What does the therapy session fee pay for?
I have seen many a discussion about how mental health services should be affordable or free for everyone. I do believe that therapy is for everyone but, unfortunately, there are still obstacles to it being free and easily accessible.
Newly qualified therapists can find it hard to get a job in an organisation that has a salary. Many jobs for qualified counsellors are voluntary or underpaid. In order to make a living, many of us will have another job to supplement our income or have to spend more time and money on accreditation with certain professional bodies in order to get a job paying a liveable wage. And, so, a lot of us end up in private practice where we have to set our own fees and attract our own clients.
I have chosen to make a living from being a therapist (alongside other jobs) as it's something that I love to do. And so, I thought it might be useful to breakdown what therapists actually charge for - as it's not just the 50 minutes that you're in the room with them.
There are quite a few things that may be taken into consideration:
The nature of the job
There is obviously the time we spend with you in a session, which we have trained for. You are paying for our experience, knowledge, and ability to hold you as a client where you are right now in order to process feelings, emotions, thoughts, relationships and situations of old, present, and potential future.
Time spent doing admin
Being in private practice means that we have to do all of the work ourselves from start to finish. This means the admin such as spending time putting emails together, writing up notes after sessions, keeping a record of our diaries, completing any audits that may happen, writing letters, etc.
Disposable income and tax
We have to account for any tax that we may need to pay following a self-assessment at the end of the tax year, which also means keeping a record of our books or hiring an accountant. But, alongside this, we have to bear in mind a fee that will allow us to actually have disposable income after rent, food, bills, etc.
Professional body membership
It is voluntary to be under a professional body for counsellors, therapists, and psychotherapists. However, as these professions aren't currently regulated under UK law, being part of a professional body shows that you are being held to certain standards and have been trained to a certain level in order to practice. Fees vary depending on the body you choose, but there are certain requirements to carry out as part of being a paying member.
Continued professional development (CPD)
As part of a professional body membership, we have to carry out a certain amount of hours worth of CPD. For me, this is at least 30 hours. We have to keep logs of the CPD we have taken, what we have gained from this, and how we will use this knowledge going forward (more admin!).
On top of this, not all CPD is free and often asks for payment i.e. it can range from £0 - £500 or more. Yes, it is true that reading books, watching educational programmes, and listening to podcasts can be classed as CPD. However, not all of us learn well this way.
As part of the ethical frameworks the professional bodies have and to make sure we are working in the best interests of our clients, we have to undertake a certain amount of supervision for the number of clients we see i.e. the more clients, the more supervision will be needed. Not only do we have to pay our supervisors (who are also working privately), this also takes up a portion of our working time.
- Self-care - Whilst this doesn't necessarily seem relevant at first glance, self-care is actually part of the ethical framework we follow from the professional body membership. We need to be able to look after ourselves in order to provide support for others. This can be free, but it does also take up time from our weeks too.
- Travel and room fees - If you're seeing a therapist face to face, it is likely that they will have factored in the costs of travel and the hiring fee for the room into the session cost. This isn't always the case, as some therapists do work from home where they have a suitable space or many (myself included) are sticking with working online.
- Website and directory fees - As mentioned at the beginning, we have to attract our own clients in private therapy; marketing costs money! Some professional body memberships include their directory of counsellors within the membership, however, other more recognised bodies ask for an additional payment to be included in their directory.
- Additional reading around what you bring to sessions - Again this is more of a time consideration when factoring this in, however, we do keep clients in mind in between sessions and take it upon ourselves to do extra reading around what you're bringing to sessions so we can be as informed as possible. Reading might be to gain a greater understanding or it might be to look at different tools/techniques we can bring into the sessions.
- Holiday/sickness allowances - We are self-employed so, if we cancel sessions or take leave, we miss out on this money. As a result, many therapists do consider an estimated amount of time they might need off a year and factor this into their fees in order to cover the loss of intake. This also might be why many therapists ask for a percentage of the session fee for last-minute cancellations on the client's side.
- Capacity (number of clients seen in a week) - The number of clients we will want to see in a week is also a big consideration when looking at session fees.
- Our own therapy sessions to explore our own stuff - Most therapists will also still have their own therapy sessions so that we can explore our own 'stuff' in order to have a better awareness.
As you can tell, it can take a lot of thought and working out when looking at how much to charge for a session! Did any of this come as a surprise to you? If you're also a counsellor, is there anything you'd add?