Permission to Be Profitable: Therapists in Private Practice

1. Is a desire for profits inherently unethical?(Required)

a. True

b. False

2. What are some potential benefits to a therapist being profitable?(Required)

a. A therapist can model a healthy attitude about money to clients.

b. A therapist has enough of a financial cushion to operate even in difficult times.

c. A therapist is financially equipped to offer low-fee or pro-bono sessions on a selective basis.

d. All of the above

3. What are some everyday situations where a therapist’s issues with profitability might be relevant?(Required)

a. Collecting fees for missed sessions

b. Discussions about raising fees

c. Discussions about past-due balances

d. All of the above

4. Why do some therapists have issues about profitability?(Required)

a. Profits are rarely discussed in graduate school.

b. Therapists fear it seems uncompassionate to discuss fees if this topic makes the client uncomfortable.

c. Therapists view discussing fees as related to their own needs, and they fear their own needs don’t matter in the therapy room.

d. All of the above

5. What are some ways that therapists can navigate raising fees in a professional yet ethical manner?(Required)

a. Giving clients plenty of notice about fee raises and/or including a fee raise calendar in the client agreement

b. Providing a list of lower-fee providers if the therapist’s new fee is unmanageable

c. Offering a number of low-fee or pro-bono spots

d. All of the above

6. How could a therapist’s unwillingness to openly discuss fees or other financial issues harm clients?(Required)

a. Clients could infer that talking about money with their therapist is taboo.

b. Clients could be afraid to celebrate their own financial success in therapy (i.e. their own job promotions, raises, bonuses, etc) if they perceive their therapist is struggling from a business or financial standpoint.

c. A therapist’s difficulty in advocating for themselves financially may create a lifestyle where they are forced to see larger volumes of clients than is healthy for them and/or render them unable to take vacations due to financial burden; this burnout could negatively impact the quality of the services they provide.

d. All of the above

7. What are some potential harms to a situation where a client is repeatedly late to sessions, and the therapist simply extends their appointment end-time without any additional fee?(Required)

a. The therapist may build conscious or unconscious resentment towards the client.

b. This pattern may foster or enable an unhealthy attitude of entitlement in the client.

c. The therapist may ultimately lose so much time in this pattern that they are less able to open spots for new clients, which may create a burden on the therapist and/or the community of potential clients who need help.

d. All of the above

8. How can therapists model healthy financial boundaries?(Required)

a. Having clear policies about missed appointments or late arrivals

b. Having clear information about “grace” within these policies, such as offering a set number of “free passes” regarding missed arrivals or late arrivals

c. Treating clients with respect, including expressing a belief that the client is able to understand and adhere to financial agreements

d. All of the above

9. Why do some therapists use an “open authorization” to charge credit cards?(Required)

a. It gives them an added assurance of payment.

b. It saves valuable time and effort that may otherwise have been spent “chasing” clients for payment.

c. It is another opportunity to literally spell out the client’s financial obligations in a format that the client personally signs and authorizes in advance, which only increases the client’s awareness of their financial obligations.

d. All of the above

10. What are some potential policies to handle late cancellations?(Required)

a. Make a clear policy of charging full fee for any late cancellation, regardless of reason.

b. Make a clear policy of charging a pre-set “late cancel fee” that is less than an actual session fee, but still enough to compensate the therapist for their time, office space, etc.

c. Make a clear policy that specifies a pre-set number of allowed late cancels per calendar year.

d. All of the above