How Much Does Therapy Cost? (And Why Is It So Expensive?)

Published on: 29 Oct 2015
empty bank expensive therapy

Seeing a therapist in an office is not affordable for most Americans. This is unfortunate for people who have looked past the stigma of therapy and committed to living happier lives but can’t afford the therapist’s rates. The average therapy session costs $75-150 an hour, and good luck if you live in a place like New York where the range jumps to $200-300.

People who rail against therapy accuse therapists of being greedy, but therapists actually have valid reasons for their high prices. Nonetheless, don’t believe you are stuck paying for therapy you can’t afford. Learning why it is so expensive is the first step toward searching for alternatives and paths to affordable therapy.

Becoming a Therapist Costs a Ton of Money

Think about how expensive it is to hire a lawyer. Clients are hiring someone with years of schooling on the subject in which they invested hundreds of thousands of dollars. It’s the same deal for a therapist — most therapists have postgraduate education and many have a Ph.D. —  but misconceptions about therapy prevent people from seeing it this way. Remember, you are not paying to chat with a friend. You are hiring a mental health professional.

Therapists Don’t Get Paid for Every Hour They Work

When people work a typical 40-hour week, their company pays them for every hour they work. Therapists, on the other hand, can only bill for the time they see clients.

Most therapists cannot manage 40 clients a week, said therapist Sarah Lee. If they fill up all their time with sessions, they would not be able to organize their clients’ information, market themselves and perform administrative duties such as negotiating rates with insurance companies.

Imagine if your company only paid you for 25 of the 40 hours you worked each week. You would need to increase your hourly rate to break even.

Then there are the cancellations, the many cancellations.

When therapist Angela Essary worked as a community mental health counselor, she booked 12 sessions a day but only saw five of those people. 

“It’s a big commitment for clients and there can be lots of no shows,” she said.

Who Pays the Rent for that Nice Office with the Comfy Couch?

expensive therapist office Betty Draper Mad Men couch

Think about how much your rent or mortgage payments cost. OK, now double that and add some more for good measure. This is what many therapists — at least those not affiliated with an online therapy network or firm —  have to do because they have no company to pay for the spiffy office they host clients in. Some buildings don’t even cover their utilities. Then there are office supplies such as the tissues they keep handy and office phones. It adds up.   

The office often costs more than their home’s rent or mortgage payment. They could save money and lower prices by inviting you to their homes and hosting the session in the living room, but that wouldn’t be the most ethical thing.

Therapists Pay More Insurance Too

Getting sued and not having any protection set up in advance is terrifying. Therapists use liability insurance to avoid tread water during lawsuits in case a client sues them. It also helps them maintain their licenses. It’s yet another cost they can’t use a company to buffer. 

Therapist Bradley Foster told Talkspace he pays roughly $600 a year for insurance premiums and dues for therapist organizations.

That’s only one kind of insurance. They may have insurance for their office in the same way people buy renters or homeowners insurance.

Those Certificates on Their Walls Have a Sort of Interest to Pay

framed degrees in therapist office

Therapists don’t stop their education once they receive those fancy degrees you see framed on their office walls. Maintaining a license or certification means investing in annual training such as continuing education fees [CEUs]. Therapists need to keep up with advances in their field the same way doctors need training on new medical technology and treatments.

Some therapists are able to have companies or firms cover their CEUs while others spend more than $1,000 a year on them, said Talkspace therapist Jennifer Fuller Gerhart. Here are some other training and certification maintenance expenses she and Foster mentioned:

  • professional development courses (not necessarily part of the CEU and can cost around $400 per course, according to Foster)
  • therapy-related books for self-study or homework for clients
  • state-licensure fees of up to several hundred dollars a year, varying depending on the state
  • fees for additional credentials tend to cost several hundred dollars a year
  • fees for professional association memberships
  • insurance billing services or payments to an assistant or billing specialist ($500 to $1,000 or more)

Therapists Need Therapists

A good therapist will stay calm during sessions and not show how much the client’s issues are impacting him or her. Still, it’s not like that stress magically evaporates. They need a therapist to deal with it and, as we’ve been discussing, that can be expensive. Also, therapists are normal people, and anyone can benefit from therapy.

And a Supervisor

Most therapists have a supervisor who helps them treat clients, address ethical issues and ensure they follow the rules of the bodies that licensed them. This supervisor is often a more experienced therapist who charges even higher rates.

Therapists pay supervisors directly if the latter are in private practice, Gerhart said, while agencies pay the supervisor if he or she is part of one. These fees can be additional or included in the supervisor’s salary. Online therapy networks pay their therapists for supervision services as well.

But Don’t Despair — Here’s How to Receive Affordable Therapy

We want to defend great therapists from accusations of being greedy or unreasonable with their prices, but we do agree therapy is too expensive on average. The overpricing is a systemic issue, but there are ways to beat the system. 

Online Therapy

Online therapy has the same efficacy as in-office therapy and is generally more affordable (it can cost as little as $32 per week). Part of this is because online therapists don’t have as many overhead costs as therapists who only work in an office. You can use an online therapy network like ours to find a therapist or check if a therapist you know will provide online service.

Ask the Therapist for a Discount or Look for Therapists With Sliding Scales

Most therapists are not in it for the money. If you tell them you can only afford a discounted rate, they might oblige.

“There are a few [clients] I give very low rates to because it’s part of our ethical code to extend a helping hand from time to time,” Essary said.

Then there are therapists who use sliding scales for all payments. Before sessions begin, check for this information on their website, therapy network or profile. 

Schools or Universities Often Offer Discounted or Free Therapy 

If you’re a student and want free or discounted therapy, ask your student health center for more information. Centers often provide this for a semester or quarter. It is a good temporary solution to have until you can find a long-term therapist online or in your area.

Therapy Practices Tend to Be More Affordable 

Therapy practices — sometimes called agencies or firms — are usually more affordable because more than one person is chipping in for the extra rent. These practices often have interns who charge even less. If you prefer in-office therapy but want to save money, try Google searching for the relevant keywords and be sure to include your area (unfortunately, there isn’t a directory yet).

Not Using Insurance Might Save You Money

It is popular for people to use insurance for therapy because they assume it will lower the overall cost. Actually, circumventing insurance is cheaper on average, especially if you use online therapy networks. Many therapists choose not to use insurance because they feel the cost of doing business with the opaque insurance companies is not worth it.

Federally-Funded Health Centers Often Have Mental Health Resources 

Federally qualified health centers [FQHCs] usually have mental health resources and the law requires they offer a sliding payment scale. You can search for one in your area using this resource.

Beat the Fees and Get the Help You Deserve

People should perceive living a happier and mentally healthier as an affordable option for everyone, not a privilege for the wealthy. It costs a little more than your Netflix subscription, but the happiness it brings will be priceless.

Commonly Asked Questions

Online therapy is significantly cheaper than in-person therapy since it does not involve many of the overhead costs of traditional brick and mortar therapy like rent and insurance. A study of online therapy discovered that text therapy is 42.2% the cost of traditional services. The same study concluded that online therapy is an ‘acceptable and clinically beneficial’ medium; the efficacy of online therapy is consistent with that of in-person therapy.

Online therapy is legitimate as long as therapy is performed by a licensed mental health specialist and facilitated by a trusted, secure platform that uses licensed counselors. A 2017 study of online therapy concluded that ‘asynchronous text therapy with a licensed therapist is an acceptable and clinically beneficial medium for individuals with various diagnoses and histories of psychological distress.’ Also, the study’s participants reported ‘high satisfaction’ from the ‘affordability, convenience, and effectiveness’ of online therapy. Online therapy enables users to connect with a licensed therapist at a significantly cheaper rate than in-person therapy, anytime and anywhere.

Although there are some free online counseling services offered, one should be very weary of these services. An offer for ‘free online therapy’ should raise skepticism. Consider whether it’s a sales tactic to get you to provide your information or use the service. Can you trust the service? Are the counselors licensed? Most free counseling services aren’t scientifically backed and work without licensed counselors. These are some titles that suggest unlicensed individuals: Life coach, Health and wellness coach, Listening services, Life consulting, EFT – Emotional Freedom Techniques, Counselor (unlicensed). When looking to improve your mental health, it’s important to trust licensed professionals with expertise in the field in order to avoid a setback. It is more effective to choose a trusted online therapy provider such as Talkspace, which offers an affordable, safe, secure and effective service for improving mental health.

Online psychiatrists, like those who work at Talkspace Psychiatry, can prescribe the necessary medication you might need. Psychiatrists are medical doctors who are trained in mental health care and medication management. They offer both pharmacological and psychological treatments.

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