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CEU Education: Fees, Slides and Cancellation Ethics

Some basic policy questions: How do you or your agency determine service fees? Do you or your organization offer a sliding scale? If, so, to whom, under what circumstances? What is your or your agency’s late cancellation policy?

Some harder questions: Do you ever feel guilty, or under-appreciated based on the fee your client pays to see you, whether or not it impacts the fee you receive? Are you involved/impacted by your agency’s decision to slide? Is the slide based solely on presenting economics, or do factors like client likability, clinician guilt, insurance issues, difficulty of presenting case, and the like play into your decisions? Do you or your agency offer different sliding scales for clients who live in the margins and have historically had less access to resources? And how about late cancellation policies? What if you don’t agree with your agency’s policies? Or what if you are the one making the policy? Do you follow them any way? Do you handle the policy differently for different clients, based on internal punitive impulses, or internal avoidance of conflict with your client, or agency?

It shouldn’t surprise us that issues related to payment are ripe for client, clinician and agency enactments of anxiety, guilt and aggression. Our management of these pose ethical risks and opportunities.

This 3-hour ethics workshop will be primarily didactic as we explore issues that arise for clients, clinicians and agencies in this pinnacle element of the frame that defines the boundaries of our relationship. The facilitator is particularly skilled at evoking a shame-free environment for clinicians to explore uncharted territory ripe with accidental enactment.



Smith is an analytically oriented psychotherapist with 25 years in practice. She is additionally the Founder/Director of Full Living: A Psychotherapy Practice, which specializes in matching clients with seasoned clinicians in the Greater Philadelphia Area.

If you are interested in therapy and live in Philadelphia or the Greater Philadelphia Area, please let Full Living: A Psychotherapy Practice match you with a skilled, experienced psychotherapist based on your needs and issues as well as your and own therapists' personalities and styles. All of our therapists are available for telehealth conferencing by phone or video in response to our current need for social distancing.

Full Living Founder and Director Karen L. Smith MSS, LCSW Karen L. Smith MSS LCSW Karen is the founder and director of Full Living: A Psychotherapy Practice, which provides thoughtful matches for clients seeking therapists in the Philadelphia Area. She provides analytically oriented psychotherapy, and offers education for other therapists seeking to deepen and enriching their work with object relation concepts.

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