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The Ethics Curriculum

The Therapeutic Relationship and The Economy

To reduce the fee or not? Can therapy be an item on sale?

Program Description

The economy goes up, and the economy goes down. When it’s down, people lose jobs, lose their incomes, and deplete their savings. Then, they have to make some tough decisions about what is most important to them. This obviously makes an impact on the therapist. It’s not only the patient who may have to make some tough decisions. Here we are, with psychotherapy and counseling as our livelihood. This requires ethical, clinical, and profoundly personal self-examination. Do we reduce our fees or not? Do we cut back on the frequency of sessions? How do we explore the meaning of this with our patients, who may be in reduced circumstances and also may have other issues specifically related to their therapy?

Learning Objectives

This program provides clinicians with the opportunity to:

Recognize the importance of managing the therapeutic frame.

Recognize the factors to consider in deciding to reduce the fee or cut back the frequency of sessions.

Understand which types of patients will be most and least responsive to these changes.

Be able to recognize one’s countertransference issues on this subject.


To Reduce the Fee or Not - Frank Summers, Ph.D. website

Dr. Summers shares his observations on the impact of the economy on his practice and discusses the dilemmas this situation raises, explaining the factors involved in modifying one’s stance on fees.

To Reduce the Fee or Not? Part 2 - Karla Clark, Ph.D.

Dr. Clark discusses the dilemmas involved in making a decision to reduce a patient’s fee, stresses why the therapeutic frame can be vital to keeping one’s clarity and perspective on this subject, and why the therapeutic relationship can’t be a sale item.

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Client Testimonials

“I really like this process, as it gives time to think about and reflect on these subject matters. I wouldn’t mind doing more of these to earn CEUs”

... Rami H.

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