The Pain of Infidelity and the Path to Forgiveness: An EFT Couples Counseling Perspective  Infidelity can shatter the very foundation of a relationship, leaving both partners helpless and devastated. As the betrayed partner, you may feel anger, sadness, confusion, and grief. These feelings are normal and to be expected. There is a path forward and healing in the process. Emotionally Focused Therapy (EFT) offers a compassionate and effective framework for couples struggling with the aftermath of infidelity, providing a path toward understanding, forgiveness, and renewed connection. The Emotional Impact of Infidelity For the betrayed partner, the experience often feels like an attack on their sense of self-worth, leading to feelings of inadequacy, shame, and fear of abandonment. The unfaithful partner may toggle back and forth from guilt, regret, and a deep sense of failure. According to Johnson et al. (2005), infidelity often disrupts the attachment bond that forms the core of a secure relationship. This bond is crucial for emotional safety and intimacy, and when it is broken, it is expected that both partners feel lost, and unsure of how to move forward. EFT: A Framework for Healing Emotionally Focused Therapy (EFT) is an evidence-based approach to couples counseling that focuses on the emotional bond between partners. Developed by Dr. Sue Johnson, EFT aims to help couples identify and express their underlying emotions, fostering a deeper understanding of each other's needs and vulnerabilities. One of the key principles of EFT is that emotions are not just feelings but essential signals that communicate our deepest needs and desires. In the context of infidelity, EFT helps couples explore the pain and betrayal on a deeper level, uncovering the underlying emotions that drive their reactions. Through EFT, couples can begin to see beyond the anger and resentment, recognizing the hurt, fear, and longing for connection that lies beneath. This process allows both partners to reframe the narrative of the affair, moving from blame and defensiveness to empathy and understanding. The Role of Forgiveness Forgiveness is often seen as a critical step in the healing process after infidelity. However, forgiveness in this context is not about excusing or forgetting the betrayal; it is about releasing the hold that the pain has on both partners. EFT provides a supportive environment for this process, allowing couples to rebuild trust and emotional safety gradually. Research by Makinen and Johnson (2006) found that couples who underwent EFT after an affair reported significant improvements in their relationship, including increased trust, emotional intimacy, and overall satisfaction. These findings suggest that EFT can facilitate not only forgiveness but also a deeper, more resilient connection. The Path to Reconnection Healing from infidelity is a journey that requires patience, commitment, and a willingness to confront difficult emotions. EFT offers a structured yet flexible framework that guides couples through this process, helping them to rebuild their relationship from a place of mutual understanding and compassion. The ultimate goal of EFT is not just to repair the damage caused by infidelity but to create a stronger, more secure bond between partners. By addressing the underlying emotional dynamics and fostering open communication, EFT allows couples to reconnect on a deeper level, paving the way for lasting change and renewed intimacy. Conclusion Infidelity can be one of the most painful experiences in a relationship, but it does not have to be the end. Through the lens of Emotionally Focused Therapy, couples can navigate the complex emotions surrounding infidelity and find a path toward forgiveness and healing. While the journey may be challenging, the reward of a renewed and strengthened connection is well worth the effort. References Johnson, S. M., Makinen, J. A., & Millikin, J. W. (2001). Attachment injuries in couple relationships: A new perspective on impasses in couples therapy. Journal of Marital and Family Therapy, 27 (2), 145-155. Makinen, J. A., & Johnson, S. M. (2006). Resolving attachment injuries in couples using Emotionally Focused Therapy: Steps toward forgiveness and reconciliation. Journal of Consulting and Clinical Psychology, 74 (6), 1055-1064.

How to Use Insurance with Out-of-Network Therapists Starting therapy can be an important step toward better mental health, but finding the right therapist can be challenging—especially if the therapist you want to work with isn’t in your insurance company’s “network.” This can be frustrating when you want to use your insurance benefits to help cover therapy costs. In this article, we’ll explain what it means to be “out of network” and how you might still be able to use your insurance to pay for therapy. What’s the Difference Between In-Network and Out-of-Network Providers? In-Network Providers In-network therapists have agreements with insurance companies to provide services at a set rate. When you see an in-network therapist, you typically pay only your copay at the time of your appointment, and the therapist bills the insurance company for the remainder of the cost. Out-of-Network Providers Out-of-network therapists do not have agreements with insurance companies. This means that you will need to pay the full cost of the session upfront. However, you may still be able to get reimbursed for some of these costs by your insurance company. Can I Still Use My Insurance Benefits with an Out-of-Network Therapist? In many cases, yes, you can. While your insurance might not cover the cost upfront, it may reimburse you for a portion of the expenses if your plan includes out-of-network benefits. Here’s how to find out: 1. Check if Your Plan Covers Out-of-Network Costs Your insurance plan might state something like “covers 80% of out-of-network costs” or “after deductible is met, will cover 60% of out-of-network costs.” This means you may get reimbursed for a portion of what you pay. 2. Check Your Deductible A deductible is the amount you need to pay for healthcare services before your insurance starts reimbursing you. Deductibles can vary widely—some people have a $0 deductible, while others might have a much higher one. If you have a high deductible, you can submit your therapy receipts to count toward it. Once your deductible is met, you can start receiving reimbursements. What Does This Mean in Simple Terms? Navigating insurance can be confusing, but understanding your plan can help you determine which therapists you can work with and how much it will cost. Here are two common scenarios that might help clarify how this works: Example 1: No Deductible with Out-of-Network Benefits Let’s say you have an insurance plan with no deductible and it covers 80% of out-of-network costs. You see a therapist who charges $120 per session. You pay $120 at the time of your appointment, and your therapist gives you a receipt called a “superbill.” You then submit the superbill to your insurance company, and they reimburse you $96 (80% of $120). This means your out-of-pocket cost was only $24, which might be similar to or less than your usual copay. Example 2: High Deductible with Out-of-Network Benefits Now, consider a plan with a $5,000 deductible that covers 60% of out-of-network costs after the deductible is met. You’ve already spent $4,500 on medical care this year, so you have $500 left to meet your deductible. You see a therapist who charges $100 per session. After five sessions, you’ve met your deductible, and for the sixth session, your insurance company reimburses you $60 (60% of $100), leaving you with a $40 out-of-pocket cost. What If My Plan Doesn’t Cover Out-of-Network Therapists? If your plan doesn’t offer out-of-network reimbursement, it might seem like you’re limited to a short list of in-network providers. However, many people successfully appeal this by demonstrating that their insurance network doesn’t include therapists who meet their specific needs. For instance, you might be seeking trauma therapy using EMDR with a therapist who is LGBTQ+ affirming. If your insurer’s network doesn’t include therapists who specialize in both areas, you can explain this to your insurance company and request reimbursement for working with a specific out-of-network therapist who meets your needs. Many clients have had success taking this approach. Why Choose an Out-of-Network Therapist? There are several reasons why you might opt to see an out-of-network therapist, including: A higher level of specialization. Greater availability for new clients. Privacy concerns, as in-network therapists are required to share treatment notes with the insurer. Flexibility, since in-network therapists may need insurance approval for the number of sessions you receive. A strong preference for a particular therapist. How Do I Submit My Out-of-Network Costs to My Insurance Company? To get reimbursed for out-of-network therapy, you’ll need to submit a superbill—a detailed receipt your therapist provides. Before you submit the superbill or see an out-of-network therapist make sure your insurance provider does provide reimbursements or you may be required to pay fully out of pocket for these services. The superbill typically includes: The date and cost of your appointment. Your therapist’s name, license number, NPI number, and practice EIN (tax ID). A diagnosis code, if applicable. A CPT code that describes the service you received (e.g., individual therapy, couples therapy). Once you have the superbill, log into your insurance company’s website, find the “claims” section, and upload the superbill for reimbursement. You can track the claim to see if it’s applied to your deductible or if reimbursement has been sent. If dealing with insurance companies feels overwhelming, there are services available that can handle this process for you. These services will submit the superbill, follow up with the insurance company, and ensure you get reimbursed without the hassle.  Navigating out-of-network insurance benefits can seem daunting, but with the right information, you can make informed decisions about your care and take full advantage of your insurance benefits.