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Sliding Scale for Economic Justice

Created by Alexis Cunningfolk

I recognize the financial privilege that exists in America today and understand that, while many people seek support, financial barriers can make it challenging.

 

As a therapist, I continuously seek ways to offer therapeutic services that meet the needs of my clients and contribute positively to my community. Balancing the costs of running a practice and supporting my family is essential to keeping my doors open, so I can continue to show up fully for those I serve. My goal is to find ways to make support accessible without compromising the sustainability of the care I provide.

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In my search for equitable ways to offer services, I came across the Sliding Scale Method for Economic Justice by Alexis Cunningfolk. This model is one of the clearest approaches I've found for assessing economic need and creating sliding scale options for those who truly need it.

 

If you feel you may benefit from a sliding scale, please read on to learn more about how I offer this option in my practice.​

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For more details, please visit the original blog post by Alexis Cunningfolk here.

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Credit: Alexis Cunningfolk

 

The Green Bottle Method

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For ease of reading, here is the text from each of the bottles in the above graphic:

 

Top of the Scale / Tier 3 (or the left bottle):

  • I am comfortably able to meet all of my basic* needs

  • I may have some debt but it does not prohibit attainment of basic needs

  • I own my home or property OR I rent a higher-end property

  • I own or lease a car

  • I am employed or do not need to work to meet my needs

  • I have regular access to health care

  • I have access to financial savings

  • I have an expendable** income

  • I can always buy new items

  • I can afford an annual vacation or take time off

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Middle of the Scale / Tier 2 (or the middle bottle):

  • I may stress about meeting my basic needs but still regularly achieve them

  • I may have some debt but it does not prohibit attainment of basic needs

  • I own or lease a car

  • I am employed

  • I have access to health care

  • I might have access to financial savings

  • I have some expendable income

  • I am able to buy some new items & I thrift others

  • I can take a vacation annually or every few years without financial burden

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Bottom of the Scale / Tier 1 (or the right bottle):

  • I frequently stress about meeting basic needs & don’t always achieve them

  • I have debt and it sometimes prohibits me from meeting my basic needs

  • I rent lower-end properties or have unstable housing

  • I do not have a car and/or have limited access to a car but I am not always able to afford gas

  • I am unemployed or underemployed

  • I qualify for government assistance including food stamps & health care

  • I have no access to savings

  • I have no or very limited expendable income

  • I rarely buy new items because I am unable to afford them

  • I cannot afford a vacation or have the ability to take time off without financial burden

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​* Basic Needs include food, housing, health care, and transportation.
** Expendable Income might mean you are able to buy coffee or tea at a shop, go to the movies or a concert, buy new clothes, books, and similar items each month, etc.

Guidelines for
The Green Bottle Method

Here is a general guidelines about how I currently price my sliding scale and to help you determine where you fall on it.

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  • The highest dollar cost reflects the true cost of sessions. It is my standard cost of sessions in the absence of a sliding scale. My rate is based on my experience and trainings. If you have access to financial security, own property or have personal savings, you would not traditionally qualify for sliding scale services. If you are able to pay for "wants" and spend little time worried about securing necessities in your life, you have economic privilege and power in our community. This price is for you.

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  • The middle cost reflects my acknowledgement that paying the full cost would present financial challenges, but who do not honestly find themselves reflected in either descriptions for the highest cost or the lowest. If you are struggling to conquer debt or build savings or move away from paycheck to paycheck living but have access to steady income and are not spending most of your time thinking about meeting basic needs such as food, shelter, medical care, child care, etc., you belong here. If you, however, can ask others for financial support, such as family members, partners, or friends, please consider using those personal resources before you use the resources of the sliding scale and limit opportunities for others.

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  • The bottom cost represents an honest acknowledgment that there are folks whose economic circumstances would prevent them from the ability to seek mental health treatment (outside of insurance) if there was not be a deliberate opportunity made for them to access services at a cost that is reflective of their economic realities. If you struggle to maintain access to needs such as health care, housing, food, child care, and are living paycheck to paycheck or are in significant debt, you probably belong here and you deserve a community that honors your price as equal an economic offering as the person who can pay the highest tier. Even when the lower tier is still prohibitive, I will work with folks to explore resources or other solutions.​

How I Implement
The Green Bottle Method

I reserve four spots in my caseload for clients who need access to a sliding scale.

Two of these spots are reserved for clients in Tier 1 and two spots for clients in Tier 2.

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All sliding scale spots are reassessed every 4–6 months to ensure ongoing need.

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Please be mindful that if you utilize a sliding scale spot when you can truthfully afford the higher tier prices, you are limiting access to those who truly need the gift of financial flexibility. Being honest with yourself and your financial situation when engaging with sliding scale practices grows strong and sustainable communities. ​

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  • Pricing for Tier 3 is $160-$200 per session, based on the service provided. Please see Therapy Fees & FAQ to learn more.

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  • Pricing for Tier 2 ranges from $125-$155 per session. Together, we will explore which side of this scale you fit on and a pricing point that allows for consistent treatment. 

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  • Pricing for Tier 1 ranges from $90-$120 per session. Please note, I will also do my best to work within your need or do my best to find referrals/resources that can work within a price point that works for you. â€‹

Let's Get Started, Today

Click the link below to schedule your free 20-minute consultation to see if I would be a good fit to help you start your therapy journey. 

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Get in Touch

Contact​

Lisa Stoll, LMFT 

(775) 899-7963

lisa@growtodaytherapy.com​

Office Location​

421 W. Plumb Lane, Suite E

Reno, NV 89509

 Office Hours​

Monday 9am to 4pm​

Tuesday 10am to 5pm

Wednesday 9am to 4pm

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Virtual Hours

Monday 9am to 4pm​

Tuesday 10am to 5pm

Wednesday 9am to 4pm

Thursday 9am to 4pm

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