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How Much Should I Pay For Therapy?

Let’s be real. Money is, well… complicated.

Dread. Shame. Desperation. Terror. Guilt. Frustration. Desire. Envy. These are just a few of the feelings that overtake us when considering our financial situation. None of us are immune to the emotional complexities that money stirs up.

If you are in a relationship with another human being, money anxiety is sure to follow. Conflicts inevitably arise when need and money intersect.

This is true for both people seeking therapy and the therapists who provide that treatment.

For clients, all kinds of questions get stirred up when it comes to paying for therapy.

“How much is too much?”

“Is my therapist taking advantage of me?”

“Am I paying for love?”

Psyched Tiffany how much to pay

In the beginning stages of therapy, it is often confusing to know what, exactly, we are paying for. The therapeutic process feels mysterious. You know something isn’t working in your life, but it’s incredibly hard to trust that the stranger sitting across from you can help.

Therapy is a huge financial investment and it often takes time to see concrete results. For those of us who have been hurt in the past, it is a huge risk to invest our hard earned dollars into something – and someone – when there are no guarantees.

Believe it or not, your therapist, too, struggles with conflicts around fees. Most therapists enter into this field out of a deep of a desire to help others. Many of us have experienced profound personal change through the process of therapy and we are invested in giving back. Thus, the idea of charging for our services stirs up conflicting feelings.

As much as a therapist may want to offer low fees, she, too, has to contend with a financial reality that includes costs of living, tens (or hundreds) of thousands of dollars in student loan debt and regular business expenses. On top of this, if a therapist is to remain sharp, she must also pay for ongoing education, personal therapy, and regular consultation. Many therapists are startled to discover that the fee, which once seemed so high, barely covers basic living expenses.

Beyond the normal complications we all have around money, the situation becomes even more confusing in therapy because many of us (including therapists seeking therapy) expect a negotiation around fee. Though we don’t ask our barbers, our plumbers, our doctors or our lawyers to “slide,” we often expect and sometimes even demand that our therapist make exceptions for us around paying for their time. Quite often, therapists comply with lowering their fees, despite the negative impact on their income.

The therapeutic relationship is a personal one, thus, when money is the basis of exchange, things become tricky for both therapist and patient. Our personal confusions around the way we handle money are often directly tied to the problems that bring us into therapy in the first place.

The questions that arise around how much to pay for therapy are often as important as the answers – for both clients and therapists.

Which brings us back to the original question around how much one should pay for therapy.

Therapy is an investment that will ultimately lead to observable change. The amount you invest should not break the bank, but it should reflect a willingness to put your money where your proverbial mouth is. Most importantly, both therapists and clients must find ways to talk about the fee.

For clients, it’s vital that you are able to ask these questions of your therapist:

  • What is her full fee?
  • If you’re paying based on a sliding-scale rate, what are the parameters and why?
  • When and how will your therapist raise your fee?

Likewise, it’s equally vital that we therapists are doing the necessary work to ensure we are not making sacrifices that lead us to burnout or resentment, by asking ourselves these questions:

  • Are you clear about your financial situation?
  • Do you know when, how and why you reduce your fee?
  • Are you continuing your education via consultation groups and your own therapy, so that you are not unconsciously enacting problematic money dynamics with your clients?

In order to learn more about this topic, I’ve created a survey for both clients and therapists in private practice in order to learn more about the ways money and therapy intersect. Take the survey here!

Tiffany McLain

Tiffany McLain

Tiffany McLain has a psychotherapy practice in San Francisco where she specializes in working with young professionals who straddle multiple identities, be this professionally, ethnically or economically.

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