What is the cost of psychotherapy and counselling?

NB: This blog post is only about the circumstances in England.  Hence the prices are local, and expressed in pounds, and the institutional context, such as the NHS, is all English.  

In England there are big variations in the price paid for psychotherapy. Often the price does not correspond to what you get out of it. A lot depends on the reasons why you go to psychotherapy, whom you approach, and even how you approach them.

The cost of psychotherapy

Psychotherapy is priced by the hour, so what you pay for a complete “treatment” of psychotherapy is determined by the hourly fee, the duration of treatment. But you would also be interested in the effectiveness of what you got, and whether the “effect” of the therapy lasts, or the treatment needs to be repeated. To give a simple example: if you can choose between a therapist who costs £80 per (therapy) hour, and see them for 15 sessions, that sets you back £1,200. If you see someone weekly for two years at £40 per hour, that will be around £3,600, and it takes longer in time spent in therapy, and it takes a longer period of your life. So if these two therapists would give you the same “outcome”, you would probably prefer to go to the first.

The outcome of psychotherapy

But what is the effect, the outcome of psychotherapy? Probably (but not necessarily) the two therapists in my example work differently. If the 2-year period of work really gives you what you wanted, and the 15-session deal made you feel a bit better at the end of it, but wears off three months after the end, you may be better off with the longer period of therapy. If only at the end of the two years you come to the conclusion that you understand yourself better, but there were some practical things in your life you wanted to change, or have more control over, and they have not changed at all, you may feel bad about your choice - though many people who have been in therapy are very positive and appreciative about the self-insight they have acquired, and how it has changed the way they see themselves and others.

It simply is difficult to choose between different kinds of therapy, to make a budget, and to even express a preference for shorter or longer working. To make things worse, there is little relationship between the cost of a therapist and their skills or effectiveness level. That's true according to people who have tried to research this, and it's true even more because one important criterion for therapy effectiveness is the quality of the therapeutic relationship you have with your therapist.  And that is always at least partly, and perhaps largely, determined by individually tiny personal factors contributing to "fit" and "rapport".

Fees of psychotherapists in London

Let me now give you some numbers. In London, UK, there are ways in which you can get therapy for free, and there are private providers who charge over £200 / hour. Most private psychotherapists and counsellors have standard rates between £35 and £120 per hour. Some of them operate a true "sliding-scale", which means that the fee they charge you is completely dependent on your income; and that still for most people would contain them in the ranges I have given. The rest of England is not fundamentally different, though the higher ranges given here probably don’t apply.

I have written about the possibilities for free counselling in another blog, pointing out some of the opportunities and pitfalls. You need to sort out first if you want to use one of those ideas, in the NHS or a charitable organisation.

Are expensive therapists better?

What about the most common range between private therapists that I indicated, between £35 and £120 per (therapy) hour? I don’t think I can throw very much light on how to deal with that. I don’t think that the more you pay, the better the therapist. Some of the more expensive ones will have studied longer, have a wider range of methods at their disposal, may have a lot of experience, and have written books or acquired a great reputation as speaker. But none of this directly equates with effectiveness. Does this mean that you should simply go for the cheapest one you can find?  I don’t think so either; some therapists and counsellors may have ended up charging so little because they find it difficult to maintain clients. But there are many other reasons, too …, including a conviction to want to offer therapy at an affordable price.

Know why you want to have psychotherapy!

Overall it is not an easy choice. Good therapy, unless you “fit” into one of the free or very –low-cost categories, tends to cost a good deal of money. And ALL therapy costs a lot of time and energy, if you want results. That's where your motivation comes in.  To just do therapy for a "feel-good factor", or "in case it would help me feel better or make me happier" may not be enough for most people to justify the expense. You are likely to get good “value” out of psychotherapy if you have a really strong wish or need, or a burning or desperate problem. If that is the case, persevere and put real effort into your choice, because it often isn't easy to change plans and move from one therapist to another, and always costs you extra time. Working hard up front to select the best possible option for you individually, and your problems and issues, is really worth the effort!

This is an interesting article / interview with a London psychoanalyst, Anouchka Grose.

If you have any questions, please leave a comment, or drop me a line directly if you prefer.