Hidden Costs of Counseling

Session length:  Some people do not understand why they do not get a full hour in a counseling session.  The 10 minutes allowed between sessions allows the therapist time to transition between appointments.  This may include taking payment from the current client and writing up notes on the completed session.  The therapist may need a few minutes to prepare for the next session.  And don’t forget:  therapists are people too.  These few minutes allow time to grab a cup of coffee or a small bite to eat between sessions not to mention a bathroom break! Another thing many do not realize is the amount of time spent on the client outside of the session.  The therapist may do a case consult with peers (without revealing personal client information) or the therapist may do extensive reading/research in preparation of the client’s treatment plan and subsequent sessions.  For every one “hour” you pay for, there may be another hour you get for “free” behind the scenes. 

Degrees/Education:  A therapist is a licensed professional who has spent several years and many thousands of dollars pursuing higher education.  A therapist must obtain a Master’s degree or PhD from an accredited institution following completion of a Bachelor’s degree.  Upon graduation the therapist must pass an extensive national exam in order to obtain a temporary license.  While holding this temporary license the therapist-intern must complete 3,000 hours of supervised experience which includes meeting with an approved supervisor each week and paying regular fees for these sessions.  Internships take between 1 ½ to 5 years to complete.   A fully licensed therapist may have completed 8 or more years of higher education and supervision.   This is a significant investment of time and expense on the part of the therapist. 

Additional Training and Continuing Education:  Like many other professionals, all therapists must renew their licenses on a regular basis.  In order to keep their licenses active, up-to-date and to be eligible for renewal, therapists must complete a set number of approved educational courses each year.  These are referred to as Continuing Education Units or CEU’s.  CEU courses can be expensive and time-consuming.  Many courses cost several hundreds of dollars and may take several days to complete and the time spent in training is time spent away from seeing clients.  Additionally, many therapists go above and beyond the minimum requirements to obtain costly specialized training in order to be as proficient as possible.    

Overhead and other expenses:  The therapist must consider the costs of overhead, which are the general expenses incurred in doing business.  These costs include, but are not limited to rent, office furniture, utilities, office equipment, office supplies, and administrative staff.  Other costs include business cards, advertising, website/internet access, licensing fees, private practice insurance and taxes. 

Conclusion:  Hopefully, this has helped to clarify the hidden costs behind your counseling session so you may understand why therapists must charge the rates they charge.  After all the above expenses are paid, the therapist does not typically net the full fee paid by the client.  In the end, a therapist may earn an average of $30 to $60 per hour in real income.   When you consider that few therapists are able to see 40 full-fee clients per week (based on the average 40 hour work week) the therapist may not earn as much as it seems at first glance.   

Feel free to ask questions or discuss your concerns with me in regards to these expenses.