How Much Does Therapy Cost in Charlotte NC?
Takeaway: The cost of therapy in Charlotte tracks pretty closely to the ranges we see in North Carolina more broadly. On the very low end, the fee for a standard 50-min session can be as little as $40. On the high end, costs can exceed $375 per 50-minute session. These are obviously the extremes. Typically, you will find the median price for therapy to be between $120 and $220 for a 50-minute session.
Before I dive into the topic of this post, it might be helpful to know a bit about me -- so, here's a brief summary of my training and qualifications: My name is Dr. Jess Ribeiro. I'm a clinical psychologist with over 16 years of clinical, teaching, and research experience. After graduating magna cum laude from the University of Pennsylvania, I pursued a PhD in Clinical Psychology at Florida State University, completed my predoctoral residency at Brown University, and post-doctoral fellowships at Vanderbilt University and Harvard University. I've since authored over 80 peer-reviewed journal articles, have been recognized as a "Highly Cited Researcher" by the Web of Science and a "Rising Star" by the Association of Psychological Science, and been named "Best Early Career Researcher" by the American Association of Suicidology. As a clinician, I specialize in the treatment of eating disorders, depression, anxiety, and OCD using leading evidence-based treatments. I'm licensed in the states of NC, NJ, and FL and, as a PSYPACT-certified provider, I'm also able to provide telehealth services in most U.S. states.
As a therapist, I've always valued being direct and transparent about what to expect with my clients. I believe you deserve to know what treatment will look like with a given provider, how long it will last, and what kind of outcomes are typical. I also believe you should have information about how much you expect to pay. The costs of therapy, unfortunately, aren't always clear. If you're searching for a therapist currently, you may have questions like, What are the therapist's fees? How do they compare to the median price in your area? How much can fees vary based on therapist's training or qualifications? Does a therapist offer reduced rates? Do they take accept your insurance (i.e., are they an in network provider)? If they're out of network, is there a process for reimbursement? Can you use your health savings account or flexible spending account?
The process of finding a therapist that's a good fit can be overwhelming. In Charlotte, NC alone (where I'm based), there are over 2,000 therapists providing psychotherapy services -- that's a whole lot of people to sift through on your own! So, in this post, I've done some of the legwork for you. If you're looking for a therapist in Charlotte and hoping to get some insight on therapy fees and costs in this area, my hope is that this post will assist you a bit in that process.
How much does a therapist cost in NC?
The cost of therapy in Charlotte tracks pretty closely to the ranges we see in North Carolina more broadly. On the very low end, the fee for a standard 50-min session can be as little as $40. On the high end, costs can exceed $375 per 50-minute session. These are obviously the extremes. Typically, you will find the median price for therapy to be between $120 and $220 for a 50-minute session. Many therapists, regardless of their standard cost, will also have a few spots in their caseload that are charged on a "sliding scale", meaning that they reduce their fee to make their services a bit more affordable. See below for more detail on estimates for median costs of sessions by treatment type.
| Type of Therapy | Average Cost of an Individual Therapy Session |
|---|---|
| Cognitive Behavioral Therapy (CBT) | $175 |
| Exposure and Response Prevention (ERP) | $170 |
| Enhanced CBT for Eating Disorders (CBT-E) | $220 |
| Dialectical Behavioral Therapy (DBT) | $200 (note: this estimate only reflects individual sessions and does not include cost of DBT skills training group that is necessary for comprehensive DBT) |
Is therapy covered by insurance?
It can be, depending on your insurance benefits. To determine whether your specific plan covers mental health services, you can always contact your insurance company. But, I'll try to give you a brief primer of the different ways that insurance may cover treatment.
Using in-network providers who are contracted directly through your insurance: The most direct way that insurance provides coverage for treatment is if you select a therapist from your insurance's in network providers list. These therapists have been contracted by your insurance provider; they'll submit claims directly to your insurance provider on your behalf. Depending on your plan, you may still be responsible for paying your deductible, a co-pay, and/or a proportion of your therapist's fees. Another thing to be aware of is that there may also be a cap or limit on the number or type of sessions that your insurance will cover or they may only cover treatment under certain conditions.
Getting reimbursed for out-of-network providers: Many insurance companies will also offer out of network benefits. What this means is that they will provide reimbursement for services you receive from a provider who is not part of your insurance company's in network provider list. In this case, although your responsible for payment initially, you can be reimbursed by your insurance provider by submitting a claim to them directly. Typically, out of network providers will provide a superbill (i.e., a summary of the services you've received) and other documentation for your to submit to your insurance company.
What are some reasons to consider an out-of-network provider?
At first, in network may seem like the obvious choice to go with but before you constrain yourself to an in network provider, here are a few things to consider:
First, therapists and counselors who are contracted as in network providers for insurance companies are often significantly underpaid. Why does that matter? Well, what this often means is that many in network therapists are juggling very large caseloads in order to make an adequate salary. This limits the amount of time they have available for you as a client, including limited time to prepare for your sessions. Seeing such a large caseload of people also increases therapist burn out, which can compromise their ability to be fully effective. It may also mean scheduling will be less flexible, making it so that you may not be able to meet as consistently as would be ideal or may have make compromises on your end to be able to see them regularly (and ultimately get the benefits you're paying for). In short, it is often less convenient and less flexible for the client.
Second, even if your network benefits include mental health treatment coverage, many insurances have restrictions on the number of sessions or types of therapies they allow. It also means you and your therapist have less control and autonomy over your treatment plan. For some people, this may mean that they have to stop or experience a break in treatment before they're ready to do so or before it would be therapeutically indicated.
Third, many specialists do not work with insurance companies. So, if you're looking for someone with a high level of expertise in a particular therapeutic approach and/or certain diagnosis, it will be harder to find with an in-network provider. Working with a specialist often means finding relief more quickly and likely a much shorter duration in therapy in the long run.
For all the reasons noted above, I (like many other highly specialized therapists) am an out of network provider. It allows me to provide high quality care to each of my patients as efficiently and effectively as possible. Therapy is an investment -- you're investing your money, energy, effort and time into your mental health. I believe that being an out of network provider allows me to maximize the likelihood that that investment converts into the outcomes you're looking for at the end of our work together.
Why is therapy so expensive?
Cost is a major barrier that can unfortunately prevent a lot of people from getting mental health treatment. Understanding some of the factors that can impact how much you can expect to pay for therapy may help justify that cost. Here are a few variables that influence the cost of mental health treatment:
Therapists' level of training, education, and credentials
All therapists either have a masters or doctorate degree -- so everyone will have an advanced degree of some sort. Individuals with a masters degree will typically have roughly two years of additional schooling after their university degree. Individuals with doctorates will have even more. As someone with a PhD in Clinical Psychology, for example, my education and training includes four years in college followed by six years in a doctoral program that included one year of a predoctoral residency, and two year-long postdoctoral fellowships. If you include my education before college, that's a total of 24 years of schooling! But, it's not just a numbers game -- it's also the quality of care you can expect to receive based on someone's caliber of training and expertise. So, in short, a therapist's training, quality of education, credentials, and expertise in a domain will typically be reflected in their price. Though the fee may be higher, you're likely to get higher-quality care that results in getting relief from your symptoms much more quickly and, as a result, not need to receive treatment for very long.
Therapists' degree of specialization
Working with a specialist, especially in a niche area (e.g., eating disorders), will be more expensive than working with someone who does not have the same degree of specialization. This is largely due to the amount of training it requires to specialize in an area and effort required to implement certain specialized treatments.
Cost of maintaining a practice
Maintaining a practice is expensive. Most therapists have to pay rent and utilities for their office, annual fees to maintain their license (which is necessary to practice and compounded should your therapist be licensed in multiple states), fees for continuing education courses required to maintain licensure, fees to maintain specialized certifications, liability and malpractice insurance, professional association membership fees, cost of professional supervision, business licensing fee, marketing, electronic health record subscription fee, website subscription fee, secure telehealth service platform fee, credit card processing fees -- to name just a few. Most of these are recurring costs that are necessary to provide services. In short, there are a lot of backend expenses that your therapist needs to cover beyond their salary without which they would not be able to practice.
Location of services
Where your therapist is located can also impact cost. In general, you can expect that cost-of-living will be reflected in a therapist's fee. So, just like the cost of things like groceries, gas, and housing is higher in more metropolitan areas, you can also expect to pay a higher fee for therapy in those areas as well.
In short, there are a lot of factors that impact the fee you're charged in therapy. It's also worth noting, like I mentioned above, that our best available evidence-based treatments are designed to be short-term (think weeks or months, not years or decades). So, while there is a financial investment to treatment, it should be time-limited, with the ultimate gains justifying the energy, effort and money you spend.
Is therapy worth the cost?
If you're deciding whether therapy is worth the expense or something you can afford, it can be helpful to think through both the potential benefits of seeking therapy and potential downsides of not. Below, I'll highlight a few things to consider.
Symptom Relief
When it comes to evaluating the efficacy of psychotherapies, the most stringent scientific studies are called randomized controlled trials. Most of our best available treatments have been around long enough that there have been dozens of rigorous randomized controlled trials designed to test how well these treatments are in reducing symptoms of mental health conditions. Meta-analyses are studies that statistically summarize the effects we see across multiple studies. When we look at some of our best available meta-analyses, the data suggest that many of our evidence-based treatments are good at reducing symptoms associated with a variety of mental illnesses. This includes recent meta-analyses that support the use CBT for depression (Ciharova et al., 2021; Cujipers et al., 2023), CBT with exposure for anxiety (Spring er al., 2018; Carpenter et al., 2018), ERP for OCD (Reid et al., 2021), and CBT-E for eating disorders (Atwood & Friedman, 2019; Linardon et al., 2017), among others.
Improved Quality of Life
We also have data that suggest evidence-based psychotherapies don't only provide relief from symptoms but also improve a person's quality of life more broadly (Carpenter et al., 2018; Hofmann et al., 2016; Kamenov et al., 2016; Linardon et al., 2017). This includes being able to feel more satisfied in other life domains that matter to you, like your relationships, family life, career, physical health, and leisure time. You can get to a place of being able to live the life you ultimately want to live in a way that feels satisfying and fulfilled.
Equips you with Tools for the Long-Term
Though not all therapists share this view, my goal is to make myself obsolete to my patients as quickly as possible. I want you to leave therapy feeling confident about the skills and techniques we've worked on together so that you can live your life fully moving forward even when you're seeing me. Seeking therapy should allow you to have a better understanding of how to navigate challenges in the future in a way that protects your mental health.
So, in short, there are clear and well-documented benefits of seeking therapy. A main point I want to underscore here is that therapy is absolutely worth it if you can afford it and, critically, as long as it's able to deliver the outcomes you're looking for. That's why I'm a big proponent of high-quality evidence-based practice that's designed to be short-term and time-limited. The cost may be higher for some practitioners who are specialized in these evidence-based practices, but often offset by the fact that you'll be in treatment for far less time than you would with a low cost but ineffective approach.
Discover how therapy can help you.
As a therapist, I am passionate about using the best available treatments, backed by decades of science, to help people get well quickly and equip them with tools for the long-term. I specialize in treating eating disorders, depression, anxiety, and OCD in adults and adolescents using leading evidence-based therapies. If you're interested in learning more, reach out for a free 15-min consultation. You can get back to living the life you want to live, and I'm committed to help you get back there.
