Making Changes Counseling in Chattanooga: Individual and Couples Therapy with Sliding Scale Fees

Making Changes Counseling is a small independent practice that provides individual psychotherapy and couples counseling in Chattanooga, operating primarily on a sliding-scale fee model rather than the standard insurance-based billing of larger therapy networks in the area.

What Making Changes Counseling actually is

Making Changes Counseling operates as a limited-roster practice in Chattanooga, meaning it maintains fewer active clients than high-volume clinics. The practice specializes in individual therapy and couples/relationship work, with a stated focus on helping adults navigate life transitions, relationship conflict, and emotional regulation. It does not offer psychiatric services (medication management) or accept insurance directly; instead, clients pay out-of-pocket, often through a sliding-scale arrangement, which allows fees to adjust based on income. This structure differs sharply from group practices affiliated with major hospital systems like Erlanger Health System or Parkridge Health, where therapists operate within insurance networks and carry higher caseloads.

Services and sliding-scale pricing

Making Changes Counseling charges on a sliding scale, typically ranging from $40 to $80 per 50-minute session, depending on household income. Sessions are weekly or biweekly; the practice does not charge a one-time intake fee beyond the first session. No additional assessments, worksheets, or evaluations cost extra.

The practice does not bill insurance, meaning clients pay directly at each session. Clients seeking insurance reimbursement may request a superbill (an itemized invoice) and file their own claims to out-of-network benefits if their plan covers that option. Verify current fees and superbill practices directly with the practice before scheduling, as sliding-scale ranges can shift.

For comparison, Chattanooga practices that do accept insurance directly (such as those within the Erlanger behavioral health network) typically charge clients a copay or coinsurance ranging from $20 to $50 per session, but require pre-approval and may have longer appointment waitlists due to higher volume. Insurance-accepting practices are convenient if your plan covers mental health, but often involve authorization delays and less control over therapist selection. The sliding-scale, direct-pay model at Making Changes provides faster scheduling and no insurance denials, but it shifts the financial documentation burden to you.

Who it suits and who it does not suit

Making Changes is best suited for adults seeking ongoing individual therapy or couples counseling who either do not carry insurance mental health benefits, prefer to pay out-of-pocket, can manage upfront payment, or need faster access than insurance-based waiting lists offer. It is particularly practical for couples, since both partners can attend the same therapist without insurance coordination issues. It also works well for self-employed people or those whose insurance plans have high out-of-network deductibles, since the sliding scale may cost less than out-of-network insurance coinsurance.

The practice is not a fit if you require psychiatric medication management, as it does not employ a psychiatrist or psychiatric nurse practitioner. It is also not ideal if you need crisis mental health support (such as emergency psychiatric evaluation), as the practice works only by appointment during business hours. Adults in acute crisis should contact the National Suicide Prevention Lifeline (988) or present to Erlanger's emergency department.

Making Changes is similarly not structured for children or adolescents; the practice focuses on adult clients. Parents seeking pediatric or adolescent counseling should contact school-based counselors, pediatrician referrals, or larger Chattanooga mental health agencies that offer age-appropriate services.

The first visit

New clients contact the practice by phone or through its website to schedule an initial session. During the first appointment, expect a standard intake: you will discuss presenting concerns, mental health history, current stressors, and goals for therapy. The therapist will explain the sliding-scale fee, confirm payment method (typically cash, check, or card at each session), and clarify the superbill process if you think you may file an insurance claim later.

Sessions are 50 minutes. The practice uses a confidentiality agreement standard to all therapy, with exceptions for imminent harm, abuse, or court order. You should come with a general sense of what prompted you to seek therapy, though the therapist will guide the conversation.

Hours, parking, and logistics

The practice operates by appointment only; hours generally fall between 9 a.m. and 6 p.m. on weekdays, with limited evening and weekend availability. Confirm current hours before scheduling, as they can shift seasonally.

Making Changes is located in Chattanooga proper (not in a hospital or clinic campus), with street parking or small lot parking available onsite. Travel time from downtown or north shore areas is typically 10 to 15 minutes. The office is not wheelchair accessible from street level; call ahead if you require accommodation.

The practice does not offer telehealth at this time, so all sessions are in-person.

Making Changes fills a specific role in Chattanooga's mental health landscape: it prioritizes continuity of care and affordability over insurance convenience, making it a practical choice for adults who value faster appointments and flexible fees over network coverage.