"Why Is Private Therapy So Expensive?" - A Transparent Look at Where Your Money Goes

Deborah Gillard
May 23
4 min read

If you’ve ever looked at the cost of private therapy and wondered why it’s often £50–£90 (or more) per session, you’re not alone. Many people ask this, especially when they’re struggling and trying to find the right support.

As a practicing therapist in the UK, I want to break down where your money actually goes...

"Why Is Private Therapy So Expensive?" A Transparent Look at Where Your Money Goes written by Deborah Gillard, therapist in Dundee, UK

The Cost of Becoming (and Staying) a Therapist

Becoming a therapist isn’t a quick or cheap path. It takes years of academic study, clinical placements, regular supervision and personal therapy. So far, I’ve invested over £25,000 in training, and I aim to continue to train in areas like psychosexual therapy and walk-and-talk therapy.

During training, therapists are expected to complete hundreds of hours of client work, almost always unpaid. Many of us (myself included) balance unpaid placements with part-time or full-time jobs to make ends meet. This often leads to burnout before a therapist is even fully qualified.

These unpaid roles are where we gain experience, but they also mean therapists often start their careers financially stretched, emotionally exhausted, and carrying significant debt.

Most therapists are constantly learning. We attend workshops, go to additional training days and conferences, read current literature, reflect on cultural and psychological developments, and evolve our practice accordingly. This is time-consuming, unpaid work, but essential to delivering ethical, relevant support.

Just like in most professions, the more experience a therapist has, the higher their fees may be. Therapists with long client histories, additional training, and specialist knowledge often reflect that value in their pricing.

Higher prices = Less clients = Better therapy

Charging higher fees can also allow therapists to see fewer clients each day or week.

This isn't about working less... it’s about working sustainably.

With more breathing space between sessions, therapists have time to properly prepare, reflect, and stay present with each client, rather than rushing from one appointment to the next. It also supports ongoing research and professional development, and most importantly, helps prevent burnout.

A therapist who is rested, focused, and fulfilled in their work is far more equipped to offer the kind of deep, attuned support that therapy is meant to provide.

Business Expenses

Private therapists cover every aspect of their business costs alone. Here are just some of the essentials your therapist might be paying for:

Professional body memberships (COSCA, BACP, BABCP, etc.) / Therapist licences
Professional indemnity insurance
Cybersecurity software (especially for online work)
Website hosting and domain
Client management systems and secure note-keeping tools (GDPR compliant)
ICO registration: mandatory annual fee to legally process and store client data
Annual Disclosure Scotland/DBS checks: required for safeguarding compliance
IT equipment and data storage to maintain secure online practice
Accounting software or professional accountants to stay on top of taxes and expenses

And if the therapist works in person? Add £10–£25 per hour for therapy room hire.

Advertising and Being Found

Therapists don’t just appear in search results by magic. To be found by clients who need us, we pay for (to name a few):

Listings on directories like Counselling Directory, Psychology Today, for example
Website design, SEO, and ongoing visibility work
Social media marketing and content creation

All of these costs are part of simply being visible, compliant, and organised.

No Paid Holidays, Sickness Cover or Pension

Unlike salaried employees, therapists in private practice don’t get paid annual leave, sick pay or a pension. When we’re unwell, on holiday, or simply unavailable... we don’t earn. Every absence affects income directly, and we often save independently for pension contributions and emergencies.

Behind the Scenes: What You Don’t See

A 50-minute session is rarely just 50 minutes of a therapist’s time.

For every hour I spend with a client, I spend at least another hour on preparation, research, reading, case notes and admin. This behind-the-scenes work is often invisible, but it’s what allows therapy to be personalised, safe, and effective.

Therapists also spend time staying current: reading journals, attending webinars, and learning from peers. This isn't just a passion, it’s part of staying ethical and informed.

Why Fees Vary

There’s currently no regulation in the UK around what therapists can charge. It’s up to each therapist to set their fees based on their qualifications, experience, and operating costs. That’s why some sessions cost £40 and others £140.

Across the UK, private therapy can cost anything from £30 to over £200 per session. Psychologists often charge more than counsellors due to their level of education and specialism, but that doesn’t mean the highest fee is always the right fit. What matters is who you connect with.

NHS Access: Free, But Often Limited

I’m fully supportive of the NHS and its commitment to free mental health care.

But I also understand why so many people turn to private therapy: the waiting lists can be long, clients often cannot chose the type of therapy they would prefer or change therapists if they don't "click" with the one assigned to them.

That’s a tough position to be in, especially when you're struggling.

Everyone deserves the chance to find the right therapist for them. And unfortunately, in today’s system, that often means going private.

It’s important to be honest here though: private therapy is a privilege. Not everyone can afford it, and that’s a real barrier. Many therapists are aware of this and try to offer low-cost slots or volunteer their time within communities or charities when possible (I do!).

Still, private therapy remains more accessible to those with financial ressources, and that’s something the profession needs to keep grappling with.

So, Is Therapy Really That Expensive...?

Let’s compare. If you had a painful knee, you might spend £70 on a physiotherapy session without hesitation, because you’re in pain and want to recover.

Therapy addresses something just as important: your mental health, relationships, sense of self and emotional resilience. When you consider the training, hours of prep, ethical responsibilities and overhead costs involved, therapy is arguably at times underpriced.

Final Thoughts

Private therapy fees can feel high, especially in a cost-of-living crisis. But they’re not arbitrary. They reflect the true cost of building and maintaining a safe, ethical, and effective therapeutic space.

Whether you go through the NHS, the private route, or community organisations, your mental health deserves care. And if you do choose to invest in private therapy, know this:

You're not just paying for time. You're paying for expertise, presence, safety, reflection, and growth. You're choosing to prioritise yourself and that’s not just valuable. It’s brave.