By David Joel Miller
Why are there so many counseling things that insurance does not cover? V and Z codes.
There are lots of life’s problems that need attention, but they don’t fit neatly under our definition of a mental illness. As a result most insurance providers won’t pay for treating these problems or if they do there are severe limits on the amount of counseling that you can get for these issues.
These everyday problems that can derail someone’s life get a “V” code. That does not mean they are not important but it does mean that generally we don’t see them as an illness, more like a challenge the person must face and overcome. There are over 20 of these “V” codes. (In the DSM-5 this list has gotten longer.)
Some of these are the kind of issues that make the news, the partners who kill each other and the extreme cases of child abuse. They need treatment but we can’t say that every couple who fights is mentally ill. What we can say is that killing your spouse is not normal or acceptable.
Conflicts with other people are a big part of this, Partner Relations problems, sibling relational problem, parent child relational problem. These conflicts can cause a lot of damage and they need treatment. Marriage, family and child counselors specialize in just these issues. The list of relation problems goes like this:
Partner Relations problem
Sibling relational problem
Parent child relational problem
Relational Problem related to medical or mental disorder
Other Relational Problem
There are life stage issues we all need to navigate. Some of us move through these concerns with no problem. Other people struggle with one or more of these issues. Each of these can become a reason to see a counselor and they do not mean there is anything wrong with you.
Phase of life Problem
Religious or Spiritual Problem
People who injure others need treatment. Sometimes they are required to go for treatment and may even be made to pay for that treatment. Victims of abuse, neglect or violence get a special status in the DSM and their treatment is found under the 995.xx codes, which are most always paid for by society. The person doing the abuse or neglect gets the “V” code and mostly has to pay for their own treatment. The categories of misbehavior towards others that may be the focus of treatment include:
Neglect of a child
Sexual Abuse of a child
Physical Abuse of a child
Physical Abuse of Adult
Sexual Abuse of Adult
The last group of things that may need attention but don’t get counted as full mental illnesses are things that people do, other than abuse or neglect that we as a society do not like. This includes things like career criminals who know what they are doing but do the crime anyway. The term “Behavior” is used here to differentiate those who don’t known that what they are doing is wrong or can’t control themselves as in Antisocial Personality Disorder vs. those who know it is wrong and do it anyway, as in Antisocial Behavior. These items include:
Adult Antisocial Behavior
Child or Adolescent
All these things and many more may be good reasons to see a counselor or therapist even if you don’t have a diagnosable mental illness.
For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog there is also a Facebook authors page, in its infancy, up under David Joel Miller. Posts to the books, trainings and classes category will tell you about those activities. If you are in the Fresno California area information about my private practice is at counselorfresno.com. Thanks to all who read this blog.