Sliding Fee Scale

What should I pay on a Sliding Fee Scale?

A sliding scale fee for therapy is offering a different price based on each client’s ability to pay.  At StorieBrook Therapy & Consulting, we offer a this opportunity to all of our clients.

Offering a sliding fee-scale has many benefits, foremost among them the ability to increase accessibility to mental health services, which we know are often hidden behind barriers including cost, privilege, discrimination, and lack of societal support.

Our practice has chosen to take a client-led, social justice approach to our sliding fee scale, working with clients to set fees that meet both their needs and ours. This means that each clinician has the opportunity to work with clients at a variety of rates, and keeps spaces in their schedule open for reduced fee clients.

"So, how do you determine what I pay?"

In a word, collaboratively (just as we like to do anything!). Below is some information on considering what you can afford, but ultimately your clinician will ask you what is reasonable given your budget, and you tell them what works for you. We do not ask you to provide proof of income or paystubs - we're nobody's accountants (and that's probably for the best!).

Common income-based sliding fee scales suggest linking fee schedules to federal poverty guidelines, and varying fees between full rates for those making 3 or more times that amount, down to a nominal rate for those near the federal guideline. This creates a useful suggestion, but in our practice we prefer to let the client lead and state their needs. So here is an example, but we will ask you to tell us what you can afford.

It is also important to us that we consider the impact that marginalized identities have on financial privilege, and so we extend this sliding fee-scale further for those whose identities have been ignored or persecuted, often to the point of adding to their financial burden (for example people undergoing gender affirming care).

Another useful model in considering what you can pay is the "Green Bottle Approach", created by Alexis J. Cunningfolk. This approach uses the image below to demonstrate how financially some people have access to more resources than others.

Looking at this image, consider where you fall - are you most like the fullest bottle, the emptiest bottle, or the one in the middle? This can help you determine where in a range of fees offered to set your rate. 

"So what should I consider when making this decision?"

There is a LOT to consider here, but clients often note that these are important considerations in setting a therapy rate:

Remember, you can always discuss these needs and any questions you have with your StorieBrook clinician. While financial decisions are up to you, we are happy to help!