Therapy is expensive because studying to become a therapist, maintaining licensure, and running a practice are expensive costs. The cost per session covers the time spent with the therapist as well as the work they do between sessions. While therapy can feel like a hefty investment, it can pay back exponentially in quality of life, even after you’ve finished.
The National Average Cost of Therapy
As of 2018, the median cost of therapy for a 50 minute session ranged from $100 to $200 with an average of $130. This varies widely, depending on the city and state where you are seeking therapy. For example, in 2018 the median cost of therapy in Florida was $125 per session while the median cost in the Miami area specifically was $200 per session. In New York, the median cost of therapy per session is $125 while in New York City the price per session is typically between $200 and $300.8 In general, online therapy providers will be more affordable than in-person options.
The most affordable therapy options may cost between $40 and $80 per session. Many community mental health clinics offer low fee sessions. Agencies that employ graduate students or therapists working towards finishing their licensing requirements may also offer sessions at a lower rate. And some therapists reserve some amount of their schedule to offer sliding scale fees to clients in need.
On the higher end, sessions can cost anywhere from $200 and up. Therapists who charge these rates are typically found in private or group practices and are often licensed psychologists (holding a PsyD or PhD) or have advanced training.
Why Is Therapy So Expensive?
While $130 may seem like a lot of money to spend for 50 minutes of someone’s time, the session fee actually has to cover a lot more than just those 50 minutes. In addition to the session itself, therapists spend time preparing for each session, writing and updating treatment plans and progress notes, and taking care of business and case management issues as they arise (i.e. scheduling, coordinating with your other providers).
Because of all the work that therapists do outside of sessions, very few see 40 clients a week. More commonly, therapists will see around 20 clients a week, leaving 20 other hours in the standard 40 hour work week for the tasks listed above. Additionally, therapists have to make time for continuing education, consultation and supervision, and business tasks to keep their practice running smoothly.
The fee you pay for therapy has to cover even more than just the time your therapist spends on you. Therapists have to pay yearly licensing fees and malpractice insurance fees. Monthly, therapists pay for their office rent, the cost of an electronic health record system or paper record supplies, and online directory profile fees.
Throughout the year, therapists pay for continuing education classes in order to keep up to date with the latest research and maintain their license. Many therapists also pay for supervision or consultation, a practice where they talk with a more experienced therapist about any clinical concerns or challenges they are facing.
After all of that is paid for, what’s leftover is the therapist’s take home pay.
The Cost Depends on the Type of Therapy & Mental Health Professional
The type of therapy being provided can affect the cost. Typical outpatient therapy, where a client attends weekly sessions, is often less expensive than more involved outpatient therapy programs. In general, the more hours per week a therapist must spend on a particular client, the higher the cost of therapy.
Two common types of therapy & their costs are:
- Cognitive Behavioral Therapy (CBT): In CBT, sessions are usually once a week for 50 minutes, with a cost between $100 and $200 per session.
- Dialectical Behavioral Therapy (DBT): DBT usually comprises a weekly individual therapy session, a weekly group session, and brief phone calls throughout the week. The cost of a DBT therapy program often ranges between $150 and $300 per week.
The cost of therapy depends, in part, on the mental health professional providing it. Mental health professionals who are still in graduate school or hold associate licenses often charge less than those with full licenses. Those with a PsyD or PhD degree may charge more than those with an M.A. or M.S. degree. Additionally, therapists with advanced training in a particular modality or technique may charge more than therapists without specialized training, regardless of their degree or license.
Ultimately, the type of mental health professional providing therapy and the geographic location where they work are two key factors that influence the cost of outpatient therapy. The more education or experience a therapist has, the higher their fees will be. In locations where office rent is high or there are very few therapists, the cost of therapy will be higher.
The Therapist’s Education & Specialization May Affect the Price
Before therapists even begin a practice, they have to complete a minimum of a Master’s degree. This requires at least two years of graduate school. Like most higher education programs, the cost of graduate school can be very expensive. Many therapists take out loans in order to pay for their education. Therapists who have completed a PsyD or PhD program are often in school for 5-7 years, resulting in even higher tuition costs. Throughout their schooling, therapists complete required internships and supervised hours, usually for no pay.
Once therapists have completed their academic training, many go on to specialize. Specialization requires additional training, as well as supervised hours, continuing education hours, and licensing fees that are distinct to their specialization.
Therapists with doctorate degrees or advanced training may charge a higher rate. A therapist who has completed a Masters degree without any additional specialization is likely to charge less than a therapist who has completed a PsyD or PhD, or who has completed specialized training. While the cost of seeing these providers is higher, their additional years of training help them provide even more effective and efficient services.
If you have a previous mental health diagnosis, working with a provider who specializes in that disorder can be more productive than working with someone who has less experience and/or training around your specific concern. The cost per session may be higher, but the overall cost of therapy may be lower. The provider can offer more specific treatment to help you address what brought you to therapy, oftentimes reducing the number of sessions needed to help you reach your therapeutic goals. In addition to potentially costing less overall, you may begin feeling better more quickly.
Does Insurance Cover Therapy?
Some insurance plans cover the cost of therapy once you have met your deductible. What is covered varies depending on your insurance company and plan. Not all insurance plans will cover all types of therapy, or therapy for specific mental health conditions. If you want to use your insurance, it is very important to call your insurance company and ask for specific details of what is covered. Because insurance plans vary so widely, contacting your insurance company is the best way to get accurate information regarding your specific coverage.
If you are an employee, some workplaces offer therapy sessions as a part of their employee assistance programs outside of the set insurance coverage.
If you have an insurance plan that covers some or all of the cost of therapy, it may still be difficult to actually use your insurance. Many therapists in private practice choose not to take insurance. This is because insurance companies typically reimburse therapists only a fraction of their usual rate.
A therapist who is in-network with your insurance company is contracted with them to provide services for fees set by the insurance company. The insurance company may also set parameters around the type of treatment therapists can provide, or the number of sessions they will cover. To find an in-network therapist, most insurance companies offer a directory on their webpage where you can search for providers.
A therapist who is out-of-network (OON) does not contract with your insurance company. These means that they are paid directly by you and not your insurance company. Therapists who are OON will typically make a note of it on their directory profiles and website. If you would like to work with a therapist who is out-of-network, check with your insurance company to see if you have any out-of-network benefits that can be used.
Instead of being in-network with insurance companies, many therapists offer superbills. This is a list of the services they have provided you, along with the cost, that you can submit to your insurance company for direct reimbursement. Depending on your plan, as much as 90% of the cost of a session may be reimbursed to you.
How Much Does Therapy Cost Without Insurance?
Without insurance, the cost of therapy typically ranges from $100 to $200 per session with a median cost of $130.8 Paying out of pocket, also called “fee for service” or “private pay,” is very common in therapy. In addition to the many therapists who don’t take insurance, clients sometimes prefer to pay out of pocket in order to more fully protect their privacy.
What Are the Benefits of Therapy?
A cost-benefit analysis of therapy can be tricky because while the cost is quantifiable, the benefits often aren’t. However, the benefits of therapy are significant! In fact, therapy can have a positive impact on almost every aspect of your life. Things that are invaluable, such as relationships with loved ones, a sense of well-being, and achievement of goals are just some of what therapy can help you improve.
Some of the benefits of therapy include:
- Reducing or resolving symptoms of mental health disorders that negatively impact you
- Processing trauma or difficult memories/emotions in a safe way so that their impact on your day to day life is reduced
- Reducing your risk for physical health conditions such as psoriatic arthritis6 and heart disease5
- Helping you more successfully manage chronic pain and illness4,7
- Recognizing and disrupting cycles of thoughts or behaviors that negatively impact you
- Developing a deeper understanding of yourself
- Learning tools and techniques to help you navigate challenges that you can use long after you’ve finished therapy
- Enhancing your emotional resilience and learning how to tap into your innate coping skills
- Developing a stronger sense of self and self-esteem
- Improving your functionality in important areas of your life such as work or school
- Discovering new perspectives
- Improving your relationships with others through healthier communication and increased understanding
What every person gets out of therapy is unique to them. Your individual needs and goals will help determine the course of your therapy so that you can get the most out of it. While you may not be able to put a price on the positive benefits gained from therapy, they are often deeply impactful and can help you live a more fulfilling, engaged life.
Is Therapy Worth the Cost?
Although the cost of therapy may seem very high, the cost of not seeking help when needed may be just as high or higher. Mental health conditions such as anxiety and depression can significantly impact your ability to function, negatively affecting all areas of your life.
Research has found that depression causes the second highest number of years lived with disability.3 Losses due to decreased productivity cost 2 billion dollars a year. On an individual level, those suffering from severe depression make $199 less a month due to missed work.2 Over time, untreated depression and other mental health conditions can be far more costly than therapy.
There are also non-quantifiable losses to consider when mental health issues aren’t addressed. You may find yourself repeating unhealthy patterns, struggle to maintain healthy relationships, or find it difficult to be meaningfully engaged in your life the way you would like to be.
Therapy can help you address mental health conditions so that they have less of a negative impact on your life. It can also help you increase your understanding of yourself and others, learn new and healthy tools for dealing with challenges, and give you the insight and support to create a life that fulfills you. Therapy helps you address issues at their root, allowing you to resolve them more fully so you don’t find yourself dealing with the same issue over and over again.
The results of therapy can be long-lasting. In fact, research has shown that participating in therapy can cause changes to your brain that show up in neuroimaging scans.1 What you learn and discover in therapy stays with you. While an investment upfront, it can pay dividends long after you’ve finished.
