Why are so psychologists so expensive?
Anecdotally, we know that the cost of private psychological support is one of the barriers to people reaching out and seeking individual therapy. The Australian Psychological Society (or the APS), which is the peak body representing psychologists in Australia, has set their recommended fee for the 2021/2022 financial year at $267 for a 45-60 minute consultation. We know this is a LOT of money for most people!
When you multiply this rate by a few sessions per day, times a few days per week, over most weeks of the year, you’ll likely come out with an astronomically large estimated sum of what your Psychologist might earn per year.
However, there are a few myths and misconceptions about this figure. You might be surprised by the breakdown, and it might provide extra information about why individual session rates are so high.
Firstly, the session fee you pay is often split between your individual Psychologist and the practice they work for. Sometimes this fee is as high as 50%. The practice’s split goes to all the running costs of operating a practice – the costs of renting or owning office space, relevant bills (such as electricity, water, internet, etc.), maintaining the materials and resources for therapy (such as furniture, pens, paper, computers, whiteboards), paying for the right to use a variety of standardised mental health assessments, other salaries of administration and cleaning staff, and relevant insurances and taxes.
The other part of the session fee split your Psychologist receives. Most psychologists working in a private practice operate as ‘sole traders’ – that is, they get are not an employee but a contractor who gets paid a fixed rate per session, and they operate as their own ‘business’ and pay their own business expenses from this fee. At least 35% of their split would go to paying Tax, and your Psychologist is most likely also contributing to their own superannuation (another 10%).
Psychologists must complete a minimum of 6 years of training. Clinical Psychologist must complete a 4 year undergraduate Bachelor degree, a 2 year Masters degree, and then two years of full time supervised practice. Psychologists, therefore, often graduate with tens of thousands of dollars of HELP/HECS debt (or student loans), which must also be paid out of that fee at tax time (usually at %2-%7 of income).
Your Psychologist would also then have a range of expenses – including their own insurances, their own professional development costs, their own registration and professional membership fees. These are all required to remain legally practising, and are often in the thousands of dollars per year.
Your Psychologist also only gets paid if they have a session. This session rate must cover their time for outside of session work, such as keeping notes, contacting other relevant health professionals, planning treatment, and writing progress reports. As contractors, Psychologists don’t usually get paid leave, so their session fees must also cover their expenses when not working, and taking holidays, study leave, or sick/carers leave. Taking time off work is important for all people, and your Psychologist can’t be practicing effectively if they don’t take their 4 weeks annual leave.
Now, the point of this article isn’t to present Psychologists are under-privileged, or hard-done by! Psychologist’s incomes are usually above the Australian average. All the Psychologists I know love their jobs and would do it regardless of what they are paid. However, hopefully this article has provided some more insight into the reasons that contribute to high individual therapy costs.
Ultimately, yes – psychologists are expensive. So, what can you do if the cost is an issue for you? Please still reach out for help! You and your mental health are worth it. Here are some suggestions to make therapy more affordable:
- Seek therapy later in the year: you can never time when a crisis might happen, and it’s almost impossible to plan when you might need mental health support. But if you’ve been putting off therapy, think about booking sessions later in the calendar year. This might be of use for two reasons. Firstly, you can get 20 therapy sessions with a Medicare rebate each calendar year. There’s less of a chance you’ll run out if you start later in the year; you’ll be able to have sessions more frequently, and you’ll be able to ‘refresh’ your session limit in January – possibly creating the situation of 40 Medicare rebated sessions in close succession. Secondly, you will have a higher likelihood of hitting your Medicare Safety Net – this is an monetary amount that, if you exceed in spending out of pocket on health expenses each year, the Medicare rebate becomes a percentage of what you’ve paid out of pocket (rather than a set amount). This can mean you get almost the entire session (sometimes up to 80%) back from Medicare.
- Speak to your therapist: some psychologists have space in their caseload for bulk-billed or reduced fee clients. Your psychologist might be able to make a plan with you whilst you struggle financially – many will want you to continue in therapy. Don’t just drop off – by raising your financial concerns with your therapist, they may be able to offer support (such as reduced fees) or by referring you to a lower-cost service.
- Look for online therapy courses: there are more and more online mental health courses being developed. ‘This Way Up’ is a great example of evidence-based, online mental health support which is much more affordable than individual sessions. Your GP or Psychologist will be able to point you in the right direction.
- Look for group therapy: group therapy can be another effective way to get face-to-face mental health support, without the costs of individual sessions. Often you get the added benefit of hearing from and meeting people with similar struggles to your own, and hearing what has worked for them.
- See if you’re eligible for any public or not-for-profit mental health support: if you are under the age of 25 you may be eligible for treatment through Headspace. If you have acute, chronic mental health conditions, you may be able to be referred through your local community mental health team (usually based at your local hospital). Often there are not-for-profits that provide specific mental health support for people within certain populations – such as those with disabilities (through NDIS), those who are Victims of Crime (through Victims Services), those who have recently had a child, those who have an Eating Disorder, or co-occurring medical condition (such as cancer).
- See if your local university has a clinic: many universities have a low-cost psychological clinic, usually staffed by Provisionally or Generally Registered Psychologists completing their specialist training through a Masters degree. They offer reduced fee individual and group therapy, and comprehensive psychometric assessment.
