Quid pro quo: fee for services delivered in a psychology training clinic

The present study evaluated the use of a sliding-fee scale at a training clinic for doctoral students in clinical psychology. A chart review of 209 individual therapy clients and a follow-up telephone interview of 87 of these clients were conducted. Results of the chart review revealed a client group of relatively low income, with only a very small number receiving social assistance or a disability pension. The follow-up survey found that the large majority of clients were satisfied with the fees charged. Service use (i.e., frequency and number of sessions), client satisfaction with services, and treatment outcome did not vary with out-of-pocket costs incurred by clients. Overall, findings suggest that training clinics can charge fees without affecting services, although future research needs to examine the extent that fee charging by training clinics may be an obstacle to service access for the poorest segments of the population.