Adjusting Clinical Fee Scales: First Session Intake Fees Moderating Couple’s Total Number of Sessions Attended in Couple’s Therapy

Abstract

Psychotherapy research has acknowledged the importance of examining attrition in therapy. However, researchers consistently neglect to look to the effect of additional fees beyond the every session fee for services on therapy attrition. Addressing this gap in the literature, the current study tested the effect that first session intake fees and income-level have on clients’ total number of sessions attended through the lens of Bronfenbrenner’s ecological systems model. Drawing upon measures of demographic information, intake fee paid, and total number of sessions attended, this study examined the relationship between income and total number of sessions attended, moderated by intake fee paid for clients attending Auburn University’s Marriage and Family Therapy Center training clinic, while controlling for relationship quality, individual symptoms, and adverse childhood experiences at intake. Results indicate that income does not predict total number of sessions attended, and intake fee paid did not moderate the relationship between income and total number of sessions attended. Explanations of findings and future directions are provided.