How much more could you earn leaving BetterHelp for private practice?

Private practice therapists in Ireland and the UK earn between two and three times more per session than therapists working through BetterHelp. At 15 client sessions per week, that difference amounts to roughly €46,800 extra per year. The maths is not complicated, but it is worth laying out in full so you can make an informed decision.

What BetterHelp actually pays per session

BetterHelp does not publish its pay rates publicly, but therapist reports are consistent and have been reported across professional forums and outlets including Vice and the American Psychological Association. The platform pays therapists between approximately $30 and $80 per session depending on factors such as session volume, subscription tier of the client, and whether live video, phone, or messaging is used. In euro or sterling terms, most therapists report earning the equivalent of €30 to €50 per completed session.

The platform also charges clients on a subscription model, bundling unlimited messaging with a set number of live sessions. The gap between what the client pays (roughly €60 to €100 per week) and what the therapist receives is substantial. BetterHelp keeps the difference as platform revenue.

There is also the question of session type. Messaging exchanges are counted as sessions but often pay at the lower end of the range, even when a therapist spends significant time composing thoughtful responses. This dilutes the effective hourly rate further.

What private practice therapists charge in Ireland and the UK

In Ireland, the going rate for a 50-minute therapy session in private practice is typically €80 to €120, with rates in Dublin often sitting at the higher end. Experienced therapists with specialist training in areas such as trauma, eating disorders, or couples work routinely charge €130 or more.

In the UK, rates vary more by region. In London, private practice therapists typically charge £90 to £150 per session. Outside London, £65 to £95 is more common, with therapists in cities like Manchester, Edinburgh, and Bristol often landing in the £70 to £85 range.

These rates reflect what clients actually pay out of pocket. They are not inflated by insurance reimbursement structures. When a client books and pays directly, the full session fee goes to you, minus a small payment processing fee of around 1.4% to 2.9%.

The real annual income difference

The table below uses conservative mid-range figures: €40 per session on BetterHelp and €90 per session in private practice. Running costs for private practice are modest and are factored in separately below.

These figures assume 52 working weeks, which is unrealistic once holidays and CPD are factored in. A more honest 46-week working year gives you:

At 15 sessions per week, working 46 weeks per year, private practice pays approximately €34,500 more than BetterHelp. Even after tax, that is a significant difference.

What it costs to run your own practice

One of the barriers therapists cite when considering the switch is the cost of running a practice independently. In reality, the ongoing costs are low.

A professional website with hosting runs approximately €20 to €30 per month if built on a modern platform. An online booking tool such as Cal.com costs nothing on the free tier or around €12 per month for the premium version. Payment processing through Stripe is around 1.4% plus €0.25 per transaction for European cards. A practice email address through Google Workspace costs €6 per month.

All in, you can run a professional solo therapy practice for approximately €40 to €60 per month in recurring costs. This is without renting a physical room. If you work online only, or rent a room by the session (typically €15 to €30 per session in shared therapy spaces in Dublin or London), the overhead remains well below what you might assume.

Compare this to BetterHelp's effective overhead: the platform takes the difference between the client subscription price and your session fee, which can amount to €20 to €60 per session. Private practice overhead is lower, not higher.

There is also the one-off cost of getting set up: a website build typically costs between €1,500 and €3,500. At 15 sessions per week, that is recouped within two to four weeks of the income difference.

Is the switch worth it?

The income case is clear. But the switch involves real trade-offs, and they are worth naming honestly.

BetterHelp provides a steady stream of referrals. You do not need to market yourself. You do not need to manage invoicing, payment failures, or no-shows in the same way. If you are newly qualified or building confidence with clients, that structure has genuine value.

Private practice requires you to attract and retain clients yourself. This takes time, and the early months can be slow. Most therapists find that filling a caseload of 10 to 15 clients takes three to six months from a standing start, using a combination of directories, a Google Business Profile, and their own website.

But once a private practice is established, the financial advantage compounds. Your income grows as your reputation grows. You can raise your fees over time. You are not subject to platform policy changes or sudden algorithm shifts that affect how often your profile appears in search results.

At 15 sessions per week, earning €90 per session in private practice, you gross approximately €62,100 per year over a 46-week working year. BetterHelp at the same volume gives you roughly €27,600. The gap is real, it compounds over years, and it is the reason so many experienced therapists eventually make the switch.

If you are weighing up a move to private practice and want to understand what a professional online setup looks like, the Karv Web Studio therapist package is built specifically for this transition. It includes everything from website to booking system to GDPR-compliant setup, so you can focus on clients rather than technology.