What is this blog about? : It talks about the concept of sliding scale therapy, how it works and who can avail it.
Who is it for ? : The clients who want to start therapy but finances may be one of the reasons that are holding them behind.
Also Check: Cognitive Behavioral Therapy Online India
Key points
Sliding scale is a system that allows therapists to make therapy affordable for those with limited financial resources and help the clients. It also helps the therapist to continue offering their services while covering their costs.
Students, Senior citizens,Individuals with Special needs, Marginalised communities are some of the key populations which can make use of this facility if they fit the criteria.
Therapy is a pathway to a healthier self. It tackles mental health conditions, equips you with coping mechanisms, and fosters self-awareness. They boost overall happiness, stress management and also physical health.
Even though people nowadays have started to become aware of the importance of therapy, it still isn’t as affordable as one would like. Some mental health professionals, hence, use a fee structure to make therapy more accessible. It adjusts the cost and fee of the sessions based on the client’s income and ability to pay.
India has a severe shortage of mental health professionals, with only 0.3 psychiatrists and 0.07 psychologists per 100,000 people. In comparison, developed countries have 6.6 psychiatrists per 100,000 people. Additionally, India has just 0.004 mental hospitals per 100,000 people, far below the global average of 0.04 as mentioned in the study done by Economic times.
Thus despite this increased awareness therapy can still feel like a luxury to many. Therapists in India, are trying every day to change the face of these practices and make them available as well as affordable to all. One such practice is charging clients for therapy on a sliding scale .
According to the Britannica dictionary, the definition of the term – Sliding Scale is – “a system in which the amount that people are required to pay in fees, taxes, etc., changes according to different situations or conditions.”
This approach allows the organization to tailor therapy costs to each client’s financial situation, ensuring that everyone, regardless of their financial status, can access the mental health support they need. By considering factors such as income, dependents, employment status, and financial hardship, the sliding scale model provides a fair and equitable solution for those seeking therapy. This practice not only promotes inclusivity but also aligns with the broader goal of making mental health care accessible to all.
How does sliding- scale work in therapeutic practice?
- Therapist sets a range – They pre-decide the minimum and maximum fee per session. The maximum fee is the standard rate of the therapist while the minimum is the lowest they can offer, without compromising the quality of care they provide..
- Discounted/ subsidised rates are offered to clients based on their paying capacity which may be determined based on various factors. These could include their income, number of individuals they are providing for, their own employment/dependent status, or if they are financially disadvantaged and legitimacy of such a claim has been established.
- Income Verification – the organization or the therapist may request clients to provide proof of income to determine and verify their eligibility for a reduced rate.
This system allows therapists to make therapy affordable for those with limited financial resources and help the clients. It also helps the therapist to continue offering their services while covering their costs.
Why is therapy so expensive and why can’t Sliding Scale therapists provide free sessions for those in need instead of sliding scales?
The reasons for the same are as follows
1. Extensive Training & Skill Acquisition: A credible therapist spends several years in training and acquiring important and suitable skills to provide effective mental health care. This includes not only academic education but also supervised practice, certifications, and continuing education. The financial cost of this education can be substantial, often involving student loans and other expenses that need to be repaid.
2. Practice Setup and Operational Costs: Setting up a private practice involves significant capital investment. Therapists need to rent or purchase office space, furnish it appropriately, and maintain it. There are also ongoing operational costs such as utilities, insurance, administrative support, and professional licensing fees. These expenses are necessary to create a safe, comfortable, and professional environment for clients.
3. Living Expenses and Overhead: Like anyone else, therapists have their own living expenses to cover, including housing, food, healthcare, and transportation. Additionally, they may need to pay for their own health insurance, retirement savings, and other benefits that are not provided by an employer in a private practice setting.
4. The Value of Time and Expertise: Therapy is a time-intensive service that requires the therapist’s full attention and expertise. During sessions, therapists provide specialized care tailored to each client’s needs, which requires a deep understanding of psychology, human behavior, and therapeutic techniques. The concept of “time is money” applies here; the time a therapist spends with one client is time they cannot spend with another – they cannot take two clients at a time or divide the attention. They are expected and trained to be fully present and focused in the therapeutic setting. They don’t just give their time but also channel their whole energy in providing the best services possible. It is only fair for them to be compensated rightfully for that time, energy and expertise.
5. Professional Boundaries and Ethical Considerations: While the desire to help those in need is strong, therapists must also consider the sustainability of their practice. Offering free sessions on a large scale could jeopardize their ability to continue providing services, as they still need to meet their financial obligations. Sliding scales offer a way to balance this, allowing therapists to adjust their fees based on a client’s ability to pay while still maintaining a viable practice.
In summary, the costs associated with therapy reflect the extensive training, operational expenses, and the valuable time and expertise that therapists dedicate to their clients. While free sessions may not be feasible, sliding scale fees provide a compassionate alternative that makes therapy more accessible while respecting the therapist’s need to sustain their practice.
Does the Center for Mental Health provide these facilities?
The answer is a definite Yes! Center for Mental Health ensures it provides a range of options for clients in need for mental health aid and in making it accessible to most.
Here’s who can typically avail of this facility
Individuals in Limited Income – A large chunk of the population who fall in this category do avail of this facility. Therapists usually consider doing income verification to confirm the client’s application. Seniors or individuals relying on a fixed pension, which may not be adequate, might qualify for a sliding scale.
Students – Financial crisis due to less or limited income during student life can make them eligible to avail of this facility. Students are mostly dependent on their parents. At least till the age of 20 major financial decisions about the individual’s finances is taken by or overlooked by their parents. Even if they are receiving any pocket money, it is still a fixed amount – especially those who are living away from home. They money they receive, monthly is a fixed amount and it may not be possible for them to budget all the expenses and add this expense to it. There are cases where the students may not exactly have the support anad encouragement from their family regarding taking therapy. In such cases too they may not have the means to tell their parents the real reason about why they need more money.
Financial hardships in the family – There can be cases where the client’s family might be going through extreme hardships due to sudden financial loss/ job loss/ loss of the breadwinner or in general lack of adequate income. . In such cases, the therapist may offer reduced fees for the client in order to ensure they receive the support they need.
Crisis – If a client has a mental health emergency (extreme suicidal thoughts for example) and requires immediate support/ treatment, the therapist may consider reducing the fees for that specific amount of time.
Special needs – Parents of children with special needs often face a lot of challenges as they try to cover all the expenses required. Educational support, medications, therapy may not seem like a big financial burden, but it can feel the same for some people.
Marginalised population – Marginalized and minority groups often experience higher rates of mental health issues due to systemic inequalities, discrimination, and lack of access to resources. Sliding scale therapy helps address these disparities by providing affordable mental health care.
The client-psychologist relationship is of the utmost importance to the practitioner. One of the key principles of practice is ‘ non-maleficence’ which means “Do no harm”. The psychologist does try to help the client in all and every way possible, regarding the finances in the therapeutic setting. Unfortunately, it can get tough to understand a client’s financial situation at times. The client should thus be as transparent and clear as they can about their financial situations so that the psychologist too understands their requirement clearly and can provide options accordingly.
In addition to that, there can be some unfortunate situations where the client is dishonest towards the psychologist and they make unfair use of the sliding scale facility. The psychologist may not always check the financial statements of the client. Since the therapeutic relationship is based on trust, the psychologist would try to make sure that the client is honest with them. But in situations like these, it is an unfair practice to dishonestly make use of the facility provided. Each and everyone needs to understand that the facility is only for those who genuinely require it. Taking undue advantage of such facilities is not only morally and ethically wrong but is also a genuine disservice and a stealing of opportunity to those who actually need it.
Sliding Scale if used efficiently and honestly is an important way to reach the general population and make therapy more affordable. It is a crucial step to help spread awareness of therapy, get rid of the stigmas and encourage more and more people to consider taking therapy and benefit from the same.