Recently a client and I were discussing their frustrations with the cost of another mental health provider. As we talked it became clear that the client was interpreting the provider’s fee as a sign that the provider was greedy and not invested in the client’s well-being.

I decided to be unusually candid about the high cost of running a private practice because I could see how much it hurt this client to feel that greed was tainting their relationship. I’ve decided to share this information today to demystify the financial realities of therapy.

The first thing to keep in mind is that therapists are paid for the time spent with clients, not for time spent on administrative duties or when sessions are cancelled with advanced notice and fees are not charged. So each session you attend, your fee is paying for:

• Office rent

• Office utilities and internet

• Initial cost of furniture and any necessary upgrades

• Cleaning services

• Office supplies

• Health insurance

• Malpractice insurance

• Liability insurance

• Accounting services

• Bookkeeping software

• Attorney fees for managing a private practice corporation

• Marketing costs, including website fees and the cost of advertising in Psychology Today’s Therapist Finder

• Monthly fees for an electronic health record system

• Credit card processing fees

• Corporate taxes on city, state, and federal levels

• Payroll taxes

• Continuing education classes required for maintaining a license

• Biannual license renewal fees

• Student loans (five years worth of graduate school for psychologists)

• Salary

• Sick days

• Vacation days

• Maternity leave

• Retirement

If you choose to see a therapist in a clinic, many of the above costs are shared and therefore tend to be reduced, which is one of the reasons clinics tend to be cheaper.

I believe everyone is entitled to receive solid therapeutic care. Unfortunately sometimes the financial realities of a therapist’s personal and business needs do not fit with a potential client’s financial realities. I do my best to accommodate where I can, but if we aren’t able to work together for financial reasons, please know it’s not because of a lack of caring.

We all have our needs.