You’re worth the investment.
Why I Don't Take Insurance and What That Means for You
I don't take insurance because I want our work to be driven by what you need, not by what an insurance policy will approve. As a neurodivergent-affirming therapist at Kestrel Psychotherapy, I chose to practice out-of-network so that care stays flexible, private, and focused on you.
TL;DR
You shouldn't have to squeeze yourself into an insurance-approved clinical box just to receive care. When skipping insurance, we control the process and reduce barriers to therapy. See the therapist who is the right fit for you. No prior approvals or surprise bills. No diagnosis required. No limitations on session length or frequency. Therapy that is as individualized as you need it to be, with room to be creative.
Yes, therapy is an investment. And no, I don't take insurance.
I know that can feel frustrating or even unfair, especially when mental health care already feels out of reach for so many people. You deserve transparency about why I made this decision.
You get to choose the therapist who works for you.
One of the most overlooked costs of using insurance isn't financial. It's the limitation on who you can see. Insurance panels dictate which providers are "in-network," which means your choices are filtered before you even start looking. For neurodivergent adults, finding a therapist who genuinely understands how your brain works, one who won't pathologize you or default to approaches that weren't built with you in mind, already takes effort. Narrowing that search to whoever happens to accept your plan can mean settling for a poor fit, or waiting months for an opening that may never come. Paying out-of-network means the search starts with fit, not with a list.
Insurance wasn't built for neurodivergent people or personalized care.
If you've ever tried to use insurance for mental health services, you know it can be a maze of phone calls, surprise costs, unclear policies, and frustrating delays. Each of these hoops can be disruptive for anyone. For an overstimulated nervous system, for someone managing mental health symptoms, or for someone who struggles with memory and organization, the process can be its own barrier to getting care at all.
And the hoops don't stop once therapy starts.
In order to use insurance for therapy, your provider must give you a diagnosis that justifies treatment. Not just any diagnosis, but one that fits neatly into medical codes, often within a narrow set of criteria. Insurance companies may also:
Limit what kinds of therapy can be used
Dictate how often we meet, session length, or the total number of sessions
Require proof that you're making progress, but not too much progress, or you no longer qualify
Request treatment reports that compromise your privacy
Deny coverage retroactively, leaving you with surprise bills and interrupting the work once it has started
For many neurodivergent adults and deep feelers, this system creates more stress than support.
What about diagnosis, labels, and permanence?
What if you're not sure neurodivergence is part of your story? What if you don't want to pursue an official clinical diagnosis, or you view neurodivergence and many mental health experiences not through a pathologizing lens, but as a spectrum of differences shaped by unsupportive systems? Seeking a diagnosis just to justify insurance coverage can feel more stigmatizing than helpful.
There's also something worth knowing: when a diagnosis is submitted to insurance, it becomes part of your permanent record. That can have downstream effects on life insurance, disability claims, and in some cases employment. For clients already navigating stigma, that's not a small thing. Paying out-of-network means a diagnosis is yours to seek on your own terms, not a requirement to access support.
Therapy isn't always about "treating a disorder."
For many of my clients, therapy is about:
Unpacking how trauma or childhood patterns still show up today
Learning to accommodate executive dysfunction
Making peace with emotions that feel too big
Reclaiming self-worth after years of masking
Supporting and loving someone with ADHD or other needs
Learning to parent in a way that honors their nervous system and values
Supporting therapists in their own growth, burnout recovery, and professional development
Exploring neurodivergence with curiosity, not shame
Building a life that feels fulfilling. Not "normal," but right
None of that fits cleanly into a diagnostic box.
So why don't I take insurance?
Because I want our work to focus on what you need, when you need it. I want our work to be responsive to what's actually happening in your life, to try new approaches, to hyperfocus when the moment calls for it. That might mean longer sessions during a transition, more frequent sessions during a hard season, or a full therapy intensive when you want sustained, immersive focus without the interruption of stopping and restarting each week. Insurance doesn't allow for that kind of flexibility.
When we work together:
You don't need a diagnosis to get started
You don't have to "prove" you're struggling
We can adjust session length or frequency based on what you actually need right now
Your privacy stays between us, not in an audit folder
You decide your goals without an insurance timeline
And if life changes and you lose coverage, our work doesn't have to stop
One more thing. Not working with insurance means I get to pour my energy into the things that matter most instead of navigating insurance billing and administrative overhead.
Being present and resourced for my clients
Continuing research and training
Supporting future therapists through thoughtful supervision
I'm not rushing through sessions or running on fumes. I'm building a practice with intention and sustainability. That benefits everyone.
What if I want to try reimbursement?
I'm considered an out-of-network therapist. If your insurance plan offers out-of-network benefits, I can provide you with a superbill, which is a detailed receipt of services you can submit to your insurance company for possible partial reimbursement. It's not guaranteed, but many clients have success with this route, especially those with PPO plans.
Many people also use their HSA or FSA accounts to cover therapy services, which is always an option here.
If reimbursement is something you want to pursue, just let me know when we meet so we can structure things accordingly.
What if the cost feels like a barrier?
You're not alone. I offer a small number of time-limited, reduced-rate spots and I'm always open to discussing options. Reach out if you have questions. Let's figure out what's possible together.
Last updated March 3, 2026
Randi Williams, LPC, CPCS | Kestrel Psychotherapy Neurodivergent-affirming therapy for ADHD adults, their loved ones, and therapists Online in Georgia, South Carolina, and Florida | Coaching and consultation available nationwide