Why I Don’t Offer Free Psychotherapy Consultations (But I Respect if You Do)

From 2006-2018, I worked as a ‘Mental Health Clinician’ with a local Family Health Organization, a system where family physicians and other allied health providers refer clients for counselling/psychotherapy in a collaborative way. This service was fully funded by the provincial government and offered free to patients.  This, of course, was before the explosion of Masters of Counselling Psychology graduates and just the beginning of the College of Registered Psychotherapists in Ontario. I, in fact completed my own masters degree during this time frame. With a significant demand for service, clients did not seem in the least bit focused on the idea of ‘goodness of fit’, as much as how many sessions they would be able to receive. It is fair to say that spending fifteen minutes for a ‘meet and greet’ was not a good use of anyone’s time.  At this juncture neither the post-grad program I was in, nor the CRPO offered any kind of guidance about consultations or how to navigate those first contacts with clients. (I did however, learn how to structure a first session in my Bachelor Social Work program). It really is since the explosion of virtual therapy and new therapists, that this phenomenon has become more the norm. What the CRPO is clear about is not incentivizing, however, I see therapists, particularly inexperienced or even not fully qualified ones advertising free consultations and even free initial sessions quite frequently. This to me is clearly both offering an incentive and a marketing strategy - rather than being of benefit to the client.  Having spoken with a number of colleagues across Ontario I know that about 50 percent of them offer free consultations - mainly as a way to ensure they are seeing clients who are a good match for their scope of practice. Also, if you are advertising on the Psychology Today on-line directory, as many of us are, this system prompts potential clients to ask for a free consultation. The ridiculous notion here is that clients will be able to determine a ‘goodness of fit’ with a therapist in this short time frame. In reality, experience teaches us that ‘goodness of fit’, or more appropriately, therapeutic alliance, evolves organically over time, and it is very difficult to establish that in 15 minutes.

The American Psychological Association, which has been established way longer than the CRPO, is very clear that consultations should be limited to only offering basic details about a therapist’s scope of practice, hours, fees and other policies. They are very clear of the ethical implications regarding offering free consultations as at that point we are ‘not the therapist of choice’, there is no signed consent form, and we are not under any circumstances, to offer assessment or intervention information. I do not think most therapists, especially in Ontario, abide by this guideline. Many therapists genuinely want to help, and often spend more time than 15 minutes, offering more service. And this tips into marketing/sales territory or incentivizing, in my opinion. Entering fully into private practice at the end of 2018 I was rarely asked for a consultation. This all changed after the pandemic and virtual service became more the norm. If a client calls me, I will generally spend a good chunk of time answering any questions they have. My website offers extensive information and I also am a frequent podcast guest and have a YouTube channel where people can get a sense of how I work with clients. A fifteen minute consultation takes away a whole hour of client service, for me, and there is no transparency in the conversation about what a client is seeking.  This being said, if this is part of your practice, I do understand and respect that. Each therapist can determine the best use of their time. 

Stacey Sanderson, B.S.W.,M.A.,R.S.W.,R.P.