Deciding to go to therapy is a huge decision that requires courage. So, when you see the fees associated with therapy, it’s hard not to feel dismay and dread.

You start to think….“You charge how much?”, “ An hour is actually 50 minutes?”, and “ You suggest I see you every week?” After some quick mental math, you may think to yourself, “I am in the wrong line of work. I should have been a therapist, and I would be rolling in dough!”. 

Believe me -you are not alone in having this line of thinking. In fact, that hourly rate creates tension for all parties involved (we know the financial realities of Canadians). 

So, let’s dive in and explore this exorbitant-sounding fee. 

First, there are two options for getting a psychotherapist; the publicly-funded route and the private route. Publicly-funded agencies provide OHIP-covered services, including mental health counselling. Or, you go to a private practitioner, where you pay out of pocket. For those with extended health benefits through their work, you may be reimbursed some (or all) of the fee. This would be similar to submitting a claim for a massage therapist or physiotherapist.

Therapists in private practice are, essentially, self-employed. So,  they have to bear the expense for all overhead costs. This can range from several hundreds to several thousands of dollars, per expense, annually.  

Here are some common costs and related amounts: 

• Office space rental: depending on if they are renting a single office, or space within a clinic, this could range between $500-$1000/month, or $6,000-$12,000/year.

• Professional insurance fees: Most private practitioners are required to have professional insurance, which ranges in coverage and amongst the varied professions, but typically costs between $500-$1,500/year.

• Professional  association fees: Here, I’ll disclose my fee as a member of the Ontario College of Social Workers and Social Service Workers, which is required for me to continue working in Ontario. $460/year

• Professional supervision: Even though psychotherapists are self-employed, it is best practice (read: ethical) to receive supervision/mentorship by another (typically more seasoned) practitioner. If scheduled bi-monthly, costs range from $900-$1,200/year

• Marketing/Electronic Records Storage: In this digital age, a website is a requirement for a psychotherapist to be found. Also, we need secure client record storage. Depending on the providers, this ranges between $700-$900/year. 

• Continuing professional education: It is a requirement of most regulatory bodies that therapists stay up-to-date and well-versed on the latest techniques, as well as keeping their established skill set sharp. Usually, the regulatory body sets out a minimum requirement for education hours.  Costs depend on the training, typically between $350-$750/year. 

• Vacation time, sick days, and parental leave: We only get paid for the attended sessions, therefore, any absence is unpaid (and actually results in loss of potential income. If the public sector pays between $30-$50/hour, just two weeks vacation and five sick days equals $3,375-$5,625/year.

The grand total costs of just the basics is $12,285 to $22, 435 per year. 

I’ve excluded the following, both for the sake of simplicity and my limited math skills:

• Preparation time and tasks outside of session: A therapist's work is not limited to the appointment. In addition to charting (as legally required), this can include  research, responding to emails/calls, writing unpaid reports’ communicating with physicians/family members,/partners of client,  finding appropriate referrals, among others. 

• Personal psychotherapy (not an official requirement, but recommended for optimal service competence and delivery to clients)

• Personal insurance fees (When self-employed, you must provide your own benefits. Also, paying into CPP, or other retirement programs, EI, etc.)

I hope this brief outline provides some insight into the rationale of psychotherapists’ fees. It’s an explanation, not an excuse. 

If finances are your main barrier to seeking therapy, please contact me to inquire about my sliding scale/reduced fee options. 

ALICIA