• Finding a therapist can seem daunting – costs do vary, which can further complicate matters

  • Therapist Camilla Nicholls shares her knowledge and experience to help us navigate our way

  • If you are seeking a therapist, you can find one here


Whenever a friend consults me about starting therapy the second question after “How do I find a good therapist?” is usually “How much should I pay?”. It is a fair question. None of us like to feel we are being taken for a ride, but there is also the concern that lower fees may mean the therapist has less experience or is, simply, less good. It is not necessarily the case. Quite often the most experienced, most highly trained therapists charge the most reasonable fees. This could well be because they are psychoanalysts who traditionally charged a relatively affordable rate per session because they expected to work with a client (or in their case, patient) five times a week. If you compare this with a practitioner of cognitive behavioural therapy (CBT), who is likely to suggest on average six sessions, any discrepancy in fees is more readily understood.


If your therapist is the only one working in your town or village they may charge more than someone practising in North London where it is hard to swing a cat and not hit a therapist or three. 


Location can affect what a therapist charges. You may be asked to pay less in some rural or generally lower income areas, and more in city centres. However, if your therapist is the only one working in your town or village they may charge more than someone practising in North London where it is hard to swing a cat and not hit a therapist or three. Some therapists will tailor their fees to when a client wants to be seen, often charging more if an evening or weekend appointment is preferred.


Level of experience will, as in any profession, be significant – whether it be as a therapist or experience garnered from previous professions. Whether a therapist is actively involved in continued professional development (CPD), publishes papers, or speaks publicly, may also be reflected in what they charge.

Some clients seek the services of a specialist. I am a co-founder of the Counselling Company that is run by a group of therapists whose previous professions were all in the media, arts, design and fashion. We’re defined by our backgrounds, others foreground their current expertise working with eating disorders or sexual abuse for example and may have undertaken extensive additional training in these areas which could warrant higher fees.


 Most therapists try to accommodate students, unwaged and low paid clients although there may be more of a wait.

Whatever the fee listed in a directory, or on a therapist’s website, it is worth asking whether the practitioner has any spaces reserved for reduced fee clients. The answer is very often yes. It is a caring profession that is adapting to the steep decline in diverse mental health services provided by the NHS. Most therapists try to accommodate students, unwaged and low paid clients although there may be more of a wait.

Transparency about fees is more common than it used to be, and directories such as the new one launched by Welldoing.org helps with that. Some practitioners choose to charge a fixed fee whoever the person in front of them is and whatever they earn. Others prefer to use a sliding scale. As a guideline for assessing what an individual may pay per session, London group practice Number 42 is one of many practitioners who use a formula devised by the theorist Lacan: 1/1000th income plus £20 towards administration costs. So if your income is £20,000 the fee would be £40 per session.

One of their therapists, Jason Wright told me, ”We are a practice of experienced therapists across a range of therapeutic interventions. The question of fees is a complex one involving all sorts of political, social and psychological narratives. [...] people seeking therapy need to have an idea of what they are likely to be spending and we wanted some clarity on our website. Each therapist is still left to negotiate the actual fee with each client/patient taking into account their practice boundaries.”

All the practitioners I spoke to were alive to the responsibility involved in setting a fee. One said, “It is not the same as paying for a plumber to unblock a sink – though symbolically they’re not so different – as you don’t expect to see a plumber every week. The financial commitment can be quite considerable and this has to be respected by therapists when they come to discussing the fee.”


 Give consideration to what you feel your good mental health is worth personally.

My advice when it comes to deciding what you feel it is right to pay is: consider what you can afford to pay on a regular basis. Find out in the initial enquiry or consultation what you are letting yourself in for; whether it is short-term work – likely to be six to 12 sessions – or open-ended which could last months or years. Give consideration to what you feel your good mental health is worth personally, and perhaps professionally too, and what value you put on the experience and training of the practitioner with whom you choose to work. Don’t be afraid to ask if a therapist will offer a reduced fee if your circumstances would otherwise prevent you from seeking help, or if your circumstances change during the time you’re in treatment. Think too about how you’ll feel if your therapist charges for missed sessions as many therapists do.


Further reading

What is therapy?

Starting psychotherapy was the best decision I ever made

The differences between face-to-face therapy and online therapy

Starting online therapy due to coronavirus? Here's my online therapist daily checklist