The National Average Cost of Therapy
As of 2018, the median cost of therapy for a 50 minute session ranged from $100 to $200 with an average of $130. This varies widely, depending on the city and state where you are seeking therapy. For example, in 2018 the median cost of therapy in Florida was $125 per session while the median cost in the Miami area specifically was $200 per session. In New York, the median cost of therapy per session is $125 while in New York City the price per session is typically between $200 and $300.8 In general, online therapy providers will be more affordable than in-person options.
The most affordable therapy options may cost between $40 and $80 per session. Many community mental health clinics offer low fee sessions. Agencies that employ graduate students or therapists working towards finishing their licensing requirements may also offer sessions at a lower rate. And some therapists reserve some amount of their schedule to offer sliding scale fees to clients in need.
On the higher end, sessions can cost anywhere from $200 and up. Therapists who charge these rates are typically found in private or group practices and are often licensed psychologists (holding a PsyD or PhD) or have advanced training.
Why Is Therapy So Expensive?
While $130 may seem like a lot of money to spend for 50 minutes of someone’s time, the session fee actually has to cover a lot more than just those 50 minutes. In addition to the session itself, therapists spend time preparing for each session, writing and updating treatment plans and progress notes, and taking care of business and case management issues as they arise (i.e. scheduling, coordinating with your other providers).
Because of all the work that therapists do outside of sessions, very few see 40 clients a week. More commonly, therapists will see around 20 clients a week, leaving 20 other hours in the standard 40 hour work week for the tasks listed above. Additionally, therapists have to make time for continuing education, consultation and supervision, and business tasks to keep their practice running smoothly.
The fee you pay for therapy has to cover even more than just the time your therapist spends on you. Therapists have to pay yearly licensing fees and malpractice insurance fees. Monthly, therapists pay for their office rent, the cost of an electronic health record system or paper record supplies, and online directory profile fees.
Throughout the year, therapists pay for continuing education classes in order to keep up to date with the latest research and maintain their license. Many therapists also pay for supervision or consultation, a practice where they talk with a more experienced therapist about any clinical concerns or challenges they are facing.
After all of that is paid for, what’s leftover is the therapist’s take home pay.
The Cost Depends on the Type of Therapy & Mental Health Professional
The type of therapy being provided can affect the cost. Typical outpatient therapy, where a client attends weekly sessions, is often less expensive than more involved outpatient therapy programs. In general, the more hours per week a therapist must spend on a particular client, the higher the cost of therapy.
Two common types of therapy & their costs are:
- Cognitive Behavioral Therapy (CBT): In CBT, sessions are usually once a week for 50 minutes, with a cost between $100 and $200 per session.
- Dialectical Behavioral Therapy (DBT): DBT usually comprises a weekly individual therapy session, a weekly group session, and brief phone calls throughout the week. The cost of a DBT therapy program often ranges between $150 and $300 per week.
The cost of therapy depends, in part, on the mental health professional providing it. Mental health professionals who are still in graduate school or hold associate licenses often charge less than those with full licenses. Those with a PsyD or PhD degree may charge more than those with an M.A. or M.S. degree. Additionally, therapists with advanced training in a particular modality or technique may charge more than therapists without specialized training, regardless of their degree or license.
Ultimately, the type of mental health professional providing therapy and the geographic location where they work are two key factors that influence the cost of outpatient therapy. The more education or experience a therapist has, the higher their fees will be. In locations where office rent is high or there are very few therapists, the cost of therapy will be higher.
The Therapist’s Education & Specialization May Affect the Price
Before therapists even begin a practice, they have to complete a minimum of a Master’s degree. This requires at least two years of graduate school. Like most higher education programs, the cost of graduate school can be very expensive. Many therapists take out loans in order to pay for their education. Therapists who have completed a PsyD or PhD program are often in school for 5-7 years, resulting in even higher tuition costs. Throughout their schooling, therapists complete required internships and supervised hours, usually for no pay.
Once therapists have completed their academic training, many go on to specialize. Specialization requires additional training, as well as supervised hours, continuing education hours, and licensing fees that are distinct to their specialization.
Therapists with doctorate degrees or advanced training may charge a higher rate. A therapist who has completed a Masters degree without any additional specialization is likely to charge less than a therapist who has completed a PsyD or PhD, or who has completed specialized training. While the cost of seeing these providers is higher, their additional years of training help them provide even more effective and efficient services.
If you have a previous mental health diagnosis, working with a provider who specializes in that disorder can be more productive than working with someone who has less experience and/or training around your specific concern. The cost per session may be higher, but the overall cost of therapy may be lower. The provider can offer more specific treatment to help you address what brought you to therapy, oftentimes reducing the number of sessions needed to help you reach your therapeutic goals. In addition to potentially costing less overall, you may begin feeling better more quickly.
Does Insurance Cover Therapy?
Some insurance plans cover the cost of therapy once you have met your deductible. What is covered varies depending on your insurance company and plan. Not all insurance plans will cover all types of therapy, or therapy for specific mental health conditions. If you want to use your insurance, it is very important to call your insurance company and ask for specific details of what is covered. Because insurance plans vary so widely, contacting your insurance company is the best way to get accurate information regarding your specific coverage.
If you are an employee, some workplaces offer therapy sessions as a part of their employee assistance programs outside of the set insurance coverage.
If you have an insurance plan that covers some or all of the cost of therapy, it may still be difficult to actually use your insurance. Many therapists in private practice choose not to take insurance. This is because insurance companies typically reimburse therapists only a fraction of their usual rate.
A therapist who is in-network with your insurance company is contracted with them to provide services for fees set by the insurance company. The insurance company may also set parameters around the type of treatment therapists can provide, or the number of sessions they will cover. To find an in-network therapist, most insurance companies offer a directory on their webpage where you can search for providers.
A therapist who is out-of-network (OON) does not contract with your insurance company. These means that they are paid directly by you and not your insurance company. Therapists who are OON will typically make a note of it on their directory profiles and website. If you would like to work with a therapist who is out-of-network, check with your insurance company to see if you have any out-of-network benefits that can be used.
Instead of being in-network with insurance companies, many therapists offer superbills. This is a list of the services they have provided you, along with the cost, that you can submit to your insurance company for direct reimbursement. Depending on your plan, as much as 90% of the cost of a session may be reimbursed to you.
You’ve probably heard of cognitive behavioral therapy (CBT), the evidence-based psychotherapy treatment method focused on changing negative thoughts and behaviors. It seems to be mentioned in nearly every self-help article online: Sleep problems? Try CBT. Childhood trauma? CBT may help. Anxiety, depression, low self-esteem, fear of flying, hangnails? CBT is the answer for you.
Basically, there’s a good chance you’ve either received CBT or know someone who has. So what is it? Does it really alleviate psychological distress, and if so, how? How much does it cost, and can you just use the techniques on your own? These kinds of details can be a mystery to the general public. Lucky for you, I’m a clinical psychologist who uses CBT in my practice, so I should be able to answer most of the questions you have about it. Let’s dig into them one at a time.
1. First, what the heck is CBT?
CBT is one of scores of treatment methods used in psychotherapy. It’s based on the assumption that many of life’s problems stem from faulty thoughts (that’s where “cognitive” comes from) and behaviors. By intentionally shifting them toward healthier, more productive goals, we can alleviate distress. In practice, cognitive behavioral therapy generally consists of identifying the problematic thoughts and behaviors and replacing them with healthier responses.
For example, say Jane Doe is anxious in social situations and has started to avoid gatherings in favor of isolating evenings at home. A CBT therapist may educate her about the fear response that is being irrationally triggered, teach her how to shift her thoughts and relax her body, and develop an action plan to help her remain calm while engaging in the party this weekend. Next week, they’ll evaluate what worked and what didn’t, and tweak their methods until Jane can comfortably socialize.
2. What kinds of issues can CBT help address, and how do I know if it’s right for me?
CBT is used for anything from phobias, anxiety, depression, trauma, self-esteem issues, and ADHD, to relational problems like poor communication or unrealistic expectations of your partner. Basically, if it’s an issue that involves thoughts and behaviors (which covers a lot of ground), CBT has a treatment approach for that.
Is it right for you? That’s a difficult question. Do your problems concern how you think and behave? For example, are you ruminating about a past breakup or finding yourself mindlessly shopping online? If so, then yes, you could probably benefit from CBT. If you are more concerned about your purpose or meaning in life, or about what moments from your past color who you are today, there may be other approaches that fit better for you (and we’ll get to that in question #9).
3. What makes CBT so popular?
One of the reasons CBT is so well-known and widely used is because it has been studied so extensively. It is a good modality to study because it emphasizes brief, direct, solution-oriented interventions. In other words, the aim is to produce clear, measurable changes in thoughts and behaviors, which is a goldmine for researchers. It also means you get to see quick results.