A.few times over the last 2 decades as a private practice psychologist, specializing in neuropsychology, I have entered into barter arrangements with patients. I have never felt completely comfortable about it, but in each case it seemed to be the best alternative. The major issue hinges around the following question: How should we act and what should we do when a patient has little or no money?
I find it curious that the meager literature on bartering in American Psychological Association (APA) journals (e.g., Sonne, 1994; Woody, 1998) makes little mention of bartering as a means of helping the needy but poor patient. It can serve as a relatively dignified way for the patient to compensate the therapist for professional work. It seems as if the compassion that psychotherapy professes has been forgotten under the scepter of potential lawsuits. According to several authors, this is in fact the main reason barter arrangements should not be made: it opens the therapist up to liability. So far I have found only one article (Hill, 1999) that discusses bartering as a legitimate means of helping out a poor person, which seems the most obvious reason to enter into such an arrangement.
My view, in common with others articulated throughout this book, is that if we do not take some risks on a regular basis, as psychotherapy professionals we are not worthy of the job. A second and complementary theme I support is that venturing into any dual relationship requires careful, thoughtful judgment, which varies considerably from situation to situation. To preclude whole categories of arrangements because of