Understanding Sliding Scale in Therapy: What It Is, Who It’s For, and Why Standard Rates Matter

If you’re considering starting therapy and wondering about the cost, you may have come across the term sliding scale. As a therapist in private practice, I want to offer some clear information about what a sliding scale is, why it exists, who it’s intended to support, and why therapy costs what it does.

What Is Sliding Scale?

Sliding scale is a reduced fee offered by some therapists to clients who need therapy but cannot afford the therapist’s full standard rate. It’s most often available to people who are not using insurance because they are choosing to pay privately due to not having insurance or their therapist is out of network and their insurance has a high OON deductible and low reimbursement rate.

The reduced rate is based on need, and that need can be financial and/or circumstantial. For example, someone may be eligible for a sliding scale if they are:

* Recently unemployed, underemployed or working a minimum wage or low-paying job with a high cost of living (common in California)
* Someone who has lost their home and been displaced due to a natural disaster
* A single parent with multiple dependents and childcare responsibilities
* Part of a household where a partner is unemployed or has a disability and is unable to work
* A student or recent graduate without financial support

In these cases, people are often living paycheck to paycheck, covering their basic needs (rent, groceries, transportation, childcare), and still unable to afford therapy at full price. Sliding scale is one way to help bridge that gap and make mental health care more accessible to those who need it most.

Who Is Sliding Scale Not For?

Sliding scale is not simply a discount. It’s not for someone who could afford therapy but prefers to pay less. That includes people who:

* Have access to financial support from family
* Have a steady income and have chosen to prioritize luxury spending (travel, designer items, aesthetic treatments, boutique fitness memberships, home renovations, etc.)
* Have savings or investments they prefer not to tap into

If you fall into one of these categories, I absolutely want you to get the support you need. But sliding scale isn’t meant for those with optional spending flexibility. In these cases, part of the therapeutic journey may include reevaluating priorities and choosing to invest in your mental health at this time.

How Sliding Scale Works in My Practice

In my practice, I reserve a limited number of sliding scale slots for clients with genuine need. These spots are offered in ranges such as $70–$110 and $115–$155 per session, depending on individual circumstances. I don’t require tax forms or proof of income—I work on the honor system, trusting clients to be transparent and respectful of the intention behind sliding scale.

After all, therapy is built on honesty. If the relationship starts with a misrepresentation of your ability to pay, it undermines the trust that’s essential for meaningful work.

Standard Rates and Why They Matter

For those who are financially stable or have access to resources, I offer package options as a way to honor your commitment to therapy while also offering some savings. Packages include:

6 Individual Sessions for $975 (1 free session included)
6 Couple Sessions for $1175 (1 free session included)

My standard rates are $195 for individuals and $235 for couples. These rates reflect not only the time spent in each session, but also the years of education, training, and investment that therapists bring to their work. Here’s a quick overview of what goes into becoming and remaining a licensed therapist:

* A Master’s degree (often costing over $200,000)
* 3,000 hours of supervised clinical training (typically taking 2+ years after graduation)
* Ongoing expenses including office space, insurance, continuing education, licensing fees, and administrative support
* A limited caseload (I see around 20 clients a week) to maintain the energy and attention required to offer high-quality care

All of these costs are factored into the price of sessions and into the quality of support I strive to offer every client.

In Summary

Sliding scale is a tool for increasing access to therapy for those who truly cannot afford it. It’s part of my commitment to social responsibility and to helping people through difficult seasons when they might otherwise go without support. But it’s also limited and based on need, not preference.

If you’re in a position to afford full-fee therapy, paying the standard rate allows me to continue offering reduced fees to others in need—and it’s a meaningful investment in yourself.

If you’re unsure where you fall or want to explore options, feel free to reach out. Together, we can see what’s possible and what feels fair—for both of us.