Mental Health And Sliding Scale Therapy

Not everyone can easily manage the costs of therapy, which is why many therapy providers now offer sliding scale therapy. You can learn more about a therapist’s sliding therapy options and negotiate a set amount for therapy by connecting with therapists in your area or online. Some therapists provide flexible pricing, starting at $80 per session. For many, affordable therapy can be obtained with relative ease.

Sliding scale therapy

Therapists and other mental health professionals understand the importance of ensuring clients can afford their services. They commonly institute a sliding fee scale to ensure that low-fee therapy is available to those who need it most. A sliding scale is a type of fee structure - based on a client’s income - that therapists sometimes use to offer people with fewer resources reduced fees. By considering a customer’s ability to pay based on their overall income, therapists can make their services more accessible, offering sliding scale rates starting at $80.

Income and therapy fees

The therapist sets up one sliding fee scale that is used for any client, whether they’re an insured patient or someone seeking financial assistance. If you have enough resources to cover the full therapy cost, you will be billed at the therapist's standard session fee. Sliding scale fees are especially helpful for those with a low income, allowing them to access mental health care at an affordable rate. For example, in a one-on-one practice where the full price is $175 per hour or per session, if you make less than the poverty threshold of $50,000 per year, your sliding scale fees may be $75 per hour, but if you have an annual income of $120,000 per year, you may pay the full price per session. 

These numbers, or the set sliding scale fees, take into account the client's pay as well as the therapist's salary. Clients who earn more money may be expected to pay closer to the full session rate compared to those with lower incomes. Sliding scales, of course, can vary for each one-on-one practice, but in the U.S., they are usually dictated by the Federal Poverty Guidelines and the Bureau of Primary Healthcare.

Who can benefit from sliding scale therapy?

The sliding scale rates can help determine how much you pay for your chosen therapy or therapist options. Clients with limited financial resources can greatly benefit from sliding scale therapy, as it allows them to access necessary care at a reduced cost.

Will paying reduced fees affect treatment?

Whether you pay the full cost of your sessions or a reduced sliding scale fee, the providers at your chosen therapy center follow ethical guidelines to give you the same standard of high-quality care as clients who pay full price. They make no difference in the way they treat you or the time they spend in pro bono or sliding scale sessions. 

Fee structures in therapy

Sliding scale fees are not unique to mental health services; many healthcare providers and educational institutions offer a reduced rate or sliding rates for their services. Talk to your primary care provider to learn more about accessing affordable mental health services. Note that the cost of therapy sessions, including sliding scale, can vary, but they often range around $120 per session depending on the therapist and location.

Do you qualify for sliding scale therapy?

If you do not believe you can afford the full price, you can present your income information and number of dependents to a provider who can offer sliding scale rates. If you meet the sliding fee scale criteria to receive affordable therapy, you'll pay reduced rates or lower sliding fees based on your level of need. Often, therapists working in individual practice have more control over the financial support they can offer clients, and it may be worthwhile to contact individual practices to see if their therapists offer a sliding fee scale.

Sliding scale therapy vs. health insurance

Sliding scales are designed for people who are paying for the service themselves directly to a one-on-one practice, therapy center, social worker, or other mental health professional rather than those who are paying through an insurance company. With those who offer sliding scale fees, you don't typically get a reduced fee for your copays or deductibles. In many cases, it's less expensive to pay out of pocket with a sliding scale fee than to use your health insurance. Some therapists may reduce their sliding scale fees to $60-$75 in special circumstances, depending on the client’s financial situation.

Therapists’ guidelines

Not every practice with a sliding fee scale has the same rules or code of conduct. A sliding scale may require you to verify income with a pay stub to prevent insurance fraud and demonstrate that you cannot actually afford to pay full price. Others may take your word for your income and set sliding scale fees based on that. If you don't qualify for the sliding fees, there are other mental health resources, such as community mental health clinics and online therapy platforms.

Online mental health support

While seeing a therapist face-to-face at a one-on-one practice may be the more traditional way to have counseling, it tends to be more expensive. Nowadays, many therapists choose to practice remotely because of the benefits it offers them and their clients, promoting a fair trade between services and expenses.

Online therapy has been proven to be just as effective as in-person therapy, offering a wider range of flexibility and availability. While many online therapy platforms don’t accept insurance, they tend to offer affordable monthly subscription plans. Some platforms, such as BetterHelp, offer financial aid to those who qualify.

Getting started with affordable online therapy is as easy as completing a quick registration process, providing contact information, and selecting a therapist that meets your needs. Payment plans are usually based on a subscription model, allowing more people to afford essential therapy.

The individual therapy and counseling services you get online, often provided by participants of the American Counseling Association, are the same as you would get in a more traditional setting. This type of therapy may be especially helpful for individuals experiencing social anxiety or depression, as they don't have to sit in a waiting room or interact with anyone but the therapist. 

Alternative options

In addition to individual therapy sessions, there are other options that offer mental health support. Some include therapy at community centers, schools, teaching hospitals, employee programs, and chat rooms. Some therapists may also work pro bono or offer services through moderated online forums or chat platforms.

• Group therapy: One of the most popular types of therapy is group therapy, which can be found in many areas at local churches or community centers. Most of the time, the sessions are free or very low cost, and you would meet with a group of people and a therapist or clergy member who moderates the session. 

• Schools or teaching hospitals: You may also be able to get counseling from a local school or teaching hospital. Teaching hospitals and clinics usually offer free therapy or low-cost counseling in a teaching situation where you'd be seeing both the therapist and an intern who is receiving training through continuing education courses. 

• Employer assistance programs: Some employers offer employee assistance programs that may have free or low-cost mental health care. This is usually separate from your health insurance and is a resource to help employees manage life challenges like divorce, grief, and other major concerns.

It's important to note that therapy is intended for non-emergency situations only. Visit your nearest emergency room if your issue is an emergency or you're facing a life-threatening situation.

If you or someone you know is struggling or in crisis, help is available. Text or call 988 or chat 988lifeline.org. Support is available 24/7. If you are experiencing trauma, support is available.