Getting Paid: Talking with Clients About
the Price & Value of Therapy 

There’s a lot of interest lately in addressing the issue of the amount of money clients pay, or don’t pay, per session for therapy. The truth is that, as a profession, we as therapists often undercharge, and are underpaid, for the therapy services we deliver. Fortunately, this seems to be changing as people are becoming more aware of the value of the therapy that therapists provide—and what therapy actually costs to provide.

So, what is the therapy that mental health professionals provide worth to clients and in marketplace?

Overall during money conversations when the price of therapy comes up, we, as therapists, need to focus on increasing people's perception of the value of the therapy services clients receive instead of routinely just dropping our fees. When clients, or prospective clients, bring up the cost of therapy services during the intake or pre-therapy conversation we have, it’s up to each of us, in our therapeutic role, to engage the client in conversation about what they actually need and can benefit from in therapy. This helps the client think through and justify paying the session rate, or continue to pay the session rate, we charge for therapy. It’s what we do in every other conversation with clients. Money matters are no different.

Yes, in these money conversations the therapist’s role, or clinical task, is to help the client clarify the value of the therapy and services they need and the results or benefits that therapy can or has delivered to their lives and relationships. Helping clients look at what they benefit or gain from, don’t have to suffer, or will heal from because they are coming to therapy is an important part of these conversations when clients become over-focused on the price or cost of therapy services. It’s not just about the money or the price of therapy services, it’s part of the therapy itself.

It’s definitely part of our clinical role to help client think through what they need or are coming to or are seeking therapy for and the results and benefits therapy is providing to them or can provide. When the therapist has this type of clinical client interaction, clients will often hire the therapist or continue coming to therapy even when the therapy costs more than what they originally wanted to pay or thought they could afford.

Remember that clients are paying for the value and benefits that therapy provides for them, not the time—and clients want a price, a number, they can justify paying. One that’s commensurate with the service and benefits they receive and need.

Do you get paid for your time or your expertise? Remember, professionals get paid for their expertise instead of for their time. Charge for your expertise and the value you provide, not just for your time.

Convey to your clients that they pay for your expertise, not just for your time. Clients often forget this when they focus on money and numbers. People will pay in full and out-of-pocket for your therapy services if they see you as a trained professional and an expert who can give them or help them get what they want.

The most common question I receive in my Money Matters workshops and practice coaching is how to respond when a client says, “I can’t afford that,” “I can’t pay that,” “I don’t want to pay that” or “I don’t know how I could pay that.” 

Good responses to “I can’t afford it” are clinically based. Work with clients, or converse with prospective clients, to find out how they could pay that amount—what it would take or what they would need to/could do to make that happen. Treat the issues that come up in these client money conversations the same way you’d treat any other client issue. Maintain your therapeutic stance and approach as you work with the client and their issues during the money conversation.

Yes, I am recommending that you address client fee and payment issues as clinical issues. Maintaining your therapeutic role or position and confidently taking charge of money conversations works—and is therapeutic for the client. Focus on the value, cost, and worth of the therapy service to the client and their life. A client will pay for that. Clients do pay for that.

Be sure to keep the focus of your interaction on the client paying for services they need and receive not on what the therapist gets or how much the therapist charges. Remember: a client doesn’t “give you money,” a client pays for services rendered. The client is not in charge of determining much therapy costs, the therapist is.

I wish you the best in your client money conversations. They are always adventures!

Lynne Azpeitia, LMFT, AAMFT Approved Supervisor, is in private practice in Santa Monica where she works with Couples and Gifted, Talented, and Creative people across the lifespan. Lynne’s been doing business and clinical coaching with mental health professionals for more than 15 years, helping them develop their careers and practices. To learn more about services, training or the monthly LA Practice Development Lunch visit www.Gifted-Adults.com or www.LAPracticeDevelopment.com.