In Ontario, therapy typically ranges from $120 to $250 per session, with the average cost for a Registered Psychotherapist (RP) or Clinical Social Worker falling around $150 to $180. Sessions with a psychologist may be higher, often between $150 to $300.
For those without extended health benefits, this can be tough to manage—and if you're feeling frustrated by the financial side of therapy, that's totally valid.
Why Is Therapy So Expensive?
1. Therapists Typically Don’t Earn a Salary or Hourly Wage
Most therapists in private practice are self-employed or independent contractors. They only get paid for the time spent with clients—not for everything else that happens behind the scenes to support your care. In fact, much of the therapeutic process extends beyond the 50-minute session, including:
• Documentation & Record-Keeping: Therapists must maintain case notes after each session to track progress and meet ethical and legal requirements.
• Treatment Planning & Research: Therapists regularly review case notes, plan upcoming sessions, and research interventions or approaches tailored to your needs.
• Consultation & Supervision: Many therapists consult with colleagues or supervisors to ensure ethical, effective care—especially when navigating complex or sensitive issues.
• Resource Coordination: Therapists may spend time outside of sessions researching other supports that may help you or liaising with other health professionals.
This “invisible work” is a core part of your treatment and it's a big part of what makes therapy thoughtful, personalized, and effective.
2. Income Can Be Unpredictable
Therapists often don’t have a consistent income. Cancellations, slow seasons (like summer or holidays), and gaps in scheduling can mean big dips in earnings. Yet, business costs remain constant, which impacts how sessions are priced.
3. Membership Fees to Regulatory Colleges and Professional Associations
To legally practise in Ontario, therapists must register with a regulatory body—like:
• CRPO (College of Registered Psychotherapists of Ontario)
• OCSWSSW (Ontario College of Social Workers and Social Service Workers)
• CPA (Canadian Psychological Association, for psychologists)
In addition to these mandatory registrations, many therapists also choose to join professional associations—such as the Ontario Association of Mental Health Professionals, or the Ontario Art Therapy Association—to access liability insurance, training opportunities, and peer networks.
Whether mandatory or voluntary, these memberships come with annual fees that therapists must pay.
4. Ongoing Professional Development
Therapists are also required to stay current with clinical best practices and ethical standards. This means attending trainings, workshops, or conferences, and sometimes earning additional certifications. These professional development activities aren’t just good practice—they’re mandatory for maintaining registration and providing quality care.
Again, private practice therapists pay for all of this themselves, and the costs can add up quickly.
5. No Health Benefits or Paid Time Off
Unlike salaried workers, therapists in private practice don’t receive health or dental benefits unless they pay for them personally. They also don’t get paid vacation, sick days, or parental leave. When they take time off, they forgo income—something many have to account for in their session fees.
6. Operational Costs Add Up
Running a practice—whether online or in-person—comes with real overhead:
• Rent or office space (or a home office)
• Computers, phones, furniture and supplies
• Personal Health Information Protection Act (PHIPA)-compliant virtual platforms (e.g. secure video software)
• Insurance (liability, commercial, and sometimes cyber insurance)
• Legal and accounting fees
• Bookkeeping
• Marketing and business tools
These are necessary to offer you a safe, professional, and confidential space—whether in person or online.
Group Private Practices vs. Solo Providers
Understanding the structure of a therapist’s practice can help explain where your money goes.
Group Private Practices:
In these settings, therapists work as independent contractors. While the clinic may provide shared infrastructure (admin support, office space, software), therapists split the session fee with the clinic to help cover those costs.
However, therapists in these settings still cover many of their own business and clinical costs, that may include:
• Liability and commercial insurance
• Continuing education
• Equipment such as laptops or tablets
• Materials for clients for use in sessions
• Other professional or client-related expenses
While the clinic provides some support, therapists still carry individual costs that influence their rates.
Solo Private Practice Providers:
Solo therapists manage every aspect of their business on their own. This includes administrative tasks, marketing, tech setup, supervision, and professional fees. Whether they work virtually or in person, they absorb all the operational and clinical expenses—and session fees reflect that reality.
A Final Thought: Therapy Should Be More Accessible
Mental health care deserves the same coverage as physical health care—but in Ontario, therapy isn’t included under OHIP (Ontario Health Insurance Plan). While some people have benefits through work or private plans, coverage is often limited and runs out before treatment is complete. We need broader, more sustainable access to mental health support—whether through public funding, employment benefits, or self-pay plans.
Therapists deeply understand the financial burden many clients face. Most entered this work to help—but they also need to cover business and living expenses, which is why fees are what they are, not a way to “get rich.” Until systemic changes are made, knowing where your money goes can hopefully offer helpful context and support more informed choices.
If you're considering therapy but worried about the cost, reach out. Many therapists (myself included) are open to discussing fees, exploring sliding scale options, or helping you find affordable care.
Your mental health is worth investing in—and you don’t have to navigate it alone.
