Fees in Psychotherapy and Counseling: Clinical Ethical and Management Considerations

Fulfills Professional Ethics for all professions. Check with your state board if you have questions.

Most therapists have difficulties in their attitudes toward money. They primarily ignore the topic, both regarding themselves and too often with their clients, especially with the clients who are more financially successful than they are. Many therapists believe in the notion that care and profit are inherently incompatible or that therapists choosing to go to graduate school to study psychology, social work, or counseling, rather than business, law or economy, reflect the motivation of most psychotherapists. As a result, setting, charging and collecting fees in psychotherapy becomes a burdensome chore for many therapists which is often not handled well either clinically or ethically.

This advanced beginner/intermediate course consists of two sections, comprised of six articles presented in both audio and text format. The first section discusses the meaning of money in our culture and identifies ways of charging clients. It includes a self-assessment tool for therapists to identify their own attitudes regarding money and then discusses what, at times, may be well-intended but fraudulent billing practices. The first article concludes with discussions of both the ethical and pragmatic concerns regarding using billing services. The second article provides an overview of the ethics of bartering as a legitimate means of working with clients with limited means to meet therapists’ fees.

The second section contains several articles that discuss therapists’ attitudes towards fees, along with the complexities of handling fee issues in psychotherapy and psychoanalysis. Discussions regarding the causes of ambivalence and discomfort when it comes to fees are included.

The final section reviews the codes of ethics of five different professional organizations as they pertain to fees, informed consent, and billing practices. This is provided for reference purposes, and the content is not included as part of the posttest evaluation.