A psychologist receives a call from an attorney wishing to seek services for depression, anxiety and substance abuse. The psychologist screens the potential patient and she believes that she can help him. When she asks about insurance, he indicates that he will use cash payments. The psychologist explains the fee structure for the initial appointment as well as ongoing psychotherapy sessions. The lawyer-patient comments that this seems low. The psychologist ignores the comment and finishes by setting their initial appointment.
The psychologist and the attorney-patient meet for the initial session. At the end of the session, the psychologist asks for the requisite fee as stated on the phone. The attorney-patient indicates that he earns about 2.5 times what the psychologist asked. He indicates that, in order for him to benefit from the treatment, he feels a need to pay what he makes an hour. He also states that if she does not accept what he is offering, he will lose respect for her as a professional and probably not return for treatment.
Not knowing what to do, the psychologist takes the cash and sets up another appointment. At the end of the day, the psychologist reflects on the interaction between she and her new lawyer-patient. She does not feel right taking a fee larger than her usual and customary rate. She is struggling that the situation is not right and feels very uneasy about the arrangement that the lawyer-patient foisted upon her.
Uncertain, she calls you for an ethics consultation.
What are the ethical issues, if any, involved in this case?
What would be your emotional response to this situation?
What factors make this situation potentially difficult for you as a psychologist?
What factors make this situation potentially easy for you as a psychologist?
What do you believe is the best course of action?
