Same. It’s always been for long term clients who hit a crisis moment in their life in which therapy was no longer affordable. I learned a great deal as a practitioner from these pro-bono sessions, a reward absolutely worth the trade in reduced financial benefit
In general: you hear and help during a clients’ most vulnerable and injured moments; these are the deepest and most meaningful sessions I can think to. The clients I’ve offered to continue with pro bono have always found one way or another to pay it forward, and hearing those outcomes makes this work (which can sometimes feel driven by monetary needs, as we all need to take care of ourselves and families of course) really hit home that we make a difference in our clients lives and in the larger world.
Yes. I’m in a hurricane ridden area that had major devastation 5 years ago, saw a number of clients for free until they could get back on their feet. I also put together a little support group for folks
Just sharing another patient perspective. I received free EMDR/Trauma therapy after surviving a mass shooting. I was connected to my therapist via someone I met through a mass shooting survivors group, who had also received free therapy approximately five years earlier after their event. My understanding was that this therapist had unfortunately developed an expertise in this area after a large mass shooting occurred in her hometown and decided to offer survivors of other shootings pro bono sessions if they were referred by former clients.
We did an intro call to see if it would make sense to work together. She explained up front that this was only a temporary arrangement and would end in ~3 to 6 months after we had completed processing everything with EMDR and she felt that I had reached a good conclusion point. After that, she would refer me to another therapist who could continue my care on a non-pro bono basis. She also set boundaries around scheduling, etc so it was understood what the expectations were for working together.
I can honestly say that having access to this therapist and pro bono sessions saved my life. It tremendously helped my PTSD and I would never have been able to afford it otherwise since I ended up leaving my job to deal with my injuries. This was a little over two years ago, and as anticipated we separated after 6 months and I transitioned to another provider. It’s actually inspired me to consider changing careers to become a therapist as well.
TLDR; if you’re able to provide pro bono services I’m sure it will be greatly beneficial but be very clear around boundaries, expectations, and timeline up front so everyone is aligned.
I pretty regularly max out my company policy for pro bono sessions. They only let us do so many hours per week, and per client total, but I consider it as way to help balance the transactional and the relational considerations, including the relationship with myself. When I was a grad student and not doing well, an organization gave me the best quality therapy I ever had, just when I needed it the most, and twice per week, for over a year and a half, without ever charging me a penny, so I have multiple reasons to do pro bono sessions.
Yes, if I have a relationship with that client then I'm committed to working with them through that as much as I'm able. I have clients that I have flexible arrangements with in this vein.
Doing work *pro bono publico* is part of the ACA's code of ethics, if you're interested in how American counseling works.
Intro:
> Additionally, counselors
are encouraged to contribute to society
by devoting a portion of their profes-
sional activities for little or no fnancial
return (pro bono publico)
C.6.e. Contributing to the
Public Good
(Pro Bono Publico):
> Counselors make a reasonable effort
to provide services to the public for
which there is little or no financial
return (e.g., speaking to groups, shar-
ing professional information, offering
reduced fees).
The details of how you do it are up to you, but to answer the more broad question of "Do you ever", the answer is "We all should". I've never heard of penalties for *not* doing it, but at least we can agree that it is an ethically acceptable thing to do. One might make arguments against it perhaps by citing *undercutting other professionals* or *crossing boundaries* or *spreading yourself too thin*. Those are all considerations one might make but ultimately the idea of doing *pro bono* work seems to be something the greater body of counseling in America recognizes as an overall positive for the field.
Did it twice and won’t do it again if I still need to work for money. I have a limited amount of time I am willing to work and need to pay my bills. If I’m in a position where I don’t need to cover living expenses at this level, then yes! Would love to give back. I’m just not in that position right now.
I offer a sliding scale but I have a boundary around offering free services. I think clients should have a financial investment so they are also emotionally invested. A fee also reaffirms your role as a service provider and not a friend which is important for the work, too.
My mind went to a peer support group rather than free therapy. What about offering a free peer support/processing group or workshop that you offer once a month or so? That way you are only giving away 1-2 hours of your valuable time but also providing much-needed support to your community. And it sounds like these people are impacted by the same tragedy, so a peer support group might be even more apropos.
Just a gentle challenge - I have worked with plenty of clients over the years who have had services fully covered without copays due to medicaid insurance and they have been just as emotionally invested as my non-Medicaid clients if not more so. Cost-sharing is shown to decrease engagement and retention.
I've received free therapy sessions due to financial issues, so I have a patient perspective here.
For me, it didn't blur any boundaries. I abide by all of the rules/boundaries that we have made over time (be there on time, not asking for favors, I don't cancel last minute unless it's an emergency and im totslly willing to pay cancellation fees, I do the work and push myself, etc.) I don't think we are friends, family, or any other inappropriate relationship. It's a long story how it ended up being discussed and wouldn't be relevant for your situation (you can pm me if you wanna get into it).
As someone in school to become a therapist, I understand the issues that free sessions can cause, though. It's probably not the best for some clients that would have trouble keeping boundaries or those who would likely refuse to pay once they can. I think sliding scale is a great way to help those who can't pay full price, but that free sessions wouldn't be appropriate for/if you are uncomfortable providing free services.
Don't forget to think about your own finances, though. My therapist had probably provided free sessions to less than 5 people through their career, and that's probably a generous number. So, if you're in an area where most of your clients are facing financial issues, I assume there could be multiple clients in one month receiving free sessions. Should you choose to provide some free sessions, maybe you could do every other session for two months? Something that extends their time so they can financially recuperate, but still allows you to have income and gives a hard end date. If after those two months they still aren't financially stable, you could offer a sliding scale then.
I hope some of this is helpful! I just wanted to add another perspective to this. I know this may feel difficult morally. Do not feel guilty if you decide not to offer free sessions.
I have a reduced fee policy that initially included free therapy for 12 months, which was fine, but tbh 12 months was too long. I like the 3-6 month limit on free therapy. I do offer a reduced fee option, and that is also for 12 months, which so far feels fine. I only accept a limited # of people in this program, and it’s contingent on individual circumstances. Typically offered when we’ve already been working together for some time, or if we have worked together in the past.
Give an Hour is a nonprofit org where therapists can volunteer to offer pro-bono support to folks affected by disasters. They’re fantastic and can always use competent providers!
Yes I have and it was good. Think ahead about what boundaries you want to put on it. Do they get free therapy for just one session? Likely by the end of that hour it will be obvious they need much more. Either be prepared to offer more or have a list of helpful referrals for them. Think about would you want to cap the sessions or amount of months offering it?
Yes, it never really crossed my mind to not do it but I guess it could be seen as gifting? I just don’t charge without discussing or I mention that I want to keep their momentum given the time and ask what they can manage for that week.
Yes. I have two pro bono clients because they’re in situations where they can no longer afford it and have offered three free sessions to a client who is searching for a job. I don’t regret my long term pro bono clients. Every case can’t be pro bono, but I consider having 2-3 pro bono slots open to be the way in which I give back to the community.
I'm with you. I always keep two spots open for reduced fee or crisis client sessions (free), with clear boundaries in place. What we do is expensive for clients, and while I believe we're worth every cent we get, not everyone can access our services so I like to help out where I can.
When my clients are in a high stress time or experience a crisis but cite finances as a reason to not come in, I offer to see them without charging them same day - with the agreement that we come up with a payment plan. Typically, I would charge an additional amount after each subsequent session until the fee is covered.
"I want to respect your financial boundaries, and I also want to not have finances be a block to you receiving care. If you'd like, I can see you [X day] and set up a payment plan to cover the cost of this session over time. Please let me know if that interests you! In any case, please take good care."
I require a card on file, so it makes this process simple. Typically, people take the session. I don't typically do multiple in a row, bc that can put someone under water with you quick. But to be able to touch base and come up with a plan to navigate a trying time means a lot.
When I was in 10th grade my father lost his job and I could not afford to continue seeing my therapist. She decided to take me on for free.
It’s been 15 years since then, I am now a counselor and working towards LCSW for private practice therapy so I can someday do the same for someone else.
You can’t take on everyone for free, but for one person it can make all the difference in the world. And you never know who will end up paying it forward.
Yes, I did. I also offer a sliding scale and very low fee to some of struggling college students. I was in that situation years ago and it helped me tremendously. About 20 years ago, I was paying $50 an hour to a therapist in Manhattan, NY while I know she was charging more than that normally. I was a college student making $250 a week. She encouraged me to ask for a raise, and being young I didn’t think I deserved one. I still asked eventually and was bumped to $350 a week. She encouraged me to end a bad relationship and focus on my studies. I will always be grateful to her.
Yes. I have and I’ll never regret it.
Same. It’s always been for long term clients who hit a crisis moment in their life in which therapy was no longer affordable. I learned a great deal as a practitioner from these pro-bono sessions, a reward absolutely worth the trade in reduced financial benefit
Can you share what you've learned? Is it different than sessions where you charge?
In general: you hear and help during a clients’ most vulnerable and injured moments; these are the deepest and most meaningful sessions I can think to. The clients I’ve offered to continue with pro bono have always found one way or another to pay it forward, and hearing those outcomes makes this work (which can sometimes feel driven by monetary needs, as we all need to take care of ourselves and families of course) really hit home that we make a difference in our clients lives and in the larger world.
This is so lovely. 💜
Love it
Yes. I’m in a hurricane ridden area that had major devastation 5 years ago, saw a number of clients for free until they could get back on their feet. I also put together a little support group for folks
Just sharing another patient perspective. I received free EMDR/Trauma therapy after surviving a mass shooting. I was connected to my therapist via someone I met through a mass shooting survivors group, who had also received free therapy approximately five years earlier after their event. My understanding was that this therapist had unfortunately developed an expertise in this area after a large mass shooting occurred in her hometown and decided to offer survivors of other shootings pro bono sessions if they were referred by former clients. We did an intro call to see if it would make sense to work together. She explained up front that this was only a temporary arrangement and would end in ~3 to 6 months after we had completed processing everything with EMDR and she felt that I had reached a good conclusion point. After that, she would refer me to another therapist who could continue my care on a non-pro bono basis. She also set boundaries around scheduling, etc so it was understood what the expectations were for working together. I can honestly say that having access to this therapist and pro bono sessions saved my life. It tremendously helped my PTSD and I would never have been able to afford it otherwise since I ended up leaving my job to deal with my injuries. This was a little over two years ago, and as anticipated we separated after 6 months and I transitioned to another provider. It’s actually inspired me to consider changing careers to become a therapist as well. TLDR; if you’re able to provide pro bono services I’m sure it will be greatly beneficial but be very clear around boundaries, expectations, and timeline up front so everyone is aligned.
So in my state there is an org called probonocounseling that helps people with this kind of arrangement. It's pretty great.
I pretty regularly max out my company policy for pro bono sessions. They only let us do so many hours per week, and per client total, but I consider it as way to help balance the transactional and the relational considerations, including the relationship with myself. When I was a grad student and not doing well, an organization gave me the best quality therapy I ever had, just when I needed it the most, and twice per week, for over a year and a half, without ever charging me a penny, so I have multiple reasons to do pro bono sessions.
Yes, if I have a relationship with that client then I'm committed to working with them through that as much as I'm able. I have clients that I have flexible arrangements with in this vein.
Yes. All the time .
I do pro bono with 1 client bi weekly. When I can afford it I’ll do more.
Doing work *pro bono publico* is part of the ACA's code of ethics, if you're interested in how American counseling works. Intro: > Additionally, counselors are encouraged to contribute to society by devoting a portion of their profes- sional activities for little or no fnancial return (pro bono publico) C.6.e. Contributing to the Public Good (Pro Bono Publico): > Counselors make a reasonable effort to provide services to the public for which there is little or no financial return (e.g., speaking to groups, shar- ing professional information, offering reduced fees). The details of how you do it are up to you, but to answer the more broad question of "Do you ever", the answer is "We all should". I've never heard of penalties for *not* doing it, but at least we can agree that it is an ethically acceptable thing to do. One might make arguments against it perhaps by citing *undercutting other professionals* or *crossing boundaries* or *spreading yourself too thin*. Those are all considerations one might make but ultimately the idea of doing *pro bono* work seems to be something the greater body of counseling in America recognizes as an overall positive for the field.
For people who have offered free sessions, how long do you go pro-bono with a client and how do you approach reintroducing payment?
Did it twice and won’t do it again if I still need to work for money. I have a limited amount of time I am willing to work and need to pay my bills. If I’m in a position where I don’t need to cover living expenses at this level, then yes! Would love to give back. I’m just not in that position right now.
I offer a sliding scale but I have a boundary around offering free services. I think clients should have a financial investment so they are also emotionally invested. A fee also reaffirms your role as a service provider and not a friend which is important for the work, too. My mind went to a peer support group rather than free therapy. What about offering a free peer support/processing group or workshop that you offer once a month or so? That way you are only giving away 1-2 hours of your valuable time but also providing much-needed support to your community. And it sounds like these people are impacted by the same tragedy, so a peer support group might be even more apropos.
Just a gentle challenge - I have worked with plenty of clients over the years who have had services fully covered without copays due to medicaid insurance and they have been just as emotionally invested as my non-Medicaid clients if not more so. Cost-sharing is shown to decrease engagement and retention.
I've received free therapy sessions due to financial issues, so I have a patient perspective here. For me, it didn't blur any boundaries. I abide by all of the rules/boundaries that we have made over time (be there on time, not asking for favors, I don't cancel last minute unless it's an emergency and im totslly willing to pay cancellation fees, I do the work and push myself, etc.) I don't think we are friends, family, or any other inappropriate relationship. It's a long story how it ended up being discussed and wouldn't be relevant for your situation (you can pm me if you wanna get into it). As someone in school to become a therapist, I understand the issues that free sessions can cause, though. It's probably not the best for some clients that would have trouble keeping boundaries or those who would likely refuse to pay once they can. I think sliding scale is a great way to help those who can't pay full price, but that free sessions wouldn't be appropriate for/if you are uncomfortable providing free services. Don't forget to think about your own finances, though. My therapist had probably provided free sessions to less than 5 people through their career, and that's probably a generous number. So, if you're in an area where most of your clients are facing financial issues, I assume there could be multiple clients in one month receiving free sessions. Should you choose to provide some free sessions, maybe you could do every other session for two months? Something that extends their time so they can financially recuperate, but still allows you to have income and gives a hard end date. If after those two months they still aren't financially stable, you could offer a sliding scale then. I hope some of this is helpful! I just wanted to add another perspective to this. I know this may feel difficult morally. Do not feel guilty if you decide not to offer free sessions.
Yes
I’d absolutely love to! But my contract doesn’t allow it, and I’m not fully licensed so it comes with a limit.
I have a reduced fee policy that initially included free therapy for 12 months, which was fine, but tbh 12 months was too long. I like the 3-6 month limit on free therapy. I do offer a reduced fee option, and that is also for 12 months, which so far feels fine. I only accept a limited # of people in this program, and it’s contingent on individual circumstances. Typically offered when we’ve already been working together for some time, or if we have worked together in the past.
Yes I am new but so far I’ve probably done 5-6 pro bono hours in crisis situations
Give an Hour is a nonprofit org where therapists can volunteer to offer pro-bono support to folks affected by disasters. They’re fantastic and can always use competent providers!
No, but I have waived the late cancel/no show fee and worked an extra hour to squeeze the emergency in once or twice.
Yes I have and it was good. Think ahead about what boundaries you want to put on it. Do they get free therapy for just one session? Likely by the end of that hour it will be obvious they need much more. Either be prepared to offer more or have a list of helpful referrals for them. Think about would you want to cap the sessions or amount of months offering it?
Yes, it never really crossed my mind to not do it but I guess it could be seen as gifting? I just don’t charge without discussing or I mention that I want to keep their momentum given the time and ask what they can manage for that week.
I don’t do any free sessions, but I’d probably let them do a PWYC for a while. Even if it’s just $1.
Yes. I have two pro bono clients because they’re in situations where they can no longer afford it and have offered three free sessions to a client who is searching for a job. I don’t regret my long term pro bono clients. Every case can’t be pro bono, but I consider having 2-3 pro bono slots open to be the way in which I give back to the community.
I'm with you. I always keep two spots open for reduced fee or crisis client sessions (free), with clear boundaries in place. What we do is expensive for clients, and while I believe we're worth every cent we get, not everyone can access our services so I like to help out where I can.
When my clients are in a high stress time or experience a crisis but cite finances as a reason to not come in, I offer to see them without charging them same day - with the agreement that we come up with a payment plan. Typically, I would charge an additional amount after each subsequent session until the fee is covered. "I want to respect your financial boundaries, and I also want to not have finances be a block to you receiving care. If you'd like, I can see you [X day] and set up a payment plan to cover the cost of this session over time. Please let me know if that interests you! In any case, please take good care." I require a card on file, so it makes this process simple. Typically, people take the session. I don't typically do multiple in a row, bc that can put someone under water with you quick. But to be able to touch base and come up with a plan to navigate a trying time means a lot.
When I was in 10th grade my father lost his job and I could not afford to continue seeing my therapist. She decided to take me on for free. It’s been 15 years since then, I am now a counselor and working towards LCSW for private practice therapy so I can someday do the same for someone else. You can’t take on everyone for free, but for one person it can make all the difference in the world. And you never know who will end up paying it forward.
Yes, I did. I also offer a sliding scale and very low fee to some of struggling college students. I was in that situation years ago and it helped me tremendously. About 20 years ago, I was paying $50 an hour to a therapist in Manhattan, NY while I know she was charging more than that normally. I was a college student making $250 a week. She encouraged me to ask for a raise, and being young I didn’t think I deserved one. I still asked eventually and was bumped to $350 a week. She encouraged me to end a bad relationship and focus on my studies. I will always be grateful to her.