Starting Therapy 101: What are your options for investing in therapy?

by Zencare Team

Like any place you intentionally put your time, attention, and resources, therapy is an investment. And in more ways than one: the work that happens in session is often challenging, and can require a significant dedication of mental and emotional energy.

It can also be very expensive.

Below, we’ll walk through a few of the options to pay for therapy and how to make the cost of sessions more accessible. Before that, though, it might be helpful to understand why and how others have made the decision; below is a story from one of our team members on how they navigated this decision at various points in their life.

What investing in therapy means to me

“When I first started therapy, budget was my absolute top priority: my therapist simply had to take my health insurance. And given my in-between-jobs insurance situation, I found myself with one local therapist to choose by default. I’m grateful to have had the space to go to therapy at all, but I don’t know that I got much out of it. While sessions were effectively free, I think that also affected my level of investment in the work itself. I showed up each week and saw the therapist I’d been assigned to, but I can’t say my life was very different because of it.

When I moved to NYC, I realized that to find a therapist I would connect with, I had to look out-of-network. Now, aside from rent, therapy is my biggest monthly expense. It is an enormous privilege to be able to make that decision, and it doesn’t come without sacrificing in other areas of my budget.

But in addition to having the freedom to choose my therapist, I believe paying out of pocket has fundamentally changed my experience of therapy itself. Because I’m investing so much, I take the work really seriously, and I build my week around session. I am extremely motivated to make progress, to feel better, and to not incur this expense unendingly or without concrete results.

It’s placing a literal value on the work my therapist and I do in session, and I am extremely thankful for it.”

Cost of therapy basics

Here are a few basics to know about the cost of therapy and your options.

1. Therapy is least expensive when you see a therapist who is in-network with your insurance.

Most copays, or the amount you pay per session to see an in-network therapist, fall between $25 - $50 after the deductible. However, for folks who live in a major city, it can be difficult to find an in-network therapist who is accepting new clients. In major cities like NYC and Los Angeles, 80% of therapists in private practice don’t take insurance: this can make the demand for in-network care overwhelming, leaving you with a potentially long wait to start sessions and little choice in who you’ll ultimately see.

2. If you are financially able, looking beyond your insurance to out-of-network therapists can significantly expand your options.

The average session fee in large cities hovers around $175/session, and higher for specialized and experienced providers. It’s a lot to wrap your mind around, and out of reach for many; before you rule this option out though, here are two potential paths worth exploring:

  • If you have a PPO or EPO insurance plan, you likely have what’s known as “out-of-network benefits.” This is when your insurance company reimburses you for seeing an out-of-network therapist: especially for student health plans or corporate health plans with good out-of-network benefits, the ultimate amount you pay after the reimbursement can be fairly comparable to in-network therapists. For example, if you have a 25% coinsurance, you can see a provider who charges $200/session and only pay $50 after reimbursement.
  • Sliding scale: Many therapists offer a sliding scale — a rate that is lower than their typical fee — to folks who would otherwise be unable to access therapy. You can always ask what’s possible given your circumstances; just know that sliding scales slots are typically limited, and you’re more likely to find flexibility during times that are less in-demand, like daytime sessions.

3. Budget for frequency of sessions

Note that when you first begin seeing a therapist, they will likely require you to schedule sessions at least once per week to establish a strong relationship before later decreasing session frequency. So, as you consider your therapy budget, factor the cost of four sessions into your monthly expenses.

Whatever your therapy budget, think of the time you invest in yourself through therapy as having a ripple effect. It would be enough if it were just a drop of self-assuredness, a sprinkle of peace in a chaotic world; but the impact of therapy can reach beyond your emotional state to improve your relationships with others, success at finding and climbing upwards in a meaningful career, and connection to a larger community and sense of purpose. You can’t buy happiness, but you can invest in and commit to doing the work in excellent therapy!