Beyond the Session: What Goes Into a Therapist’s Cost Per Session

At an initial glance, therapy rates can seem high. With market averages that range from about $125–$175 per hour in the Tampa Bay area, it can seem like a little too much without understanding what all goes into it. For transparency’s sake, I’ll break down what kinds of factors go into a therapist's cost per session. Knowing what you’re paying for and why you might have to pay that much may also provide some peace of mind if you’re struggling to justify it or feel as though it’s unfair or exorbitant in some way.

For the sake of this discussion, the context will be that of a therapist in private practice and assumes that they either don’t take insurance—or that they don’t take the insurance you have. What follows is a look beyond the session: what goes into a therapist’s fee.

You’re paying for a master’s-level (minimum) educated therapist who has likely also received other advanced-level trainings and certifications. Becoming a licensed therapist in Florida (and most states, for that matter) is no small feat. It requires at least two years of graduate school, student internships, a licensure exam, and a minimum two-year post-graduation registration period that often requires paying for supervision, accruing at least 1,000 clinical hours, and working for little pay. The path to licensure requires a large investment of time and money—with many therapists being burdened with student loans that might range from $60,000 to $100,000 or more.

All the stuff between sessions: Although you pay for the 50–60 minutes, more goes into the therapy hour than time spent with clients. There is often prep time for sessions, treatment planning, post-session documentation, responding to emails/calls/texts, accounting, scheduling matters, consultation with peers, continuing education training to maintain licensure, and research. The average time spent per client each week might actually be closer to an hour and a half—and in some cases, more.

Overhead costs: Therapists in business for themselves often have overhead expenses that include initial startup costs, office leases, internet, scheduling software, secure and HIPAA-compliant telehealth platforms, business phone/email, required liability insurance, licensing fees, administrative help in some cases, accounting software, and other office needs such as computers and furniture.

The cost of not being able to bill for 40 hours per week: Many private practice therapists consider full-time to be something around 20–25 sessions per week. Although some can tolerate more, 25 is in many cases the high end in order to do all of the other stuff between sessions and not have to work more than the traditional 40 hours. 

No-show gaps and income variability: The business of therapy can be risky at times and unpredictable. It doesn’t offer some of the same protections as would be provided working as an employee for an employer. Even with a well-enforced cancellation policy that holds clients responsible for missed sessions, it’s hard to say what kinds of unpredictable emergencies might come up, who might cancel a session within the required timeframe, or how many clients will begin to wrap up their work. Additionally, there are seasonal fluctuations (often slower summers) and things like hurricanes to account for that might take a therapist out of work unexpectedly for a few days.

Lacking benefit packages: Therapists in private practice are not afforded things like PTO, health insurance, or sick time. This means it’s often necessary to pay several hundred dollars per month for high-deductible health coverage and to set money aside for time off or being out due to injury or illness.

Marketing: Being in the business of therapy requires establishing a presence in order to be found. This means needing to network, build a website, and create paid listings on therapist directories such as Psychology Today.

Sustainability: Working as a therapist can be emotionally taxing. Although some client work is harder than others, even the most rewarding work can demand a good amount of mental labor and focus. Therapists often set hours and determine rates based on what they know they need to take care of their own mental health and personal finances so that they are best equipped to show up for clients from the best possible emotional place. Burnout is real, and therapists working for less compensation than others often find themselves needing to see more clients—and can easily be consumed with their work, stressed out, and lacking any sort of balance in their life. It becomes all about others with little priority for self.

Contract splits: Therapists that are not solely in business for themselves—say, contractors who choose to provide services for an established counseling practice—have to pay the practice percentages that range from 50 percent to 30 percent of the hourly rate. The percentage they sacrifice goes directly to the business, which is responsible for many of the expenses listed above—although even contractors do have many of their own annual operating costs that group practices typically do not cover.

Final Thoughts

When you consider all that goes into therapy—years of education, hidden hours of work, business expenses, and the energy it takes to not just do the clinical work but also the business work—it becomes easier to understand why rates are set the way they are. Therapy—it’s more than a conversation. It’s a deeply personalized and professional service from someone who has put in the time and made commitments to your growth. Knowing what all goes into your investment might just help you feel more confident that the support you are receiving is valuable, worth it, and thoughtfully priced. When all time and labor investments are factored in, a good therapist with a full caseload can often do well-enough to feel fairly compensated and at least financially stable.  A fair rate helps ensure they can continue to show up fully, care deeply, and keep doing the work that supports others in thriving.

A Personal Thank You

I finish with a personal thank-you to all of my clients who have given me the opportunity to do the kind of work that I love. Without the investment in yourself, I wouldn’t be able to do this - and I’m grateful for that everyday.