"I’m poorly and had to cancel my session last minute and I’m being charged for it, is this usual?", "I’ve pre-paid a number of sessions, but I’ve decided not to continue therapy, can I obtain a refund" and "My therapist refuses to provide me with a receipt?" These are some of the many queries we’re asked about in relation to fees.

Although therapists aren’t required to provide a contract by law, best practice suggests that there should be a clear discussion about fees and this agreement should be stated within a written contract and given to the client prior to the start of any therapy. Contracting before therapy starts ensures that the client is fully aware, and in agreement with, the arrangements made and avoids any confusion at a later date.  

Contracts are evidence of explicit and informed consent. A contract should clearly state the fee, when and how it is paid and by whom (and any information about when a review to charges might happen).

Clients should also know what fees are payable if they miss or need to cancel a session. It’s usual for therapists to give clients a notice period, whether that be 24hrs, 48hrs, a week etc. Over the years I’ve even come across a couple of therapists who charged for cancellations no matter how much notice was given. However, regardless of the notice period, this should also be covered within the contract.  

In relation to block-booking/pre-paying a number of sessions, this may be considered unethical from a client’s perspective and that it’s of greater benefit to the therapist than to the client. Some therapists may ask for upfront payment for several sessions, the advantage being a clear income stream. However, the disadvantage is that there may be problems if a client misses a session, wants to end therapy, is unhappy about the therapy or takes a holiday during a paid period. What are the implications of having paid for sessions in advance? If clients are paying for a service that they haven’t received yet, it’s important to be as clear as possible from the beginning, for example, does the contract state that the remaining sessions will be reimbursed?

Sometimes clients may be offered a discount for paying in advance, which may also be considered unethical; an exploitative marketing ploy that entices clients with the offer of reduced fees and, again, of greater benefit to the therapist than to the client. 

With regard to providing invoices and/or receipts, while BACP doesn’t say specifically that a client must be provided with these, it seems to make good business sense, as well as being good, ethical practice, even if only sent electronically.  

Best practice may be to allow a number of different methods of payment according to client and practitioner needs (including accessibility needs). Whatever form of payment is used, records should be kept for transparency, tax purposes and data protection. Working online is likely to influence choice as is the setting in which practitioners work. 

Our Ethical Framework commits our members to ‘Show respect by agreeing with clients on how we will work together’ (Commitment 3c) and building an appropriate relationship with clients by ‘communicating clearly what clients have a right to expect from us’ (Commitment 4a) and ‘communicating any benefits, costs and commitments that clients may reasonably expect’ (Commitment 4b).

It’s the therapist’s responsibility, as the professional, to ensure contracting is clear and their clients understand the commitment they’re making in relation to fees. 

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