Sliding Scale Therapy: How It Works, How to Qualify, and More

Deciding to seek help from a professional therapist is a courageous step and one that might change one’s life.

However, the major challenge that affects many people and even discourages them from seeking help is the financial side of things. While it’s hard enough for one to convince themselves to seek therapy, they also have to figure out how to pay for it.

Therapy can become costly, and most people will decide against treatment because of the professional fees alone. It is a challenge that also affects those with health insurance.

It is where sliding scale therapy comes in. It enables you to get mental health treatment without putting a strain on your finances.

What is Sliding Scale Therapy?

It is a therapy based on a fee structure that takes your income into account to calculate your therapy cost. Sliding scale fee structures are used for both private practices and non-profit therapy clinics. This method is meant for people who cannot afford the standard rates that therapists charge.

A common question one might have is, “Why do private therapy practices offer it?”

It is because they want to help people who can’t afford their rates. Many counselors charge at least $100 per session, meaning several sessions can quickly add up to become a financial burden.

However, their fees are justified because of the various costs therapists incur to maintain their practices. These include things like paying taxes and renting office spaces.

Private practitioners also have to pay for:

  • Health insurance
  • Licensing fees
  • Liability insurance
  • Credits and educational courses

It’s worth noting that most therapists don’t believe that your income should determine whether you can access therapy or not. Most of them are compassionate and wish they didn’t have to turn people away because they can’t afford their standard rates.

However, these professionals also have to sustain themselves and their families. Hence, sliding scale rates are the compromise that allows them to help more people.

How Does It Work?

As mentioned, sliding scale therapy works by allowing people to pay according to their means. So, the lower a person’s income is, the lower the sum they will pay for therapy. The sliding scale structure is used by various service providers like dentists, lawyers, and even medical providers to make the service more affordable for their clients.

With this structure, the amount you are supposed to pay directly relates to a specific income figure. Alternatively, it can be relative to one’s income compared to the Federal Poverty Level (FPL).

For example, let’s assume a therapist charges $250 for an hour. Anyone who earns an income less than 100% of the Federal poverty level can pay a specific minimum that the therapist chooses. Those with incomes higher than the FPL will pay more according to a percentage where their rate of income falls.

Does Sliding Scale Structure Affect Level of Care?

No. The quality of the service is standard for everyone. The sliding scale structure is just a way to determine how you pay for your therapy. The therapy provider will offer the same high-quality care that the person paying the standard rates would receive.

In most cases, the therapist will choose to apply the scale according to your situation and handle the required paperwork. Other counselors will leave it all to the accounting personnel and might not even know how much clients pay for the service.

Either way, the quality of therapy services are standard for everyone.

How to Qualify for Sliding Scale Therapy

To qualify for the sliding scale fee, you have to prove that you cannot pay the full price. The easiest way to do this is by presenting your financial/income information to your therapy provider or social worker. You should also include the number of dependents you support.

The therapist’s office should decide how much you will pay once you satisfy the criteria. Many people benefit from the sliding scale structure for common mental health problems such as anxiety, substance abuse, and eating disorders.

Does Sliding Scale Therapy Sum Up to Insurance?

Sliding scales are designed for people paying for the therapy service directly. So, those who use insurance cannot enjoy the lower rates. At the same time, most insurance companies also do not cover mental healthcare.

If you are finding it difficult to get a therapist who accepts insurance, you are not alone. A lot of mental health professionals and institutions limit the insurance payments they accept.

How to Ask About Sliding Scale Structure

Therapists usually don’t advertise that they offer their services based on the sliding scale fee. So, you will have to take it upon yourself to ask. Don’t be afraid to do it.

It’s important to ask about the costs before you schedule your first session. You also need to be open with the therapist when your financial situation changes. For example, if you lose your job, you should notify them. The therapist might agree to a temporarily reduced rate.

Some counselors offer sliding scale rates, while others do not. Most therapists who don’t provide this option accept insurance payments. Other counselors might not offer sliding scale structures because they fear upsetting clients who might find the system unfair. However, they may make up for it by applying other cost reduction methods like:

  • Including some weekly pro bono sessions
  • Allowing clients to pay using payment plans
  • Offering sessions for half the rate of hour sessions

Finding a Sliding Scale Counselor Therapist

Finding sliding scale therapists takes some work because not all of them share that piece of information on their website or when advertising. So, it is up to the prospective client to call and ask them about their payment policies.

Private practice sliding scale counselors are harder to find than those in public service. So, if you are not finding any luck in the private sector, integrated health clinics might be worth a look.

All you need to do is search for integrated healthcare clinics online and visit those around your area. This information is available on the department of health and human services online site. A lot of integrated health clinics accept both insurance payments and sliding scale fees.

Online Therapy: The Cheaper Alternative

Sliding scale counseling is a decent choice for people with financial constraints that limit their ability to pay the full rates. However, as explained earlier, it is not offered by every therapy clinic. Clients have to search for a while to find a counselor who offers it.

Online therapy is a worthy alternative because it is cheaper and offers a lot in terms of convenience.

Face-to-face therapy is partially costly because of the expenses that come with the brick-and-mortar location. A therapist has to care about rent, utilities, employee salaries, and office supplies. The client also has to spend money on transport for every session.

Removing these costs makes online therapy significantly cheaper. With online therapy, counselors can work from anywhere, including home. Clients can also have their sessions from home or wherever they are comfortable without the need to travel.

Through text, audio and video calls, therapists and clients can communicate regularly.

Online therapy is also quite flexible in terms of time. With face-to-face sessions, clients have to set appointments. However, with online counseling, you can have your sessions at your preferred time.

You can read therapy reviews and choose the best platform for you.

How It Works

Online counseling and traditional therapy are quite similar. The only difference is the setting and mode of communication. Online therapy is more convenient and may be a good option for people with depression or anxiety since they might find it challenging to go outside in public.

You only need an electronic device such as a smartphone and an Internet connection, and you’ll be able to speak to a professional from anywhere.

Other Alternatives

Sliding scale mental health treatment has various other alternatives that a person can consider. Most of them are free, but they might not be as effective as a traditional therapy.

Group Therapy

Group therapy is common among churches and local community centers. The session involves meeting with a group of individuals and a counselor to preside over the session. Group therapy sessions can be free or low-cost. The major downside to this is that you won’t receive the individual attention you would get from regular therapy.

Counseling from Schools and Teaching Hospitals

If you are a student, you may get free counseling from your school, which is already paid for as part of the fees. So, it makes sense to take advantage of the sessions available. Teaching clinics offer low-cost therapy sessions, often involving seeing a therapist and an intern in training.

Employer Assistance Programs

In some jobs, employees are granted programs that may include cheap mental healthcare. It is separate from usual health insurance. It’s meant to help employees deal with various issues in life, such as grief, divorce, and separation.

Online Chat Rooms

There are people out there experiencing what you might be going through too, and one way to talk to them is through online chatrooms. They are usually anonymous chats where people share their experiences dealing with specific challenges and offer help to strangers struggling with the same problems.

However, to participate in these chatrooms, you need to be fine with talking to strangers about your challenges. It can be quite liberating because you know they don’t know you and cannot see you.

Chatrooms also have some downsides. For instance, there are no professionals to moderate, so things can get out of hand.

Final Thoughts

Choosing to seek therapy is a significant step that might change your life for the better. So, you should not let your finances get in the way of receiving the help you need. Sliding scale mental health help is a good option, but you can try the other alternatives such as online therapy if finances are still an issue.

Finally, note that while online therapy is reliable, it is not intended for emergencies. If you experience a life-threatening situation, find your way to the nearest emergency room or contact the National Suicide Prevention Lifeline for immediate assistance.

Let’s learn to prioritize our mental health like we do our physical health.

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