I’ve been reading and enjoying Blind Spots, a 2011 book about why people make choices that go against their own genuinely-held values. It’s a good read, full of insights that I hope to bring to my work in ethics and policy going forward. One unexpected nugget for therapists: Your late cancellation fee might actually be encouraging late cancellations.
fees
Is therapy more effective when people pay a fee for it?
The idea that clients should pay at least a small fee for therapy in order for therapy to be effective has been around for a long time. But it doesn’t hold up as well as you might think.
This is one of those things that I learned in grad school and simply accepted as truth for a long time. And then I was startled when I actually looked into it. Not only does forcing clients to pay even a small amount for therapy not help outcomes, some evidence suggests it makes outcomes worse.
Is a sliding fee scale unethical?
Back in 2008, the American Counseling Association not only advised against using a sliding fee scale, it went so far as to call sliding fee scales “discriminatory.”