Episode 15: Why I Don’t Offer Free Consultation Calls (and Why That’s Ethical)

In this episode, I explain why I don’t offer free consultation calls and why that decision is grounded in ethics, safety, and respect for therapeutic labor. I unpack the myth of the “quick 15-minute call,” why it almost always turns into unpaid therapy adjacent work, and the very real risks of engaging in clinical conversations without informed consent.

I talk openly about mandated reporting concerns, client safety, sexual harassment in the therapy room, and why structure and intake paperwork aren’t cold or rigid; they’re protective. I also challenge the idea that something being “standard practice” makes it ethical, especially in a profession where unpaid emotional labor (particularly from women) is deeply normalized.

This episode is a candid look at boundaries, burnout, transparency, chronic illness, and why the intake session is the consultation just done ethically, thoroughly, and with consent.

Transcript

0:01

Welcome to both sides of the couch. I'm Carrie, a therapist who also happens to be a human navigating chronic illness, which means I see life from both sides. This is where I share honest stories, lessons, and little reminders that you don't have to have it all figured out to keep showing up. Let's get into today's episode. Today's episode is why I don't offer free consultation calls and why that's ethical. This is one of my favorite ethical dilemma topics to talk about. I have a lot to say and I just wanna start by saying this may make some people feel uncomfortable, and that's okay. It's a common expectation that therapists provide free consultation calls. I often hear it's just a quick 15 minute call, and i'm here to say that I do not offer free consultation calls, and that's not just about money. It's about ethics, safety, and respecting therapeutic labor. Unpaid labor and therapy isn't generous. It's unethical. The myth of the 15 minute phone call I used to offer this. I can't say for sure how long that I'm gonna say it was for a few months when I first opened my practice. Why did I offer it? Because it was a checkbox on psychology Today. So in my mind, I feel like either Psychology Today had a part in starting this idea or perpetuating it that therapists should be offering free consult calls. So I didn't last very long with the free consults, although I'm pretty sure only a handful of clients really ever asked for them. It was just if somebody asked, but I think the biggest thing I learned and still stick by is that a 15 minute call is never 15 minutes. It's never 15 minutes. I think potential clients have this idea that they're gonna be able to get all of their stuff out, and it's, it's really not gonna take that long. And then I'll have time to hear from you and ask you questions too, when in reality. Just them telling me what they wanna tell me usually is far beyond the 15 minutes. So if I've actually scheduled only 15 minutes for you, I basically just have to hang up on you about 12 minutes. I'll interrupt you and say I'm sorry. So our time is actually almost up. If you want to schedule an appointment with me, reach back out to me. And that leaves the client going, what? All I did was talk. So if I don't keep it contained in the 15 minutes, then I'm giving you, in most cases, it ended up being an hour of my time. It routinely becomes a life history, a trauma preview, a crisis check, which ends with, so can you help me? Which all I really have to say to that is, yeah, that's what my job is. But more importantly, I think, is that therapists are trained to listen, attune, regulate, and assess, and there's no way that we can turn that off. So that means as soon as I pick up the phone, the work has already started. If I'm listening like a therapist, this is therapy adjacent labor, whether you wanna label it that way or not. So the biggest reason for me, why I do not offer these free 15 minute. Consultation calls is that consent is not optional, and I think most people expect you to pick up the phone or to call them and just have a chat, but in my opinion, this is therapy and it requires informed consent. I need to have intake paperwork completed without consent forms. The clients don't know the limit of confidentiality. The clients don't know mandated reporting rules, and clients don't know what counts as therapy versus consultation. My informed consent. Is a multiple page document talking about a lot of different things, from my counseling philosophy to privacy, to confidentiality mandated reporting, things about telehealth, things about my licenses and training, things about my policies, things like how I don't do any communication that isn't HIPAA compliant. I mean, it's a ton of stuff. There's no way I would be able to verbally even go over that in 15 minutes on a phone call with somebody. So a consult call can easily cross into a client telling me some sort of disclosure of abuse. Often you hear about harm to self or others, or other ongoing safety concerns. I am not comfortable creating a situation where I'm ethically or legally responsible without the client being fully informed of that responsibility. I think that mandated reporting risk is real and not hypothetical because it's happened to me. People often disclose serious things before they even realize what they've disclosed in a consult call, and that's dangerous to me 'cause there's no signed consent. There's no acknowledgement of reporting obligations and there's no shared understanding of the rules. That's unsafe for everybody. Unsafe for the client, and unsafe for me, and I'm not willing to accidentally become responsible for a reportable situation during what someone thinks is an informal chat. This has happened to me before in those couple months where I was doing these calls The client will start telling me a story. They're saying, oh, I'm really looking for help with this issue. And it turns into them disclosing to me that they have intent to harm themself. And here I am in a situation with somebody I don't really know, maybe they told me their name. I don't have any documentation with their name. I don't have a copy of their driver's license or id, I don't have any signed consent forms. I don't know what their address is. I don't even really know what state they're located in because they've just possibly verbally told me this. That's really scary. Not just legally because I could get in trouble, but for the client because I don't have a way to keep them safe. I've also had instances where the person is telling me a story, I think they don't even realize that it's not quite relevant to be bringing up and it happens to disclose abuse that needs to be reported. Now what do I do? All those issues again? I don't know any personal information about them. So now I have to stop the conversation. Let them know I'm a mandated reporter, and then I have to ask them to provide me with that information so I can make a report. I'm putting myself at risk and I'm putting the client and whoever they're talking about as a victim of abuse at risk too, because I'm not able to properly report it. This is not okay with me. So I have another episode that relates to this next point. It is episode 10 and it's on sexual harassment in the therapy room. Free consult calls are also an issue for me for sexual harassment. Therapists, especially women, are disproportionately subjected to sexualized comments, boundary testing, and inappropriate disclosures. Consult calls are often used to do that because there is no paper trail. There's no formal structure and there's no accountability. Requiring intake paperwork sets the expectations. It establishes professionalism, and it filters out the bad guys. In this situation, structure isn't cold, it's protective, and I'm allowed to protect myself too. But don't clients need to see if it's a fit? Yes, absolutely. But I do not believe fit can be determined in a 15 minute phone chat. I think even after the intake session, sometimes fit unfolds over time. It often takes multiple sessions to really know if you and the therapist or their modality is gonna be a good fit. I know this firsthand as a client myself. A therapist I had last year, I ended up seeing for probably five months before it hit me that we're not a good fit and we're not working well together. So this therapist offering me a free consult would not have allowed me to determine the right fit. There's too many factors going into that. In fact, I don't think I've ever met anyone. As a client or ever had any clients meet me and after one session be like, I just don't see this working out between us. That is usually discussed many sessions in after you've hit some sort of wall and you're like, so maybe this isn't working between us. Do you know a therapist who is more specialized in this? Or do you know a therapist who has this type of personality? And then I'm gonna provide a referral. I require any consultation for fit to be done in the first intake session. So with couples, there's several intake sessions when we're doing Gottman method, which is what I'm certified in, but I only require the first session where I'm meeting both parts of the couple I have a set list of questions and an assessment that I'm doing to make sure that I'm gonna be a good fit for this couple, and that they're gonna be a good fit for couples counseling in general, because there are some things that would exclude people from being appropriate for couples therapy, like active ongoing abuse. But it, I think it also gives the clients a really good picture about me. Even though a lot of it I'm asking questions, I always try to make sure for my clients that I'm giving them some sense into treatment during the intake session. So, okay, you told me that you're struggling with this. So how I would usually treat an issue like this would be by using this, and sometimes I'll use an intervention in session. With my couples, often flooding will come up immediately and I'm like, Hey, let me tell you what flooding is and here's what we do about it. Let's practice this together in session so my clients do get a sense of treatment and where the path is heading between us in that first session. You also probably get a good idea of personality fits in that session too. I actually do talk a lot in my intake sessions because I do go over informed consent and talk about myself and the modalities that I use so the client gets a really good picture of me versus a 15 minute consult where I'm just listening and going, Uhhuh, Uhhuh. Yeah, I can help you with that. So to sum up, I think the intake session allows real interaction. It also allows consented assessment. We've gone over all of that. They've been able to read my forms. They understand what therapy is and isn't, and it allows both parties to evaluate, fit the intake session. Is the consultation just done ethically, thoroughly, and with consent? Other therapists do. It does not equal. I have to. I've had people tell me before, but this is a standard practice. I'm not here to say whether it is or it isn't. I'm just here to say, I don't care if other therapists do it. I'm not their boss. I'm my boss, and I don't do it. There are therapists that offer free consults. Like I said, I did offer them when I was brand new into private practice, but the truth is many therapists are burned out. Underpaid and socialized to overgive. Normalized exploitation does not become ethical because it's common. Just because something is widespread doesn't mean it's a best practice. It often means it's just survival. Transparency does not equal free labor. I already provide a lot of information about myself on the internet. Clients can find out much more about me from my website than they're gonna find out from talking to me on a 15 minute phone call. I have extensive information on my website about the modalities I use. I have a ton of blog posts that talk about couples therapy and Gottman method and certain aspects of therapy. I also have started this podcast. My podcast episodes are linked on my website. I have links of all my work with other people, like the writing I do for the Gottman blog or other websites or interviews. I have an interview linked on my account that I did a YouTube video with someone. You can see me on my website talking to somebody. Clients can find out a lot about me before reaching out. I'm giving that information and I think that's what they're asking for when they want to consult. That information's there and I can be transparent about myself and my credentials and my therapy style, and who I am as a person and all that without requiring unpaid emotional labor on my part. I also think that unpaid labor is a norm in many different careers. I talked about this in my episode on Therapy Done and Psychology Today, and I've written about it as well. I don't work for free. I don't work in exchange for potential of marketing benefits. It just doesn't align with me and how I live as a person. I would never, ever expect any of my healthcare providers to see me or perform services for me for free, so I can decide if I like them or not. I don't think anybody would, I mean, who's walking into their doctor's office and saying, I want this session to be free today so I can decide if I like you. You'd be laughed out of the building. I don't require anyone performing a service for me to give me free labor when I hire someone to do something on my house. I am paying them for their services. The only thing that typically comes free, if anything, is gonna be a free estimate, and I do provide free estimates. They're right there on my website. I'm very transparent about my fees. I think there's also a lot more unpaid labor that women are expected to do in our society, and I'm a strong advocate that women stop this. By refusing to do unpaid labor, no matter what that labor is, and this is one of those ways that I can protest that. I don't work for free. I'm not going to do labor for you for free. That may sound harsh, but I think it's standing up for myself also as a chronically ill person. My time and efforts have the potential to cost me more than they cost other people. If you haven't heard of Spoon Theory before, I'm not like a big fan of the meta metaphor. I think it's a little confusing, but the idea is like you have so many spoons at the beginning of the day. So if I get 10 spoons a day. And it costs me three spoons just to have the energy to get outta bed in the morning. And it costs me two spoons each session I'm doing. You know, I have to be very careful about the spoons I'm spending because by the time it hits mid-afternoon, I may not have any spoons left. So when I think of free consults, I think I'm giving away spoons that are. A short commodity for me, and I'm not getting anything in return, and that's not fair, and it's not a decision that I can make for my body. So who's this boundary for? I think it's for everybody. This boundary protects clients. It gives them clarity, it ensures their safety, and it gives informed consent. This boundary also protects therapists. It protects us from burnout. It protects us from exploitation, and it protects us from harassment. It also protects the therapeutic relationship itself. We're gonna have a much better relationship if we've talked about and form consent, and we're doing it in a structured intake session. Starting therapy with clear boundaries builds trust in the relationship. It models healthy limits and it sets the tone for the work. So in closing, I don't offer free consults, and that's not because I don't care, it's actually because I really do. I had love to hear your thoughts. Please share in the comments. Feel free to reach out to me. Thank you so much for listening. Thanks for joining me on both sides of the couch. If something you heard today resonated, share this episode with someone who might need it. And if you'd like to support the show or find more of my work, check the links in the show notes. Until next time, take care of yourself on both sides of the couch.