Why Is Therapy So Expensive?

For many people, therapy can be prohibitively expensive. While our medical costs are usually covered by some type of insurance, therapy often is not. And even if your insurance does cover therapy, there can be some major drawbacks, such as:

1. a long waiting list, either weeks or months;

2. high copays, sometimes as much as private therapy would cost on its own; and

3. the necessity of a diagnosis, which can stay on a person’s medical record forever

If you do not have insurance that covers therapy, though, or want to pay out-of-pocket for some of the reasons listed above, you might be shocked to discover that therapy can cost anywhere from $60-$200/session. It may come as a further shock to learn that therapy takes some time; unlike visiting a doctor, your mental health issues are not ever solved in a single visit.

Many people might think that all a therapist does is sit there and get paid an enormous sum of money per hour. However, let us take a step back and realize, first of all, that the therapist has paid for his or her degree in both time and money. A doctorate program takes around seven years to complete, whereas a master’s degree may take three years and cost around $50,000. So, a therapist’s time is expensive because he or she has spent a lot of time and/or money learning the craft.

Secondly, you meet a therapist in an office—hopefully a nice office with comfortable furniture, adequate lighting, sufficient heat and air-conditioning, and perhaps a waiting room. The therapist must pay for this space: typically, rent accounts for the largest cost in a therapist’s practice.

It is important to understand a few more things. The money you give to a therapist cannot just go right into his or her pocket—it has to be reported and taxes must be drawn out. A therapist is also required to keep current on his or her continuing education credits (CEs), which cost time and money. Finally, a therapist must find clients—a large portion of earnings must be reinvested into the business so that the therapist can ensure him or herself a steady stream of referrals.

In my own practice, I have also realized that people coming and going accounts for a good deal of lost time and money. This is why I like to settle on a fee that the client feels comfortable paying every week over a period of at least six months. Although it is likely less than what other therapists charge, I find that the stability, predictability, and longevity leads to better results.