The Cost of Therapy

It’s no secret that psychotherapy is costly. Mental health services are not prioritized or well-funded by government budgets or insurance providers. Mental health providers have always fought to be taken as seriously as other branches of healthcare, but the fight has not yet been won. Unfortunately that directly impacts you, the client, leaving you with the challenge of paying for psychotherapy.

When considering the cost of entering therapy, take a moment to consider the cost of not entering therapy.

Cortisol is a naturally occurring steroid hormone produced by your adrenal glands. When your fight or flight response is activated through trauma, anxiety, or fear, or when you are extremely stressed, your adrenal glands will produce more cortisol than necessary. When your body is chronically exposed to excess cortisol, it can lead to heart disease and increased risk of heart attack and stroke, frequent headaches, muscle tension or weakness, sleep issues, weight gain, memory and concentration impairment, digestive issues, and more. This in turn all cycles back to further mood disturbance and anxiety.

The cost of not addressing your mental health is far greater than the financial cost of therapy itself.

So, what’s the next step in affording therapy?

Let’s start with health insurance. The nuances of mental health coverage are vast. You should always check with your health insurance company first to understand your benefits. You might have unlimited visits, you might have a certain number of visits covered before a copay kicks in, and you might even have a separate EAP (Employee Assistance Program) benefit that covers a certain number of sessions completely free. There is no one straight answer to this, so always check first.

Something to be aware of is that therapists have no control over cost when it comes to insurance coverage. We are not able to change or have a say in your copay or out-of-pocket amounts. We, like you, must follow your benefit allowance.

If you are covered, next we have the actual session cost. Multiple factors can impact this number. You may have a deductible that needs to be met before sessions will be covered at all, leaving you with the full out-of-pocket session cost. You may have a set copay amount, typically between $20-$40. You may have a coinsurance percentage, where you pay a percentage amount of total session cost instead of a set dollar amount. All of these cost questions can be answered by both your insurance provider and your therapist’s billing department.

Some therapists choose not to panel themselves with insurance companies and prefer to set their own private pay rates. A therapist should clearly advertise if they do or do not have a sliding pay scale, but you are welcome to ask.

Most therapists accept both insurance reimbursement and private pay, to make their services more accessible.

Here is a bit of behind the scenes information. Quite frequently, therapists are contractual workers, not salaried employees. This means that they only get paid if they see a client for that hour. This also means that if they set their private pay rate extremely low, say at $20 per session, they have no additional salary to provide income. This, plus the level of education and expertise they are providing, is the reason you will see private pay rates of therapists closer to the $100-$200 range.

What if none of these options are available to you, and you truly need free services? A lesser known option is to look to your local colleges and universities. Check to see if they have graduate psychology, social work, or counseling programs (not undergraduate). Typically, graduate students in these programs need to accrue a certain number of practicum hours to obtain their degree, which means they need to train with real clients. These services are free to community members. Your therapist will be a student in training and not a licensed clinician, and they will typically move on after the semester ends. You will likely be assigned to a new student and continue your free services.

What questions do you have about the costs associated with psychotherapy?