How to calculate counselling fees? A guide for counsellors.

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Adam Kincel, PhD

Biography:

Adam Kincel is the founder of Kensington Counselling Rooms and Pimlico Counsellors and Psychotherapists. He researches uncomfortable topics, including money in psychotherapy.

23.11.2019

Ways of calculating counselling fees

There are various ways businesses decide what the price should be. Some companies check the competition to see how much others charge, some calculate their counselling fees by costs and add a profit margin on the top, some like many big businesses nowadays are prepared to offer services and products for less than it costs to produce them as they want to grow before they start making a profit. The lack of discussion on calculating counselling fees led to a vacuum filled by own attitudes to money, generational gap and a fixed idea that if you have graduated you should charge around £45 per session.

The minimal discussion on the financial matters in psychotherapy may be rooted in our uncertainty and shame of talking about money. Some of us may feel uneasy charging for our services as helping others may feel natural. The generational divide is between generations of therapists who were trained during a more supporting housing situation, they usually own home and often work from it, while the new generation has to pay the high fees for therapeutic room rental and marketing that does not concern most established psychotherapists and supervisors.

This article is an invitation to a more robust discussion on psychotherapeutic financial matters and includes an alternative to calculating the counselling fees psychotherapists may charge. It is an invitation to rethink various aspects of our work that contribute to how we set our prices. All of the questions are based on personal beliefs and decisions; no two therapists should come with the same outcome.

In this article, I will ask you four questions and then propose a calculator with a formula that may be a way to calculate your counselling fees. I suggest you note down an answer to each question on a sheet of paper.

What is a decent salary for the work you do?

Let’s start with a question what a decent salary for the counselling or psychotherapy is? We are looking here for a full-time salary of psychotherapists or counsellor in the NHS or other organisations plus-minus what you believe you should earn? We are coming from different social and economic backgrounds, and at different times of our lives we may value ourselves or the therapy differently, so after you research the salary in the NHS in your area, check if you feel comfortable with this as your salary? Please note down that salary per annum with all taxes as you will need it for the counselling fees formula calculator below.

What are annual expenses in a psychotherapeutic private practice?

Having found the salary, let’s move to consider the annual expenses. If you are a seasoned therapist you can check your last year self-assessment or limited company statement, but please do remember that we are calculating the full-time salary, so for example, if you only work three days make sure that you increase your expenses to a five-day simulation.

For people who need to figure out their counselling fees for the first time, I have prepared a prompt list of some possible expenses people

  • Expenses:
    • Room rental – this is probably the most significant expense if you work in a large city such as London, the final price depends on how many clients you plan to see as a full time professional (see below)
    • Continuous professional development – with a minimum of fifty hours (UKCP standards) and the reality that most of us completes even more hours each year this is usually the second biggest expense. Please add here the cost of travel to the workshops and conferences, hotels and food if permitted by your accountant
    • Clinical supervision including travel to and from the destination of your supervisor
    • Personal therapy including travel (see above) – as most of the guidelines for psychotherapists suggests that we should be in personal therapy, I have included this as a business rather than a personal cost
    • Books and subscriptions
    • Registrations, insurance and other professional costs
    • Advertising (website, directories – e.g. Counselling Directory or Psychology Today, Google Ads, business cards, ads, etc.) – this expense will differ if you work long term or short term as in general short term therapists need to invest more in advertising
    • Accounting and banking
    • Mobile phone, emails, etc. (consider that the percentage of your mobile phone use if you don’t own a separate phone for your business purposes
    • Stationery
    • Equipment, e.g. computer, printer, scanner, shredder (you will not buy them each year, so consider how often you plan to exchange)

How many hours a week is full time for a psychotherapist?

This is a personal question and in order to provide a diversity of opinions. While the United Kingdom Council for Psychotherapists suggests that full time for psychotherapists is anything more than 20 hours, I have asked three senior therapists from our practices in Kensington and Pimlico to share their experience. Please note the number of hours that you think constitute the full time for you. This number may change as depends on our capacity for clients, support and work-life balance.

Cristina Durigon:

That’s an interesting question and of course, this can vary from practitioner to practitioner. In my personal experience, a full-time psychotherapist would be seeing a range between 18 and 22 clients or supervisees per week. This would mean offering more or less 4 to 5 hours of clinical contacts per day. The rest of the day would be dedicated to writing notes, attending supervision or undertaking other administrative tasks. Of course, this varies depending on a number of situations such as time of the year and workload, so, therefore, these are not fixed number. I hope this helps to give you an idea of what a typical week for a full-time psychotherapist would look like.

Gilead Yeffett:

My experience of a full-time practice is working five days a week, my average week includes 26-28 clinical hours.  I predominantly work with couples and parents-children; two- or three-person sessions last an hour and a half so I plan each day to cover no more than six and a half clinical hours.  I find the work highly rewarding and find that with the right weekly supervision I can maintain a solid and viable psychotherapy business.

Emily Cavendish:

What constitutes full-time is not just about clinical hours, it is also about how you manage your resources and the extent to which your work with clients can expand to fit the time and the space you have available. I did not set out to see 30 clients a week and, in truth, I would prefer a slightly smaller caseload. However, as for so many professionals who are self-employed, there can be a ‘feast or famine’ aspect to setting up a business. I am very familiar both with intense anxiety about how I can possibly see everyone and give them the attention they deserve, as well as a gut-churning fear of all my clients abruptly ending therapy and no new referrals coming in. This unpredictably is one of the features of private practice which makes it hardly to regulate the number of clients you take on. Perhaps one answer to the question of ‘what constitutes a full-time clinical practice?’ is that it is the number of hours you can work and simultaneously honour the needs of your clients alongside your own. This is a tricky balance to strike and one that must be subject to ongoing review.

How many weeks will you work on average with a client in a year?

To understand the salary of a psychotherapist over a year, therapists need to be clear how many times in a year they may see a client. Although this can be a simple question based on therapists availability, it includes essential considerations about holiday plans, time saved for sick leave, continuous professional development as well as the therapeutic boundaries. Does your contract with your clients protect you and the therapy from them taking too many holidays? For example, a therapist may plan 4 weeks of holidays, include time for 2 weeks of sick leave, 1 week conference and offer up to 5 cancellations for their clients – this equals to 40 working weeks in a year. Another example would be a therapist who expect to be paid during all of the clients' absences, travelling once for a conference, not working over 4 weeks in August and 2 weeks of Christmas and allowing only one week off due to sickness – their working year is 44 weeks. I am suggesting here only models where therapists charge for missed clients sessions with a short notice such as sickness, train cancellations, etc.

Counselling fees formula:

In the above paragraphs, you were guided through ways of figuring different amounts that now can be put into the calculator below:

 

The counselling fee that you calculated above is an average fee for a session, but you may consider increasing your price to offer some charitable work.

Social responsibility and offering discounts

A lot of my supervisees, especially those who just begun, offer discounts to clients almost automatically. As we (therapist) often had helping roles in our families, the offer of help and work for little money may seem natural to us. Others may feel that they have not qualified enough yet, so their counselling is not worth the full fee anyway. Both of the above reasons are unfortunately related to therapists own lives and have little to do with the reality of the client’s situation; they also may not support therapists in their long term relationship with their clients. A therapeutic relationship lasts for years and it is vital that the therapists prevent a situation when they may feel resentful towards clients, especially if they think they don’t value the work.

If it comes to the requests for discounts, it is important to consider if the client is not devaluing a therapy as they may devalue their own emotions and psychological health. Some of the clients may come from affluent backgrounds where money has always been a point of negotiations; they may bring these skills to the therapy too, expecting that the price we offer is a starting price of negotiations.

Having warned about all ways how it may be wrong, I think that therapy should be and isn’t at the moment accessible, and would encourage therapists to offer part of their time to people who cannot afford it. This can be done on a fixed fee basis where therapists increase their average fee (see above) by the amount they want to reinvest supporting low-cost clients or a sliding scale basis. If you choose to make it on a fixed fee basis, you need to find a discreet way of informing your clients about the low-cost places for example by writing on your website that you offer a small number of concessionary places. The sliding scale system is described below.

Sliding scale

The sliding scale system is a fair and transparent way of offering prices relevant to clients incomes. Therapists prepare the sliding scale considering the average calculated above and link it with the average salary in the area or of the group of clients that they already have in their practice. When clients come to the first session or even in the discussion over the phone, the therapist presents the scale. In most of the cases, clients are asked to self-identify the place on the scale, and we would not usually ask for evidence of their salary.

The problem is that your practice may become an attractive option to the people on low income only and you may need at some point not to accept clients who earn below a certain amount as you will earn below the calculated average.

I hope that the above system and counselling fees calculator will stimulate some discussion on how to calculate fees for psychotherapists and counsellors.

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