According to the National Institute of Mental Health (NIMH), therapy is a treatment technique that "aims to help a person identify and change troubling emotions, thoughts and behaviors." A variety of therapy modalities, including art therapy, talk therapy, hypnotherapy, cognitive behavioral therapy, and others, help people with anxiety or stress, depression, anger management, life improvement goals, specific fears or phobias, addictions, weight loss, and other issues. Therapy is typically provided by a mental health professional who has undergone years of training for specific mental health services. Traditionally, therapy takes place in a mental health professional's or therapist's office with talk being the basis of the session, although many providers also offer online therapy sessions as well. Several factors affect the average cost of therapy.
Types of therapists
The NIMH recommends that individuals find a therapist who specializes in their area of need. Some needs are situational, such as divorce, the death of loved one or a major life change. Professional therapists offer support to individuals and families transitioning through these kinds of changes. Some people need or want ongoing professional support in dealing with specific mental health care issues such as clinical depression or bipolar disorder. Other therapists focus on working with young children and teenagers.
The patient's medical diagnosis or personal area of need should guide them in choosing the right type of therapist — and there are many different types.
Psychologists have an advanced degree in psychology — although not medical doctors, they often have a Ph.D. — and may conduct research as well as work with patients. They usually work to diagnose mental disorders in their clients and determine the best treatment plans, often working alongside a patient's psychiatrist or other doctors. Psychologists cannot prescribe medicine, but they may collaborate with doctors to identify the best medications for specific mental disorders and chronic behavioral problems.
Psychiatrists are medical doctors who specialize in mental health, including substance use disorders. They are qualified to assess both the mental and physical aspects of psychological problems, and they can diagnose and treat mental, emotional and behavioral disorders by ordering a full panel of laboratory and psychological tests and prescribing mental health medications. Psychiatrists help patients with a variety of mental health issues, including chronic problems like clinical depression and anxiety as well as sudden issues, including panic attacks, hallucinations and suicidal thoughts. They often work with a client's care team of doctors, psychologists and counselors to develop a treatment plan.
Psychoanalysis is a modern form of psychotherapy that can help patients with long-term psychological problems. Psychoanalysts help people dig deep into problems that stem from their childhood, usually regarding distorted ways of thinking about themselves, the world or their relationships with other people, rather than guide them through short-term problems brought on by a specific life stressor, such as divorce.
Licensed professional counselors (LPCs) are therapists who specialize in talk therapy for individual patients, couples seeking marriage counseling, or families who need group therapy. Counselors will talk to clients often about anything troubling them, whether a mental disorder or general unhappiness. They establish trust with their patients so that they can discuss their problems and suggest solutions or additional treatment plans. Counselors generally do not hold advanced degrees, but are trained to recognize mental illness and can suggest treatment by a psychiatrist if necessary.
Marriage and family therapists
Marriage and family therapists (MFTs) are similar to LPCs in that they typically offer talk therapy, problem analysis and possible solutions. However, their focus is on the dynamics of marriage in a couple or the dynamics of a family. Some sessions include both members of the couple, while others are conducted one-on-one with each person to lead them toward better communication skills, a clearer understanding of what they need from their relationship, or improved parenting techniques.
Therapists who are also licensed psychiatrists can prescribe medication for mental health needs, but therapy is not reliant on medication. Most people engage in therapy to improve their well-being by creating shifts in thought patterns and behaviors. People can work with a therapist regardless of whether they have insurance, and some therapists offer sliding-scale rates for patients with financial hardships.
Therapists' rates vary, depending on their training and experience, geographic location, and other factors. In general, the more highly educated the therapist, the more they charge — a psychiatrist who can prescribe or manage medications, for example, may charge as much as $400 for one 45-minute session. In contrast, an MFT is likely to charge an average of $100 for each session.
The biggest cost variable, though, is the patient's insurance coverage. Some therapists participate in insurance networks, so the patient may only pay a $25-$50 copay. Others opt not to take insurance — filing an insurance claim requires making a diagnosis, and some therapists aren't willing to make a diagnosis just to work with an insurance company. Some insurance providers allow their subscribers to pay out of pocket, then submit their receipts for reimbursement for out-of-network therapists; it's wise to verify mental health insurance coverage before choosing an out-of-network therapist.
Many therapists incorporate more than one type of therapy approach, often with cognitive behavioral therapy as the base. It's a good idea to research a prospective therapist to learn about their specialties, training and other background to find the best fit. Here are a few cost examples for the average price of individual therapy sessions:
- John Nichols, Psychotherapist, MS, LPC/MHSP in Brentwood, Tennessee: $125
- WholeStar Therapy in Denver, Colorado: $90
- Cat Russell MS, LPC in Corpus Christi, Texas: $60
Couples therapy, or marriage counseling, provides support and solutions for relationships in crisis as well as for relationships that are thriving and doing well. Some couples choose relationship counseling to strengthen an already strong foundation. Some may be suffering and considering a divorce, in which case outside support may help. In couples therapy, the relationship itself is the client, not one person or the other. MFTs observe the ways people behave in a couple, or in their family, and help identify problems with the relationship; they then work with the couple to create a treatment plan that helps both parties get their needs met. Ideally, the MFT helps the couple or family function better as a happy family unit.
For example, Cat Russell MS, LPC helps couples identify and deal with the underlying issues that drive the actions, thoughts and even feelings that may be causing harm to the relationship. She aids with communication, problem-solving and conflict resolution. Here are some examples of couples therapy costs:
- WholeStar Therapy: $120 for a 60-minute session
- Joan Warren Therapy in New York, New York: $150 for a 60-minute session
A big variable in the cost of mental health therapy is your health insurance provider. Some insurance providers offer generous mental health coverage, while others require you to pay for most of it out of pocket or will only reimburse you for certain types of mental health professionals. Check with your insurance provider to find out what's covered by your insurance plan.
Some therapists offer concentrated programs to address specific issues such as anger, weight loss, smoking cessation or grief. Sometimes these programs are offered as a series of sessions in one package, with reduced per-session rates when the package is purchased. Package sessions give therapists ongoing intensive time to help clients resolve issues that are holding them back. Joan Warren Therapy, for example, offers an eight-week anger management counseling course for $800. Standard therapy sessions from Joan Warren Therapy are $125, on average, so this package offers a $200 discount.
Sliding scale fees
Many therapists offer sliding-scale pricing for their sessions. A sliding scale is usually determined by financial need — clients who are able to demonstrate their income may qualify for lower rates. Not all therapists advertise sliding-scale rates, even when they offer them, so it's always a good idea to ask if this is an option. Yasmina Mobarek in Seattle, Washington, charges $50-$120 per session, depending on her clients' needs. Dr. Mobarek focuses on a psychoanalytic approach to therapy, and her specialties include marital and premarital counseling, depression, trauma, and post-traumatic stress disorder (PTSD).
When to get help
The National Institute for Mental Health recommends seeking help if you are experiencing overwhelming sadness or helplessness that doesn't go away, serious or unusual insomnia, sleeping too much, difficulty focusing on work or carrying out everyday activities, constant worry and anxiety, excessive drinking or drug use, harmful behavior toward yourself or others, or dealing with a difficult transition (such as divorce, children leaving home, job difficulties or the death of someone close). If children have behavioral problems that interfere with school, family or peers, it's also helpful to seek professional help from a therapist for the child as well as for yourself.
- Take advantage of the free or low-cost initial consultation that a therapist may offer before diving in. These allow you to get to know the therapist and vice versa before spending the money or engaging for a longer amount of time, recommends John Nichols, Psychotherapist.