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ethics of therapy and payment

Posted by pegasus on April 11, 2011, at 10:23:16

I've been pondering something a lot lately, and am wondering whether you guys might have some helpful ways of looking at this. The issue is that I'm going to be starting my own part time private practice next fall in a mental health related field. I'm finding one of the stickiest issues about the whole thing, for me, to be money. I really want to be able to work with folks who don't have a lot (which is a lot more people than those who have a lot). But, then, how do I afford that? I hate the answer that I just can't. It's so unfair to so many people who can't afford regular fees.

One tricky bit is that my husband is not at all in favor of my practice being a money sink, even for a little while. Even though I have another part time job that is more lucrative. And I can't really blame him. It's been expensive to get through school, both in terms of time away from my family and in terms of actual money. He's been supportive, but I think enough is enough. My practice will have significant expenses (office rent, insurance, supervision, continuing education, etc.). And, of course, we have living expenses just like anyone, although we try to be frugal.

I've heard folks here talk about how Ts that can really reduce rates for low income clients are more ethical. And I agree to some extent, and want to be ethical in that way. But is it unethical to not reduce my rates if I can't afford it?

Maybe the answer is that I'll need to get a good base of clients who can pay before I can take on clients who need special arrangements. It just seems to cold to approach it that way. But if my practice doesn't support itself, then this becomes an expensive hobby, which is not at all what I'm after (or my potential clients, I'm sure). I want this to be my life's work.

I wish there was a fairy godmother who paid for everyone's therapy. That way clients could get the help they need, and Ts could make a living, all at the same time.

Any thoughts?

Peg

 

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poster:pegasus thread:982468
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