As a therapist setting your ‘price point’ can be a tough. Us therapists tend to be an altruistic bunch. We come into this profession to help and support people, we tend to give a lot, but why, oh why do we then charge so much?
I’ll let you into a secret – the worst part of my job is answering the ‘what are your fees?’ question. But here’s the thing, you aren’t just paying for the time you are with the therapist, you are paying for so much more. You’re paying for their expertise, knowledge, understanding and research.
Breaking this down, what is it you are really paying for? How come it costs so much to get the support you need and what help can you get?
A therapist’s training
Depending on the type of therapeutic support you are accessing, your therapist will have accessed training of varying lengths. For some, such as Cognitive Behavioural Therapy, this training is shorter than for play therapy or psychotherapy for example, which usually take over 4 years. These trainings come with a requirement for a certain number of therapeutic hours – around 200 – which your therapist will have been closely monitored and assessed on. You are paying for this expertise, this brain power.
A therapist training is never done. They should have requirements for Continual Professional Development (CPD) to maintain their registration and up to date practice. They will often pick up a book or do a ‘quick’ Google search (which inevitably turns into hours), looking for literature to support their practice. You are paying to access this knowledge and understanding.
The therapist’s training will have taught them how to work with different people, different presenting problems and to adapt. You are paying for them to work with you, providing the support you need and for them to help you come to resolve in your difficulties. You’re paying for their expertise, their understanding and knowledge.
A therapeutic hour
A therapeutic hour, which, by the way, isn’t even an hour! This is the specific time you are with the therapist. The time for you with them. Depending on the type of therapy you are looking to access, this could be anything from 40-60 minutes. As a play therapist, my sessions are usually 40 minutes with individuals and 50 with groups; with some clients this is actually 30 minutes. Any longer and I will have lost the focus of my client and their engagement in the session. Some weeks they may manage longer, but therapy should be consistent and so we have to set a time limit somewhere. You’re paying for this time.
Your therapist will use time either side of your session to make notes that they need to keep, perhaps refresh themselves of the progress you have made thus far (although this is often stuck in their mind, because your therapist remembers you!).
Why does therapy last so long?
As a therapist, the second worst part of my job, after answering how much a session costs, is answering the question; ‘how many sessions will I need’. In truth, the answer to this is unanswerable from the outset; how long is a piece of string? It depends on a lot of factors and the type of therapy you are accessing. On average, children engage in around 16 sessions of play therapy – but I have worked with children who have had 9 sessions and others who have had over 50 – it really depends on the need. And yes, this does come with a cost. Initially when I start working with children I will suggest 8-12 sessions and review from around week 6 depending on their need. Therapy should work at the pace of the client. If therapy moves too quickly, the client may disengage from sessions and need to start again to support their processing. Therapy should not be rushed; even if this does come with a price tag.
Supervision
Before you start seeing a therapist, ensure they have supervision. This, in my opinion, is a vital part of being a therapist and ensuring best practice. Supervision is where your therapist will see a supervisor who has had additional training to support your therapist. They are most often therapists themselves too. Supervision allows your therapist to discuss their practice, their responses and the way in which they are working with their client base. Supervision ensures practice is overseen in some way, so questions can be asked, techniques and tools suggested and matters to be see from a ‘third party’ to ensure you receive the best therapy your therapist can offer.
This does mean that sometimes there will be discussion in relation to you. But, the reason for this is to look at the therapist’s practice and not your difficulties.
Supervision should happen frequently and comes with a price tag too – a cost that adds to the cost of therapy.
Registration
A must before starting to work with a therapist is to check they are registered with an appropriate body. There are a lot of registration bodies out there. I suggest ensuring the registration body is registered themselves with the Professional Standards Authority. The PSA regulate professions not regulated by law; a lot of therapeutic support falls into this category. This registration comes with a cost. Hence, part of the expense of therapy. Those not with a registered body, may be cheaper, but they are unregulated.
The admin
As with all roles working with others, there is an administration side to things. Keeping client files up to date is vital. Your therapist may also need to book and pay for the space in which they see you, send invoices for your sessions, all of which are essential to making your sessions happen.
When working with children there are also calls to be made. Checking in with parents, carers, teachers, social workers, the list goes on. This is not a weekly ‘to-do’ but one that has to take place to ensure appropriate support is offered to a child.
Then there is the insurance, disclosure and barring checks, professional registrations that all have to be in place to ensure you can see your therapist safely.
Brain space
This might seem an odd one. Think about renting a drawer in a filing cabinet for the rest of time. Once you see a therapist, you will be stored in their memory. They will think about you between sessions, read things to support their work with you, and once your therapy has finished, they will still think of you from time to time. They will wonder about you a long time after your time with them has come to a close. Whilst this isn’t a service you are paying for, its worth keeping in mind how you will be in their mind for years to come.
How can I get help with the cost?
Putting it all together, therapy costs so much because you are not only paying for the therapist’s time. You are paying for their understanding, their empathy, their knowledge, their learning and all the admin bits that go along with it. Charging clients for their sessions is a tough part of the job and a lot of therapists find this part a difficult one. If, for whatever reason you are struggling to meet the costs of your support or support for your child, speak to your therapist about this before terminating the sessions. They may know of a way to access support with paying for the sessions. Turn2Us is a great website for looking for various grants that may be given to support with emotional health needs. There are of course free therapy routes through the NHS (speak with your GP) and charitable organisations such as Childline so be sure to look into these options too. Additionally if your child has an Education Health and Care Plan (EHCP) therapy can sometimes be included in the funding from this and for children who are placed on Special Guardianship Orders (SGO) or adopted, there is the Adoption Support Fund – speak with your social worker or local authority.
In a nutshell, you may be paying a lot of money for the therapeutic support you are receiving; but if it is the right support and the right fit of a therapist, this cost will be invaluable moving forward. This could just be the cost that changes things for you, for the better. It might just save your life.
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