The cost of therapy?

06th April 2022

Most therapists in private practice charge set fees for their therapy services, often depending upon the type of therapy offered, for example counselling, CBT, hypnotherapy etc, and length of the sessions. I am sure many people that access therapy, wonder what their session charge covers and how therapists arrive at their therapy fee.

Below are factors to be considered and costs which, in turn, may form part of the therapy charge:

• Training, knowledge and experience - the therapy fee reflects training costs incurred to gain the skills, experience and knowledge to become a fully qualified therapist.  This training is vital to be proficient enough to hold a professional, confidential and ethical space which allows effective therapy to safely take place.
• Professional memberships - whilst it is currently voluntary to be registered with a professional body, most ethical therapists hold membership with one or more professional/regulatory bodies, such as BACP, UKCP or CNHC.  Holding such memberships verifies certain levels of training, standards and ethical codes of practice. Such memberships incur annual costs to keep valid registration and ongoing costs to maintain membership.  Also, under current GDPR regulations therapists need to be registered with ICO (Information Commissioner’s Office), again another cost.
• Continuous professional development (CPD) - to maintain professional standards, most therapists wish to keep up to date with the evolution of therapy/theories/practices and may wish to do additional training to develop their practice. CPD is also a requirement to maintain membership with regulatory bodies - each have individual requirements, but all stipulate that a certain number of CPD hours must be undertaken to expand knowledge and develop therapy skills through completing further training courses, reading around relevant subjects, partaking in training days/workshops, listening to podcast/programmes - all of which incur considerable costs and time to undertake and record.
• Supervision costs - part of maintaining professional memberships and working within the ethical framework for counselling and psychotherapy is a requirement to undertake supervision.  Supervision is a considerable monthly investment, both timewise and cost, but is a vital outlet for therapists to discuss any issues or clients (in confidence) with another trained therapist or supervisor.  Supervisions affords a confidential space in which therapists can offload and explore the effectiveness of their therapy. The number of supervision hours required depends upon the number of clients seen per month, but this must be undertaken, not only as part of the ethical framework/regulatory membership requirements but also to protect clients and therapists. 
• Indemnity insurance cost - to practice ethically, therapists must have personal liability insurance, to protect themselves and clients.
• Room costs - many therapists hire/rent a space in which to practice, so rental costs are part of the course.  Lots of therapists work from home, incurring utility and running costs for facilities/refreshments and furnishing costs to create a comfortable and relaxing space in which to conduct effective therapy.  There are also general maintenance and cleaning costs to take into account.
• Travel costs - for therapists who travel to work/to their rented room, costs of travel need to be considered.  Considering the current fuel price hikes, this can be an ever-increasing cost.
• Promotional/marketing costs - most therapist have a website and undertake some form of marketing to have presence and visibility for potential clients. There are many directories to join, such as The Counselling Directory, BACP Register, all of which charge an annual registration fee.  Social media marketing can be freely accessed, however, lots of time needs to be invested in keeping social platforms updated and many social media sites now charge for advertising.
• Online platform and phone costs - Many online platforms, such as Zoom and Microsoft Teams, now charge a monthly or annual fee. Telephone calls, using mobile data and wifi to contact clients all have cost implications.
• Administration time - therapists spend time outside of therapy sessions writing up client notes, maintaining client records, confirming appointments, emailing/texting clients, sending out contracts, writing referrals, communicating with GP’s, updating policies, websites, social media and much more.
• Therapy preparation time - therapists spend time preparing for client sessions, planning what may be covered in sessions, reading and researching relevant materials/theories/strategies, preparing the therapy space and preparing any client materials/handouts etc. All of this is time spent in addition to the actual session time with clients.
• Taxable income - private therapists are often self-employed, so the fee charged is subject to tax deduction. Keeping accounts and expense records takes time and often incurs additional accountancy costs.
• Holiday/sickness pay and cancellations - most private therapists are self-employed, which means cancellations, sickness and taking holidays means a direct hit to salary. This needs to be considered and a percentage accounted for throughout the year, as well as instigating a cancellation policy.
• Limited capacity - therapists may be limited as to the number of clients they can see each week, depending on the amount of time they can rent their room and their personal availability.  Many therapists have another job to supplement their therapy income, so work part-time.  Also, to maintain ethical standards and good practice there is a limit as to how many clients can be safely worked with each day.
• Therapy tools - purchasing items to use in therapy, such as emotion cards, therapy stones, providing strategy/technique handouts, pens/paper/paints for clients to use as well as purchasing therapy and theory books to expand knowledge and use as references can be quite a costly business.
• Self-care - therapists must maintain good mental health and wellbeing to facilitate effective support for others. Self-care is not only vital to maintain ethical therapy but is a requirement of professional regulatory bodies too. Self-care can be free of course, but may also involve costs of taking part in activities such as yoga, meditation classes, exercise classes, joining the gym etc.
• Personal therapy - sometimes therapists need therapy too!  They are only human and often have difficult times in their lives to navigate whilst providing therapy for others.  It is vital to maintain good mental health, to be able to support clients effectively, so therapists benefit from their own therapy and a space in which to explore their thoughts and issues.

After considering all of the above costs, therapists need to be left with enough disposable income to make employment as a therapist a viable form of income to support themselves and any responsibilities. Being a therapist is a responsible and demanding role but is also extremely rewarding and this is why therapists do what they do, despite all the challenges of running a sustainable practice.

So next time you wonder why therapists charge their fee, spare some thought as to what that fee covers and hopefully you will conclude it is a fair price for the service provided and money well spent on your mental health and wellbeing.

''It’s incredibly liberating to spend an hour talking to someone and not caring about what you sound like.

It’s about understanding myself.

Sometimes I’ll speak to my therapist for an hour a day. It’s become part of my routine.’’

Shakira - Music Artist

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