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Why is Therapy So Expensive?

A common question amongst a lot of people is why is psychotherapy so expensive (and how much do therapists make?)?

In this blog post we hope to share some helpful information and shed light on the behind the scenes process and reasoning for the seemingly high fees charged for therapy sessions.

1. Psychotherapy is a Regulated Profession

In Ontario, psychotherapy is a regulated profession just like dentistry, nursing and many other healthcare professions. A regulated profession requires a body or “college” to create, maintain and enforce a set of practice standards for their registrants. This means that all Psychotherapists must achieve a high level of education, pass a registration examination, practice under supervision (until qualified), maintain ongoing education, and practice under a set of guidelines called a controlled act. In addition, they must pay annual registration fees. The regulatory body can monitor and reprimand psychotherapists where needed to ensure consistency and the highest level of care for all clients. One thing the regulatory body does not mandate is the fee the therapist may charge for sessions (which is why therapists have wildly different rates).

In Ontario, the regulatory body for psychotherapists is the CRPO (College of Registered Psychotherapists of Ontario).

2. Psychotherapist Must Obtain and Maintain a High Level of Education

Let’s break this down a little further. Psychotherapists are required to have a bachelor’s degree (typically 4 years) and a postgraduate degree (typically 3 years) before applying for registration. That’s 7 years of education prior to even seeing their first client. Once they are in the field they must participate in ongoing education (also referred to as professional development). Therapists who specialize in a specific disorder or client population will also have additional years of training and certification.

3.Being a Psychotherapist Takes a Toll on Your Body and Mind

Now let’s look at what is required of a therapist when they are in practice. Did you know that one hour of therapy is approximately equal to four hours of administrative work when it comes to measuring energy expended? Therapists are required to be emotionally and physically in tune to their clients in session. That means whatever is happening in the background or in their personal lives, whatever stressors they have from previous client sessions have to be checked at the door. You are the only thing that can matter during your session. Given the demand of the therapeutic hour, many therapists must limit their caseloads in order to practice safely and effectively.

4. What Does An Hourly Rate Cover?

Let’s also not forget that therapy is not covered by OHIP or other funding programs. If a client has private insurance, it’s often not enough to cover the full cost of the session. This means if a therapist lowers their rate, they are the ones affected. The hourly rate that a client is charged not only has to cover the therapist’s time, it has to cover the administration fees, if the therapist has an office space (and the city they’re located in will greatly affect this), marketing fees, etc. Typically the therapist will take home only half of what the session charge is.

Therapists determine their session fees based on all the factors mentioned above and a few more; how much does it take to run their practice; how much money do they need to live; how much student loan debt do they have; how much do their annual certifications cost; if they need to practice under supervision, how much does supervision cost?

5. What Does a Therapist Actually Make?

The yearly salary of a psychotherapist depends largely on whether they work in a private practice or a clinic setting. The average hourly rate is estimated to be about $43.00, with an annual gross salary of about $70,000. Compared to other professionals who require the same level of education, a psychotherapist’s annual salary is quite low.

As therapists, we too participate in therapy and we are keenly aware that therapy can be cost-prohibitive. At the Journey, our motto is anyone who needs therapy, has therapy regardless of the cost. We’ve worked hard to create an Affordable Therapy Program to allow people to access therapy at a range of rates that can fit their budget. While we would like to provide ‘affordable therapy’ to everyone, our program is reserved for those who have lower incomes, higher family expenses, and little or no private insurance coverage. We strive to do our best to accommodate every request, while prioritizing need.


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