Why is Couples Therapy So Expensive?

If you have been searching for couples therapy in your area, you are likely experiencing “sticker shock.” Some of the best therapists in town are charging between $200 – $300 per hour.  After crunching the numbers, you realize if you need months of therapy than it will amount to a few thousand dollars. So, you are likely wondering,  is couples therapy really worth the expense?

Yes it is, and here are the reasons why marriage and couples therapy can be so expensive:

  1. The therapist who (truly) specializes in couples therapy has extensive and costly training that enables them to do this work. All of these specialists have a minimum of a masters degree and many have a doctorate. These degrees require years of post-graduate study. After this extensive education, therapists must do their clinical hours under supervision that they pay for on a weekly basis for a minimum of two years. Many therapists elect to complete additional training in a particular method of couples’ therapy (such as EFT or The Gottman Method). Therefore, marriage therapists are highly educated and highly skilled, and their expertise is not, and should not be, inexpensive.
  2. Insurance does not cover couples therapy. Relationship problems and couples/marriage therapy do not have a “billable diagnostic code” for insurance.  Some therapists will give one partner a diagnosis and bill for sessions under that client. You may be able to find a therapist willing to do this, but again, he or she may be a general therapist and not have specialized training to work with couples. Some therapists ethically wish to avoid labeling one of you when the problem being treated is a relational Unfortunately, insurance reimbursement DOES NOT commensurate with the experience of those who specialize in couples therapy or other complex mental health disorders.
  3. Couples therapy takes longer than individual therapy. Relationship dynamics are complex. Working with you both as a couple will take more time than individual therapy.  The assessment process alone can take up to four sessions. You also may have waited too long to get help and the problems can be bigger and more complicated by the time you finally make the call to find a therapist.
  4. Couples therapists have a hard time with the “50 minute hour.” The sweet spot for an effective couples’ session seems to be around 75 – 90 minutes.  Research supports this estimate. Things are usually hitting a pivotal point around 50 – 60 minutes and stopping right then is difficult.  It is much better to tie up loose ends as much as possible in each session and this often requires more time with two people than it does with one.

Options If You Can’t Afford Couples Therapy

Keep in mind that marriage therapy will always cost less than a divorce.  If you are financially struggling, you may be able to find a “sliding fee” therapist or community agency for less than a traditional marriage therapist.  If you are near a university or training center, going to that institution’s clinic may be a viable solution as well, but expect to be working with someone still under supervision for their degree and/or license.  Note that the quality may vary with these selections, so be sure to ask the right questions to find out about the therapist’s specialized training with couples and/or how he or she will be supervised.

A couples workshop or group is also often a lower cost option. Reading highly recommended self-help books together can also be beneficial. These options may only work for couples with minor or less complicated issues. Doing a workshop and reading self-help books can also possibly assist in shortening the time you need to be in marriage therapy.

It never hurts to ask the therapist for a reduced fee.  The worst he or she can say is “no.”  The next question might be about another therapist or a resource the therapist might recommend in your area if their services are still beyond your financial reach.

Although couple therapy is costly, it is absolutely worth it. If you are not sure that it is right for you and your spouse, you both can always commit to an initial visit only at first.  Making the effort to find the best help you can afford or budget your money for this service is a sound idea.  When you commit to counseling, give it a full and sincere effort and you will find it was a wise investment in your relationship.

I’m Dr. Marni Feuerman, a licensed marriage and family therapist with extensive training in couples therapy. My office is in Boca Raton, Florida but I also conduct online therapy sessions. Reach out for more information. This article was originally written for Brides.com.