Therapy costs money. You don’t get to walk away with a physical product or a material symbol of what you paid for. Why does it cost so much and how do we justify the cost?

The big factor is that when you are going to a therapist, you are paying for a private slot of time with the therapist to work on your mental health. This limits how many therapy sessions that therapists can do in a day. Many therapists hold full time caseloads between 15 to 25 clients a week. That sounds very different from a standard 40 hour work week. However, after your therapy session, therapists also have to complete progress notes, bill your insurance for sessions, apply credit card payments, and a litany of other administrative duties. Therapists may need to also take some time out to collaborate via phone with another medical provider of yours in order to provide the best treatment.

This is also why many therapists charge cancellation fees. If you don’t show up for your session, it’s not easy to replace that income with another client. In order for therapists to show up and be there for you, we have to make enough income to maintain our personal lives and business lives.

Therapists have to earn at least a Masters level degree and undergo a lengthy licensure process before they are cleared to work with clients. The journey to becoming a therapist involves a steep financial and time investment. Our education involves clinical practicums working with clients while also taking classes and learning theories. The more education or advanced training a therapist has, the more they will charge. In addition to our initial education, therapists are required to obtain continuing education on a regular basis to maintain our licenses, which can also be costly.

The work of therapy can also be emotionally intensive for therapists. You can always talk to your family or friends about mental health problems, but this may not be as effective as talking to a therapist. Often, people respond in conversation using only their personal frame of reference or thinking from their personal wants. In that sense, guidance you receive from loved ones may be biased. This is natural for people to do, though. A therapist trains themselves to focus on providing guidance that is helpful for you. They will not shy away from difficult feelings or emotions you will have. When it comes to conditions such as trauma, I have found that even loved ones will find it difficult to be present and listen to descriptions of trauma, purely because it can be saddening and uncomfortable to hear. A therapist will be there for you while you work through these emotions. Because of this intensive work, a therapist will need to recharge and may limit the number of sessions they do. A burnt-out therapist overworking themselves will not be able to provide quality care for you.

Therapy can be expensive due to all these factors. It may be worth paying a higher fee per session especially if the therapist provides effective treatment and you feel better sooner. If you feel better sooner, you may ultimately need less sessions and pay less. I recommend weighing the cost of the session rate with the benefits a specific therapist can provide for you. If you can work with your ideal therapist and improve your mental health sooner with fewer sessions, I would consider that a win.

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