When it comes to paying for therapy, there are a few options. Your insurance benefits might pay for it, or you might pay for it. If you pay for it, you might pay a set fee (the same for everybody) or your therapist might have a “sliding scale” fee structure.
What is a “sliding scale”?
A sliding scale fee structure means that the fee you pay for therapy “slides” or varies depending on your income. Many therapists and agencies use a sliding scale in order to provide discounted services to clients with less financial flexibility.
Why would a therapist offer a sliding scale?
Since cost can be a barrier to clients coming to counseling, using a sliding scale is one way that therapists try to balance providing services with being compensated for their time.
The American Counseling Association’s Code of Ethics (2014) explicitly states that “Counselors make a reasonable effort to provide services to the public for which there is little or no financial return (e.g., speaking to groups, sharing professional information, offering reduced fees)” (C.6.e). This means that anybody who is a member of the American Counseling Association (the world’s largest association for professional counselors) has an ethical obligation to use their counseling knowledge and expertise in a way that benefits the community, and so many counselors choose to offer sliding scale services as a way to fulfill this duty.
How do I know if a counselor or agency has a sliding scale?
Ask! Some clinicians will state it directly on their website, while others might designate a couple spots in their schedule to providing services at a discounted rate. The best way to find out if sliding scale fees are an option with that counselor or agency is to ask directly.
How does a sliding scale work?
The agency or counselor will likely ask you for your income (usually monthly or yearly), and based on your income, you may be eligible for a reduced rate. Different clinicians will calculate the reduced rate differently, but if they say they are using a sliding scale, they should be taking your income into consideration when quoting you a fee.
The ACA Code of Ethics does not specify what a reduced fee is, so the numbers themselves are up the agency or clinician. In general, you will see lower rates with agencies, training clinics, and provisionally licensed clinicians; you will see higher rates with private practices and fully licensed clinicians.
What else would you like to know about sliding scale fee structures? Comment below and you might see your question answered in a future blog post!
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