What’s your sliding scale? Do you have a sliding scale? How low is your sliding scale? What’s your discounted rate?
These words are often the first thing a therapist encounters when a potential client calls, emails, texts, or DMs about therapy. It’s no surprise that mental health professionals find this a jarring and highly awkward beginning to an interaction about starting therapy—and that therapists, themselves, have many questions about the best way to respond effectively, both clinically and professionally, to these potential clients during this important first contact.
In fact, the most often asked question I encounter in Money Matters Workshops and at LA Practice Development Lunches is: “What’s the best way to respond when the first thing a caller—or a text, email or message—asks about is a discounted rate or sliding scale?”
Responding to callers and clients who are asking, but don’t really need or qualify for a lower therapy rate, is a very different type of conversation than the one clinicians trained for and are familiar with—people who genuinely have, a financial need.
Just because clients are anxious about the price or cost of services doesn’t necessarily mean therapists should automatically give a price accommodation. The price a client can afford and the price a client wants to pay may not always be the same thing.
It’s often hard for us as helping professionals to remember that helping a client doesn’t always have to mean giving everyone who asks a reduced rate or routinely offering the lowest possible price for therapy. It also can mean helping people find a lower priced type of treatment and referring them.
While I wholeheartedly support the values that the term “sliding scale” represents, that professionals can help people in need by sometimes--at their discretion and when their schedules allow it—charging less or making other specialized arrangements, so that people can still get affordable help when they need it, I also firmly support mental health professionals charging and being paid a fair price for the professional services they provide to clients.
As therapists, our task is to find the right balance of how, and how much, we can adjust session prices, for which clients, and how many—and not go out of business. In the current climate, navigating talking about prices with these clients takes more specialized skills and requires a totally different mindset, approach, and vocabulary.
As in any clinical endeavor, the words you use to describe your services do make a difference. Yes, the meaning our words convey can either increase or decrease the amount of money we earn and are paid for our professional services. You’ll find that more people will pay in full and out of their own pocket for your services, when they believe you are the professional who can give them what they want—and the wording you use to describe your services conveys that.
Money Talk: Words & Phrases to Consider
Here are some examples of words that can make a difference in income when a clinician talks, writes, or communicates about therapy or money matters—and how and why these words can affect the perceived value, and subsequently, the amount a person is willing to pay for the therapy services provided as a clinician.
This information applies equally to face-to-face conversations in real time or virtually, to emails, texts, social media postings, and what’s printed in marketing materials or is on your website. Each one of these words and phrases can have a direct effect on the amount a client pays you for your clinical services.
As you read the following information, be sure to remember:
Words & Phrases to Consider for Presenting Pricing & Adjusted Pricing
These days the term “sliding scale” seems to come with a lot of baggage for clinicians, clients, and those seeking therapy. For many lay people, the word “sliding scale” means: the price can slide all the way down to zero; the rate will, of course, upon request, always be adjusted to the lowest possible price regardless of the financial need or available resources of the asker; and therapists will always give a lower price to anyone who asks because it’s their job to take care of people’s needs.
An alternative to using “sliding scale” is to use more definite or declarative wording:
For those with a lower income or who demonstrate a financial need—and are eligible, pricing based on lower income . . . special arrangements . . . specialized price/prices/pricing . . . price accommodation(s) can be discussed/made. The adjusted price for a 50-minute session of therapy is . . . The charge for your therapy session is . . .
Here are three examples of what can be said when callers or clients ask about or mention a sliding scale, discount or reduction. These are meant to be tailored to what works for you, your practice, and clientele.
Only Do What Fits You, Your Clients, and Your Therapy Services Best
Confidently take charge of money conversations about prices by using any of aforementioned professional and clinical language recommendations that work with your client population and clinical practice. Focus on the value, cost, worth of the therapy service to the client and their life.
Remember to keep the language, wording, and focus of the clinical and professional money matters conversations on the client responsibility for payment for services needed, received and provided— not on what or how much the therapist gets or charges or how much the number is. Allow the client to pay a fair price for the therapy benefits they receive from you, the highly skilled and trained professional that you are.
Lynne Azpeitia, LMFT, AAMFT Approved Supervisor, is in private practice in Santa Monica where she works with Couples and Gifted, Talented, and Creative Adults across the lifespan. Lynne’s been doing business and clinical coaching with mental health professionals for more than 15 years, helping professionals develop even more successful careers and practices. To learn more about her in-person and online services, workshops or monthly no-cost Online Networking & Practice Development Lunch visit www.Gifted-Adults.com or www.LAPracticeDevelopment.com.
Lynne Azpeitia, LMFT
For 10+ years Lynne Azpeitia has helped therapists to live richer and happier lives through her workshops, private practice and career coaching, and her practice consultation groups which train, support, and coach licensed therapists, interns & students how to create and maintain a successful, thriving clinical practice and a profitable career