“Why is Therapy so Expensive?!“
It’s no secret that going to therapy is a BIG investment. Depending on your local area’s going rates and the level of experience of a provider, you could be looking at upward of $150 for a 50 minute session. Most people are not looking to spend that much money per week. Four weeks of therapy at that rate is more than most people’s grocery bills! So why on earth would anyone pay that?
Therapy is an investment in your mental wellness. And a good therapist is a good investment- in YOU. Not only the you you are now, but the you of the future.
“But why are their rates so high? It’s just talking! I can always talk to my best friend or hairdresser.”
therapists are professionals
Did you know? Most therapists have at least 2 years of full-time post-graduate education, such as a Masters of Social Work or Mental Health Counseling. That’s a total of 6 years of college. These graduate programs typically do not provide student aid, so most therapists have hefty student loans, not to mention that they likely weren’t earning a salary during those years. While I can’t say for other types of programs, in an MSW program, I was a full-time student carrying a full course load, PLUS I worked 2 days or 3 days a week FULL TIME in clinical internships, which was unpaid. There was no time to earn a living.
The reputation of a graduate program should never be a deciding factor in choosing a therapist; however, a high-quality institution typically has its reputation due to the strength of its training programs. They have access to the best clinical internships, professors, and research. So their grad school loans may be higher, but these folks have a solid training background and the drive to excel at a high level.
Translation: they know their stuff, and they will work hard for you.
It’s Not Cheap to Be Me!
In addition to graduate school, therapists have to be trained further under the supervision of a more experienced professional after they receive their Master’s or PhD. Often, these are unpaid trainings, or even supervision and training that the therapist themselves paid for. In order to become licensed at the independent level, there are many requirements that cost time and money including ongoing 30 hours of training for license renewal, initial licensure testing, biannual licensing fees, and any other fees per the state or jurisdiction.
Private practice therapists also have to pay malpractice insurance each year. They have a business to run just like any business, with start-up costs, software and internet expenses, equipment, office space, record-keeping and accounting fees, and more. When just starting out, it’s typical for a new private practice therapist to be breaking even for months or years.
As a new practitioner, I’d have skeptical clients question whether I was just “in it for the money” since the hourly rate can seem exorbitantly high. If that were the case, there are far higher paying jobs I could do that require a lot less of me working for free in between the hours I actually do get paid. (Keep in mind, we are not paid for doing paperwork, managing our billing and bookkeeping, making phone calls to other providers to collaborate on cases or make referrals, reading books and studies to stay up-to-date, etc).
Return on Investment
If you spend $400 per month on therapy for 3 months, that’s $1200 you’ve invested in yourself. What value would you place on becoming the best version of you? Is there a limit to what you should spend in order to overcome problematic behaviors that keep you from reaching your life goals, or cause strife in your relationships? Trust me, therapy is a lot cheaper than divorce.
If you’re a parent or hope to become one someday, what value you would place on being the kind of parent who raises healthy, happy kids, because they themselves are grounded in their sense of self. Way too many adults are walking around carrying wounds from childhood. Those wounds likely won’t resolve on their own, and if not dealt with prior to entering parenthood, will likely play out in one way or another in future generations.
We often think of leaving a legacy for our children. That thought typically conjures up money, an investment home, jewelry. But what if the best legacy you could leave is one of a solid foundation of mental health? Learning tools to manage your mood swings, to problem solve within relationships, and to self-soothe when triggered, are all lasting gifts you give to yourself and all those you interact with both now and in the future.
How to make therapy more affordable
For many people, there truly is a barrier to accessing therapy. Marginalized communities such as Black and Indiginous Americans have generations worth of barriers to overcome. But there is hope. Everyone has a right to access mental health. I’m listing a few options to consider here, but there are many more. The National Alliance for Mentally Ill (NAMI) has a great article with even more. They suggest, as I do, that you start with your insurance provider to see what they will cover.
Use Out of Network Benefits
Most private practice therapists do not take insurance (there’s a good reason for that which I’ll explain in another post), but if you are lucky enough to have insurance that allows out of network benefits, that helps take the edge off a bit. Out of Network benefits means you submit a claim to your insurance company after you’ve paid the therapist for the session. Your insurance company pays you back per your plan allowances (after deductibles, etc). You can read more about how Out of Network benefits work in this post.
Ask About Single Case Agreement
If you have a mental health condition such as anxiety disorder or PTSD, and there are no qualified therapists in your area specializing in your condition, you have a right to request that your insurance company creates a special contract with a specialist who is out of your network. This is known as a Single Case Agreement. The rules around this agreement vary by insurance provider, but it is definitely worth inquiring about if you don’t have Out of Network benefits. The insurance provider may cover a limited number of sessions, but it may be just enough to get you started in the right direction. Sometimes, if further treatment is needed, they will extend the agreement. YOU have to advocate for yourself. This won’t be easy, so get ready to sit comfortably on the phone for some length of time. But, your hard work and patience just may pay off if you speak up for what you need and deserve!
Use Your HSA or FSA Card
Most therapists can now accept Health Savings Account (HSA) or Flexible Spending Account (FSA) cards when you pay for your session. This is something you’ll want to ask about, of course, before you attempt the payment. If you have an HSA or FSA through your employer, these cards work like debit cards for paying copays and other bills from healthcare providers, as well as prescriptions, etc. These are benefits that are typically offered through employers. If you don’t have one, but think your company might offer this benefit, keep in mind that October is when you have a chance to participate in programs like these. They typically offer tax savings, as the money gets taken out of your paycheck before taxes, allowing you to set tax-free money aside to pay for anticipated healthcare costs.
Ask About a Sliding Scale
Some therapists offer a sliding scale payment option. Sliding scale fees are typically based on what a client is able to afford given their income or personal situation. Many therapists reserve a few slots to accommodate clients in need of financial assistance in order to access the benefits of therapy. There may be an application required, and sometimes, there is a time-limit to use of this special rate in order to allow others the chance to experience therapy as well.
Seek Low-Cost Care in Your Area
Websites like Open Path Collective have partnered with therapists who are willing to hold one or more slots available for pro-bono or low-cost therapy. With Open Path, you’ll pay a small membership fee to have access to this list of therapists, with fees per hour ranging from $30-$60 fo individual therapy sessions.