Why Therapy is so Expensive and how it’s Costing Both Clinicians and Clients
In today's world, mental health awareness is on the rise, and seeking therapy has become a crucial resource for countless individuals. However, the price of therapy often leaves people with lingering questions and concerns. To truly understand the impact of therapy costs, we need to delve into the multifaceted factors that contribute to these expenses and explore the systemic effects they have on both clinicians and clients. In this blog post, we'll unravel the mysteries surrounding the costs of therapy and shed light on the vital role therapists play in supporting mental health. We'll also discuss the Catch 22 situation that our society finds itself in as the demand for mental health services continues to surge.
1. Expensive Training: The Price of Expertise The journey to becoming a therapist is an expensive one, with little financial support available aside from student loans. Professionals in the psychology field obtain advanced degrees in psychology, counseling, or social work, with ongoing commitments to stay up-to-date with the latest therapeutic practices. Unfortunately, many individuals have to rely on student loans to fund their education. According to the APA, the median student debt for those with advanced degrees in psychology was a staggering $80,000 in 2013.
2. Limited Education Funding: When most folx decide to further their education they are often funded by the institution and work as teaching assistants in exchange. This often offsets the out-of-pocket costs for students. For some reason, the psychology profession has very few paid teaching assistant options, especially for clinical psychology degrees. Why this is, I’m not sure.
3. Poor Insurance Coverage: An Unfortunate Discrepancy Despite the rigorous training and education therapists undergo, insurance companies often fail to reimburse them fairly. Psychotherapy is consistently undervalued and paid at rates far below those of medical services. When therapists become in-network with insurance companies, they are typically paid an average of $80 per session, compared to the approximately $300 for a doctor's visit. This inequity in reimbursement rates places an unsustainable financial burden on therapists, leading 42% of them to offer only private pay options, which ultimately affects clients.
4. Caseload Caps: Balancing Quality and Quantity While increasing the number of clients might seem like a way to make therapy more affordable, it comes at a cost. The quality of care diminishes, and therapists risk burning out more quickly. SAMSA released their findings on addressing burnout in behavioral health providers and low caseloads were key indicators for prevention. Caseloads have to be capped, and session prices adjusted to cover the necessary costs. Margins in psychotherapy remain low, making it a challenging financial endeavor.
5. Customized Care and Techniques: Tailoring Therapy Therapists must customize their methods for each client, requiring them to possess an extensive toolkit of specialized skills and therapeutic techniques. This adaptability allows therapists to create personalized treatment plans, ensuring more effective care. Continued education is necessary even after receiving licensure, as therapy methods evolve, further contributing to costs.
6. Standards and Legal Obligations: Ensuring Quality Licensed therapists are held to the highest ethical and legal standards to protect clients' safety and confidentiality. This commitment entails continuous professional development, regular supervision, and meticulous record-keeping practices, all of which contribute to the quality of care.
7. Overhead and Practice Costs: The Business Side of Therapy Running a therapy practice involves various overhead costs, including electronic health records, administrative staff salaries, necessary equipment, insurance coverage, and marketing efforts.
8. Time-Intensive Commitment: A Wholehearted Investment Effective therapy requires a substantial investment of time, effort, and emotional energy from both therapists and clients. Sessions often span 45 to 60 minutes and may occur weekly or more frequently. Therapists also dedicate time outside of client meetings to stay informed and consult with other clinicians to ensure the quality of care. The Catch 22: Balancing Costs and Value The cost of psychology education is high, yet it is undervalued by insurance companies and employers of clinicians. Consumers, too, have a perceived cap on how much they should pay for therapy. This leads to several challenges:
For Therapists: Many therapists are forced to become business owners to attract private-paying clients, taking on roles like marketer, administrator, and chief financial officer. This added responsibility accelerates burnout.
For Clients: Therapy becomes more expensive for clients, often resulting in out-of-pocket expenses.
As awareness of mental health's importance grows, so does the demand for therapy services. However, therapists are grappling with business-related stressors, which can lead to burnout. They're exploring new income avenues outside of direct client care to make ends meet and seek reprieve from emotional burnout. While the surge in demand for mental health services is encouraging, the financial resources do not yet match it. As long as market rates for therapists remain low, it will be challenging to attract and retain mental health professionals, exacerbating the shortage of much-needed services. The cost of therapy is more than a simple financial equation; it's a reflection of the systemic complexities that therapists and clients navigate daily.
So we now find ourselves in a catch 22. As awareness of mental health's importance grows, so does the demand for therapy services. However, therapists are grappling with business-related stressors, which can lead to burnout. They're exploring new income avenues outside of direct client care to make ends meet and seek reprieve from emotional burnout. While the surge in demand for mental health services is encouraging, the financial resources do not yet match it. As long as market rates for therapists remain low, it will be challenging to attract and retain mental health professionals, exacerbating the shortage of much-needed services. However if rates sky-rocket the cost then falls on clients making services less accessible.
So what can we do? Honestly, I don’t know. This is an area that requires creative problem solving and input from all parties involved. We need to see each perspective with compassion and change our cultural perspective and value of mental health services as well.
Ultimately, the cost of therapy is more than a simple financial equation; it's a reflection of the systemic complexities that therapists and clients are burdened with the most.
References:
Phillips, L. (2023, August 15). A closer look at the mental health provider shortage. Counseling Today.
https://ct.counseling.org/2023/05/a-closer-look-at-the-mental-health-provider-shortage/
Clay, R. A. (2013). Crushed by debt? Psychology graduate students are graduating with huge student loan debts. APA and APAGS are working to help. gradPSYCH Magazine, 11.
Luona Lin, Assefa Meron, and Karen Stamm, PhDDate (April 1, 20231) The tremendous impact of the pandemic era pushed many practitioners to their limits. Vol. 54 No. 3
https://www.apa.org/monitor/2023/04/psychologists-covid-burnout
