Shrinking the Stigma

Welcome to the blog of Roya Dedeaux, Marriage and Family Therapist Intern #73122. You are reading one of the posts in my “Shrinking the Stigma” series – where I will answer questions people have about the logistics and process of therapy. Because of its confidential nature, we tend to shroud the therapy process in so much mystery! My blog attempts to dispel that mystery and make it easier for you to use it as the wonderful resource it can be. Check out the other blog posts at

“I’m trying to figure out how much it will cost, what does ‘sliding scale’ mean?”

Some therapy providers will offer “sliding scale” fee agreements. This doesn’t mean “cheap” or low cost automatically.  It means they will ask for proof of your income, expenses, or proof of financial hardship, and adjust their fee accordingly. I have worked at a clinic where I worked with one client who paid $15.00 and another who paid $85.00. Same therapist, same clinic, different income levels just determined different prices. When you are asking a therapist about sliding scale, just remember it might not end up being cheaper than a therapist with fixed rates.

It also means that if your income level changes, you will be asked to do a new fee agreement. If you were unemployed when you started, but have a job a few months into therapy, your session fee will be readjusted to match your new income level.

Your therapist may have other reduced fee policies.  Some will have lower fees for students, for example. Or, if there are time slots that are harder to fill, your therapist might have a few times a week at a reduced rate. Your therapist might have lots of demand for her 4-8pm sessions, so in order to increase her business efficiently she might charge less for the less-coveted 3pm spot.

Money is a part of the therapy process. You’re paying for services and your therapist is operating a business. It’s the therapist’s legal and ethical requirement to tell you their fee before you begin therapy with them, and it’s your job to make sure you uphold that agreement! It’s better to be upfront if there is ever an issue, because you don’t want finances to get in the way of the rest of your therapy. We’ve been told it’s rude or distasteful to discuss money, but in this situation, don’t let that stop you from talking about it with your therapist. It’s part of what we’re here for.


“How long will therapy last? Why do therapist charge so much?” Look for answers to these questions and more in other blog posts here at!

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