How Much Is Therapy Without Insurance? Costs and More

By Whitley Lassen, PsyD
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February 16, 2022

One in five Americans has some type of mental health issue, yet many people aren’t getting the support they need.

Psychotherapy (often referred to as talk therapy) has been shown to be effective at improving symptoms in a diverse range of mental health concerns.

But only about 45% of adults with depression, anxiety, post traumatic stress disorder (PTSD), and other mental health  conditions received treatment in 2019. 

Some of the biggest barriers to therapy are stigma, access, and cost.

Thankfully, affordable therapy options without insurance exist.

In this article, I’ll explain the typical cost of therapy as well as therapy options for those on a budget. From sliding scale therapists to support groups to online therapy, there’s something to help everyone get the care they need.

Typical Cost of Therapy

The cost of therapy can depend on a variety of factors, including:

  • Location: Therapists in cities and areas of high costs of living generally charge more.
  • Training and reputation: Highly experienced and doctoral level therapists are often more expensive.
  • Specialization: Therapists who specialize in a particular condition or treatment may charge more.
  • Length of session: Generally, the longer the session, the more expensive the cost.

Based on these factors, the average cost of therapy can range between $65 to $250 or more per hour.

Types of therapy

Not all types of therapy are the same.

Some people and some mental health issues respond better to certain types of therapy than others.

Though most therapists will take the client’s personality, history, and concerns into account when designing their treatment approach, some people prefer to seek out therapists who specialize in one type of therapy.

Some of the more popular psychotherapies in the U.S. include:

  • Cognitive behavioral therapy (CBT): CBT is a short-term approach that focuses on helping people understand the thoughts and feelings that influence their behaviors. The goal of CBT is to help people deal with their current problems as efficiently as possible. The length of treatment can vary from person to person; some people need only a few sessions and others require a few months of treatment.
  • Dialectical behavior Therapy (DBT): DBT incorporates behavioral change, problem-solving, and emotional regulation with validation, mindfulness, and acceptance.
  • Eye movement desensitization and reprocessing therapy (EMDR): EMDR is a specific type of therapy used to treat PTSD. It uses a series of repetitive eye movements to help replace negative emotional reactions to traumatic memories with less-charged reactions or beliefs. 
  • Exposure therapy: Used to treat obsessive-compulsive disorder (OCD), PTSD, and phobias, exposure therapy is a type of cognitive behavioral therapy that helps someone gradually face their fears with the goal of decreasing their anxiety response to  those feared situations, events, or objects.
  • Interpersonal therapy: Interpersonal therapy helps individuals evaluate their social interactions, recognize negative or unhelpful social patterns, and learn new strategies to interact more positively with other people.
  • Psychodynamic psychotherapy: Rooted in recognizing past negative patterns and behaviors, psychodynamic psychotherapy often uses open-ended questions and free association to help people identify unconscious patterns of negative behavior and emotions. It can be used to treat depression, anxiety disorders, and personality disorders. 

Does insurance cover therapy?

Under the Affordable Care Act, all health insurance companies in the U.S. must cover therapy as part of their mental health services.

But although insurance plans cannot impose different rules or charge more for mental health care, it can be difficult to find the right therapist through their programs. 

Oftentimes insurance coverage for mental health means having to choose an in-network therapist.

For many people, finding a therapist who compliments their personality, understands their mental health concerns, meets their needs, and is a good fit takes some trial and error.

Then try to find one who’s also in-network on top of that.

To make matters more difficult, some therapists have waitlists for new clients, and some insurance companies require meeting diagnostic or logistical criteria to get a referral for treatment. 

Understandably, this frustrating process can convince some people to pay out of pocket for their mental health care—or give up on their search entirely.

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Sliding Scale Therapists

One option for affordable therapy outside of insurance is to work with a mental health professional who offers a sliding scale program.

Therapists with a sliding scale offer select patients treatment at a lower rate.

Many therapists note this option on their website or profile, but not all do, so ask about it.

Affordable Therapy Options

If sliding scale programs are still out of reach, other therapy options may work for those on a budget.

School resources

Many schools and universities offer free therapy for all students, and some universities offer free or discounted therapy to those studying to become mental health professionals.

Contact the campus health program to inquire. 

Non-profits

Several health organizations and nonprofits offer sessions with therapists who volunteer their time.

To find local options, search for local nonprofits that offer group or individual therapy sessions. 

Employee assistance programs

Many companies provide confidential low-cost or free therapy sessions to employees struggling with a mental health issue  that’s interfering with performance at work.

Keep in mind that treatment is often capped at a specific number of sessions.

Social services

Low-income U.S. citizens without insurance may be eligible for mental healthcare coverage through their state’s Medicaid program or the Healthcare.gov marketplace.

And persons with disabilities or those over the age of 65 can apply for Medicare. Just be sure to shop for health insurance plans that include mental health coverage. 

Clinical trials

Volunteering for a clinical trial isn’t for everyone, but for those who are comfortable with it, this option can open up access to free, cutting-edge treatment, therapy methods, or medications.

To look for an appropriate trial, search the National Institutes of Health Database.

Keep in mind that the types of trials available may vary, participants are unable to choose their type of treatment, and there may be risks associated with participation.

Support groups

Sometimes, talking to peers can be especially helpful for recovery.

Free support groups across the nation focus on a variety of topics, including loneliness, grief, anxiety, PTSD, substance misuse, and depression. Some groups meet in person, while others meet virtually. 

Open Path Collective is an example of non-profit therapy.

Therapy apps

Many online and telehealth services— including K Health—offer virtual therapy at a more affordable price.

Crisis and suicide prevention hotlines

For a crisis or emergency situation, free hotlines, including the National Suicide Prevention Lifeline at 1-800-273-8255, or the Crisis Text Line text HOME to 741741,can provide immediate help.

For a comprehensive list of hotline directories, visit this page.

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When to See a Therapist

It takes courage to seek help for mental health, and unfortunately, the cost of therapy can discourage people from obtaining the support they need.

Know that help exists, including a variety of low- and no-cost options.

If you don’t know where to begin or have hesitations about therapy, reach out to your healthcare provider for assistance. They can discuss your options and help you access appropriate care for your situation.

How K Health Can Help

Did you know you can get affordable mental health care with the K Health app?

Download K to check your symptoms, explore conditions and treatments, and if needed text with a doctor in minutes. K Health’s AI-powered app is HIPAA compliant and based on 20 years of clinical data.

Frequently Asked Questions

Can I negotiate my therapy bill?
Yes. Many therapists offer sliding scale or flexible payment plans. When reaching out to possible therapists, ask whether they offer these options.
How often should I go to therapy?
How often you go to therapy varies based on personal preference, availability, resources, and your therapist’s recommendation. In the end, the frequency of sessions is up to you.
Can you get free therapy?
Yes, there are a number of free resources available for those who are interested in therapy but cannot afford the cost. Options include employee assistance programs, social services, school resources, non-profits, and crisis hotlines.
Can I fire my therapist?
In general therapy will be more effective if you feel comfortable opening up to your therapist. If their personality, style, or approach doesn’t feel like a match it’s okay to let them know. It’s normal to trial a few therapists before you find the right one!

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Whitley Lassen, PsyD

Whitley Lassen, PsyD, MBA is a licensed clinical psychologist with 15+ years of experience providing therapy to clients using evidence-based interventions, such as Cognitive Behavioral Therapy (CBT). Dr. Lassen also has extensive experience in behavioral health leadership and received an MBA from the University of Cincinnati Carl H. Lindner College of Business, with a concentration in healthcare administration.