How to set your therapy fees: A framework for UK practitioners

There are therapists in the UK charging £40 per session who are burning out. And there are therapists charging £120 who have a waitlist and feel entirely at ease with it. The difference is rarely about qualifications. It is almost always about how they think about money.

Fee setting remains one of the most avoided parts of private practice. Therapists who are comfortable sitting with difficult emotion often hesitate when the question becomes: what do you charge?

This is not about picking a number.

It is about how fees actually play out in real practices, and what happens when they are set without a clear view of the numbers behind them.

Why this feels difficult, and why it matters

Let’s name the elephant in the room.

Therapists often have a complicated relationship with money. Across surveys and practitioner reports, a clear majority describe some level of anxiety, guilt, or internal conflict when thinking about fees. That does not meaningfully reduce with experience.

This is not a personal failing. It is a professional hazard.

You entered a caring profession, likely because you are wired to help. Along the way, a cultural message can take hold that caring and charging are in tension. That a “real” therapist would sacrifice financially in service of their clients.

The BACP Ethical Framework offers a useful counterpoint. It includes self respect as a core principle, defined as fostering the practitioner’s integrity and care for self.

There is also a clinical argument that is often overlooked.

When your fee is too low to support a sustainable caseload, you compensate elsewhere. You take on more clients than you can comfortably hold. Your attention stretches. Financial pressure sits quietly in the background. Over time, resentment builds and the quality of your presence shifts.

In practice, this pattern shows up clearly. Therapists who charge too low rarely notice it immediately. Their calendar fills, cancellations feel more disruptive, and over time they stretch their availability rather than adjusting their fee. The pressure builds quietly.

The work does not collapse overnight. It erodes.

Charging appropriately is not about maximising income. It is what allows you to do good work over the long term.

What the market looks like in 2026

Before setting a fee with confidence, you need a clear picture of what is happening in practice today.

Recent data from 2025, still reflective of early 2026, shows consistent ranges.

By role and qualification

• Counsellors and psychotherapists: typically £50 to £90 per session, with many clustering around £60 to £75
• CBT therapists: commonly £70 to £120
• Clinical and counselling psychologists: £100 to £180, with London based specialists often exceeding this
• Couples and relationship therapy: typically £80 to £180

By geography

Regional variation still exists, but it is less deterministic than it once was. London remains the highest priced market, but other cities show wide internal variation.

The myTribe Insurance survey from 2025 illustrates this. While London averages around £160 for psychologists, cities such as Leicester appear higher than expected despite lower median incomes. Geography influences pricing, but does not define it.

For counsellors and psychotherapists, typical fees sit around £50 to £80 outside London, and £70 to £100 within it.

Online vs in person

The gap between online and in person pricing has narrowed significantly. Many counsellors and psychotherapists now price both formats identically. For psychologists, a modest gap persists. The myTribe 2025 survey found the national average for online consultations was around £116, compared with £130 overall. This gap is closing as online delivery becomes standard practice.

The framework: four questions that set your fee

Rather than anchoring to what others charge, a sustainable fee emerges from answering four questions grounded in how a practice actually runs.

Question 1: What does it actually cost to run your practice?

Most therapists underestimate the true cost of a billable hour.

The visible costs are straightforward: room hire, memberships, insurance. The less visible ones are where the calculation breaks down: supervision, CPD, cancellations, unpaid time, and administrative work around each session.

What tends to happen in practice is that therapists anchor on session time alone. The surrounding time is not tracked, so it is not priced. Over time, that gap compounds.

A realistic annual cost base for a sole practitioner in England typically falls between £5,000 and £12,000 before tax. With premium room hire, additional memberships, or admin support, this can rise to £15,000 or more.

This matters because of how therapists are paid.

You are not billing 40 hours per week. The BACP recommends a maximum of 20 client hours for sustainable practice. In reality, many practitioners work closer to 15 to 18.

Once notes, communication, and non billable work are included, a 50 minute session often represents closer to 90 minutes of total time.

Add holidays, illness, and CPD, and realistic billable hours fall to around 700 to 800 per year.

This is the number most fee discussions ignore.

In practice, very few therapists track this explicitly. Which means most fee decisions are made without a clear denominator.

If your overheads are £8,000 and your target income is £50,000, you are solving for your fee. At 750 billable hours, this places your required fee in the region of £67 to £73 before pension, buffer, or margin.

Most therapists who run this calculation properly reach the same conclusion. They have been undercharging.

When these numbers are tracked over time, fee setting becomes straightforward. Without them, it remains a recurring source of uncertainty.

Question 2: What does the local market support?

Once you know your floor, you need to understand the range.

Look at what qualified therapists with similar experience and modality are charging within a 10 mile radius. Counselling Directory, Psychology Today, and the BACP directory all publish fees.

This is not about copying someone else’s rate. It is about understanding price sensitivity in your local market.

Key nuances

• Modality matters. EMDR, trauma focused therapies, and couples work often command higher fees
• Experience compounds. A therapist with 15 years of experience can reasonably charge more than someone newly qualified
• Local affluence shifts the range, but does not cap it. Practising in a wealthier area gives more room to charge higher fees, but a strong specialism or extensive experience can justify a premium in any market

Question 3: What Is your fee’s relationship to value?

This is often avoided: what is the value of the service you provide?

BACP research suggests that 73% of people who access therapy find it helpful. There is also evidence that paying clients may show stronger commitment and outcomes. The financial investment itself carries weight.

Compare therapy to other professional services. Solicitors, physiotherapists, and accountants charge comparable or higher rates without hesitation.

You are not charging for time alone. You are charging for expertise built through training, clinical hours, supervision, and ongoing CPD.

Question 4: Is your fee honest about what you need?

This is the most personal question.

There are broadly two ways therapists arrive at a fee. Either by intuition, often influenced by discomfort around money, or by working backwards from actual numbers. Only one of these holds up over time.

What income do you need to live without financial stress? What would allow you to remain in this work long term without burnout? Include pension, savings, illness cover, and holidays.

Your fee should reflect this deliberately, not emerge by default.

The Sliding Scale: When to offer it, and how to do it properly

Many therapists feel a pull towards offering reduced fee work, and there is real value in that impulse. Accessibility matters. But the way most therapists implement sliding scale fees is financially unsustainable and ethically ambiguous.

Here is the problem. An unstructured sliding scale, where you discount ad hoc in response to whoever asks, without a policy, puts you in the position of making a clinical and financial decision under pressure, often in the moment of intake. That is a recipe for inconsistency, resentment, and gradual erosion of your income.

A sustainable sliding scale requires three things:

• A floor. Your sliding scale should never go below the cost per hour of running your practice. Charging £30 when your overheads cost £35 per hour is not generosity. It is slow financial self harm.
• A cap on slots. Decide in advance what percentage of your practice you are willing to allocate to reduced fee work. Many therapists use 10 to 20% of their caseload as a guide.
• A policy, not a negotiation. Write your criteria down. Decide your tiers and apply them consistently.

It is also worth noting that offering a sliding scale is not an ethical obligation. There are other ways to contribute to accessibility.

When and how to raise your fees

If you have not raised your fees in over a year, inflation has already reduced your real income. The consumer price index has risen significantly over the past three years. A fee that felt right in 2023 is worth materially less today.

Signs it is time to raise your fee

• Your schedule has been consistently full for six months or more
• You have completed additional training or achieved a new qualification
• Your overheads have increased
• You notice reluctance or resentment around client work
• You have not raised your fee since qualifying

How to communicate a fee increase

Give meaningful notice, typically four to eight weeks. Be direct and warm, but not apologetic. You do not need to justify the increase at length.

Most clients will accept a well communicated increase without difficulty. The discomfort is usually greater on the therapist’s side than the client’s.

Putting it together: A step by step summary

1. Calculate your cost floor. Add up all practice overheads for the year and divide by your realistic billable hours. This is the minimum you must charge to break even, and your fee should sit comfortably above it.
2. Define your income target. What do you need to earn, before tax, to live well and stay in this work for the long term? Work backwards to arrive at a required hourly rate.
3. Research your local market. Check what therapists with comparable qualifications and modalities are charging in your area. Position yourself consciously within that range.
4. Apply your premium factors. Years of experience, specialist modalities, accreditation level, and whether you work online or in person all influence where in that range you sit.
5. Set your sliding scale policy, if applicable. Define your tiers, your slot cap, and your criteria. Write it down and apply it consistently.
6. Review annually. At a minimum, adjust for inflation each year. Reassess after completing significant additional training, achieving a new accreditation, or when your caseload consistently exceeds your available slots.

A final word

The fee conversation is not separate from the therapeutic work. It is part of the structure around it.

A practice where fees are set deliberately tends to be more stable, more consistent, and easier to sustain over time. A practice where fees are avoided tends to compensate elsewhere, often in ways that are harder to see at first.

How you price your practice communicates something about how you value your expertise, and shapes how your clients value the space they are investing in.

Set your fee accordingly.