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When To Talk To Your Clients About Fees

When To Talk To Your Clients About Fees

With nearly two thirds of people in the United States unable to make co-pays or pay their medical bills, it is no stretch of the imagination to think that some of our clients will not be able to afford their co-pays, let alone pay fully for services. One of the other things that is pretty common is that people do not like talking about money, especially when they are struggling. It can be embarrassing.

That’s why there may be times when we as therapists must be proactive to talk with a client about money and their ability to pay, so that we can keep the relationship going, and work out something with them before they get themselves in more financial struggles. As it may not always be on our minds, here are some things to think about, to tip you off as to when it’s time to talk about finances and ability to pay.

First, one of the obvious things is that in session they are talking about their finances and money problems. If this is a topic that comes up repeatedly, then we know they are trying to tell us something important, and it is up to us to attend to it. People find ways to tell us the important things, and it is up to us to try to understand what they are saying, and it is also up to us to have clear and frank conversations when the client is unable or unwilling to do so.

Another obvious sign would be clients cancelling or rescheduling often. There are many different reasons for cancelling, reluctance, denial or other defense mechanisms, or environmental factors like an inconsistent job. But one factor that is not often thought of is that they cannot pay for their sessions. This one may be tricky, but keep in mind it may for financial reasons.

Coming in infrequently may be another sign that they need help but cannot afford it. Again, this may for more defensive reasons, for example a client that only comes in during a crisis state, but then disappears when longer term services are offered to address ongoing issues. There is, however, the possibility that they are coming only when they are desperate, because they can only afford emergency treatment otherwise.

Going along with that are people coming in less frequently than is suggested or recommended. If you think the person needs weekly contact, and they are only trying to schedule something once a month, that may be a sign that there are financial pressures that need to be addressed.

Lastly, if they are trying to negotiate, haggle, or barter for services, that’s likely a sign that there are money issues. While there are people who try to negotiate with everyone, it is equally likely this is someone who cannot afford services and they are trying to work something out. This is likely a motivated client and trying to work within their means.

Obviously, none of this means you are obligated to charge a fee below your standard or make a situation untenable for you. As we know, caring for others starts with caring for yourself first. But it does help in our understanding of the person seeking our services and can be a great use of immediacy to have an open and honest conversation about money and ability to pay, that they may not get anywhere else, which will go a long way towards strengthening your relationship with them if you are able to continue it. It can also potentially open a pathway for them to receive the services they need, or at least be referred to more appropriate services that can work with them.

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Jason Simpkins
Posted on 03/23/2018 by Jason Simpkins

Jason Simpkins is a writer at Open Counseling. He is a clinical social worker in Michigan and is dedicated to having quality mental health care available to everyone. And as a University of Michigan graduate, he says a hearty, Go Blue!



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