Navigating Therapist Rate Changes: What Current Clients Need to Know

As a professional in the field of therapy, raising rates is a topic that often arises, especially as therapists seek to keep up with rising costs and meet necessary financial requirements. Whether current clients have to pay these new rates or continue with the old ones depends on several factors, including the therapist’s policy and the terms of the original agreement. Let’s delve into the various scenarios and ethical considerations.

Common Scenarios for Rate Changes

Therapists can choose from several approaches to handle rate changes, each with its own implications for current clients.

Grandfathering

Many therapists opt for a grandfathering policy, which means that current clients might continue paying the original rate even after a rate increase. This policy is designed to maintain a sense of continuity and trust in the therapeutic relationship. However, it’s important to note that this approach is not universal and can vary widely depending on the therapist's discretion.

Notification

Another common practice is to provide notification to clients ahead of any rate changes. Therapists usually inform clients well in advance, giving them a chance to discuss the changes and decide whether they can continue with the therapy. This approach allows for better communication and can help prevent misunderstandings.

Contract Terms

If there was a signed contract at the start of therapy, it may specify how rate changes are handled. These terms can vary widely and provide a clear framework for both parties. For instance, the contract might outline a specific period during which current clients must continue to pay the old rate.

Sliding Scale

Somewhat less common but worth noting is the sliding scale. Some therapists offer a sliding scale based on clients' income. This means that even if the rates increase, clients might still pay according to their financial situation, making therapy more accessible to a broader range of clients.

Ethical Considerations

According to the California MFT Law and Ethics Exam by Benjamin E. Caldwell, PsDD, therapists can raise or lower fees whenever they want, even for existing clients, as long as they provide adequate notice. The adequacy of notice is not strictly defined, but it should be sufficient to allow clients to make informed decisions. Additionally, therapists must ensure that their fee changes align with ethical and legal standards.

Ethical Standards

To avoid any ethical issues, therapists should:

Ensure fee changes are within the rules set for therapists in their area, such as not violating federal antitrust laws by setting common fees with other clinicians or clinics. Avoid setting different fees based on race, national origin, or any other protected class. Avoid setting fees that are exploitive, meaning high fees that take advantage of clients' vulnerability or wealth.

Understanding the Therapist's Perspective

For clients, it’s essential to communicate directly with their therapist when any changes to fees are announced. Here are a few points to keep in mind from a therapist's perspective:

Therapists often operate on a much smaller scale than some might assume. For instance, if a therapist sees 40 clients a week, it doesn't mean they can multiply their hourly rate by 40 to determine their annual income. The reality is vastly different.

Therapists need raises sometimes to keep up with inflation and rising costs. Simply relying on higher insurance payments isn't always sufficient. Therefore, it's important for therapists to raise their rates when necessary.

From my experience, I have never increased rates by more than 15% at once and have typically increased them by 10% at most, usually only every couple of years. It is always better to communicate directly with your therapist about any changes to fees to understand how it will affect you.