I pay out of pocket. Right now I have been going to therapy every other week for 50 minutes. Before that, I went every 3-4 weeks for 90 minutes. I try not to think about how much I have paid for therapy over the last few years. It has really benefited me. Since I pay out of pocket, I can take the cost as a tax deduction if I itemize. I also deduct for the miles driven to T's office and a fee for parking each time. Every penny counts!