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Author: Ted Dekker

The Rich Therapist

The big insurance companies (all those HMOs and PPOs) have profoundly affected how therapists are paid. In reality, it's not unusual for therapists to make between $35,000 and $55,000 a year. (More than your average startup writer, granted!)

To put that in perspective, though, if you can write JavaScript, C++, or PHP, you can easily make more, and you don’t even have to have a college degree (though certainly one tends to be preferred).  I know exceptional therapists who carry a full case load and still make only $25,000 to $30,000 a year.

While $100 an hour may seem steep, the only money therapists make is during client sessions.  Therapists don’t get benefits, health care, or retirement plans from their employers (if they even have employers).  In fact, if a therapist works for a practice owned by someone else, the employer may take 50% or more of what the therapist makes for each client seen.

Add that to the fact that insurance pays therapists a reduced fee for each session (say $40 to $80, though it can be less)—and suddenly that $125/hr you think your therapist is pocketing becomes $20 or $30 at most—a rate that’s comparable to skilled construction workers (e.g. brick masons, boilermakers, elevator installers).

Now, the longer one practices therapy, the more likely one is to start a practice or move into a position as one of the primaries, so as a client base grows, one's salary will also go up—but again, that can take years and often decades. 

The Occupational Outlook Handbook provides good general information on job earnings and requirements. (If you've never visited, it's a great resource.) Here are some entries; everything in italics is a direct quote.