A common question I receive is whether I can provide a superbill for couples therapy so clients can seek reimbursement through their insurance. I choose not to do so, and I want to be transparent about why.

In my practice, the couple is the client. Emotionally Focused Therapy (EFT) isn’t focused on diagnosing or treating one partner’s mental health condition—it’s focused on the relationship itself. Insurance, however, requires a medical diagnosis assigned to one person, which would mean diagnosing one partner and framing relational work as individual medical treatment. That doesn’t accurately reflect what we’re doing together, so it’s not an approach that fits my practice.

Protecting Your Privacy

A diagnosis submitted to insurance becomes part of a person’s permanent medical record, which can affect future life insurance, disability coverage, and employment. It’s also worth knowing that in the event of a divorce, mental health records and diagnoses can become relevant to custody arrangements, spousal support, and other proceedings — even if that feels unimaginable right now. Many couples prefer to keep their relational work private, and paying out of pocket allows for that.

Freedom to Do the Work That Actually Helps

Staying outside the insurance system means sessions are driven by your relationship goals, not diagnostic codes or insurance requirements, and you maintain a higher level of confidentiality.

When a Diagnosis Is Present

If one or both partners are dealing with anxiety, depression, trauma, or another diagnosable condition, individual therapy is the often most efficient and effective path for addressing those concerns directly. EFT can support a partner’s well-being by strengthening the relationship around them, but it’s not a substitute for targeted individual care.

If you have questions about any of this, I’m happy to discuss this more in a free consultation.