There are so many obstacles that stop people from seeking therapy, and cost is a major one. Many people who are curious about therapy are unsure how to find a good therapist, or might think their concerns aren’t “serious” enough for therapy. There can be cultural factors and social stigma that discourage people from looking for emotional support beyond what’s available within their family, or perhaps their church. But for many people, the number one obstacle to accessing mental healthcare is the cost.
Why is Therapy So Expensive?
Therapy is a Form of Healthcare
The cost of therapy can range anywhere from under $50 to $200 or more per session. Costs vary widely depending on the license type and experience level of your therapist, whether they have advanced specializations, and the going rates for therapy where you live. Although people might think nothing of spending $100+ on an occasional self-care expense (a woman’s haircut can easily run that much), when it comes to therapy people often have a hard time justifying the ongoing expense, unless there’s an acute crisis.
But in reality, therapy for mental health belongs in the same category as any other kind of healthcare, both in the complexity and variety of conditions it addresses, and in the degree of positive (and preventative) impact it can have on a person’s functioning. Just as getting treatment for a broken femur allows you to perform some pretty critical daily functions, getting treatment for anxiety, anger, trauma, or a troubled relationship can help give you the emotional skills, mental flexibility, and coping abilities needed to function better in some of the most pivotal areas of your life. Not to mention the fact that unresolved emotional difficulties can often begin to manifest as physical symptoms if left untreated — e.g., digestive issues, chronic pain, fatigue, immune disorders, headaches, and more. Your mental well-being is an irreplaceable resource for you to be able to go to work, be a functional parent, maintain the relationships on which your quality of life depends, and better cultivate the awareness of what your physical body needs to stay healthy. Our emotions and our physical health are inextricably linked, and as a society we are finally beginning to acknowledge that.
You’re Paying for Your Therapist’s Expertise
As with the medical profession, much of the fee you pay has to do with what your provider knows, not just what they do. If you’re working with a licensed mental healthcare provider (whether they’re a therapist, psychologist, or psychiatrist), that person has spent YEARS obtaining a Masters degree (if not a doctorate as well), and completing thousands of hours of closely supervised additional training. They need to know enough to be able to independently diagnose and treat an extensive variety of mental, relational, and emotional concerns. A single therapist needs to have a broad working knowledge of just about every topic related to human behavior and functioning (neuroscience, cognition, sleep, motivation, relationships, communication, and sexuality, just to name a few), as well as a specialized knowledge of an array of specific disorders and their treatment protocols. To top it off, they need the interpersonal skill and technique to communicate and implement all that head knowledge in a way that’s actually useful to people.
You’re Paying for all the Time Your Therapist Puts in Outside of Session
In addition to what happens in session, there is also a lot that happens off the clock to bring you the best possible care. In many ways, a therapist cannot take you further in your personal growth than they have gone themselves, so their continued growth, both in clinical skill and in personal maturity and wisdom, are actually quite vital to what you can hope to gain from therapy.
The cost for therapy actually covers:
time for your therapist to read and keep up on current psychological literature,
time to attend ongoing trainings and professional conferences,
time to maintain good clinical records, write treatment plans, and keep up with legal compliance requirements for their practice,
time to complete the recurring continuing education courses required by their licensing body in order to maintain their professional competence and a license in good standing,
time for to regularly engage in professional consultation with other mental health clinicians,
time to respond to client emails and provide you with referrals to additional resources as needed (e.g., nutritional consultants, psychiatrists, and other specialists — and perhaps even books and resources relevant to your ongoing treatment),
time to run the nuts and bolts of their business so that clients can interface with a well-organized system for scheduling, attending sessions, and evaluating progress on their goals,
time to do marketing so they can stay in business, and ensure that the people who need their help can find it,
time to participate in their own ongoing therapy so that they are always growing, too (and can remain sensitive and present to the experience of what it’s like to be a client).
All of what happens outside of session allows your therapist to show up as the person that they do in your work together, and to constantly be learning and growing alongside of you.
All of it is important to the quality of care you experience as a client.
Why Don’t More Therapists Discount Their Rates?
In my experience, most therapists wish they could offer more of a discount. We go into this profession to help people, above all else. And while the hourly rate can seem expensive, the vast majority of therapists are not providing 40 paid hours of counseling per week (and the ones who do burn out very quickly). If you’re curious, a “full caseload” is roughly 20 clients per week, give or take — but this varies widely depending on the clinician, whether they have a child with special needs at home, or any number of other personal factors that are largely invisible to the client. For therapists, “full time” work is essentially defined as the number of clients that your life can realistically sustain while still allowing you to provide a high-quality standard of care.
The vast majority of the therapists I know are incredibly gracious with regard to fees, and in fact have spent years undercharging what their services are worth. Many therapists offer pro bono sessions to certain vulnerable populations, or discount their fees to assist clients during periods of crisis. But if your therapist is not able to offer those accommodations, remember that their choice to charge a higher fee may be a big part of what enables them to limit their client load in order to bring you the best, most attentive care.
Why Don’t More Therapists Take Insurance?
There are a lot of answers to this question, and for a detailed look into this issue see Dr. K. Dixon’s article on the 10 reasons why more therapists don’t take insurance. But to put it simply, here are two of the biggest reasons:
Insurance companies grossly underpay therapists for their services. Each insurance company essentially decides whatever amount they are willing to pay a therapist for services rendered to treat a specific diagnosis. It can vary from one insurance company to another, and by geographic area — meaning that compensation is not based on the therapist’s own rate, or level of experience. As a result, solely insurance-based therapists often have to add many more clients to their caseloads just to survive in business, leading to professional burnout and poorer client outcomes.
Insurance companies benefit by finding ways not to pay for the services people need and deserve. They can make demands of providers that are enormously time intensive, forcing them to justify their services, or even “clawback” thousands of dollars they’ve paid to therapists in the past, sometimes for administrative mistakes that they themselves have made. The likelihood of being underpaid, and the time required away from seeing clients to deal with administrative headaches, discourages many therapists from accepting insurance, even though it kills us to see so many people not getting the treatment they need. Removing the societal obstacles to affordable mental healthcare access is something we all need to work together to change.
That said, even if a therapist does not contract directly with your insurance company, there’s a good chance you might be able to get some of your therapy reimbursed through “out of network” coverage. For more on the ins and outs of using insurance, check out How Can I Get Insurance to Help Pay for Therapy?
Where To Find Affordable Therapy
The good news is, even without insurance, there are still options for people who need more affordable therapy, and of course there are ways to find a therapist who works with your insurance. Many therapists will reserve a couple of spots in their caseload specifically for sliding scale or insurance clients, so they can run a financially sustainable business but still help more people who otherwise might not be able to access mental healthcare.
Here are some great places to start your search:
Alma - You can search Alma’s directory for providers in your insurance network with some great customizable search filters. I love how easy this site is to use, and if you’re going to deal with insurance, they make it as painless as possible for both the client and the therapist. Alma is available in a growing list of states and compatible with a variety of insurance plans (and they also let you search for out-of-network therapists who could be a good fit, too).
Mental Health Match - I recently discovered this directory and. love it, too. You can filter your search by price range, the kinds of elements you’d like to have included in treatment (equine-assisted therapy, anyone?), and even some personal characteristics/affiliations of the therapist, so it only shows you people who fit your price range match your most important criteria. It’s a great way to cut down on the overwhelm of scrolling through PsychologyToday or similarly endless listings!
Open Path Psychotherapy Collective - Therapists who list their services on Open Path agree to provide sessions within the $30-60 price range ($30-80 for couple or family sessions). This is one of the best prices for therapy you’d probably find anywhere, short of a local clinic in your area that offers an assistance program for clients in need. For a nominal membership fee, you get access to therapy at these rates for as long as you have financial need. You can filter your search results for in-person or online therapy, therapist specialities, treatment approach, and more.
For a detailed list of tips and resources on how to find affordable therapy in your area, check out my blog post on How to Find a Good Therapist.
Is The Cost of Therapy Worth It?
There is some interesting research that shows a correlation between the amount of money that people pay for therapy and the amount of benefit they report getting from it. Is this because only high-priced therapists are good at their job? Is it the placebo effect? Could it be that people who pay more for therapy are more invested in using it to its fullest potential, e.g., by coming prepared with topics to discuss, and working hard to self-reflect and implement changes between sessions? Or — because they’re paying enough to want to get the most of this experience — are they more willing to push back and ask questions of the therapist when things aren’t clicking, so that adjustments can be made to improve the experience? When things involve some financial sacrifice, we tend to value them more.
some things are better at full price
In my years as a therapist, I’ve found that charging too little for therapy actually becomes problematic for many clients. It creates feelings of guilt for them, or concern for the therapist’s well-being, in a way that distracts from the work they came to do. In a society that discourages us from burdening other people with our problems, paying for therapy is actually a relief to most people, because it gives them a feeling of permission to take up space. It allows people to not feel guilty about “burdening” the therapist with their problems, particularly when it comes to the heavier emotions, traumatic stories, or harder-to-kick habits that keep cropping up again and again.
You don’t have to worry about wearing out the therapist’s patience, or sounding selfish because you’re talking too much about your life. You paid for that time. You’re allowed to use it however you need to. And you can trust that your therapist doing what they need to do in charging more than the bare minimum for services, so they have the emotional reserves to be fully present with you in whatever you’re going through.
permission to be a mess
For a long season in my own life, I was half an hour late to every session with my own therapist, but she never criticized me for it, even though I felt terrible about it every single time. Before long, we both came to understand that having the freedom to be late was exactly what I needed during a season of intense overwhelm, and it comforted me to know that she happily got paid just the same, whether I was there for the whole session or only half of it.
My therapist’s gracious understanding of what I needed at that time was so life-giving for me, and helped me learn to structure my life more compassionately, in a way that matched my actual needs and capacity in any given season, rather than trying to force life to work in a way that didn’t make sense for where I was. Without having to worry that I was being a burden to my therapist, I was able to explore and find resolution to this tension over time, and benefit from therapy in the ways I needed most.
The Value of Health Can’t Be Measured
We live in a world full of critical voices saying that we don’t really matter that much. We are measured according to our instrumental value to the world — our productivity, our output, our visible success — rather than our inherent worth as people. We are conditioned to be focused on the needs of others (or at least to politely pretend that we don’t have any needs). We’re not supposed to take up too much space. We tell ourselves we don’t have the time or the money to work on those things simmering in the background of our lives — the ones ready to boil over if the temperature gets turned up just one more degree.
And yet. Imagine how life would be different if each of us were operating as the most fully functioning version of ourselves — the most alive, vibrant, generous version, with energy left to give for others. The most emotionally attuned parent. The most thriving, supportive spouse. The person able to be brave and vulnerable enough to reap the irreplaceable benefits of real relationship. Imagine how the world could be different.
Don’t Wait
If you’re ready to stop putting your needs on the back burner and learn how therapy can help you grow into a healthier version of yourself, click here to schedule your free 15-minute phone consultation, or give me a call at 626-598-6234. I’d be happy to answer any questions you have about therapy, and if I’m not a good fit for you, I’d be glad to recommend someone else!
Don’t wait to start the process of reaching out. There are some endeavors that are too costly not to begin.
Important disclaimer: Although I am a licensed marriage and family therapist by profession, I am not YOUR therapist. The content on this site is for informational or educational purposes only. Although I strive to provide accurate general information, the information presented here is not intended to be a substitute for professional medical advice, diagnosis, or treatment, and does not constitute medical or other professional advice. Your use of this website does not establish any kind of patient-client relationship with me, and you should consult a healthcare provider in your area if you are seeking medical advice, diagnosis, or treatment. Reliance on any information provided herein is solely at your own risk.