LCSW & MFT Exam Prep: Fees

By Bethany Vanderbilt on September 5, 2012

Let’s face it: while most of us don’t go into a helping profession because of the paycheck, most of us DO depend on our income to live — to pay rent or a mortgage, to care for our families, to care for ourselves.  Managing the financial aspects of our profession can be tricky, but ethical boundaries can guide and support you in this aspect of your work. As usual, there are a couple of ways this topic can come up on exams — let’s take a look at a sample.

Sample:

A school therapist evaluates a 6 year-old student and concludes that the child is likely suffering from both ADHD and a Learning Disorder.  The therapist meets with the family and provides a referral to a psychologist in the community for further testing.  Several days later, the psychologist calls the therapist, thanks her for the referral, and suggests an ongoing relationship in which the psychologist gives the therapist a percentage of the testing fee in this and future cases. The therapist should NEXT:

A. Ensure that no conflict of interest exists before moving forward

B. Consult with school administration about this arrangment

C. Refuse the offer

D. Report the psychologist to the licensing board

I was surprised to find that there are a couple of pretty significant differences in the ethical guidelines regarding financial arrangements for social workers and MFT’s.  Social workers are ethically bound to consider the client’s ability to pay when setting fees, while MFT’s are bound to “conform to accepted professional practices,” (AAMFT Code of Ethics, 2012).  The AAMFT Code of Ethics specifically discusses situations in which therapists may use collections agencies or legal means to recoup fees, while the NASW Code of Ethics does not address this topic.  Both professions, though, share the same standards regarding bartering, accepting/giving compensation for referrals, and accurately representing the services rendered. The complete NASW Code of Ethics can be found here: http://www.naswdc.org/pubs/code/code.asp The complete AAMFT Code of Ethics can be found here: http://www.aamft.org/imis15/content/legal_ethics/code_of_ethics.aspx

Answer:

C is the best answer to the question above: whether you’re an MFT or a social worker, whether you’re in private practice or working for an organization or agency, accepting fees for a referral is unethical.  Even though the therapist in this case has provided a clinical service to the client, the financial arrangement that the psychologist is suggesting would involve the therapist accepting compensation when no service is being performed.  A and B are not the best answers because regardless of the therapist’s use of consultation or consideration of conflicts of interest, accepting kickbacks for a referral is considered unethical.  D is not the best answer because the therapist’s NEXT task would be to refuse the offer. Understanding your professional code of ethics can help you PASS your exam, but more importantly, it will help keep you and your clients safe once you are licensed! 

Coming up next week: Boundaries  

Think our straightforward, sensible approach could help you PASS your social work or MFT exam? If you’re preparing for a social work exam, check out our Social Work Study Materials. If you’re preparing for an MFT exam, check out our MFT Study Materials. Learn more about our offerings at The Therapist Development Center.

Looking for more practice questions and some study tips? Check out our new Social Work Exam Study Guide:

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