If a client cannot pay, the ethically appropriate action is to:

• A. Stop therapy until payment is made
• B. Continue to see the client and arrange a reduced fee that they can afford
• C. Bill the client for the full amount anyway
• D. Refer the client to a social service agency

Answer: (B)

When a client cannot pay, the priority is to keep treatment accessible by adjusting fees to what they can afford. This approach supports beneficence and justice by removing financial barriers to care and preserving the therapeutic relationship, which is essential for ongoing progress and safety. Offering a reduced fee, sliding scale, or pro bono options helps ensure continuity of care, demonstrates respect for the client's autonomy, and prevents harm that can come from abrupt termination.

Stopping therapy until payment is made would disrupt care and amount to abandoning the client. Billing the full amount despite financial hardship imposes a barrier to care and is not ethically appropriate when it would prevent the client from receiving needed services. Referring the client to a social service agency can be a helpful adjunct in some situations, but by itself it does not address the immediate need to continue therapy; the preferable action is to modify the fee arrangement to allow ongoing treatment while exploring other resources as needed.