A common question that is often asked by new and perspective clients is whether I offer a sliding scale or reduced rate for the services I provide. The stigma behind money management and charging for your services in therapy can often be a source of fear and uncertainty, as therapists sometimes face judgement for setting fees that are either too high or too low (ie. they either overvalue or undervalue their services). I would like to take the opportunity to share a little bit of the 'behind the scenes' knowledge of setting a reduced rate or sliding scale, and what therapists may have to consider before offering this in their practice. After all, this is a choice that therapists make depending on their practice, therapy style, and financial ability.
A sliding scale is a fee system that some therapists will set that allows clients to pay between a certain bracket amount of the therapists' full fee. For example, some therapists will set a sliding scale between $80-140 (with $80 being their cheapest rate and $140 being their full rate). Depending on a number of factors that contribute to the clients financial situation, the client may pay anywhere on that scale for their session, which typically changes depending on whether the client's financial needs change with time.
Q: Do you offer a sliding scale?
A: No, I have opted not to offer a sliding scale. As a solo clinician, a sliding scale can be complicated to organize and keep track of, as each client's needs and financial situations vary. As such, sliding scale rates are often available in larger private practices with more clinicians of different expeirence levels or in multi-level organizations that receive subsidies for the services they provide. In other words, larger practices and organizations can afford to charge and monitor a sliding scale as they have more staff and availability to accommodate a range of fees.
Q: So, if you don't offer a sliding scale, how do you support clients who cannot pay for your full session fee?
A: I know and understand that paying out of pocket for therapy is an investment. I am not ashmaed to admit that I also attend my own therapy and as a solo small business owner, I don't have benefits to pay for my sessions either. So...I get the frustration of having to pay for therapy out of pocket! To accommodate those who need easier access to my therapeutic services, I offer a range of session lengths that offer come at a reduction from my full session fee. For example, current clients can take advantage of 20 or 30-minute appointments that start as low as $45! In addition, my virtual services are also at a reduced rate as there are less operating expenses required for virtual sessions, in comparison to an in-office appointment. For those who truly struggle to pay for my full rate but would benefit from my full session length (50 or 75-minutes) and demonstrate a strong inability to pay my full rate, I offer a reduced rate.
A reduced rate is a set fee that therapists may set for those who show a need or financial restriction to their ability to pay for their appointments, but the need for therapeutic supports is high. Due to the current state of the pandemic lately, there is a greater need for mental health support AND a reduced fee as many people are facing job loss, lay offs, or reduced hours in their jobs. As such, therapists are working hard to accomodate more individuals on their caseloads at a reduced rate or on a sliding scale. My reduced rate is a $30 reduction to my full fee. That is almost a 25% reduction. In order to offer this to my clients, I have to consider a couple of things:
How many clients can I afford to see per month at this reduced fee?
How do I ensure that other clients can access this reduced fee in a way that is fair and equal?
How do I monitor and keep track of clients at this fee?
What might clients at this rate expect from me, that may be different from those that pay my full rate?
In essence, I can only afford to see 5 reduced rate clients on my caseload at any given time. If a current reduced rate client ends therapy with me or has not been in contact to schedule a follow-up appointment with me for more than 60 days, I offer their spot to the next person on my waitlist. This is how I ensure that I am offering my rate fairly to those in need, while also being fair to the expenses I have as a solo clinician. I actively keep track of all my clients on my caseload each month and reach out to perspective clients on my waitlist on the 1st of each month to ensure I give them an opportunity for support. If I do not have a space available to accept them as a new client, I often provide information on other colleagues who are accepting new clients and work within the individual's expressed needs. My reduced rate only applies to sessions of 50 and 75-minute durations and is monitored every 6 months. At the end of our 6 months of working together, I discuss the clients' comfort with going up to my full rate to allow another individual on my reduced rate waitlist to be accepted. If a client cannot comfortably move up to paying my full rate, an agreement may be set in which we slowly increase the rate per month in order to allow another individual entrance into my practice. Again, this is my way of staying organized as a solo clinician and ensuring I provide equal and fair access to anyone who reaches out for support at any time.
As you can probably tell, there is a lot that often goes on behind the scenes for therapists to be able to offer particular rates, services, and session lengths. Every therapist and practice is so unique, and thus I structure mine on fairness, equality to access mental health support, and flexibility to access sessions that fit your need and lifestyle. From personal experience as a therapy client, I know the value that therapy brings to our lives and I also understand the financial investment it can be.
I value therapy.
I value myself as a therapist.
I value you as a client.
The services and fees I set represent this value and the value of therapy I provide each and every session.
If you have any questions about sliding scales and reduced rates, please don't hesitate to get in contact! To find out more about my services please see the "Work with Me" tab on my website.