Using Insurance for Couples Work: Relationship-Based Family Therapy

At Sprout Therapy PDX, we support clients navigating relationship challenges with partners, family members, or other significant loved ones. When more than one person participates in therapy and you'd like to use insurance, services are billed as Family Therapy.

What Is Family Therapy?

Family Therapy is a covered insurance service focused on treating one person’s mental health concerns within the context of their closest relationships.

• One person is designated as the Primary Client, whose diagnosis guides the treatment.

• Sessions may include partners, children, caregivers, or other loved ones to support the Primary Client’s care.

• Therapeutic goals focus on improving the Primary Client’s functioning, often by addressing family relationship dynamics and communication.

• The Primary Client is the legal owner of the therapy record. Other participants may only access information with a signed Release of Information (ROI), which can be revoked at any time.

Who Counts as “Family”?

“Family” includes not only biological or legal relatives, but also partners, guardians, caregivers, and other close support people—consistent with Oregon law and insurance standards.

When Out-of-Pocket Couples Therapy May Be a Better Fit

Some clients prefer equal participation and shared access to the therapy chart. In these cases, Couples Therapy is offered as a private-pay service, since this format isn’t covered by insurance.

Private-pay Couples Therapy may be right for you if:

• You want joint ownership of the therapy record (both names on the chart) and share equal access to the record. This may be preferable for contexts where future legal proceedings (e.g., custody disputes, separation, or divorce) could involve questions of access or ownership.

• Your focus is solely on the relationship, rather than one person’s mental health.

• Neither participant has a mental health diagnosis to support insurance billing.