This is the 4th post in the series
Reduced Fees, Sliding Scales, and Lessons Learned.
The series actually begins here.
How Does Your Reduced Fee Reflect on Your Overall Reputation?
Are you thinking about advertising the fact that you offer a sliding scale fee? I strongly discourage mental health professionals from doing this and here’s the reason why . . . .
Once referral sources discover that you routinely provide services for a reduced fee, that is the idea that 
becomes attached to your name i.e. you provide the cheap stuff.
That’s NOT what you want to be known for even if you run a non-profit and routinely charge less than the Usual and Customary Fee for your services.
Your reputation should be based on the services that you provide and what differentiates you from your peers . . . not on having the lowest rates in town.
You make a good point. As a balancing (not refuting) view lower fees don’t necessarily mean lower quality. Quality services (quick responses to referral sources, being on time for appointment, getting referrals in within a week, progress updates when appropriate and with releases, focusing on real life measurable outcomes, professional and collaborative participation with teams, frequent check in on the therapeutic alliance, and discharge planning from the outset) are recognized by both the client and the referral sources. The fee in therapy isn’t tied 1:1 to quality… you can do both and be known for both.
Thanks for a great thought provoking blog!
J. Kipp! Welcome back! You are absolutely right. Low fees do not equate to poor services and higher fees do not equate to higher quality services. What I meant to say is that once a therapist becomes known as the one who offers services at a reduced fee, colleagues often begin to refer all their low-fee clients to that therapist while keeping their full-fee clients for themselves.
It’s important for therapists to know what they can and can’t afford to give away – time, talents, and resources – and to recognize the implications for doing so. Those boundaries will enable you to donate the right amount to the right clients in the right way . . . so that your clients and your own needs are met while growing your private practice.
Tamara, I’m not sure whether to question your choice of colleagues or the ethics of those colleagues first; that is assuming you actually experienced what you talk about here. You raise some solid points for consideration. They aren’t points that support some of the conclusions you draw, however. You sum it up best in the second paragraph of your response to J Kipp. And none of what you say there implies that any of the ‘bad things’ you mention will happen.
Hi, Rob. It’s good to have your voice here.
“Colleagues” in this post is defined as the members of one’s profession so I’m sure that we can agree that I didn’t “choose” my colleagues. And, overall, I am very proud to be associated with the licensed counselors that I work with.
And, yes, I actually have experienced other professionals acting on their clients’ best interests and referring them to services with sliding scale fees. As a Licensed Professional Counselor, it is expected that we will gather and have available resources for our clients. As such, it is logical to conclude that if you advertise that you provide your services on a sliding scale fee, others will likely retain that information as a resource for future clients in need.
It has also been my experience on more than one ocassion to have been present in conversations with other professionals who questioned the quality of a therapist’s skills based solely on the fees charged for services. As I’ve already stated, it is not logical to draw conclusions about quality of services based on fees charged or the population being served. Nevertheless, my point is that it happens.
The truth is your published fees say a lot more about your perception of the value of working with you; and, those same published fees say a lot less about the actual quality of the service being provided. I’m simply advocating that counselors be conscious about when / where / how they choose to adjust (and advertise their adjustments of) fees to accommodate clients in need.
Rob, do you offer a sliding scale fee and, if so, do you publish it?