What is Sliding Scale Therapy? [And How It Works in 2024]

Written by Nicole Laoutaris
Last updated on: Feb 29, 2024
In short, sliding scale therapy involves therapists offering a discounted rate for their sessions, often as low as half of their regular hourly charge. This reduced fee is determined based on your income, ensuring that individuals without insurance can still access treatment and engage in therapy.

What Exactly is Sliding Scale Therapy?

Sliding scale therapy is a payment model designed to make therapy more accessible to a broader range of people, especially those with limited financial resources.

Many counsellors offer something called a “sliding scale” for clients who are unable to afford their full fee. Most therapists offer discounted rates this way because they want therapy to be accessible to those who need it. It’s up to the therapist if they want to offer and advertise a sliding scale option. Often, they’ll decide on a set number of discounted sessions within their full calendar. Accessing a discounted rate will depend on their availability.

  • Adjustable Fees: The cost of therapy sessions is adjusted based on the client's income and ability to pay. This means that people with lower incomes pay less for therapy than those with higher incomes.
  • Accessibility: This model aims to reduce financial barriers to mental health services, making it easier for individuals from various economic backgrounds to access therapy.

How to Access Reduced-Rate Therapy

Whether you need to provide your income tax documents to qualify for sliding scale therapy depends on the specific policies of the therapist or counseling service you are considering. Each therapist or therapy service may have different requirements for determining eligibility for sliding scale fees. The availability and specifics of sliding scale therapy can vary across different regions and practitioners in Canada. Not all therapists offer this option. The exact fee scale and criteria for determining the fee are often at the discretion of the individual therapist or clinic.

Therapists who offer sliding scale pricing typically have a method for assessing a client's income.

  1. Income Verification: Some therapists may request proof of income to determine your eligibility for sliding scale rates. This could include income tax documents, pay stubs, or other financial statements.
  2. Honour System: Other therapists might operate on an honour system, where they ask clients about their financial situation without requiring formal proof. In these cases, they rely on the honesty of their clients to accurately report their income.
  3. No Verification: There are also situations where therapists do not require any proof of income and simply allow clients to self-determine their ability to pay based on the sliding scale provided.
  4. Initial Consultation: Often, the process for determining eligibility for sliding scale fees is discussed during an initial consultation or intake session. This is a good time to ask about what documentation, if any, is needed.
  5. Privacy Concerns: If you have concerns about privacy or sharing personal financial information, it's important to communicate these to the therapist. They might be able to provide alternative options or reassurances about how your information will be handled.

It's always a good idea to directly contact the therapist to inquire about their specific policies regarding sliding scale fees and what documentation they require. They can provide the most accurate and relevant information for your situation.


  • Limited Availability: While sliding scale therapy is an option, it may not be widely available in all areas. Some therapists may have limited spots for sliding scale clients.
  • Quality of Care: The quality of care offered by therapists who provide sliding scale services is typically the same as that offered to full-paying clients. The reduced fee does not reflect a lower standard of therapy.
  • Insurance and Coverage: In some cases, health insurance or government programs may cover a portion of therapy costs, even with sliding scale pricing. It's important for clients to check their coverage options.

If you need mental health support but face greater financial barriers, walk-in therapy and low-cost clinics offer therapy sessions by accredited and qualified therapists at a lower cost. You can use tools like eMentalHealth.ca and wellnesstogether.ca to find counselling services and customize your search to find free and publicly funded options. 

Finally, try checking in with the nearest university that offers a counselling education program. Often these programs provide free counselling as a way to help graduate students log hours of clinical experience.

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About the Author

Nicole Laoutaris

Nicole Laoutaris is a freelance writer and adult learning professional based in the Greater Toronto Area. She specializes in educational content for brands and companies in industries such as mental health, pet health, lifestyle and wellness, cannabis, and personal finance. Nicole holds a double undergraduate degree in Communications and Film studies from Wilfrid Laurier University, and post-graduate certificate in Corporate Communications from Seneca College. She currently lives in Hamilton Ontario with her spouse and her cat.