I got called to the carpet during a recent phone consult with a potential client. The caller wanted to know why I charge “so much” for psychotherapy and why I don’t offer sliding scale (i.e. reduced) fees. He was also quick to point out that the ethics of my profession expects psychologists to give back to the community as justification for his inquiry.
In short, he wanted to know if I was a money-hungry therapist that didn’t care about people’s well-being and just wanted to line my pockets with dollar bills.
Talk about shame and judgment!
My triggers all went off and I lit up like a Christmas tree. And yet, after breathing through the discomfort his question created in me, I realized that he deserved an honest answer (despite his tone when asking). It’s a valid question given my line of work deals in mental health, a delicate and intimate part of our well-being.
A Quick Aside
You may not know this, but many psychologists and therapists have feelings of shame around the subject money. Most therapists trained in non-profit agencies, working with very distressed individuals and families that had no other access to therapy, support, or related resources. That work is usually not paid or paid very little because it’s considered training. After years of working for little to no compensation, it makes them feel very uncomfortable charging people in need. They often forget the years of hard work and training because helping comes so naturally and easily to them.
After a second that felt like an eternity, I composed myself and responded.
The answer I gave him shocked the hell out of both of us, lol. At his suggestion, I’m sharing my response. It went something like this:
“Yes, paying for therapy out of pocket is expensive and I understand that not everyone can afford that. I see psychotherapy as a personal investment – no different than a house, a car, a luxury handbag or fancy shoes that will bring years of enjoyment, happiness, and satisfaction. It’s an investment in yourself so you can be the best version of yourself and share it with your family, friends, colleagues, and community.
As a psychologist that specializes in issues related to self-esteem, shame, and self-worth, I have to be incredibly clear how I’m impacted by these topics, personally and professionally. I can only take my clients on the journey insofar as I’ve been willing to go myself. Charging a fee that reflects the quality of my work allows me to set boundaries and value myself and the work I do. It also means that I’m being congruent as a person and professional – modeling these healthy behaviors for my clients.
Basically, I walk the talk.
I get that working with me feels like the best fit for you because of my specialty and that you’re frustrated that finances are a barrier. Using out-of-network benefits for reimbursement or going the insurance route are good options. There are some great therapists that are in-network and can help you, too. I’m happy to refer you to some of them that I know and trust.
The answers to your questions about sliding scale and giving back to the community are related.
I don’t offer sliding scale fees to therapy clients because I choose to reserve reduced fees for people in need of psychological and neuropsychological testing, which are services are exceedingly more expensive to afford.
I partner with the Division of Vocational Rehabilitation (VR) in Florida’s Department of Education to provide free quality psychological evaluations to people with mental health conditions that get in the way of finding and keeping jobs. My evaluations help these people find appropriate workplace settings, get accommodations so they can work, and get retraining so they can return to the workforce, their self-confidence and self-worth returning along with it. Men, women, and young adults that can’t afford health insurance are able to find meaningful work and become happy productive members of our society.”
If you’re interested in getting involved with VR, you can learn more here.
We hope this article helps demystify why therapy costs “so much” as you’re searching for support. If you like what we have said and what we stand for, then please accept my invitation to schedule a free 20-minute Clarity Consult. You can also reach us at (305) 501-0133. We will gladly address your concerns, and point you in the right direction if we’re not a good fit for each other.