they offer the most complete framework for understanding and healing human brokenness. I am not suggesting that we reject all clinical methods. Rather, we must recognize that the Christian faith itself can serve as the counseling theory. From this foundation, we can carefully borrow techniques from secular theories—so long as those techniques are filtered through Scripture, aligned with biblical anthropology, and used to help people grow and heal in ways consistent with the character and truth of God. To understand the specific areas of compatibility and conflict between secular psychotherapies and Christian beliefs, the work of Jones and Butman (2011) in Modern Psychotherapies provides a comprehensive and critical resource. They offer theological assessments of numerous therapeutic models and advocate for a “critical, theologically informed appropriation” rather than uncritical adoption of psychological theories. Their framework evaluates each theory through the lens of Christian doctrines such as human depravity, divine grace, and sanctification. The authors also trace the historical development of Christian engagement with psychology—from suspicion, to over-acceptance, to careful critique—highlighting the present need for thoughtful theological discernment in clinical practice. Eric Johnson’s works, Foundations for Soul Care (2014) (Buy on Amazon) and God and Soul Care (2017) (Buy on Amazon),further argue for the richness of therapeutic resources within the Christian tradition. Johnson asserts that the Christian faith is inherently therapeutic, rooted in a robust theological anthropology and communal ecclesiology. He emphasizes that the church, not secular psychology, is the primary context for true soul care. While he acknowledges psychological insights as gifts of common grace, he insists that Scripture must serve as the canon and foundation for Christian counseling. Johnson’s approach affirms that a distinctly Christian understanding of healing cannot be reduced to secular mechanisms, even when such mechanisms are empirically validated. David Entwistle’s (2015) Integrative Approaches to Psychology and Christianity (Buy on Amazon) offers another helpful perspective. His “Allies Model” affirms the unity of truth under God’s sovereignty and suggests that psychology and theology can cooperate without compromising biblical integrity. This model emphasizes the necessity of theological primacy in evaluating any psychological insight and the importance of distinguishing between surface-level techniques and foundational worldview assumptions. Entwistle's taxonomy of models—including Enemies, Spies, Colonialists, Neutral Parties, and Allies—clarifies how different approaches to integration carry distinct theological implications. He also acknowledges the difficulty of maintaining theological fidelity across denominational lines and the risk of minimizing the gospel in pursuit of compatibility. Research literature supports the position that full integration of secular counseling theories with Christian faith can be challenging, particularly in professional and educational contexts that prioritize secular norms. Studies have shown that Christian clients may feel marginalized in secular therapy, and Christian counselors may struggle to uphold their faith while adhering to professional ethics rooted in secular humanism (Hook et al., 2012; Rose et al., 2001). While religiously integrated therapies have demonstrated effectiveness, they also require careful theological alignment and individual sensitivity (Tan, 2011) (Buy on Amazon). A client-centered inclusion of spirituality is not equivalent to biblical integration, and the distinction must be made clear. Other scholarly sources also support the selective use of secular techniques when filtered through a robust biblical worldview. The essential criterion for this discernment is the authority of Scripture. Theological principles such as the sufficiency, clarity, finality, and infallibility of Scripture must govern any use of psychological methods (Johnson, 2017; Jones & Butman, 2011 - Buy on Amazon). Spiritual discernment and the guidance of the Holy Spirit are vital in evaluating whether specific counseling techniques align with God’s truth. The phrase “Christian worldview” can aptly be described as viewing the world through God’s revealed Word—emphasizing that psychology can inform but never replace theology. Key Principles for Filtering Counseling Techniques Through Scripture Principle Description Sufficiency The Bible contains everything necessary for salvation and godly living. Clarity The Bible is clear and understandable to all believers. Finality The Bible is the ultimate authority in all matters of faith and practice. Infallibility The Bible is without error or contradiction. Conclusion Christians can confidently rely on the foundational truths of the Bible as their primary guide in counseling. While secular counseling theories operate within worldviews that may fundamentally differ from a Christian perspective, specific techniques from these theories can be thoughtfully and cautiously utilized. This selective borrowing requires a rigorous process of filtering these techniques through the lens of Scripture, ensuring they align with biblical principles and are applied with discernment. The ultimate goal remains the spiritual well-being and growth of the client, guided by the unwavering truth and love found in the Bible. Christians in helping professions can stand firm on this truth, extending grace and effective care by integrating insights from various sources while always prioritizing the unshakable foundation of God’s Word. References Entwistle, D. N. (2015). Integrative approaches to psychology and Christianity: An introduction to worldview issues, philosophical foundations, and models of integration (3rd ed.). Cascade Books.(Buy on Amazon) Hook, J. N., Worthington Jr., E. L., Davis, D. E., Jennings, D. J., Gartner, A. L., & Hook, J. P. (2012). Empirically supported religious and spiritual therapies. Journal of Clinical Psychology, 68(2), 146–162. https://doi.org/10.1002/jclp.20861 Johnson, E. L. (2017). God and soul care: The therapeutic resources of the Christian faith. InterVarsity Press. (Buy on Amazon) Johnson, E. L. (2014). Foundations For Soul care: Delivering and receiving biblical counseling. Zondervan. (Buy on Amazon) Jones, S. L., & Butman, R. E. (2011). Modern psychotherapies: A comprehensive Christian appraisal (2nd ed.). IVP Academic.  (Buy on Amazon) Rose, E. M., Westefeld, J. S., & Ansley, T. N. (2001). Spiritual issues in counseling: Clients' beliefs and preferences. Journal of Counseling Psychology, 48(1), 61–71. https://doi.org/10.1037/0022-0167.48.1.61 Tan, S.-Y. (2011). Counseling and psychotherapy: A Christian perspective. Baker Academic. (Buy on Amazon) Taylor, C. (2007). A secular age. Belknap Press. (Buy on Amazon) Watkin, C. (2022). Biblical critical theory: How the Bible's unfolding story makes sense of modern life and culture. Zondervan Academic. (Buy on Amazon) AI Disclosure This blog post was created with the assistance of AI technology to ensure clarity, organization, and proper citation formatting. While the structure and research support were enhanced by AI, all theological and clinical insights reflect the author’s personal experience, convictions, and professional expertise. Readers are encouraged to consult Scripture and seek guidance from trusted Christian leaders and clinicians for further application.