Counsellors' Approach for Managing Money Matters

Title: Counsellor’s management of money matters when working with fee paying clients

Introduction

Setting the fee can be a difficult task for the counsellor, as primarily he or she is a service provider and financial planning may not come naturally to the counsellor. Therefore, as Bor and Stokes (2010) say, setting professional fee is one of the most “vexing problems” for a practitioner. However, it is essential to do so, because setting of fee is akin to conveying the relative value of the counsellor’s professional services. The beginning time is the best time to convey the fee structure and schedule to the client. This is also important because the therapy provided by the counsellor is essentially a service contract with the client, and the details of fee (that is, consideration of the contract), has to be done at the very outset. Bor and Stokes (2010) say that fee management is not just an essential aspect of practice, it is something that a responsible and prudent counsellor will think carefully about and plan well in advance, even before setting up the practice. Fee management is an important component of financial planning for the counsellor. This planning will include the counsellor’s preferences of how he or she would like to bill the client, what the billing cycles would be and what mode of payment the counsellor would prefer to be paid in. Bro and Stokes (2010) especially caution the independent practitioners to give thought to these matters of financial planning, if they want the practice to sustain itself. They say that private practice is generally not established for charitable purposes, therefore, counsellors would have to think carefully about their expenses and structure their fee payments accordingly.

It is important to note that there is a legal obligation on the client to pay the fee in consideration of the services rendered by the counsellor. Mitchel and Bond (2010, p.48) write that in private practice, therapy is given in return of consideration, that is fee, by the client. This fee structure, like any other consideration must be discussed and agreed upon by the counsellor and the client at the beginning of the therapy. At this time, the client and the counsellor can even agree upon the mode of payment. Thus, payment can be per hourly session and will also depend on the frequency of sessions and the duration of the treatment (Mitchel and Bond, 2010, p.48). Important questions that the researcher hopes to get answers to are related to the method or process that the counsellors follow in setting their fees and billing fee. The steps taken by counsellors in case they are not paid by the client are also a point of interest. As counselling is primarily a service provided for the benefit of the clients, there are important ethical issues also involved in fee structuring and payments.

Methodology:

When looking at a phenomenon, in this case the phenomenon being counsellors’ response to non-payments, it is important to gain insight into multiple experiences and different angles (McLeod, 1999 and Cresswell, 2007). In order to do this I will be carrying out this research by interviewing a minimum of five counsellors. There will be no specific inclusion/exclusion criteria except that they are in private practice and have an experience with non paying clients. I will use a semi-structured interview incorporating Moussakas’ transcendental phenomenology (Cresswell, 2007) process. I will begin the interview with two standard interview questions. The first question requires a textual description (what happened), the second question will require a structural description (how they responded) and any subsequent questions will emerge from the participant’s response. I will allow approximately 50 to 60 minutes for the interview. All interviews will be taped and transcribed. Although my own practice is structured differently, where I do not charge fee from my clients and my practice gets donations from clients, I have a deep interest in this area as I want to learn how counsellors with fee paying clients manage money matters. It is one of the least researched areas in our field and gets generally back-benched in the face of more pressing concerns.

Data analysis

As the research is being conducted through the method of semi structured interviews, there will be open ended questions asked to the participants. It is expected that the answers to the questions will give a rich and in depth information. Therefore, there will be a considerable amount of textual information that will be the subject matter of data analysis (Piercy). Mc Craken’s five step programme for data analysis of semi structured interviews may be helpful here. Piercy explains the five steps that are involved here. The first step involves reading and reviewing each interview transcript twice. First reading is for the purpose of content understanding. The second reading is for identification of useful comments, which can be noted as observations. These observations are developed into preliminary descriptive and interpretive categories in the second stage of analysis. A thorough examination of these preliminary codes in order to identify connections and develop pattern codes, is undertaken in the third stage. The fourth stage of analysis involves a determination of basic themes by examining clusters of comments made by respondents and memos made by the researchers. The final stage examines themes from all interviews across such groupings, to delineate predominant themes contained in the data. These predominant themes then serve as answers to the research questions, and form the basis for writing up the data (Piercy).

Ethical issues

As their are participants involved in this research, ethical issues will have to be considered at the outset. First and foremost, the consent of the participants is required and such consent must be voluntary and informed. Here the ‘informed’ aspect of the consent has to be the responsibility of the researcher, which means that I would be required to clarify the purpose, methodology and other relevant issues to the participant, so that the participant can decide whether he or she wants to be a part of the research. Appendix 1 (see below) is the ‘Participant Consent Form and Information Sheet’ and in this the participant will be informed of the purpose, procedure, benefits and risk to the participant, and confidentiality. In order to ensure that the research is transparent and no deception is involved, I will brief the participants about the nature of the research. Confidentiality of the participants is also an important ethical issue in the research and therefore, the participants will remain anonymous during the analysis of the data. I will also need to consider participants wanting to be acknowledged in the write-up (Kvale, 2007) and may not want to be anonymous. For the sake of fairness to those that want to remain anonymous and the sake of regularity, all participants will be anonymous. Participants will be given a copy of the transcribed interviews so they could correct and amend anything that they feel is not an accurate representation of what they have said. As interviews will be recorded and transcribed I will ensure that they are kept in a lockable cabinet which only I have access to. Any data stored on a USB storage device will be password protected. It is important to also ensure that participants are able to contact someone after the interview is over in case they have any questions about the study or anything that they have discussed. Participants will be able to speak to someone after the interview if necessary and this information will be provided on the debrief form (see Appendix 2). Participant will not be required to answer questions that they do not want to answer. If at a later point in time, they want to withdraw their data, they will be free to do so. Finally, trust is an important issue in the establishment of honest participation, as Kvale says that “Creating trust through a personal relationship here serves as a means to efficiently obtain a disclosure of the interview subjects’ world” (Kvale, 2006, p.482). I will therefore seek to maintain a transparent, open and clean process so that the participants are forthcoming with information.

Discussion:

The perspective of the counsellors in case of non payment of fees and the steps that the counsellors may take to prevent such a situation, are interesting and pressing questions related to private practice. However, there is a paucity of research in the area. This research project seeks to fill that existing gap in order to understand the methods employed by practitioners in order to ensure timely payment of their fee by the client. The ethical precepts that the counsellors may face in case of non payment and the measures that the counsellor would take in such a situation are also relevant to the issue at hand. As a counsellor-client relation is a fiduciary relation, that is, a relationship of trust and confidence, the counsellor may consider it unethical to stop taking sessions of the client if he is unable to pay for some reason. At the same time, the counsellor will be economically pressed to ask for fee as it will be financially not viable for the counsellor to run a practice without getting fee from clients. It is therefore a question of ethical dilemma as well. This is what makes this research so interesting.

Participant Consent Form and Information Sheet University of Greenwich

Purpose:

The title of this research is: Counsellor’s management of money matters when working with fee paying clients.  The study is part of MSc Therapeutic Counselling final year dissertation, under the supervision of Quentin Stimpson.   The purpose of this study is to look at the experiences of counsellors who have experienced non-payment from paying clients and how they have managed money matters with fee paying clients.

Procedure:

If you agree to be in this study, you will be asked to do the following: Participate in an interview for approximately 50-60mins regarding your management of money matters with fee paying clients which will be audio recorded and transcribed.

Benefits/Risks to Participant:

Due to the nature of interview you will be asked to think about some of your processes during therapeutic encounters with clients. This may result in uncovering unprocessed issues and may cause distress. Please tell the interviewer if it is experienced and/or seek personal therapy.

Voluntary Nature of the Study/Confidentiality:

Your participation in this study is entirely voluntary and you may refuse to complete the study at any point during the interview or refuse to answer any questions with which you are uncomfortable. You may also stop at any time without an explanation and without any consequence. You are free to ask the researcher any questions you may have. Your name will never be connected to your results or to your responses on the questionnaires; instead, a number will be used for identification purposes. Information that would make it possible to identify you or any other participant will never be included in any sort of report. The data will be accessible only to those working on the project. All data collected will be stored on a USB memory stick which will be password protected.

Statement of Consent:

I have been given, and read, an Information Sheet concerning this research, and any questions that I had concerning the research have been answered to my satisfaction. Initial of Participant_______________________________________ Date: __________ Initial of researcher____________________________________________ Participant Code for data query purpose:………. Thanks for your participation!

University of Greenwich

Debriefing Form for Participation in a Research Study

Thank you for your participation in this study titled ‘Counsellors’ response to non-payment by paying clients’.  Your participation is greatly appreciated.

Purpose of the Study:

The purpose of this study was to look at how counsellors respond to client’s non payment of session fees and what influenced the response. I realise that some of the questions asked may have provoked strong emotional reactions.  As a researcher, I do not provide mental health services and I will not be following up with you after the study.  However, I want to provide every participants in this study with a useful list of resources that are available, should you decide you need assistance at any time.

Confidentiality:

Your participation in this study is entirely voluntary and confidential. Your name will never be connected to your results or to your responses on the questionnaires; instead, a number will be used for identification purposes. Information that would make it possible to identify you or any other participant will never be included in any sort of report. The data will be accessible only to those working on the project. All data collected will be stored on a USB memory stick which will be password protected. You may decide that you do not want your data used in this research.  If you would like your data removed from the study and permanently deleted you can contact me on kf210@gre.ac.uk for up to 3 weeks after the interview has taken place. Your interview took place on this date…………….. The last date that you can contact me to withdraw is………….. Please quote your personal code below when contacting me.

Final Report:

If you would like to receive a copy of the final report of this study (or a summary of the findings) when it is completed, please feel free to contact me via email kf210@gre.ac.uk.

Useful Contact Information:

If you have any questions or concerns regarding this study, its purpose or procedures, if you have a research-related problem or wish to take part please feel free to contact me on kf210@gre.ac.uk or my supervisor on q.stimpson@greenwich.ac.uk. If you feel upset after having completed the study or find that some questions or aspects of the study triggered distress you may wish to explore this further with your clinical supervisor or personal therapy. Your personal code is………. Please quote this when contacting us regarding your participation.