Paying full fee, or even the lower end of a sliding scale, for a private practice therapist can be a confusing experience. You might wonder, “why is therapy so expensive?”
While it feels like you are paying for an hour or so of your therapist’s time, the cost of therapy covers much more outside of the session. This includes notes and legally required documentation, web services such as confidential practice management and video session platforms, alignment with changes in legal and ethical obligations, maintenance of professional and business licenses, ongoing education and professional development, memberships in professional associations, consultation with other professionals, personal therapy to ensure that the therapist's experience doesn’t harmfully affect your therapy, and not to mention cancellations or emergencies. Therapists are also not packing their caseloads with a full 8 hours of clients a day - this is a recipe for burnout, and a therapist with too many clients can’t give you the emotional and mental attention that you deserve.
Why don’t many therapists take insurance?
The fact of the matter is, being an in-network provider through an insurance company makes all the work listed above even harder and more costly, as insurance companies often demand additional clinical documentation, limit the scope of therapists’ work in ways that do not align with their clinical values, and generally do not pay a fee that reflects the work put in.
What should I be paying for therapy?
This is a question only you can answer. You may consider average costs in your area, the connection you feel to a certain therapists’ approach, or availability. You may also consider how therapy may impact other areas of your life, such as your relationships or career, when determining worth.
One way to calculate the cost may be to consider the cost of therapy as 10% of your gross income. However, everyone’s finances include so many different considerations, so it is up to you to decide what you are willing and able to pay. If you are in a more privileged position financially, you can also consider that paying a higher rate may allow your therapist to offer lower rates to those who need them, or to do other community work part-time that does not pay as much as private practice.