The Cost Of Therapy

Typically, psychotherapy is pretty expensive. This is because it has its roots in an aristocratic white social environment, and because it developed out of a western medical milieu where professional medical people held high status and commanded high fees. Nowadays, "psychotherapists" include medical doctors (psychiatrists), psychologists (PhD's, PsyD's, or EdD's), and Masters level practitioners including clinical social workers (MSW, LISW, LCSW, etc.), and clinical counselors (LPCC's, LCPC's, etc.).

The debate about the cost of therapy is never ending, and there does not seem to be any clear cut way of resolving the dilemma. I say" dilemma" because many people who would benefit from good therapy will never have the opportunity to do so because the cost of the service is out of their reach. This is no different in many cases from the costs of medical and health care in general in our current economic system and insurance/(obscenely) profit driven health care system.

So what to do? There are community "mental health" agencies that are supposed to pick up this slack, and make therapy (or more commonly, "counseling") available to the masses. The reality however is that these agencies are typically government funded, and we all know what happens to funding for all "non-essential" services as a general rule: it is, of course, drastically cut. This means that many of these community mental health agencies go out of business. The ones that remain spend most of their time and energy struggling to survive, to raise funds, to meet ever increasing paperwork demands, and to provide direct services to ever growing numbers of people. It is not uncommon, for example, for a therapist at such an agency to be expected to see 25-30 clients a week. Plus do all the paperwork involved. Plus attend meetings. This is not possible if it is also expected that the therapist will be able to remain healthy and to provide quality service.

Then there are the private practice therapists. If insurance is funding the service, it may also not be uncommon for a therapist to see 30 clients (or patients) a week. If insurance is not funding the service, this number is likely to be considerably lower. Still, we all know that there are millions of Americans who do not have health insurance, and so are left to fund therapy services out of pocket. This is where the high cost becomes problematic for many.

The dilemma is extended when you factor in the legitimate need of the therapist to be able to make a living. So what does "make a living" mean? Of course this is different for every person.
Is the British surgeon who makes a million dollars a year under the socialized health care system, and living very well, being deprived because she or he is not making the 2 million she would make in unregulated America? You see how this goes.

So it becomes a very personal moral, ethical, practical and spiritual consideration for each practitioner. How much do I charge for my services? What are my legitimate needs? What are the "customary and usual" fees in my community? Are these within my personally acceptable parameters? Are they too high? Too low?

To be continued......................





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