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Gillian Dreher
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So you’ve decided that therapy is right for you or a loved one. As you begin your search for a therapist, you may be asking yourself: how am I going to afford this? For many, spending $100-$200+ a week on therapy sessions is simply not possible. Luckily, many providers are aware of this and choose to offer sliding scale fees to help-seekers.

To help you learn more about sliding scale fees and determine how to access reduced fees for therapy sessions, we spoke to Licensed Professional Counselor and owner of Everything But The Therapy Laura Brassie. After working for years as a therapist in her private practice, Laura decided to shift gears and start her own business helping therapists manage their practices and connect with clients that are the best fit for them.

“I’ve worked with a wide variety of therapy practices who all view sliding scales in different ways,” says Laura. No matter how they are implemented, Laura agrees that sliding scales are an important way for therapists to expand care access to lower-income clients.

Brassie pulled from her own experience as well as what she’s learned from the therapists she works with to help us learn more about what sliding scale fees are, how care-seekers can find out if they qualify for them, and how to access a therapist who offers a sliding scale.

What are sliding-scale fees?

A sliding scale fee is a reduced fee that some mental health providers offer to clients who are in need of therapy but aren’t currently able to afford a therapist’s full rate.

You may have visited a therapist’s website and seen a flat fee that a provider will charge you hourly for therapy services. Some providers will also note that they offer a “sliding scale rate” or “reduced rate” for help-seekers who are in need. Others may offer sliding scale rates upon request.

Brassie says that offering a sliding scale rate is one way providers can support clients who are financially in need, however, accepting insurance coverage is another way they can support clients through lower rates.

“What many clients don’t know is that by accepting insurance, therapists accept a rate that is much lower than what they could typically charge for private pay in their local area,” says Brassie.

Brassie notes that if the therapist you’re considering doesn’t accept insurance, they may be more likely to offer sliding scale rates.

How do I know if I qualify for sliding scale fees?

Many care providers offer sliding scale fees based on the care seeker’s “need,” either due to current life circumstances or income.

The way that need is determined varies from provider to provider; some may ask to verify your income before offering you a sliding scale rate while others may not. Brassie notes that it is very common for care providers to verify income before offering a reduced fee, so care seekers shouldn’t be alarmed or offended at this request.

In Brassie’s experience, “Some practices offer sliding scale for a particular amount of time (ex. 10 sessions at a reduced rate), and others offer a certain number of spots in their caseload (5 clients get sliding scale indefinitely).”

When Brassie has offered need-based sliding scale fees rather than those based on income, “it was usually as a stop gap.” For example, if a client lost their job or insurance coverage, she might offer them a reduced fee for a set period of time.

Brassie reminds help seekers that they “should ask about the policy so they know what to expect.” Because offerings and qualification criteria vary, the best way to know what a specific provider offers is to ask.

How can I access providers who offer sliding-scale fees?

Brassie’s advice for accessing providers who offer sliding scale rates is simple: ask them! “Try to remember that the therapist you’re talking to has heard this question many times, and is not going to judge you or think differently of you for asking,” she says.

In addition to looking for potential therapists who offer reduced rates through search engines and your insurance provider, websites like Healwise and Open Path Collective make it easy to connect with therapists who offer sliding scale fees.

Brassie reminds us “if the therapist you contact doesn’t have any sliding scale spots available or the rate they name doesn’t work for you, please don’t push it.” Trust that the provider is offering you the best they can and if they aren’t the right fit, that’s okay– you’ll find one who is.

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Paying For Care
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