Money, therapy and why therapists charge what they do

I recently put my prices up. This prompted some reflection on the relationship between therapy and money – why paying for care can feel liberating or complicated, and why therapists charge what they do.

Therapy as a service

At its core, therapy is a service. Just as you pay for a manicure, or a plumber fitting a new tap, you pay for 50 minutes with a therapist.

Therapy is also so much more – and this is where paying for it can feel uncomfortable. It is a relationship. You share complex feelings and private details with your therapist. You – probably – don’t do that with your plumber.

Many clients enjoy the freedom that paying brings. The therapist is not a friend. That’s the point. You pay for your session and for that very reason, are free to talk and feel in ways that normal life doesn’t usually provide.

For others, though, paying for therapy can feel awkward. Sharing emotional moments and intense discoveries with a therapist, and then remembering that this rare experience is predicated on a financial transaction can be jarring or disappointing.

Is it worth the money?

Another issue around therapy and money is the simple question – is it worth it? My answer is yes. Of course it is.

Some people do not feel therapy is a worthwhile expense. Why spend money just to talk? Some may be curious about therapy, but struggle to justify the expense. Others would like to have therapy, but cannot afford it. Access to therapy remains an issue for the industry. Low-cost counselling services often have lengthy waiting lists and rely on voluntary staff, and it can remain the preserve of affluent, middle-class individuals.

Therapy is not a quick fix, either. Unlike a plumber, therapy is a weekly expense and not a one-off payment. To experience meaningful change, clients may be committing to several months or even years of work. This, unfortunately, puts therapy beyond the budget of many.

Money and meaning

Money itself is another strand of complexity. Money is freighted with meaning and associations. Most of us grew up absorbing the family code around money – what it stood for, what it guaranteed, what it could and couldn’t be spent on, what was enough or too much.

Clients often talk about money in sessions. It can be linked to their self-worth, their social standing, to stress, security, guilt or pleasure. Not having money can generate shame. Having money can generate shame.

Why therapists charge what they do

With all this complexity, it may be useful to consider why a therapist charges what they do. Below is a breakdown of expenses:

Training – therapists train for years. I am about to embark on my fourth year of training, out of a desire to grow my understanding and improve the service I give to clients. Each year of training so far has cost more than £3000. In addition, qualified therapists often engage in CPD to specialise in specific areas or simply expand their skills and knowledge.

Supervision – this is a space where I discuss my clinical work with a professional counselling supervisor who offers guidance and support to ensure that clients receive quality counselling. It is an ongoing cost, and a requirement for ethical practice.

Personal therapy – most therapists engage in therapy, both as self-care, and to ensure their own personal material does not intrude on their client work.

Insurance – another ethical requirement.

Room hire – for those therapists working in person, the cost of hiring rooms can trim around a fifth off their fee.

Software – from paying for online meeting platforms to accounting software.

Personal website – building it and hosting it.

Advertising – online counselling directories which charge a monthly fee for a listing, fliers, business cards…

Time – this is perhaps the biggest one. Therapists spend time reflecting on their clients. I write brief notes after each session, but I also keep longer reflective diaries and process notes, often topping these up throughout the week between sessions, as thoughts occur to me about my client work. I hold my clients in mind. Their stories live with me. They impact me.

Since the therapist is the tool of therapy, I also need time each week to decompress after often challenging and intense sessions. While more clients would mean more pay, I am careful to stick to a client base that feels emotionally and ethically manageable for me.

Explanation not justification

This article is not meant to justify, only to explain what being in private practice costs the therapist. Like any business, it has overheads, but then again, therapy is not like any business. It is a caring profession, more art than science, more relationship than simple service. Sometimes paying and care are uneasy friends, but being a therapist takes time, training and often courage, and the fee charged reflects that.

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