A client cannot pay fees temporarily due to job loss. What is the recommended ethical practice?

• A. Continue to see the client and offer a reduced fee she can afford
• B. Cease treatment until payment is made
• C. Bill the client for the full amount anyway
• D. Refer the client to a social service agency for aid

Answer: (A)

When a client experiences temporary financial hardship, the ethical priority is to preserve access to care and maintain the therapeutic relationship. The best approach is to continue treatment and adjust the fee to what the client can reasonably afford, such as a sliding-scale or a temporarily reduced rate. This supports the client’s ongoing progress, reflects beneficence and justice by reducing financial barriers, and aligns with the duty not to abandon clients because of payment issues. The counselor should clearly discuss and document the new fee arrangement, and reassess as finances change. Offering this adjustment keeps care continuous and professional, rather than terminating services or billing full amounts regardless of ability to pay. Referring to social services can be a helpful resource, but it does not replace the ethical obligation to try to maintain therapy with a feasible fee.