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Private Practice Kickstart
with Miranda Palmer, LMFT
& Kelly Higdon, LMFT

Can you do a lower fee?

Can you do a lower fee?
Can you do a lower fee?

Can you do a lower fee?

The exchange of money for your services is not simply a financial transaction in business. There is often an unconscious exchange happening as well, an acknowledgment of roles and of value.

This exchange is powerful when brought into the room between a client and therapist. It opens the door to discuss what therapy means to them if it is “effective” or meeting unspoken expectations.

Discussing your fee is the first container provided to the client prior to them coming to their first session. How you handle this, hold responsibility and boundaries with it, impacts the client and is your first cornerstone of trust.

There are some common reactions that therapists have when discussing fees that we feel is worth exploration.

1.     They don’t discuss it until after the first session. In some states, it is required that the fee be set prior to the appointment. This means the client knows what they are getting into before the relationship is formed. Imagine forming a bond with someone and then being told of an expectation you can’t meet in order to maintain that bond. Discuss the fee from the outset. Get comfortable with saying “My fee is $xxx.” Look in the mirror and repeat it until you are able to say it with clarity and assuredness.

2.     They wait for the client to bring it up. No matter your clinical orientation, if there is an important issue that you see in the session, do you wait till the client sees it or do you bring it up with them? As a therapist, your role is to manage your business and to provide the boundaries for the work and the fee is part of that. Putting it on the client is unnecessary. Bringing forth your fee, up front is you saying, I have taken care of these aspects of my business for us to do our work.

3.     They get defensive. The reason that people call expecting to negotiate the fee is because our community has taught them to do that. It does not happen when they go to a restaurant or their doctor because those communities are quite clear that their fee is set and not negotiable. The person asking for a lower fee or a packaged fee is doing so because that is what they know to do. It is not a personal attack and it isn’t about you at all. Respond with kindness, be factual but not defensive. “Thank you for asking about that. I keep a flat fee for all of my clients. Does this fee not work for you? Tell me more about your situation so I can help.” The discussion about the fee is another opportunity to discuss if this is a good fit for you and the client. You can give them referrals out if it isn’t and that will be more helpful for the client in the long run.

4.     They take a lower fee than they want. Getting clients through the door just so you can fill slots is a recipe for resentment and frustration down the line. It also is harder to come back from and make changes to when you realize that you cannot sustain the fee you agreed to. If you agree to a fee, it is your decision. Take responsibility for these decisions in your business and understand the clinical impact it may have on the relationship. Having a confident therapists makes for a more trusting relationship with the client.

Sliding scale fees can be part of your practice but you want to have a process by which you determine if someone is eligible for the lower fee. If all your clients sat in a room together to discuss what they pay you and how that was determined, would you be confident that it was clear amongst all of them?


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Can you do a lower fee?

Kelly Higdon, LMFT

Kelly Higdon, LMFT is a private practice expert that believes therapists are some of the most important healers in the world. She teaches therapists how to grow successful businesses from scratch and to move beyond the couch with multiple streams of income. Get to know Kelly better through her free private practice marketing trainings, the Business School Bootcamp for therapists, or through private practice consultation.


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APA Reference
Higdon, K. (2019). Can you do a lower fee?. Psych Central. Retrieved on December 10, 2019, from