If your first reaction to thinking about therapy is mentally checking your bank account, you're not alone. The reality is that therapy can be expensive, and the cost is a barrier to access for many. A 2020 survey on mental health found that 58% of participants worry about how much they have to pay for their treatment and medication. 43% admitted to skipping appointments to save money. 

Therapy isn't the type of thing you want to start and not follow through with, especially in times of crisis. Thankfully, affordable and effective treatment is available. There are therapy options at every price, from sliding scale payments to online alternatives. 

How much does therapy cost?

Therapy can get expensive; there's no sugar-coating it. According to the Market Intelligence Report, national spending on mental health services in 2019 was $225.1 billion. Access to mental health resources has improved over the years, especially with the 2008 Mental Health Parity and Addiction Equity Act which ensures that health insurance companies can't make coverage for mental health resources more restrictive than for physical health. However, that's only one part of the puzzle; it doesn't force providers to accept your insurance. Many therapists and services don't take health insurance. 

There isn't an easy answer for how much therapy will cost you. The price varies depending on where you live, who you see and your insurance. But we can give you a rough idea of what to expect. Without insurance, traditional therapy can cost anywhere from $100 to $200 per session, depending on your diagnosis and treatment. How long your session is will also influence the final price.

Most online therapy services -- like BetterHelp and TalkSpace -- cost around $60 to $90 per session. Some platforms cost more or less, depending on the features they offer. For example, if you have access to medication management with a psychiatrist, you should expect to pay more. If your plan only includes messaging with a therapist, that could cost less.

Factors that influence the cost of therapy

At this point, I know what you're thinking: Why does therapy cost so much? The cost of therapy depends on several factors, including the therapist's expertise and location. 

• Financial standing: Your income can influence how much you pay for your sessions. Some therapists or online therapy platforms offer financial assistance to those who need it. How flexible the price will be depends on your therapist or online therapy service. Even if you're not sure if you qualify, it's worth asking what financial assistance is available. 
• Your therapist's expertise: Therapists with additional degrees or extensive training and experience will likely be more expensive than newer therapists. That is also true for highly specialized therapists. The more specialized the therapy you need, the more you should expect to pay. 
• Your location: Where you live will impact how much you pay for therapy. We know it seems unfair, but it all comes down to the cost of living in your area. The more your therapist pays for office space and utilities, the more your sessions will cost. 

How to pay for therapy

Determine if your insurance covers the cost

The unfortunate truth is that just because you have insurance doesn't mean it'll be easy to find a therapist within your provider network. And if you do find a therapist that accepts insurance, that doesn't mean they'll accept your insurance. 

A National Alliance of Mental Illness survey found that 33% of people had trouble finding a therapist who would accept their insurance, both in or out-of-network. Finding a psychiatrist is even more difficult. Only about 20% of mental health practitioners accept some form of insurance. Why do so few therapists and psychiatrists accept insurance? It's because there's a historically low rate for reimbursement. A 2019 analysis shows that trend continuing for mental health providers. 

All that said, insurance still can significantly bring down the cost of therapy. Talk with your insurance provider to ensure that therapy is covered under your plan. They will be able to tell you what percentage they cover and what your copays will be. Asking your primary care doctor for a referral for in-network mental health providers is a great place to start for finding a therapist. 

Ask about sliding scale therapy 

Some mental health providers avoid the hassle of filing insurance claims completely, meaning they don't accept insurance, even if you have it. To make up for this or to accommodate those without insurance, some therapists will offer sliding scale payments which base the amount you pay on your income and expenses. If you can afford to pay the full amount, then that is what you will pay. 

Note that sliding scale therapy is the same quality of care that you would get from a session you paid in full for. The sliding scale intends to make it more affordable, not give you only the help you can afford. Not all therapists will offer sliding scale payments, so it's important to ask them upfront about their payment flexibilities. 

Consider online therapy

Research shows that online cognitive behavioral therapy is as effective as seeing a therapist in person. Online therapy does allow for more flexibility in price thanks to the elimination of overhead costs like rent and utilities. 

There's a flexibility with online therapy that you don't get with in-office visits. You can sit on your couch and take your meeting. Or talk to your therapist through text or chat from anywhere. Online therapy takes the pressure off fitting a session into your busy schedule or eliminates the anxiety of working with someone face to face. 

Does free therapy exist? 

True free therapy is hard to find and often takes a fair amount of work -- including calls with your insurance company or research into local resources. Here are a few places you can start:

• Employee assistance programs: Some employers offer discounted counseling sessions. These programs won't always result in free sessions, but the prices are typically considerably lower. You can talk to your human resources department to find out your options. 
• Mental health organizations: There are a ton of resources and free therapy locators from mental health organizations like the National Alliance on Mental Illness or Substance Abuse and Mental Health Services Administration. They will help you find local resources. 
• Free mental health apps: While they are not a replacement for therapy, you can also use mental health apps daily to help your mental well-being and track your wellness journey. There are several free mental health apps available for download. 
• College resources: College or university-run mental health resources are available to students and staff. You can receive free or low-cost treatment sessions from students training to become mental health professionals. 

Too long; didn't read? 

Yes, therapy can get expensive, and the insurance struggles are hoops you shouldn't have to jump through. But that doesn't mean therapy is out of reach. Many therapists and online resources will tailor your treatment costs to your income. Don't be afraid to ask about pricing and insurance questions before you start working with a therapist. And don't mistake affordability as an indication of lower quality. You can get effective and helpful therapy within your budget. 

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.