Sliding Scale Therapy

Feb 4, 2024

Therapy can change our lives! It offers support and guidance to tackle our life challenges, improves relationships, and boosts overall well-being. But for many people, therapy is still a luxury they can’t afford due to financial constraints.

Fortunately, sliding scale therapy is a  bridge that closes the gap, making therapy accessible and a reality for everyone.


What is Sliding Scale Therapy?

Sliding scale therapy is a payment model used by some therapists and mental health clinics. Under this model, the fee for therapy services is adjusted based on the client’s income and ability to pay. This approach is designed to make mental health services more accessible to people from all economic backgrounds. Sliding scale therapy is perfect for you if you are unable to afford the full fee. Unlike traditional therapy with a fixed rate, most therapists offer discounted rates through sliding scale therapy. 


How Does it Differ from Traditional Therapy Payment Models?

Feature Sliding Scale Therapy Traditional Therapy
Cost Fees based on income level, making therapy more affordable for low-income individuals Fixed or standard rate per session
Payment structure Often uses income brackets to determine session fees Pay at the time of service or billed monthly
Accessibility Aims to remove financial barriers and improve access for everyone Can be unaffordable for many people
Inclusivity Provides a more inclusive option for individuals with diverse financial situations May not accommodate individuals with varying income levels


How Does Sliding Scale Therapy Work?

Sliding scale therapy works on the principle of adjusting the cost of therapy sessions based on an individual’s income or ability to pay. For instance, a therapist may charge $60 per session for an individual earning $30,000 to $40,000 annually, while someone earning $120,000 to $150,000 may pay $150 per session. Additionally, some therapists offer a flexible rate range (e.g., $80-$120), allowing clients to choose a fee they can afford or pay per session. This way, therapy stays fair and accessible for people with different incomes, creating a supportive space for everyone.


Where Can You Find Sliding Scale Therapy?

If you’re interested in exploring sliding scale therapy, there are several ways to find therapists who offer this service in your area, which include:

  • Private Practice Therapists Only some private practice therapists will offer sliding scale therapy. To find the ones who do, you can explore online therapy directories or contact local therapists via phone or email to inquire.
  • Community Mental Health Centres These centres often offer therapy on a sliding scale or even for free, depending on income. Contact your local health department or check their website to find one near you.
  • University Counselling Centres Some universities offer therapy to students and the community on a sliding scale. Check with your local universities or colleges to see if they have such programs.
  • Online and Resource Platforms Various online and resource platforms, such as MentalHealth.gov and National Alliance on Mental Illness (NAMI), provide information on mental health services, including a directory of local mental health care providers, some of which may offer sliding scale therapy.


Who’s Eligible for Sliding Scale Payment?

The whole purpose of siding scale therapy is to make therapy accessible to those who otherwise cannot afford it. It is especially helpful to people who don’t have insurance and have to pay the fee out-of-pocket or if their therapist is out of network with their insurance provider. Even for someone with insurance, the cost of therapy might be expensive if they have limited income, a large family, or regular medical bills. The eligibility for the sliding scale payments depends on various factors such as:

  • Income
  • Number of dependents
  • Factors such as disability, chronic health conditions, or temporary unemployment


How do You Ask for Sliding Therapy?

Even if a therapist doesn’t openly promote sliding scale fees, it’s always worth asking. Talking about finances can feel awkward, but asking about sliding scale therapy is an important step towards getting the support you deserve.  Here are some tips on how to approach the conversation:

  • Do your research: Check the therapist’s website or online profiles to see if they mention offering sliding scale fees. If not, you can still ask. 
  • Prepare yourself: Consider your income range and prepare yourself to share it with the therapist.
  • Be upfront and honest: You have every right to inquire about affordable options. Share your interest in sliding scale without feeling embarrassed.
  • Ask questions: Clarify any details about the sliding scale structure, such as income brackets, eligibility criteria, and potential rate changes based on income changes.
  • Express your needs: If the offered rates are still outside your budget, be open about your limitations and see if there’s room for negotiation.


Slidng scale therapy


What are the Benefits of Paying on a Sliding Scale?

Sliding scale payment system offers various advantages that go beyond mere financial considerations. This flexible fee structure not only dismantles financial barriers but also contributes to creating a mental health landscape that is more diverse, ethical, and accessible. Here are the numerous advantages that sliding scale payments offer.


Reduced Financial Barriers

A rigid fee structure can become an insurmountable hurdle, pushing essential support out of reach. Sliding scales break down such barriers. By offering a flexible fee structure based on an individual’s financial circumstances, therapy becomes more affordable for everyone, regardless of income level. 



Sliding scale helps remove economic barriers and opens the door to individuals with diverse income levels who might otherwise face exclusion. This approach promotes inclusivity and ensures that mental health support is available to a more diverse population. 


Increased Diversity in Therapy

Traditionally, therapy was considered a luxury reserved for the wealthy.  Sliding scales challenge this notion by ensuring that mental health support is accessible to everyone, regardless of their background, including socioeconomic status, ethnicity, or life experiences. This approach allows anyone to access tailored mental health support that suits their needs.


Professional Development for Therapists

Therapists who work on a sliding scale gain exposure to a broader client base, which pushes them out of their comfort zones. This diversity offers valuable professional growth opportunities, improving interpersonal skills and deepening a therapist’s understanding of socioeconomic differences.


Ethical Practice

Beyond affordability, sliding scales align with the ethical principle of making mental health services accessible to all individuals, regardless of their financial situation. It promotes fairness and social justice by acknowledging individual circumstances and adjusting fees accordingly.


Positive Societal Impact

Sliding scale payments reduce financial barriers, making mental health care more accessible to a wider population. This positively impacts communities, families, and workplaces, contributing to a healthier and more resilient society.


Types of Therapy Available on Sliding Scale


Individual Therapy

Individual therapy, or one-on-one therapy, is a common type of psychotherapy where you and your therapist explore your thoughts, feelings, and behaviour in a safe space. It helps you to deal with challenges like anxiety, depression, or a relationship issue and learn how to handle them better, becoming stronger in the process.


Group Therapy

In group therapy, the therapist works with multiple clients simultaneously. These sessions create a supportive space where individuals with similar challenges can share their thoughts, gain insights from others’ experiences, and experience personal growth together in a shared environment.


Family Therapy

Family therapy focuses on addressing problems within the family, such as communication patterns and relational dynamics. The sliding scale helps repair these connections by allowing families facing financial constraints to access professional support to improve communication, resolve conflicts, and strengthen relationships among family members.


Online Therapy

Online therapy allows you to have therapy sessions from the comfort of your own space at a time that suits you. You can connect with experienced therapists online and discuss your concerns via video calls or secure messaging. It makes mental health services available to people with geographical or mobility challenges.


Is Sliding Scale Therapy Right for You?

It’s an affordable option that provides access to quality therapy, especially if high costs have been a barrier. Sliding scale therapy allows you to receive professional support tailored to your income, making mental health care more inclusive and accessible. It’s worth exploring if you’re seeking therapy but are concerned about affordability. This flexible payment model ensures that therapy is an option for everyone, regardless of their financial circumstances. If you are still not sure if sliding scale therapy is right for you, consider these factors:


Your Budget

The sliding scale in therapy is a flexible pricing system designed to consider individual financial situations and adjust the cost of therapy accordingly. The sliding scale can make therapy more affordable if you have a limited budget or are experiencing financial hardship. 


Your Insurance

Therapists who provide sliding scale therapy may or may not accept insurance. If your health insurance covers mental health services, checking how it aligns with the sliding scale system is important. Some therapists may accept insurance and offer a sliding scale for uninsured or underinsured clients.


Your Therapy Goals

Consider your therapy goals and the importance of finding a therapist to meet your needs. If cost is a significant factor, the sliding scale system can help you access therapy that might otherwise be financially out of reach.


How Are Sliding Scale Therapy Fees Calculated?

Here are some insights on how your therapist will determine their sliding scale fees:

  • Minimum and Maximum Charges Therapists set minimum and maximum charges, considering factors such as their qualifications, experience, and living costs in their area. The focus is on setting an affordable minimum fee for those in the lowest income bracket while still providing enough income to cover basic costs and maintain the quality of their practice.
  • Income Level-based Fee Calculations Therapists may change the fees for sliding scale therapy based on the client’s income. To assess a client’s financial situation accurately, therapists may ask for proof of income, such as pay stubs or tax returns. They usually use a formula to calculate the rate, such as [Annual Income] x [0.001].


What is the Typical Range of Fees for Sliding Scale Therapy?

The rates of a siding scale therapy session depend on your income level. However, to give you a general idea, here’s a rough estimate:

  • If your income ranges from $30,000 to $40,000 income, you might pay $40 to $50 per therapy session
  • For an income range of $50,000 to $70,000, you might pay $60 to $80 per therapy session.
  • If your income exceeds $120,000, you may not qualify for the sliding scale and would pay the standard rate.


Alternatives To Sliding Scale Therapy

Sliding scale therapy is just one approach to making treatment more affordable. Here are some alternatives to consider:

  • Pay what you can afford This payment model gives you complete control over the amount you pay per session, even if it’s lower than the therapist’s standard rate. Additionally, some therapists provide a limited number of pro-bono (free) sessions each year, further improving access to therapy for those in need.


  • Bartering Bartering involves exchanging goods or services for therapy sessions. These could include skills, services, or goods the therapist finds beneficial. However, the value of goods or services exchanged for mental health services should be equal.


  • Payment Plans This option can be especially helpful if you face temporary financial challenges and need help paying the full session fee upfront. This option allows clients to make smaller, regular payments that fit their budget.

Does a Sliding Scale Therapy Work with Insurance?

Insurance coverage for therapy depends on your benefits policy and insurance provider. It’s best to contact your insurance representative to understand your coverage details and the amount covered for therapy sessions. However, it’s important to note that not all therapists accept insurance, and even if they do, combining insurance with their sliding scale rate may not be possible. Some therapists may offer reduced co-pays or deductibles for clients on a sliding scale, while others may be open to negotiating a lower rate based on your insurance coverage.


A liberated women, unburdened by financial constraints, experiences newfound freedom on her journey towards sliding scale therapy.


Access Affordable Therapy at Thrive Downtown Counselling Centre

At Thrive Downtown Counselling Centre, we believe that everyone deserves access to quality mental health care, regardless of their financial situation. We recognize the importance of your healing journey, which is why we offer a number of sliding scale slots specifically for those who need them. Your path to well-being is our priority, and financial barriers shouldn’t stand in your way. With affordable therapy options available, we invite you to reach out to us. Let’s take the steps towards your well-being together. Don’t wait—start your journey to healing today.



If you feel like therapy is something that you can’t afford, you’re not alone. The good news is that sliding scale therapy isn’t very expensive. We strongly believe that mental health care is a basic right and should be accessible to everyone without breaking the bank. With sliding scale therapy, you don’t have to shy away from getting the help you need because of fear of financial strain. 


Sliding Scale Therapy FAQs


How much is a therapy session in Vancouver, BC?

The cost of therapy can differ based on factors such as the therapist’s experience and qualifications, the type of therapy required, and the location within Vancouver, BC. Generally, for a 50-minute individual counselling session, you can expect to pay somewhere between $160 and $180+GST. However, couples’ counselling sessions are slightly more expensive, around $225+GST per 90-minute session.


Does Every Therapist Offer Sliding Scale Therapy?

No, not every therapist offers sliding scale therapy. The decision to offer sliding scale fees depends on each therapist or therapy practice. Sliding scale therapy is offered on an individual basis and is up to the counsellor and practice. Several factors can influence whether a therapist provides sliding scale options, including financial circumstances, practice policies, and personal philosophy.


Does BC Medical cover counselling?

Unfortunately, BC Medical does not cover the cost of private counselling or psychotherapy sessions. However, numerous low or no-cost community counselling programs exist and provide valuable support without financial strain. Additionally, many therapists offer sliding-scale therapy, making their services accessible regardless of your financial situation.


Are Sliding Scale Therapy fees based on income or other factors?

Sliding scale therapy fees are primarily based on your income and ability to pay. However, the goal of sliding scale therapy is to ensure that everyone can access the benefits of therapy. Therefore, therapists consider factors beyond income when adjusting fees, such as family size, employment status, student or veteran status, and disabilities.


Is Sliding Scale Therapy available for individuals with insurance?

There is no definitive answer to this. Some therapists may offer it for uninsured or underinsured clients, while others may decline due to lower pay, contractual restrictions, and extra paperwork.


Can I apply for Sliding Scale Therapy if I have financial difficulties?

Financial barriers often prevent people from receiving the mental health support they need. However, sliding scale therapy is a great option to help you overcome these financial barriers, providing you with the essential support you deserve. Whether you face low income, unexpected expenses, or other challenges, exploring sliding scale options can empower you to invest in your well-being.


Is Sliding Scale Therapy available for online counselling?

Yes, sliding scale therapy is available for in-person and online counselling, making it even more accessible and flexible for your journey toward well-being. However, the availability of sliding scale options for online counselling can vary among therapists. To find the most suitable options, contact the counsellor or counselling center you are interested in.


Are there any documentation or proof of income requirements for Sliding Scale Therapy?

Therapists may have different approaches regarding documentation and proof of income requirements. Some therapists may request documentation, such as tax returns, pay stubs, unemployment benefits forms, proof of residency, or other financial statements; others may simply trust clients to provide truthful information about their finances.


Can I switch from Sliding Scale Therapy to regular fee-based therapy later?

Yes, in many cases, you can switch from sliding-scale therapy to regular fee-based therapy if your financial situation changes over time. Therapists are usually flexible and willing to adjust their fees accordingly. 


Are there any government programs or organizations that offer sliding-scale therapy assistance?

Yes, several government programs or organizations, like the Canadian Mental Health Association (CMHA), offer sliding-scale therapy assistance, which helps connect individuals with suitable services, including those with sliding-scale options, within their communities. Moreover, the federal government has invested in programs such as togetherall, Wellness Together Canada, and Hope for Wellness Help Line. 

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