Barter: Ethical considerations in psychotherapy

The use of barter as a method of payment in psychotherapy carries a number of risks, including that of exploiting the client and complicating and possibly damaging the therapeutic relationship. However, barter is one way of increasing the availability of therapy, respecting class differences, and avoiding the problems associated with using insurance for payment. The author proposes factors to consider in order to barter ethically in therapy: (1) the nature of the transference, (2) the kind of dual relationship created, (3) the economic context, (4) the relative cost of the barter to each participant, (5) other therapist-client power differences, and (6) the problem of evaluation.