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  • Tesia Bryski, MEd, RP

Sliding Scale Therapy

In any given year, 1 in 5 Canadians will experience a mental health crisis.


That number has not been updated since the pandemic hit, and given my work as a therapist in the past year, I think it’d be safe to say that statistic has drastically increased.


According to the Canadian Psychological Association, the delivery of mental health services in Canada can be characterized as a silent crisis. They write, “An increasing demand and need is unmet by provincial and territorial health care systems and private insurers.”


Therapy is a privilege. As many public institutions do not have the budget, funding, or staffing to meet the high demand of mental health concerns among Canadians, many people turn to find therapists in the private sector.


Therapists in private practice rely on their hourly rate to fund their monthly expenses, including overhead (office rental), insurance fees, licensing fees, and many softwares to help run their business (i.e., I pay for a scheduling software, an accounting software, marketing platforms (Psychology Today, email domain & website), and now a premium membership to Zoom to deliver compliant and confidential online sessions). Don’t forget about the student loan fees for years’ worth of university and ongoing training to keep the skills sharp. In short, it’s really quite expensive to run a private practice.


Sliding scale therapy has always been important to me. As hourly fees in this industry continue to rise with demand, many folks are left without any option but to omit therapy altogether due to factors including unemployment, supporting a family, or simply trying to make ends meet. Many communities experience systemic barriers to accessing therapy services in the first place.


Personally, the balance has always been difficult. Between wanting to offer more sliding scale services and trying to keep up with my own monthly expenses, the sustainability game has been challenging. I’ve always aimed for 30-40% of my services to be sliding scale.


With content such as writing an E-Book, I am hoping to bridge the gap between that tension. By selling content, I truly hope to gain funds to cover expenses so I can continue to offer low fees for therapy. My priority will always be accessibility.