Imagine this: You’ve just wrapped up an intense session where you supported a client in navigating through the stormy waters of childhood trauma. As you take a deep breath, you glance at your calendar. The next hour is reserved for following up with voicemails, responding to a pile of emails, updating client notes, and completing insurance paperwork for a client whose claims are mysteriously rejected. When you finally sit down to eat dinner—if you’re lucky enough to eat it warm—there’s another call. It’s from a client in crisis. Despite the long day, you pick up the phone, not out of obligation or overextension, but because you are deeply committed to the ongoing care and support of your clients. This commitment is what drives you to be there for them in their times of need.

This scene reflects the reality of what it means to be a dedicated therapist. It’s not just about the sessions themselves, but the myriad of tasks that fill the hours outside of face-to-face client time. These behind-the-scenes duties, driven by our commitment to providing exceptional care, are integral to ensuring that our clients receive the best support possible. It’s this level of investment and dedication that underscores the true value of the work we do and why the fees we set need to reflect the full scope of our professional engagement.

The Myth of the “Golden Therapy Hour”

People often think that the fee a therapist charges is solely for the 50-minute session we spend with clients. This couldn’t be further from the truth. The reality is that for every therapy hour, there are countless unseen hours that go into providing high-quality care:

• Administrative Work: Scheduling, rescheduling, and handling the logistics of the practice.
• Research and Preparation: Reviewing treatment modalities, customizing interventions, and staying up-to-date with the latest research to ensure the most effective care.
• Documentation and Compliance: Completing clinical notes, treatment plans, and insurance forms, all while ensuring compliance with legal and ethical guidelines.
• Professional Development: Engaging in continued education, supervision, and consultation to sharpen our skills.
• Client Communication: Handling crisis calls, communicating with family members (with consent), and following up on assignments or reflections shared in-session.
• Insurance Hassles: Wrestling with rejected claims, processing payments, and navigating insurance policies—all of which take time and energy that isn’t reimbursed.

Each of these elements eats into your time and emotional bandwidth. Yet, the fee clients see doesn’t reflect the full scope of your work. This misconception can fuel judgments about what therapists “should” charge, leaving many of us questioning whether we have the right to set sustainable rates.

Dissecting the “Altruistic Martyr” Complex

Therapists enter this field to help others. But somewhere along the way, that desire to be of service often turns into a pressure to sacrifice our own well-being for the sake of our clients. This complex tells us that setting higher fees is somehow “greedy,” that asking for what we’re worth diminishes the value of our care. This mindset can lead to burnout, resentment, and a weakened capacity to support the very people we set out to help.

Breaking Down the Internal Barriers

Where do these beliefs come from? For many, it’s rooted in:

• Societal Expectations: The pervasive idea that those in “helping” professions should do so out of the goodness of their hearts, not for financial gain.
• Scarcity Mindset: Fearing that setting higher fees will drive clients away, leaving us without enough work to sustain our practice.
• Imposter Syndrome: Feeling like we aren’t “good enough” yet to charge our worth, even with years of experience and advanced training.

Words of Wisdom

“It’s okay to want financial stability and to set rates that reflect your full scope of work. Doing so isn’t a betrayal of your values—it’s a commitment to staying in this field long-term, with the capacity to keep serving those in need.”

Reflect on where these beliefs may be holding you back. Then consider small steps you can take to challenge them, like talking with trusted colleagues, seeking supervision, or gradually adjusting your rates over time.

Building the Bridge Between Service and Sustainability

Think of your practice like building a bridge. One side is service; the other side is sustainability. If you’re focused only on service, your bridge is lopsided, and eventually, it will collapse under the weight of unpaid bills, burnout, and emotional exhaustion. If you only focus on sustainability, you risk building a bridge too far away from your values.

But when you mindfully build a bridge between the two, with strong pillars of self-respect and client care, you create a path that’s resilient, balanced, and capable of supporting both your needs and your clients’. It’s about finding that balance where service and sustainability meet.

The Bigger Picture: Therapists as Advocates for Change

As therapists, we have the power to shift the conversation around what we’re worth and why it matters. By owning our value and setting fair fees, we send a message that mental health services are valuable, necessary, and worthy of investment. This shift isn’t just about money—it’s about transforming how our society values mental health.

Call to Action

Take a stand for yourself, your colleagues, and your clients. Reevaluate your fees, engage in conversations about pay transparency, and support advocacy efforts aimed at better insurance reimbursements and fair compensation for therapists.

Fee Setting Worksheet for Therapists: Calculating Your True Worth

Use this worksheet to gain clarity on what you need to charge to sustain your practice and meet your financial goals. Consider all aspects of your professional life, including time spent on admin tasks, training, and self-care.

1. Calculate Your Total Annual Expenses:
   • Rent/Office Space: __________
   • Licensure Fees: __________
   • Professional Development: __________
   • Administrative Software/Tools: __________
   • Supervision/Consultation Fees: __________
   • Marketing/Advertising: __________
   • Personal Self-Care (e.g., therapy, supervision): __________
   • Miscellaneous: __________
2. Determine Your Desired Annual Income:
   • Desired Salary: __________
3. Add Annual Expenses + Desired Salary:
   • Total Annual Revenue Goal: __________
4. Estimate the Number of Sessions You Can Realistically Offer Each Week:
   • Number of Sessions per Week: __________
   • Number of Weeks You Will Work per Year: __________
   • Total Annual Sessions: __________
5. Calculate Your Minimum Session Rate:
   • Total Annual Revenue Goal ÷ Total Annual Sessions = Minimum Session Rate: __________
6. Final Adjustments:
   • Consider if the calculated rate reflects the full scope of your work. Does it account for crisis calls, prep time, consultation, and other hidden hours? Adjust your rate accordingly: __________

Reflection Question

What would it feel like to charge a rate that truly honors your value and the work you put in?

The Hidden Labor of Being a Therapist: The Emotional and Cognitive Load

People often focus on the visible work therapists do in sessions, but the true scope of our labor goes far beyond the therapeutic hour. Every session is accompanied by hidden emotional and cognitive labor that’s rarely seen but always felt. You’re not just listening during a session—you’re holding complex emotions, managing countertransference, and employing a balance of evidence-based techniques and holistic care that require ongoing training and mastery.

Think of your professional energy like a bank account—let’s call it the Therapist Energy Bank. Every task you take on, from direct client work to administrative duties, withdraws energy. Responding to late-night texts, squeezing in a crisis call, spending your weekend reviewing research for a client’s unique situation—each action, no matter how small, pulls from your energy reserves. Without appropriate compensation, self-care practices, and boundaries, your energy bank can easily become overdrawn, leading to burnout, reduced empathy, and compassion fatigue.

Words of Wisdom

“It’s not about counting every second of work—it’s about recognizing that your energy and time are finite. Honoring your needs allows you to replenish your energy bank and show up fully for your clients.”

If this feels overwhelming, start small. Reflect on one area where your energy feels most depleted and consider a small shift—a clearer boundary, a tiny change in your schedule, or an adjusted fee that honors the work you’re doing.

The Evolution of Fees: A Natural Part of Professional Growth

Setting and evolving your fees is not a one-time decision—it’s an ongoing process that should adapt as your skills, experience, and expertise grow. Just as other professionals increase their rates over time, therapists too should feel empowered to raise their fees as they acquire advanced certifications, specialized training, or accumulate years of experience.

Think of fee-setting like tending a garden. As you grow in your practice, your fees should naturally evolve, reflecting the richer, more nuanced understanding of the human experience that you bring to your clients. This evolution is not just about financial gain—it’s about honoring the value of your continued commitment to learning and self-improvement, which ultimately enhances the care you provide.

Words of Wisdom

“Raising your fees isn’t a betrayal of your values—it’s a celebration of your growth and the expanded expertise you bring to each client. Remember, your journey and investment in your development deserve acknowledgment.”

If you’re not ready to raise your fees across the board, consider a gradual approach. Try adjusting for new clients, or increasing by a small percentage that feels comfortable. Each step is progress.

Real Voices from the Field: The Struggles and Strengths of Fee-Setting

Many therapists struggle with fee-setting because it touches on deeper emotional themes of worth, value, and identity. Here’s what some of your colleagues have shared:

“I used to feel guilty charging higher fees. But after months of juggling too many clients and constantly feeling drained, I realized I wasn’t being fair to myself or my clients. Setting boundaries and honoring my worth allowed me to show up fully present, and that made all the difference.” – A therapist with 10 years of experience

“The idea of raising my rates used to feel terrifying, but I knew I couldn’t continue undercharging without it affecting my health. Once I set my new fees, I found that clients actually respected my time more, and I was able to give better care because I wasn’t so stretched thin.” – Licensed Clinical Social Worker

Words of Wisdom

“There’s no one right way to set your fees, and everyone’s journey is unique. If you feel conflicted, take a moment to pause and reflect on what feels right for you. It’s okay to seek support and revisit your fees as your practice evolves.”

Begin with a small change that feels aligned with your values and capacity. Trust that your decisions around fees can shift over time, and you have the freedom to adjust as needed.

How Fair Fees Benefit Clients and the Mental Health Field

It’s important to remember that setting fair fees isn’t just for your benefit—it has a ripple effect that extends to your clients and the entire field. When you establish fees that truly reflect the value and effort you put into your practice, several things happen:

– Improved Quality of Care: When you’re financially stable and not overextending yourself, you have the capacity to invest in ongoing training, self-care, and consultation—all of which contribute to higher-quality care for your clients.

– Reduced Burnout and Increased Longevity: Therapists who set sustainable fees are less likely to experience burnout and more likely to remain in the field long-term. This stability benefits the community by ensuring that experienced, seasoned therapists are available to support those in need.

– Supporting a Healthy, Diverse Field: Fair fees help ensure that therapists from diverse backgrounds, who may face additional financial burdens, can continue to thrive in this profession. This leads to a more inclusive field that better serves the needs of diverse clients.

Words of Wisdom

“Valuing your work financially doesn’t mean you’re abandoning your commitment to accessibility or compassion—it means you’re ensuring you can continue to provide quality care without compromising your well-being.”

Implement changes at a pace that feels supportive. It might start with one client, one new boundary, or one fee adjustment. Each change creates a healthier practice and better care.

Developing Fee Courage: Standing Firm in Your Value

Building confidence in your fee-setting practices takes time and reflection. It’s normal to feel anxious or uncertain when adjusting your rates. Developing “Fee Courage” means moving through these fears and aligning your fees with your professional worth. Here are some prompts to help you explore this:

– What fears come up for you when considering raising your rates?  

– How might holding back on setting a fair fee impact your professional satisfaction and quality of care over time?  

– What support do you need to feel more confident in setting and discussing your fees?  

Words of Wisdom

“Cultivating fee courage isn’t about pushing through discomfort—it’s about leaning into the values that guide your practice. Remember, you’re not just setting a price; you’re affirming your worth and the importance of the work you do.”

Start small—try having a conversation about fees with a trusted colleague or mentor. Practice stating your rates aloud. Over time, your comfort and confidence will grow.

Addressing Societal Misconceptions About Therapy Fees

Societal misconceptions about therapy fees often come from a misunderstanding of what therapy involves. To many, it’s just “talking,” and the value of that hour is perceived to be far less than it actually is. However, the reality is that therapy involves years of specialized training, emotional labor, ongoing professional development, and managing the weight of clients’ suffering—all of which require compensation that reflects these demands.

Clarifying the true scope of therapy with clients, other professionals, and the broader public is essential to shifting the narrative around fees. By educating others on the multifaceted nature of therapeutic work, we can advocate for a broader understanding of the value of mental health services.

Words of Wisdom

“You don’t have to justify your fees to everyone, but you do deserve to acknowledge the depth and breadth of what you offer. By advocating for fair compensation, you’re helping shape a healthier, more accurate understanding of the work we do.”

Share your value in a way that feels authentic and comfortable. You can start small, such as communicating the scope of your work on your website or in initial consultations, without feeling the need to justify yourself.

Creative Financial Options Without Sacrificing Boundaries

You can maintain your financial health and still contribute to accessibility through thoughtful, intentional decisions that honor both your clients’ needs and your professional boundaries. By leveraging different formats, offering flexible resources, and exploring innovative ways to reach diverse audiences, you can make mental health care more accessible without compromising your own well-being. Consider integrating some of the following options into your practice:

Working with Insurance-Based Clients

Choosing to work with insurance can be a meaningful way to provide accessible care for clients who may not be able to afford private-pay fees. However, it’s crucial to be strategic in how you manage your insurance caseload, as working with insurance can come with unique administrative and financial challenges.

Tips for Working with Insurance:

• Negotiate Reimbursement Rates: Reach out to insurance companies to negotiate higher reimbursement rates, especially if you have advanced certifications or specialized training. This ensures that your rates are more aligned with your expertise.
• Set Clear Policies: Establish clear policies for missed sessions, paperwork requests, and communication to reduce administrative burdens.
• Consider a Hybrid Model: Balance your caseload with a mix of insurance and private-pay clients to help stabilize your financial health and reduce overreliance on insurance reimbursement.

This option allows you to provide services to clients who rely on insurance while also maintaining a sustainable practice.

Sliding Scale Spots

Offering sliding scale spots (aka reduced fee spots) is a common approach to increasing accessibility, but it’s important to do so mindfully. Consider limiting the number of sliding scale clients you take on at any given time, ensuring you have enough full-fee clients to maintain your financial health and prevent burnout. This way, you’re able to balance your need for sustainability with your desire to support clients from different socioeconomic backgrounds.

Tip: Set clear criteria for who qualifies for sliding scale options, and reassess periodically to ensure it’s meeting the needs of your practice and clients alike.

Group Therapy or Workshops

Offering group therapy or psychoeducational workshops at a lower fee can be an effective way to serve more clients at once, while still respecting your time and energy. Group settings can provide unique therapeutic benefits, such as peer support and a sense of community, while also allowing you to deliver high-quality care at a reduced rate per person.

Ideas for Group Topics: Consider running groups on topics like anxiety management, grief support, social skills for neurodivergent adults, or mindfulness practices. This format allows you to scale your impact and create a supportive space for more people to access your expertise.

Online Resources, Toolkits, and Self-Help Guides

Creating downloadable resources such as guided meditations, workbooks, or self-help tools can offer support to clients outside of individual sessions. These resources provide clients with helpful strategies they can use independently, which adds value and can also become an additional revenue stream for your practice.

Ideas for Resources: Create a ‘Self-Soothing Toolkit’ for clients to download, featuring grounding exercises, journal prompts, and relaxation techniques. Alternatively, develop a video series on managing common mental health challenges or navigating major life transitions.

Blog Posts and Articles

Even sharing information with the community through blog posts, articles, or newsletters counts as a way to contribute to accessibility. By creating and distributing educational content, you provide valuable psychoeducation and support for those who may not be able to afford therapy sessions. This form of outreach can bridge the gap for individuals who are seeking guidance and information but may not have the resources for ongoing therapeutic care.

Blog Post Ideas: Write about strategies for managing anxiety, tips for maintaining emotional health during life transitions, or explore deeper topics like navigating relationships as a neurodivergent person. Each post can serve as a stepping stone, making mental health care more approachable and accessible.

Digital Workshops and Webinars

Consider hosting digital workshops or webinars on specific topics. This option allows you to reach a broader audience without the overhead costs of an in-person event. You can record these sessions and make them available for purchase afterward, providing an ongoing resource that clients can revisit as needed.

Webinar Topics: Host a webinar on coping strategies for parents during challenging times, or a session on understanding boundaries and self-care for healthcare professionals. These workshops can become part of a larger series that you offer throughout the year.

Collaborative Community Initiatives

Partner with local organizations or community centers to offer reduced-rate services or free workshops. By collaborating with other entities, you can expand your reach and provide support to underserved communities without taking on the full financial burden yourself.

Ideas for Collaboration: Partner with local schools to provide a workshop series on youth mental health, or collaborate with a nonprofit to offer a series on trauma-informed care. This not only expands accessibility but also helps build community relationships and awareness of mental health resources.

Therapy Packages

Instead of offering a reduced fee for every session, consider offering a package of sessions at a reduced fee than individual sessions. This can make therapy more affordable while still honoring the financial value of your work.

Example: Offer a 5-session package for clients looking to work on a specific goal, like coping with grief or building resilience.

Pro Bono Spots with a Defined Limit

If you’re passionate about offering pro bono services, set a defined number of pro bono spots in your practice and re-evaluate periodically to see if you can sustain them. This ensures you’re able to maintain your own financial stability while still giving back to the community in a meaningful way.

Tip: Make sure to build in time to rest and rejuvenate, as providing pro bono services can be emotionally intensive. It’s important to fill your own cup so you can continue to serve others.

Offering Support via Social Media Content

Many therapists use social media platforms to offer support and education on a larger scale. By sharing tips, creating short videos, and discussing relevant mental health topics, you can provide value to a wider audience. This helps build a sense of community and provides support for individuals who might otherwise have no access to mental health services.

Ideas for Social Media Content: Share infographics on coping mechanisms, create short videos about managing holiday stress, or post Q&A sessions on common mental health topics.

Creating Value While Maintaining Boundaries

These creative financial options allow you to serve diverse client needs without sacrificing the boundaries that protect your well-being. When implementing these strategies, remember to honor your time and energy by setting clear boundaries around your availability and commitments. This ensures that you can sustain these efforts over the long term, providing consistent, high-quality support to your clients and community while maintaining your own financial health.

Final Thought: By thoughtfully integrating these creative options into your practice, you can contribute to accessibility in a way that aligns with your values and boundaries, creating a ripple effect of support and care for your community.

Words of Wisdom

“Offering financial options doesn’t mean sacrificing your own financial health. It’s about finding creative ways to extend your reach while respecting the boundaries that keep you energized and effective.”

Choose options that feel sustainable and aligned with your goals. Small adjustments can make a meaningful impact, without leading to overwhelm or burnout.

Celebrating Your Worth: The Ripple Effect of Value

Think of your professional worth as a stone dropped into a pond. The ripples move outward, impacting not just you, but your clients, your practice, and the broader mental health field. When you value your time and energy, those ripples spread. You create a wave of sustainable, high-quality care that serves everyone better. Setting your fees is like choosing the right size stone—it determines how far and how effectively those ripples travel.

Words of Wisdom

“By honoring your value, you’re not just advocating for yourself—you’re contributing to a healthier, more sustainable mental health community. The positive impact of your worth ripples far beyond the therapy room.”

Take it one step at a time. Value yourself for each step you take in building a practice that serves you and your clients well.

Your Worth is Not Up for Debate

Your worth goes beyond the therapy hour. It’s in every email you send, every research article you read to support a client’s unique needs, every late-night crisis call you take, and every training you attend to deepen your skills. Your worth is like a mosaic, with each piece—empathy, expertise, creativity, presence, and specialized knowledge—coming together to form a unique and invaluable whole. When you honor all these facets of your professional identity, you’re not just valuing your time; you’re valuing the entirety of who you are and what you bring to each therapeutic relationship.

Your worth also includes the education, skills, and experience you’ve cultivated, the intuitive and creative abilities you bring into your sessions, your energy and attunement to clients’ emotional states, and the expertise to navigate complex clinical situations. It’s reflected in your ability to hold space for difficult emotions, adapt interventions, and customize care for each individual who comes through your door. So, as you consider your fees, remember: setting fair compensation isn’t merely an economic decision—it’s a powerful affirmation of your professional value and a testament to the dedication you bring to offering quality care.

Words of Wisdom

“Every small step you take to honor your value adds to a stronger foundation for yourself, your clients, and the mental health community. You’re creating a ripple effect of positive change.”

If this feels like a big leap, focus on making one small adjustment. Each decision you make to honor your worth will build on the last, creating a sustainable path forward for your practice and your well-being.

Written by Jen Hyatt, a licensed psychotherapist at Storm Haven, Counseling & Wellness in Temecula, California. 

Disclaimer: The information provided in this blog post is for general educational and entertainment purposes only and should not be considered legal or professional advice. Readers are encouraged to consult their local licensing boards, governing bodies, and legal counsel to ensure compliance with ethical and professional standards.