How to Discuss Therapy Fees with Clients

Let’s talk about a topic that makes many of us squirm: discussing fees with clients. Being upfront about money matters is crucial for a healthy therapeutic relationship. it sets the stage for an honest, trust-based relationship with your clients. When you’re upfront about costs, you’re showing respect for your clients’ financial decisions and avoiding any nasty surprises down the road. I’ve seen many therapists be vague about fees or not list them on their website. That doesn’t help anyone and makes future conversations about money even more difficult causing issues in the therapeutic relationship.

When it comes to discussing fees, earlier is usually better. Here are times you want to make sure you are bringing up your fee:

• Initial Contact: When a potential client reaches out, give them a heads up about your fees. It saves everyone time if your rates don’t align with their budget. I always like to say to potential clients “Just so you are aware, we do not take insurance and our fee is $225 an hour.”
• In Paperwork: Your fees should be everywhere in your paperwork. It should be clear what you charge per hour, how long the hour is, and if you charge for other things such as communication outside of session.
• Fee Changes: Planning to adjust your rates? Give your clients plenty of notice, I like to do 60 days at least. Nobody likes surprise price hikes!

Feeling a bit nervous about the money talk? You’re not alone, I always feel a little nervous every time I raise my fees. Here are some tips to make it easier:

• Practice makes perfect, rehearse your fee spiel until it feels natural. I will say it in front of the mirror. I also practice not saying anything after I share my fee. I used to jump in with “But let me know if that’s too expensive!” I have a fee and it is up to potential clients to decide if they are able to afford it.
• Remember your worth. You’re providing a valuable service. Own it! Our work is often life-changing. And we paid a LOT of money for our degrees and continue to pay money for trainings and licenses. I find it helpful to write out the cost of my education and training to remind myself of all that I do to provide good work.
• Keep it matter-of-fact. Treat fee discussions as a normal part of business – because they are. A private practice is a business, not a hobby.
• Be confident. If you seem uncomfortable, your client might feel uneasy too.

When you’re laying out the financial details, make sure to cover:

• Your standard rate. Be clear about your per-session cost and how long sessions are. If you offer intensives, couples therapy, or groups, make sure to be clear about the different fees.
• Payment methods. Cash, card, check? Let them know what works for you.
• When payment is due. After each session? Before sessions? Monthly? Spell it out.
• Cancellation policy. What happens if they need to reschedule or miss a session? Make sure you are consistent and clear about this in your paperwork and go over it in the first session.
• Insurance info. If you accept insurance, explain how it works. If you don’t, be clear about that too. If you offer superbills, make sure to explain how they work and that they require a diagnosis.

Remember, the goal is to be thorough without overwhelming your client. A simple, “Here’s how the financial side of things works in my practice…” can be a great opener.

Therapy isn’t cheap, and clients often have questions. Here’s how to handle some common ones:

“Why is therapy so expensive?”

Instead of getting defensive, try explaining the value. “I understand it’s a significant investment. Therapy involves not just our session time, but also my preparation and ongoing training to ensure I’m providing you with the best care possible. It’s an investment in your mental health and personal growth.”

“Do you offer a sliding scale?”

If you do: “Yes, I offer a limited number of sliding scale spots based on financial need. Let’s discuss your situation.”
Make sure to have a date to check back in to see if they still qualify for a sliding scale!

If you don’t: “I don’t currently offer a sliding scale, but I can provide referrals to other options in our area if that would be helpful.”

“I can only see you once a month at that rate.”

If that is not appropriate clinically, it might be best to refer out: “It’s important that you see a therapist more than once a month to help sustain your mental health. Let’s talk about some other options/therapists who might fit your budget.

It’s important to not be vague or make deals with clients that you can’t sustain. Having a clear boundary around your money limits is critical. Talking about money might not be the most fun part of our job, but it’s a crucial one. By being upfront about your fees, you’re setting the stage for a smooth, professional relationship with your clients. Remember, you’re providing a valuable service, and it’s okay to be compensated fairly for it.

So, next time a new client reaches out, take a deep breath and dive into that fee discussion. Trust me, future you (and your clients) will thank you for it!