How Much Does Therapy Cost?
Psychotherapy, also called talk therapy, is considered a gold standard treatment for depression, anxiety, and a variety of other psychiatric conditions. But although the effectiveness of therapy is widely recognized nationwide, there is no clear industry standard on the cost of treatment. A number of factors may impact the cost of therapy with a licensed mental health professional. If you understand and take advantage of these factors, you may be able to improve your access to effective mental health care.
How Much Does Therapy Cost?
The cost of therapy may vary from as little as $5 per session to as much as $400 per session. A few of the factors that influence how much you pay are:
- Your therapist
- Your geographic location
- Your medical insurance
- Your income
- Your treatment setting
- The going rate for therapy in your community
While there is a wide range when it comes to cost, many therapists tend to charge $75-$150 per session. It is best to discuss the cost of treatment during your initial session with your mental health provider before you commit to long-term care.
Why Can It Be So Expensive?
Although the cost of therapy may vary, many people who have mental health issues believe therapy is expensive. Why is it so expensive? One reason is you are working with a highly trained professional.
Take a moment to consider the high cost of hiring an architect, a lawyer, a surgeon, or any other professional in a specialized field. These individuals often study for many years, receive training from industry experts, and invest hundreds of thousands of dollars in their college and postgraduate education. The same is true for a therapist. When you come to therapy you are not merely chatting with a friend—you are working closely with a licensed expert in the mental health industry.
If the cost of care is restricting your ability to get treatment, you may benefit from trying online therapy rather than traditional in-office therapy.
A therapist has to fulfill many responsibilities if he or she wants to have a successful practice. In addition to providing counseling services, your therapist also has to organize client information, negotiate rates with insurance companies, advertise his or her services, and manage cancellations. These administrative duties take many hours to complete each week and they contribute to the high-quality care you expect. However, your therapist is only able to bill for the time he or she spends in therapy with you. This means your therapist may have to charge you (and other clients) higher fees in order to make a profit.
A third reason therapy may be expensive is the cost associated with continuing education. To maintain his or her license to provide mental health services, your therapist may have to pay continuing education fees or invest in annual training courses to keep up to date with the latest developments in the mental health field. Continuing education fees may total thousands of dollars each year. There are also additional costs associated with getting therapy materials for clients, state licenses, personal development courses, insurance services, mental health association memberships, and staff.
Types of Therapists
Your therapist may be a licensed psychiatrist, psychologist, clinical social worker, psychoanalyst, counselor, or marriage and family therapist. The type of therapist you work with can influence the amount of money you pay for each therapy session.
There are therapists who offer counseling services to families that are dealing with divorce, parental issues, the death of a loved one, financial issues, communication challenges, or major life transitions. Other mental health professionals provide support for cognitive, behavioral, and emotional issues such as bipolar disorder, anxiety disorder, clinical depression, and other health concerns. Some licensed therapists focus on helping young children or teenagers. If you believe you need therapy, the National Institute of Mental Health recommends you search for a therapist who specializes in treating your specific issues.
Besides their area of focus, therapists may also differ in their therapeutic approach. Common psychotherapy approaches include:
- Cognitive behavioral therapy
- Dialectical behavior therapy
- Expressive arts therapy
- Narrative therapy
- Gottman Method couples counseling
- Mindfulness-based cognitive therapy
- Interpersonal therapy
Some therapists provide mental health services in-office, on the internet, or both. How much does therapy cost when receiving in-office sessions versus online sessions? The difference in price may be drastic. In most cases, online therapy is much more affordable than in-office therapy. If the cost of care is restricting your ability to get treatment, you may benefit from trying online therapy rather than traditional in-office therapy.
Therapists may work on a panel of mental health providers that accepts insurance. If your therapist accepts insurance, the cost of your therapy sessions may be reduced to a copayment or deductible payment. Please check with your insurance provider to find out about your mental health coverage before you begin therapy. Other therapists choose not to accept insurance and instead offer their counseling services for a fee.
The cost of therapy may change depending on where you live. In the state of California, for example, a typical therapy session may cost between $65 and $250. If you live in New York, working with a therapist may be more expensive. It is not uncommon for therapy sessions in New York City to cost $300 each.
The cost of treatment also depends on the demand for mental health services in your community. Areas with high population densities, such as major cities, tend to have higher demand and higher costs. How much does therapy cost in your area? The best ways to find out involve calling the mental health centers in your community, speaking with your doctor, or using the internet to search for licensed therapists in your location.
Specialties and Experience
The expertise and experience of your therapist may impact how much you pay for therapy. As in other fields, mental health professionals who have an excellent reputation, years of experience, and specialized skills that are in high demand are likely to charge higher fees. If you are eager to reduce your mental health costs, it may be helpful to search for licensed therapists who are new to the mental health industry or new to your community. Therapists who are still building their professional profile may offer excellent services at a much lower cost.
Your health insurance is arguably the most important determinant of how much your therapy will cost. If you do not have health insurance, you will likely have to cover the entire cost of therapy out of pocket. You may also face challenges when trying to access mental health care even if you have health insurance. This is because some insurance plans do not provide comprehensive coverage for talk therapy and many practicing therapists do not take insurance.
Of all medical and health care providers, licensed therapists are the least likely to accept health insurance. While 89% of other health care professionals (such as dermatologists, cardiologists, and podiatrists) take insurance, only 55% of psychiatrists accept it. A number of therapists choose not to take insurance because of the challenges of working with insurance companies.
Some insurance companies cover most of the cost of treatment if you work with a therapist within their network. If you are unable to find a suitable therapist within your insurance network, you may have to seek treatment from a mental health provider who is outside your insurance network. If you have “out-of-network benefits” your insurance company may pay a large percentage of your treatment costs.
Insurance Requires a Diagnosis
Insurance companies tend to take a medical approach when it comes to health issues. If you are sick, your insurance company may want to see a blood test, x-rays, or other medical reports to verify you are ill and confirm the type of medication you need to get well. Mental health treatment, however, often involves preventative or maintenance work. As a result, it is sometimes difficult for therapists and clients to justify their health and treatment claims.
Insurance companies that provide coverage for mental health issues typically require a mental health diagnosis. However, many people who come to therapy do not have a diagnosable mental health condition. Individuals and couples who come to therapy for grief counseling or couples counseling are usually not covered by their insurance. People with complicated diagnoses such as dissociative identity disorder (formerly called multiple personality disorder) may not receive coverage.
When insurance coverage is provided for a diagnosed mental health issue, the coverage may only be temporary. If you are diagnosed with clinical depression, for example, your insurance company may pay for your treatment. If you make good progress and are no longer considered clinically depressed, your insurance company may cease payment even if you and your therapist believe you need ongoing care.
Although some insurance companies accept mental health diagnoses, your therapist may have concerns about the rate of reimbursement. In many cases, there is a wide gap between the rate a therapist charges per hour and the reimbursement rate he or she receives from insurance companies. For example, a therapist who charges $140 per session may receive a reimbursement of $50 per session from some insurance companies. These and other related issues have resulted in some therapists choosing not to accept health insurance from clients.
Insurance Can Require Full-Time Paperwork
Filling out the required paperwork for insurance companies requires a lot of time and effort. In many hospitals and medical centers, it is a full time job for certain members of staff. Many therapists do not hire assistants as they want to keep overhead costs and client fees as low as possible. If your therapist accepts insurance, he or she likely spends a large portion of his or her work hours managing piles of insurance documents.
Dealing with insurance companies can be incredibly frustrating for therapists. Submitting a single bill may involve justifying their services to an insurance representative, jumping through bureaucratic hoops, providing status reports, and keeping in contact with insurance providers who are late with payments.
Sliding Fee Schedules
Although a large percentage of therapists do not accept insurance, many are willing to offer their services on a sliding fee scale. A sliding fee scale is a pricing model that provides various prices for products or services based on your income. If you have financial limitations, your therapist may be willing to provide mental health services at a lower price you can afford. Please be aware that you may need to ask your therapist if he or she is willing to work on a sliding fee scale as it is not always advertised.
Community Mental Health Clinics
Low-cost therapy may be accessible at community mental health agencies, clinics, or hospitals. The care providers at these facilities are often mental health interns or students in training who are working towards licensure. Therapy at a community mental health clinic may be as low as $5 per session. In some cases, therapy is free of charge.
How much does therapy cost? As shown, the answer depends on a number of factors. But while therapy is generally considered to be quite expensive, there are affordable options available to you if you know what to do, who to ask, and where to look.