highest hourly rate for therapy

[bmedclinic]

What's the highest rate you've heard of for someone paying for psych therapy ? Not talking assessment here, just hourly rate for therapy. If it makes a difference to you, the instance I heard about was cash pay in a major metro area.

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[Ollie123]

350/hour (cash). Hourly rate with an incredibly renowned academic (i.e. "Wrote the book" on X) with a small side practice who only carried a handful of cases at a time. I'm sure there are plenty of cases of people paying significantly more though.

 

[clinpsyc87]

$500/hr. Inpatient psychologist, head of adolescent unit. Upon discharge a girl's dad requested she see his daughter. She informed him she doesn't see private clients. She now sees private clients. Major area with a .1%er

 

[BuckeyeLove]

I imagine Yalom's rate is through the roof

 

[BuckeyeLove]

I actually had a professor, completely old school dynamic analyst, practicing in a very well-to-do area of an unnamed city that loves chili, and dude only accepted 300 an hour, cash. wasn't exactly well-renowned, but he was booked up eight months out. word of mouth with the worried-well is a very powerful thing apparently.

 

[smalltownpsych]

My challenge is that I prefer the really sick to the worried well so I don't know if I'll ever be able to charge those types of rates. I also don't know if I have the arrogance/confidence necessary to market myself as that much better than the rest in order to justify the rates.

 

[bmedclinic]

I only ask, not to aspire to that type of practice, but because I heard a cousin of mine (27 yo) went to a "CBT therapist" in a major city and he apparently paid $500/hr. At first I thought maybe it was a clerical error (adding an extra zero). I feel badly for my cousin- 5 sessions later, $2500 down the drain, and he now believes "cbt doesnt work" rather than much more logical conclusions we would all come to.

On the flip side, I had a local guy "brag" to me (maybe he wasnt bragging, but at the time it seemed like it) that he bills $80/hr. Perhaps I misread him though and he was defensive and came off as bragging, but at the time I couldnt understand why he was bragging about such a topic.

 

[PsyDr]

I went to a "big name" analyst. He charged 400/hr. Changed to a training analyst who was in the typical range. Turns out I am not 50k/yr unhappy.

 

[deleted343839]

Of people I've known personally I think the highest I've heard is $300/hr. But I read a piece in the NY Times a few years back that mentioned old-school psychoanalysts in Manhattan who charged upwards of $500/hr. I was blown away.

 

[smalltownpsych]

I only ask, not to aspire to that type of practice, but because I heard a cousin of mine (27 yo) went to a "CBT therapist" in a major city and he apparently paid $500/hr. At first I thought maybe it was a clerical error (adding an extra zero). I feel badly for my cousin- 5 sessions later, $2500 down the drain, and he now believes "cbt doesnt work" rather than much more logical conclusions we would all come to.

On the flip side, I had a local guy "brag" to me (maybe he wasnt bragging, but at the time it seemed like it) that he bills $80/hr. Perhaps I misread him though and he was defensive and came off as bragging, but at the time I couldn't understand why he was bragging about such a topic.

Doesn't he know CBT takes 8 sessions? 😉 Also, I'm surprised it didn't work because I thought paying more increases the placebo effect or at least you have to say it works to minimize cognitive dissonance or feeling like you got took.

 

[Therapist4Chnge]

$275 & $350...both in NYC. Neither are big names, just good clinicians w. enough biz smarts to support their rates; high overhead locations though.

 

[cara susanna]

Any idea what these people would approximately be taking home?

 

[smalltownpsych]

300 x 30 = 9000 x 48 = 432,000 less 30% overhead would be about 300k Not bad.

 

[Dr.Penguin9000]

300 x 30 = 9000 x 48 = 432,000 less 30% overhead would be about 300k Not bad.

That's better than what many physicians, especially primary care and peds, earn.

This doesn't seem very common or sustainable, or am I wrong?

 

[Therapist4Chnge]

I wish it were that easy. I can't think of a realistic scenario where a clinician can expect to bill out 30hr of clinical work per wk at that rate. It'd be nice though.

 

[PsyDr]

That's better than what many physicians, especially primary care and peds, earn.

This doesn't seem very common or sustainable, or am I wrong?

You're asking if someone who represents less than 1% of the private practice psychologist population is uncommon?

People discuss the extraordinary. The chances of getting into the mlb is minuscule. The chances of pro baseball players becoming the star of the game is even less. But we still discuss Babe Ruth.

 

[deleted343839]

You're asking if someone who represents less than 1% of the private practice psychologist population is uncommon?

People discuss the extraordinary. The chances of getting into the mlb is minuscule. The chances of pro baseball players becoming the star of the game is even less. But we still discuss Babe Ruth.

Kind of reminds me of that post a while back when someone wanted to become a "personal psychologist to a celebrity." That was a gem.

http://forums.studentdoctor.net/thr...e-to-become-a-celebrity-psychologist.1125384/

 

[PsyDr]

Ahhh psychology: where everyone is above average.

 

[smalltownpsych]

That's better than what many physicians, especially primary care and peds, earn.

This doesn't seem very common or sustainable, or am I wrong?

Not very common at all from what I understand. Maybe the top 5% of psychologist are doing this? It's difficult to really find the stats on some of this because when you are running a business, you keep the profit low for tax reasons. First, you have to work with a population that can afford to pay this and second be effective enough that they will keep coming and refer to you. Insurance panels won't pay this much, that's for sure. If you can get half that 300 number you are doing well with them. You can still make a pretty good living that way.

edit to add: I wrote this earlier and didn't see the above posts. That 1% figure is probably about right.

 

[Therapist4Chnge]

I think it is more likely that a well established/known clinician has a small private practice (<10 pts) on the side of a day job as an administrator, researcher, consultant, etc.

There are most likely strings that come w. charging that much (more flexible hours, taking calls after hours, etc). If not...my hat is off to that clinician, but ppl willing to pay that much above "the going rate" will probably expect some flexibility.

 

[123EW]

I think it is more likely that a well established/known clinician has a small private practice (<10 pts) on the side of a day job as an administrator, researcher, consultant, etc.

There are most likely strings that come w. charging that much (more flexible hours, taking calls after hours, etc). If not...my hat is off to that clinician, but ppl willing to pay that much above "the going rate" will probably expect some flexibility.

I know someone who charged $450/hour cash and had a cap of 10 per week. They were always receiving calls after hours and such. Even though they charged more for the after hours work, this was not discouraging. After all, the folks that can freely fork over $450/week are not likely feeling the pinch.

I also know of someone that has 30+ clients/week. They charge $125/hour. They are frequently feeling burnt out.

Personally, I am not interested in the least of either of these scenarios.

 

[smalltownpsych]

I see over 30 patients a week. Sure I get tired, but then again I get compensated for the work so it tends to even out. When I was on salary, I had almost the same stress and workload and made half the money so for me it is worth it. Although on a Friday at 5:00 like right now, I am thinking that it might be too much.

 

[Therapist4Chnge]

It amazes me that more clinicians (doing therapy) don't burn out. The caseloads sound unmanageable at times, especially for salaried positions.

 

[LMK]

Kind of reminds me of that post a while back when someone wanted to become a "personal psychologist to a celebrity." That was a gem.

http://forums.studentdoctor.net/thr...e-to-become-a-celebrity-psychologist.1125384/

I remember that! That was fun...lol

 

[smalltownpsych]

It amazes me that more clinicians (doing therapy) don't burn out. The caseloads sound unmanageable at times, especially for salaried positions.

Wait till next week when I am on call and add even more contact hours. I have been going at this pace for about 2 years now and plan on 3 more. I have worked harder at other jobs in my life for a lot less money so it isn't that bad. Internship is one example, also when I was in my early 20s I worked 60+ hours a week delivering electronics and high end furniture for about 500 bucks a week, now that was real work.

See its Saturday morning and I already feel well-rested and optimistic again. 🙂

 

[Ollie123]

It amazes me that more clinicians (doing therapy) don't burn out. The caseloads sound unmanageable at times, especially for salaried positions.

Always amazed me too. In my current position I'm expected to do 6-7 45 min sessions per day (which means scheduling 7-8). That is pushing it for me and I know many folks have significantly higher caseloads. I only do 2 clinic days a week, which makes it somewhat more tolerable. If I could keep my effort constant and spread them out throughout the week that would be even better, but logistics make that tough. To be fair, I rarely hit my numbers though and haven't heard any complaints about it yet. Cancellation rates and the nature of some of the folks I'm seeing simply mean its not going to happen.

The sessions themselves are actually manageable, but the case management that goes along with it is what gets to me. The amount of time spent on the phone dealing with rescheduling, coordinating care, etc. adds up fast and can significantly eat into non-clinic days.