Work backwards from the income you need and the sessions you can sustainably hold, then check that number against your area rather than setting a fee by looking at what other therapists advertise.
Category
PricingWritten by
Danny McCabe
18 September 2026
Almost every therapist I have talked to about this set their first fee the same way: they looked at what three other people in their town were charging and picked the middle one. It is an understandable method and it produces a number with no relationship to what the practice actually needs.
Work backwards from the income you need and the sessions you can sustainably hold, then check that number against your area. Setting a fee by looking at what other therapists advertise anchors you to their circumstances, not yours.
Start with three numbers.
One: what you need to earn. Not what you would like. The figure that covers your life, before tax, in a year.
Two: how many sessions you can actually hold. This is the number people get wrong. A full-time therapy week is not 37 hours of clients. Most therapists find their sustainable ceiling somewhere around 20 to 25 client hours, and that is before you account for the fact that you will not be at that ceiling every week of the year.
Three: how many weeks you will work. Take 52, subtract annual leave, bank holidays, sick weeks, and the weeks in August and around Christmas when the diary empties whether you planned it or not. Forty is optimistic for most practices.
Twenty sessions across forty weeks is 800 sessions. That is the number to divide your income requirement by, and it is usually a lot smaller than the one people assume when they multiply a weekly rate by 52.
The fee is not income. Out of it come:
Add those up annually and divide by your session count. That is the per-session cost of running the practice, and it comes off the top of every hour you work. For a therapist paying for a room in a city, it is not a small number.
Only now is it worth looking at what other people charge, and the reason is different from what you would expect. You are not looking for permission to charge what you calculated. You are looking for a sanity check on whether your market can support it.
If your calculation produces a fee well above everyone around you, that is not automatically wrong. It may mean you need fewer clients than you assumed, or that you have overestimated your costs, or that you are pricing for a specialism you have not yet articulated on your website. It is a prompt to look again, not to lower the number.
If it produces a fee well below everyone around you, you are almost certainly undercharging, and the most common cause is the sustainable-sessions number being set too high.
Many therapists want to keep some low-cost slots, and that is a good instinct badly implemented most of the time.
What works: a fixed number of named slots at a stated reduced rate, decided in advance. Two slots at a lower fee, allocated as they come free.
What does not work: an open invitation to negotiate, assessed case by case. It turns every intake into a means test you are not qualified to run, it makes the fee feel provisional, and the therapists who do it end up with a caseload where half the clients are paying less and nobody quite knows why.
A fee that is not on your website gets discussed by email with people who were never going to book. Publishing it filters out the mismatches before they cost you an hour of correspondence, and it signals that the number is settled rather than negotiable.
The objection is always that it will put people off. It does. It puts off the people who would have found out in week two and left anyway, and it does so before they take up your time.
Raise for new clients first, from a stated date. Existing clients get notice, usually a couple of months, and a fee increase applied to everyone at once.
The fear is a mass exit. In practice most clients do not leave over a modest increase, and the ones who genuinely cannot absorb it are the conversation the sliding-scale slots exist for.
The useful figure is not your session fee. It is your fee multiplied by the sessions you will realistically hold, minus the cost of running the practice. Get that number and compare it to what you need. If they do not meet, the answer is a higher fee or a lower overhead, and the second one is often easier than therapists expect.
Not sure where your practice currently sits? The free assessment is a reasonable place to start.
Free Assessment
Take the 5-question assessment and find out in 2 minutes.
Free Download
5 things every solo therapist needs to get found online and book clients consistently.
Free Audit Call
Book a free 30-minute call. We'll review your current setup and tell you exactly what to fix first.
Blog and articles
A contact form asks an anxious person to compose an introduction, a booking link asks them to pick a time, and the second converts substantially better for exactly that reason.
BetterHelp pays therapists as self-employed contractors, so the gross figure is not the take-home figure. A US therapist loses 15.3% to self-employment tax before income tax even starts, and an Irish sole trader pays income tax, USC and Class S PRSI on platform income like any other self-employed earnings.
Your face, your fee and whether anyone else has been here before. They are deciding whether this will be awkward, whether they can afford it, and whether you are real.
Karv Web Studio uses cookies
We use cookies to improve your experience, analyse site performance, and support our marketing. You can choose what you’re comfortable with below.
