Fee Disclosure In Therapy

Your consumer attitude gets strengthened every time you remember how much you pay for services (Here are some tips on how to make therapy more affordable). This makes money a very important grounding element of every consumer-provider relationship, especially the therapist-client one, where it is very easy to lose sight of financial reality because of the emotional nature of therapy work.

The most important thing for you, as a consumer, to know is that a prospective therapist has to disclose their fees prior to seeing you. In California, this is not just an ethical requirement, it’s a law. It may also be a legal requirement for other states. (Check with your state licensing boards) Here is what California Association of Marriage and Family Therapists Code of Ethics says about fee disclosure in therapy:

“Marriage and family therapists disclose, in advance, their fees and the basis upon which they are computed, including, but not limited to, charges for canceled or missed appointments and any interest to be charged on unpaid balances, at the beginning of treatment and give reasonable notice of any changes in fees or other charges.”

And here is what Code of Ethics of American Association for Marriage and Family Therapy says:

“Prior to entering into the therapeutic or supervisory relationship, marriage and family therapists clearly disclose and explain to clients and supervisees: (a) all financial arrangements and fees related to professional services, including charges for canceled or missed appointments; (b) the use of collection agencies or legal measures for nonpayment; and (c) the procedure for obtaining payment from the client, to the extent allowed by law, if payment is denied by the third-party payer. Once services have begun, therapists provide reasonable notice of any changes in fees or other charges.”

Sometimes, however, the above rule gets interpreted by therapists in the way that undermines its original intention to inform clients as much as possible about the therapist’ payment policy so they would be able to make an informed decision about hiring the therapist or not, or, in other words, to enter into a professional relationship with this therapist.

It’s not uncommon for therapists to respond to the question about how much they charge by saying “Let’s talk about it in person.” When you see them in person, it’s your official first session for which you will be paying unless the therapist told you in advance that your initial meeting with them would be free of charge. How can you walk into the therapist’s office knowing that you will have to pay for their time but not knowing how much?

Sometimes, it’s easier for both clients and practitioners to discuss the practitioner’s fee in person, which is a perfectly legitimate thing to do if you, the client, aren’t required to pay for the time you and the prospective therapist discuss financial arrangements.

It is also legitimate for a therapist to charge you for the first meeting a significantly discounted price commonly known as the “intake assessment fee”, as therapists often call the initial meeting an “intake session”. In that case, the “intake fee” should be disclosed to you before the meeting.

The bottom line is that it is simply unfair to charge you the practitioner’s full fee, if any amount of your session’s time was spent on discussing the therapist’s policies. The therapist should be paid for the work they do during sessions, not for the time they spend with you. The amount of time the therapist spends with you in and of itself doesn’t help you in any way. It’s the work that both you and the therapist do during that time that makes a difference.


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