In our initial consultation call about therapy, I often tell clients who want to consider a sliding scale space that we’ll take a week to think about what makes sense. This post can hopefully help us decide collaboratively and give you some good ideas for when we talk about money in therapy. The questions in this post were inspired by Chynna Haas.
The reasons I offer a sliding scale in my therapy practice are:
1) People’s financial lives can change quickly. It want to do my best to ensure that no one I work with and build a relationship with looses access to therapy once because of their inability to pay. That means that if you go through a divorce, loose a job or experience a financial hardship, you shouldn’t have to worry about finding a new therapist because of money.
2) Good therapy should be accessible to people who need it most. It’s part of my commitment to offer EMDR and therapy to clients based on fit, even when they can’t afford to pay the full fee.
3) Talking about money can be therapeutic, I believe we can have conversations that are transparent and help us heal our relationships to money if we don’t avoid them. It’s important that the price of therapy is something that people are conscious and intentional about. I want the number we decide on to feel like an investment, something you think about and budget for. It should be an amount that will motivate you to bring your best self. But the cost of therapy should never put you at risk of loosing access to housing or food. A healthy investment will be different for EVERYONE. A sliding scale spot can be $20 or $200.
Here are some things to consider if you’re wondering whether or not it could be equitable for you to have a sliding scale space in therapy. It’s great to take some time to reflect and journal about these questions before we talk.
Income and Earning Potetial:
If you have a high earning potential, you’re probably not a good candidate for a low fee sliding scale space. Here are some questions to help you figure out if you have a high earning potential or income.
Is your salary higher or lower than the average person where you live?
Do you have more than one stream of income?
Do you experience discrimination in hiring due to your background?
Are you sick or disabled in a way that impacts your ability to work?
Is your career stable? Have you ever been denied work due to incarceration history?
Housing and Assets
Housing and assets impact your financial freedom and stability in important ways. It’s important to recognize whether or not any of these things impact your ability to pay for therapy.
Do you own the home you live in or get help with paying your rent or mortgage? Do you have stable housing?
Do you own or lease a car? Or do you rely on public transportation?
Are you able to figure it out when your bills are due?
Does your housing meet your needs?
Do you have enough space for yourself at home? Or live far away from where you need to be for work our school?
Do you have significant debts? Medical or student loan debts?
Do you have assets or money saved and invested for retirement?
Family Support and Intergenerational Wealth
Even if you personally don’t earn a lot, many people have access to resources because family members have enough wealth to help support them.
Do you have access to family resources and financial help making payments if you need them?
Do you live at least partially off of unearned income?
Are you supporting other people in your family with you income?
Expenses
Your expenses can have a big impact on your financial life.
Is your health insurance covering a significant part of your therapy?
Is someone else paying for therapy? Or are you paying for therapy or are you paying for therapy using a flexible spending or health savings account?
How easily can you easily meet all of your basic needs and still buy new items, or go on retreats and vacations?
Do you have medical expenses not covered by insurance? Or immigration expenses?
It’s okay (and NORMAL) if these questions bring up some emotions for you, I’m looking forward to connecting and talking more about them in our next meeting.
Sydney
