Finding a Therapist Shouldn’t Feel Like Buying a Used Car

I have been thinking a lot lately about how weird it has gotten to figure out what therapy actually costs.

Finding a therapist is already difficult enough.

You are looking through websites trying to figure out who this person is, what kind of therapy they actually do, whether they understand what you are dealing with, whether you could imagine sitting in a room with them, whether they have an opening that works with your schedule and, somewhere in all of that, whether you can actually afford to keep seeing them.

Then you get to the price.

And sometimes I swear it starts to feel like buying a used car.

The listed price is $200.

But there is a sliding scale.

Great.

What is it?

Nobody knows.

Maybe you email. Maybe you schedule a consultation. Maybe eventually you find out there are a couple of appointments available at $175.

So technically there is a sliding scale.

I don’t know. That whole process feels strange to me.

Therapy costs money. I get it.

Before anybody gets mad at me, I am a therapist who owns a private practice.

I am very aware that running a therapy practice costs money.

There is rent. Electronic health records. Insurance. Licensing. Training. Continuing education. Consultation. Software. Taxes. All of the administrative work we do that nobody is directly paying us for. Don’t forget how much it costs to just get a Master’s degree! Student Loans…Ugh

And therapists should make a living.

I absolutely do not believe therapists should work for nothing because they chose a helping profession. Therapists should be able to pay their bills, take vacations, raise families, get sick, retire someday and generally have a life.

So this isn’t really about whether a therapist should charge $125 or $175 or $225.

It is more about this:

Can we just tell people what things cost?

The sliding-scale thing gets weird.

I understand the idea behind a sliding scale.

You want to make therapy available to more people. Great. I am completely on board with that.

But “sliding scale available” has become one of those phrases that can mean almost anything.

Is there an actual scale?

Are there two reduced-fee spots?

Do I need to tell you my income?

Do we negotiate?

Is the regular fee $200 and the sliding-scale fee $180?

Do I have to schedule a consultation before anybody will tell me?

And now the person who is already trying to work up the nerve to go to therapy has to basically say:

“Hi. I would like some help, and also I can’t afford you. What do I need to tell you to prove that?”

That’s not exactly my favorite way to start a therapeutic relationship.

Especially because money already carries so much shame for people.

I would rather you just know.

At The Therapeutic Workshop, our standard individual therapy rate is $125.

That’s the price.

We are private pay. We don’t bill insurance directly. Some people can use out-of-network benefits and get reimbursed by their insurance company, and we can provide the documentation for that.

But we aren’t going to make you get halfway through the process before telling you what therapy costs.

And $125 isn’t affordable for everybody.

I know that.

Private-pay therapy isn’t going to work for everybody either.

I know that too.

But I would rather have somebody look at our website and say, “Okay, I can make that work,” or “Nope, that’s not going to work for me,” than make them jump through a bunch of hoops before they can make that decision.

There is something respectful about giving people enough information to make their own choices.

Expensive therapy isn’t automatically better therapy.

This is another part of this whole thing that gets weird.

If one therapist charges $125 and another therapist charges $225, I think there can be this assumption that the $225 therapist must somehow be considerably better.

Maybe.

Maybe not.

There are all kinds of reasons therapists set their rates where they do.

Experience can be part of it. Specialized training can be part of it.

So can rent.

So can location.

So can demand.

So can wanting to see fewer clients every week.

And sometimes the answer is simply: That’s what they decided to charge.

There isn’t a therapeutic Kelley Blue Book somewhere telling us what a particular therapist is worth.

And price doesn’t tell you whether you are actually going to connect with that person.

It doesn’t tell you whether you are going to feel understood.

It doesn’t tell you whether the way they practice therapy is going to work for you.

It doesn’t tell you whether six months from now you’re going to think, “This has actually made a difference in my life.”

The relationship matters.

Experience matters.

Training matters.

Fit matters.

Price certainly matters.

But price and quality aren’t the same thing.

Because you’re not buying one session.

This is probably the biggest thing for me.

When someone says therapy costs $150 or $200 or whatever the number is, we sometimes talk about it like somebody is making one purchase.

Most people aren’t buying one therapy session.

If therapy is actually going to be part of your life for a while, you are asking:

Can I afford this next week?

Can I afford it the week after that?

Can I afford it for three months?

Six months?

A year?

That $25 or $50 difference per session gets pretty significant when you start multiplying it out.

Which is why I don’t think conversations about therapy pricing are somehow beneath the therapy.

Money is part of people’s lives.

Financial stress is part of people’s lives.

Being able to sustainably continue therapy is part of therapy.

We should be able to talk about it.

Ask what it costs.

If you are looking for a therapist, ask.

What is your fee?

What does “sliding scale” actually mean?

Do you have reduced-fee spots?

Do you provide superbills?

Are there different costs for intakes, groups or longer sessions?

How frequently do you usually meet with people?

These are completely reasonable questions.

You aren’t being difficult.

You aren’t being cheap.

You are trying to figure out whether you can realistically make this work.

And I think therapists should be able to give you clear answers.

Finding a therapist is weird enough already.

This is such a strange service to shop for in the first place.

You are trying to find a person you may eventually tell things that you have never told anyone else.

You are trying to decide whether this stranger feels safe enough, understands you enough and knows enough to help you with something that may be incredibly important in your life.

That is already a lot.

There are going to be different ways therapists handle pricing. Some take insurance. Some are private pay. Some have actual sliding scales. Some reserve lower-cost spaces. Some have interns or groups that make therapy more accessible.

That’s all fine.

I don’t think there needs to be one correct way to do it.

I just think you should be able to understand what you’re buying and what it is going to cost before you’re emotionally invested in buying it.

Finding a therapist is already vulnerable enough.

It shouldn’t also feel like you’re walking onto a used-car lot and waiting for somebody to go talk to their manager.