Although the meaning of money matters in psychotherapy has been addressed since the inception of this practice, these discussions have focused almost exclusively on the perspec tive of the client. It is only recently that the pro fessional literature has begun to examine more extensively the perspective of the practitioner regarding money and the fee. The dramatic and at the same time subtle infiltration of managed care into various aspects of social work practice recently has required individual practitioners and consequently, the profession as a whole to actively attend to fee concerns. Within this cur rent economic-practice climate, a range of re curring fee issues and related ethical dilemmas have surfaced.

This discussion delineates some of the fee related issues and accompanying ethical dilem mas commonly experienced by social work practitioners. The discussion is an effort to en hance awareness and recognition of the issues that may in turn serve to inform practitioners as they struggle to intervene with clients in clinically and ethically sound ways. Although the literature on ethical dilemmas in social work practice has addressed important concerns such as client confidentiality, practi tioner values, sexual misconduct, and choice of treatment modality, scant attention has been paid to ethical dilemmas that are fee related. An ethical dilemma may be described as" any con troversy that involves conflicting moral prin ciples in which one experiences different moral pulls"(Purtilo & Cassell, 1981, p. 7). In at tempting to resolve such dilemmas, consider ation is given to personal values, attitudes, be liefs, duties, and obligations. Ethics plays a central role in clinical practice" not only as in forming clinicians' goals and basic method ological assumptions but also as being an aspect