July 2, 2024

Episode 71:

How to Provide Pro Bono or Sliding Scale Fee without Impacting Revenue

In this episode, I’ll breakdown how you can provide pro bono or sliding scale fees in your private practice without impacting your bottom line.

Episode 71: How to Provide Pro Bono or Sliding Scale Fee without Impacting Revenue

Show Notes

Welcome back to the Designer Practice Podcast and I’m your host Kayla Das.

Do you offer pro bono or sliding scale sessions in your practice, but you struggle with the impacts it has on your overall revenue?

In this episode, I’ll breakdown how you can provide pro bono or sliding scale sessions in your private practice without it impacting your bottom line.

Defining Pro Bono and Sliding Scale

So, first of all, what is pro bono and sliding scale? As a helping professional, you may feel compelled to provide free services or low-cost rates for your clients who may not be able to afford your services otherwise. When you provide free sessions, you are providing pro bono services. And when you adjust your fee to assist a client to access therapy, you are providing a sliding scale. But when you provide free or low-cost services in your private practice, you may notice the impacts it has on your financial situation.

One of the biggest complaints that therapists have when providing pro bono or sliding scale services is that they feel burnt out trying to make ends meet. That’s because when it comes to providing one to one therapy, your time is your money. So, when you provide free or low-cost therapy sessions, you are taking up your time and losing money doing so.

Now there may be some colleagues, supervisors, or even business coaches out there that have told you to never provide free or low-cost services. Some might even use the statement that I really dislike, “know your worth”. While there may be other people who say that you have to provide free and low-cost services. Well, I’m of the opinion to do what feels right for you, because at the end of the day, it’s ultimately your choice and your financial situation.

I don’t believe that by providing pro bono or sliding scale sessions that you are devaluing your services in any way or that you don’t know your worth. I equally don’t believe that by not providing free and low-cost services that you’re being unethical in any way. What I do believe is that as long as you’re coming from a place where you are instilling your own values, which may be very different from other people, while also ensuring the continuance of care for your clients, you choose which path is right for you.

But a stumbling block that some therapists come across is knowing how to provide pro bono or sliding scale services without impacting revenue. Because if your time is your money, how do you manage both?

Well, we’re going to discuss this.

Providing Pro Bono and Sliding Scale Sessions

As many of our Code of Ethics and Standards of Practice outline, we have an obligation to ensure a continuance of care to our clients, but there are many ways around providing continuance of care without negatively impacting our overall revenue.

1. Develop a Financial Plan that Includes Pro Bono and Sliding Scale Sessions

The first step is to develop a financial plan that includes pro bono and sliding scale sessions.

If you choose to add pro bono or sliding scale sessions to your practice, the first thing to do is to create a financial plan that includes the number of sliding scale sessions you want to provide and ensure that your regular rate of pay can offset your expenses and bring in profit. This starts with setting or raising your private practice fee in accordance with your expenses.

I do have a step-by-step guide teaching you how to set your private practice fee. If you want to download this guide, please scroll down to the show notes and click on the link.

When you have a strong financial plan, you know how many pro bono or sliding scale spots that you can afford each week to provide so you don’t hurt your bottom line.

2. Create a Practice Policy for Pro Bono or Sliding Scale Provision

The second step is create a practice policy for pro bono or sliding scale provision. Once you’ve identified how many pro bono or sliding sale spots you can afford each week, create a policy around it to help keep yourself accountable. Your policy may include how many spots that are available any given week, how long a client can receive free or low-cost rates. And if applicable, the minimum dollar amount for a sliding scale session.

For example, if you could only afford to offset one pro bono or two sliding scale sessions each week, you could write a policy stating something like this:

“At [your business], each therapist may offer a maximum of one pro bono or two sliding scale sessions a week at half price of the regular session rate, at their discretion. If a therapist agrees to provide pro bono or sliding scale services, the client will have a maximum of five sessions at this rate.”

You might even go a little bit further and explain the criteria of how you determine who receives these spots, such as is it by request, is it first come first serve, etc.

Not only does having a policy in place help you remain accountable to yourself, but it also provides equality in your services. For example, if you pick and choose who you give a sliding scale to and if every week the spots vary. This may be perceived by clients who do pay your full rate as being unfair or unequal, even if this isn’t your intention. Whereby if you have a policy of how many spots you have available and the criteria for determining need, now you have something to show if there is ever a dispute by a client regarding your pro bono or sliding scale selection process.

3. Offset Income Loss

Finally, is how can you offset income loss?

As I mentioned earlier in this episode, your time is your money when it comes to one-to-one therapy. However, there are ways to offset income loss from providing pro bono services.

Supervise a Student Intern to Provide Pro Bono Services

The first way to offset cost is to take on and supervise a student intern who is training to become a therapist, where they can provide pro bono services to your clients. This way, you can focus on providing services to full pay clients, while they focus on providing free services in your practice. But of course, you’ll also need to keep some time aside to provide supervision to the student intern.

Offer Pro Bono or Low-Cost Group Therapy

Next you could offer pro bono or low-cost group therapy sessions so you can help more people, but not take away from your time. Let’s say that according to your financial plan, you only have the capacity to provide two hours of free services a week. You could provide two one-hour one-to-one sessions to clients, or you could host a two-hour group therapy program where you could work with four, six, or even eight clients at a time.

Add Passive or Alternate Income Streams into Your Practice

Thirdly, you could add passive or alternate income streams into your practice to compensate for income loss. There are many ways to add passive or alternate income into your practice, such as providing clinical supervision groups, renting out available office space to other therapists, or monetizing a blog or podcast to name a few. But when you have additional income coming in, the financial impact of providing free or low-cost services lessens.

If you’re interested in learning additional ways to add passive income into your practice, check out Episode 6: 15 passive Income Streams for Therapists and Coaches.

Refer Out When You’re at Capacity

Finally, if you’re at capacity or a client exceeds their allotted pro bono or sliding scale sessions, you can also refer out to other therapists or counseling centers that provide services that fits your client’s needs.

Conclusion

So, as you can see, there are ways to build in pro bono or sliding scale services without it impacting revenue. First, create a financial plan that includes pro bono and sliding scale services, so that you know how many sessions you can realistically provide. Then, develop clear policies around providing free and low-cost services, so that you can keep yourself accountable. And finally, incorporate ways to offset income loss so that you can provide services without worrying about the loss of income.

I hope you enjoyed this episode of the Designer Practice Podcast. If you’re listening to this episode on a major podcasting platform, please don’t forget to hit subscribe so that you can follow us to make sure you don’t miss a thing.

Until next time, bye for now!

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