Why is therapy so expensive?

Sheesh! You’d think that almost by definition as a psychotherapist you’d be dealing with a group that is more likely to be unemployed or at least underemployed. Financial uncertainty or problems themselves often trigger episodes of mental illness.

From a client perspective I totally understand and empathize with you.

At one appointment long term T and I discussedthis. She felt bad for the prices (she charged less than most in our community). Self employed people pay about 40% in taxes, then to pay for any billers or staffing as well as rent and any other expenses such as being on various online advertising, etc. What I pay because of my insurance, like leaves them very little for that hour.

It is a big issue that many people in society that would benefit from therapy the most, simply can't afford it. Kind of like healthcare in some countries I guess. Plus it takes a lot of time and money to become a therapist, so I guess we are paying for experience.

My 50 minute therapy session costs half what my partner charges for an hour of his tattooing services, that seems kind of odd. But I suppose you get a lifelong piece of artwork for that money. Mental health seems very difficult to price, or is it priceless? Good question.

Hi there I totally appreciate what your all saying I’m lucky I’m in the uk I don’t pay we have unbelievable nhs system what I will say though you can’t put a price on mental health

Therapy is big business and it perpetuates itself. Therapists pay a lot for training (often to private training providers, in the UK at least), pay for supervision (to privately employed supervisors), pay for ongoing training (to private providers), pay for their own therapy (with private therapists). Add in an inflated sense of self-importance and and assumed professionalism and, boom!, you've got a whole lot of cost they need to pass onto clients. And here come vulnerable and wounded clients who are desperate for healing and will pay because something gentle and caring is so integral to our lives as humans that we will source it where we can. Obviously, therapists need a wage and some of them are talented, but the fact that easing heartache is a business matter does not sit well with me.

I should say that my therapist charges me a nominal amount and often doesn't charge me at all. I am grateful, but then this gratitude causes issues of its own. I feel like charity, I see her as Lady of the Manor issuing alms to the poor. Fees are rarely a neutral matter in therapy.

Any service like this (therapy, doctors, dentists - don't get me started on dentists - LOL, lawyers, accountants, etc.) is costly if you are paying the standard rate. There are lower cost options available, and at least in the U.S. you can generally use insurance if you follow insurance lists, etc. Unfortunately, it can be hard to find those lower cost options and/or some don't qualify.

Therapists are maintaining the cost of running a business, and depending on how their practice is set up and where it is set up, those costs can be rather extensive. The bottom line is their bottom line. They have to be able to afford the costs of running their business and make income beyond that for their own pay. Some therapists work out of a larger practice where the costs for other personnel, space, utilities, etc. is shared which helps some.

The only way many people afford therapy is because they find therapists associated with their insurance so that their personal cost is a copay rather than the full rate.

Many therapists do offer a sliding scale of lower rates for a certain number of clients that they have figured into their budgeting, but there is an obvious limit on how many clients they can maintain that way.

My physical therapist charges my insurance twice what my therapist does for the same hour of therapy. They both have comparable amounts of postgraduate education and training. They both improve my health to comparable degrees (neither one cures me, they both allow me to function better with whatever illness I have, I'll never be completely free of either of them).

Yes, one is more emotional labor and the other is more physical labor but as a culture we undervalue one of those. Hint: it's the one provided mainly by females, that we think should be provided for free in child rearing, caring for elderly and ailing relatives, and so forth.

I'm not saying it's exist to question the cost of therapy; clearly it isn't! The whole medical system is overpriced to the point of ridiculousness. But even inside that asinine system, gender bias persists and it has to do with the type of labor we value more.

I signed up for a different insurance in December 2019. I basically had to choose between my physical health and my mental health. The insurance has turned out to be amazing since I’ve had a lot of doctors visits and medical issues and surgeries and procedures. I’ve barely had to pay anything regarding my physical health. But my therapy bills and Pdoc bills are outrageous. I have to take money out of my dwindling savings every time I get a bill. I basically can’t afford it but I for some reason want to continue.

This is a really important point. There was some study or another conducted which indicated that female therapists are more likely to lower their fees than male therapists. I am not sure if this was UK specific. I suspect the phenomenon is linked to imposter syndrome (itself more likely to be experienced by women), as well as the sense of general inferiority which patriarchy teaches women to feel about ourselves.

My T gets approximately $60 between insurance and my copay per hour of therapy. With that she has to pay rent, utilities, a billing person (which she finally got because she couldn't figure it out on her own), plus have money for her own personal insurance, food, housing, etc. Obviously she could do better if she went with private pay--no insurance--but we live in a semi-rural area and she would likely have to have an office "down the hill" in a pricier community (which means higher rent, etc) in order to have clients that could afford private pay. I do private pay for my Pdoc but I couldn't afford private pay for a Pdoc and a therapist. When my Pdoc was taking insurance he was being reimbursed $180 per 15 minute appointment. I private pay $200 to see him for a 25 minute appointment. But he also moved his office to Palm Springs which is ultra expensive (it's a beautiful office though). He said when he was taking insurance he had 1000 patients and couldn't keep track of them all like he wanted to. Private pay allows him to see fewer clients but have better control over their care. I'm sure some insurances pay better or worse than mine. I think my T is underpaid.

I kind of regret my initial wording here, I understand that they cannot work for free. I wish the US would quit coming up with 14,000 excuse to not build a universal healthcare system and just do it.