Are you a therapist who's ever been faced with the dilemma of a current therapy client who can no longer afford your therapy rates? It's a common scenario, and on today's episode of "Beyond the Session with Aisha R. Shabazz," we explore the importance of having a sliding scale and pro bono policy in place. But even if you accept insurance, don't tune out, because these details apply to you too. 

Do you know the difference between pro bono, sliding scale, low fee, and reduced rate? Have you ever considered the various scenarios in which a client might ask for a reduced rate? Aisha covers these re-definitions & scenarios and offers valuable insight into how to approach them.

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The audio for this podcast is edited by Aleksandra V.

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Copyright 2024 Aisha R. Shabazz

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If your client told you they could no longer afford your

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therapy rates, what would you do?

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Welcome to Beyond the Session with Aisha Shabazz on today's

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episode of Beyond the Session.

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We'll talk about why it's important for every therapist to have a sliding

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scale and pro bono policy and protocol.

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And if you accept insurance, don't tune out because these

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details apply to you two.

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So let's take a moment to break down what pro bono.

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And sliding scale means because the terms are really important, we

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need to be saying the same thing.

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And there's a lot of jargon that flows around, not only just in business and

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in marketing, but in this podcast.

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And that's why, you know, I have the little segments that talk about the biz

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buzzwords and the marketing ABCs, because I don't want you to get lost in trying to

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keep up with the things that I think are necessary to help you keep your practice.

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So the term pro bono is Latin, and it means for the good of the public, and

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it's widely associated with the word free.

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But some industries use this term to describe discounted services.

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But for the purposes of this episode, we will define pro bono

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services as a service that costs $0.

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The term sliding scale, as far as I'm defining it, is anything

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that's less than your full.

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And there are many therapists that consider sliding scale as

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a variable rate depending on a person meeting a certain criteria.

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I don't see it that way because that makes it complicated.

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Now you can define your sliding scale as, you know what, I'm gonna

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charge this amount of money based on this criteria and that amount

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of money based on that criteria.

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But again, to keep things simple and streamlined, sliding scale

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is anything less than your.

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There are two more terms, and again, these can be used intermittently or

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interchangeably with sliding scale as well, and it's low fee and reduced rate.

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And the reason why I think I see these often used sliding scale, low fee and

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reduced rate is because it's indicating to the person that's seeking out

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the service that there is a discount involved now low fee and reduced.

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I am contextualizing that as this is the lowest that the rate could ever be.

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So technically there are three tiers.

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Pro bono, which is completely no money at all, is exchanged sliding scale,

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which is less than your full rate.

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And then low fee slash reduce rate is somewhere in the middle, but closer to

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pro bono than it is to sliding scale.

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So technically you would have four tiers.

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Full rate, pro bono, sliding scale, low fee reduced rate.

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Okay, so for those of you that accept insurance, you know that insurance

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companies do not reimburse us for the full cost of what it takes to provide therapy.

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So don't underestimate the fact that you are offering insurance.

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You are technically offering a sliding scale rate by virtue of taking insurance.

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If your full rate is $200 and an insurance company is only reimbursing

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you a hundred dollars, you are offering a sliding scale rate at 50%.

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Now, you might be thinking to yourself, well, the client is paying a copay.

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Yes, that's a portion of that $100 in this scenario.

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But overall, you were not getting the full rate.

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That means you slid your scale down.

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Okay.

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Now that we have those bases covered, let's go through a couple

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scenarios in which clients could ask for a sliding scale rate.

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A pro bono rate or a low fee reduced rate.

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The number one thing that I see is when clients change jobs.

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When a client changes a job, oftentimes what happens is

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that their insurance changes.

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So if you are accepting insurance, And your client was in network with your

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insurance provider that you had a contract with, and then they changed jobs and

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changed insurances, that client might come to you and say, you know what?

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I can't afford your private pay rate.

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Can you offer me sliding scale, pro bono, low fee reduced?

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You need to be able to answer that question for that client.

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Can you offer that?

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Can you.

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Have you even thought about it before the client asked you that question?

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I hope the answer is yes after this episode.

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The second thing, and it's still around employment, is if they lose their job.

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So their financial circumstance has changed.

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Now, even if someone was private pay and paying your full rate, if they lose their

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job, they're losing a source of income revenue into their household and that

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could impact their ability to afford your.

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The third thing that cycles around jobs is if their employer

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changes their insurance policy.

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Cuz that happens often.

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Some employers, they shop around consistently for the best deal for

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an insurance plan, and sometimes they just go through cycles after cycle.

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Of changing the insurance provider.

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So those are three scenarios in which a client, a current client, could

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come to you and say, you know what?

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I can't afford your rate.

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Can we have a conversation?

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Another situation that could inspire your client to ask for a reduced rate

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is if they have a major life event.

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So if they're getting married, being partnered with someone, cohabitating

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with someone, it changes your financial situation, it changes your lifestyle.

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So they might not be able to allocate the same amount of resources

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that they did when they were not partnered or cohabitating with.

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Another major life change is if they add a family member to their household,

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whether it's a baby or maybe even becoming a caregiver for a loved one that changes

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your financial dynamics in your household.

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So again, do not underestimate the likelihood that a current client could

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ask you for a different rate than what they have been paying before.

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Now, how do you address this?

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Well, there are a lot of things that go into this, and I will go over one of

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them to keep this episode very concise.

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The one thing that I want you to consider is creating a protocol and

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a policy around what happens when a current client asks you for a

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different rate than your full rate.

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And the reason why I want you to consider this ahead of time is because

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if you feel like you're put on the spot, , then you might make a decision

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that is not in the best interest of the client and the best interest of the

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practice, and in your best interest.

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It might sound selfish to say, I have to think about it, or it might

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sound really exciting to be like, oh yes, let's have a conversation.

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If you have to think about.

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that is already ensuing some doubt into that situation of like, oh,

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maybe I shouldn't have asked.

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But if you have the response of, oh, let's have a conversation about this,

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then it's allowing the person on the other end, your client to know that like, oh,

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okay, my therapist was prepared for this.

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Just like they're prepared for the other things that happen in session.

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So you wanna be able to hold space for those conversations, those delicate

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conversations, because money, A sticky topic, and despite our best intentions,

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we don't say the things that we want to say in the moment, . So give yourself

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an opportunity to create your policy and your protocol around what exactly you

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would say to a client in the event that they ask for a rate that's different than

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what they've been paying historically.

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The biggest tip that I have for people in creating these policy,

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Is putting together something and then running through the details

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with someone that you trust, someone that is familiar with your practice.

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So maybe it's a private practice buddy.

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Maybe it's someone who is your accountant, and maybe it could just

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be someone who is not attached to your business at all, and it's someone that

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is gonna be able to give you unbiased.

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So we all have that person in our life.

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We're like, oh, can I bounce an idea off of you?

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Or How does this sound?

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I would encourage you to go to that person and ask them,

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what do you think about this?

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To get their opinion about it, get their feedback.

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How does it make them feel?