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  • Writer's pictureDr Carol Newall

Psychological Therapy Fees: Reasons Why They Vary

Updated: Oct 3, 2019

medicare fees, expenses, and gap fees
How psychologsits set their rates

Fees vary considerably between psychologists. It can range from $87 to $1000 and beyond. Clients are often baffled by why the charges vary and what they are getting for their money. Moreover, all Australians are entitled to 10 Medicare Rebated sessions per year, pending GP referral (usually in 6 session- then 4 session- blocks). The rebates also vary between psychologists and clinical psychologists. So here are a few things you may need to consider when choosing your psychologist.

Rebates vary based on qualifications and training

There are lower Medicare rebates for seeing a psychologist compared to a clinical psychologist. For example, a standard 50min session with a psychologist will mean that you will receive a rebate/refund of $86.10 from Medicare for that session. A higher rate of rebate ($126.50) from Medicare applies for a clinical psychologist.

Clinical psychologists spend a longer time in formal educational settings and typically hold a Master of Clinical psychology degree. Even after conferral of that degree, they spend about 2 years closely supervised in the field before they can be officially endorsed as a clinical psychologist. However, does that mean that you will get more bang for your buck from a clinical psychologist?

Personally, I have met some incredibly knowledgeable, skilled, and brilliant psychologists. I have met incompetent clinical psychologists. The field is varied. The evidence for better outcomes based on qualifications is still unclear and our field has been debating the Medicare tiers for psychologists in the last few years and currently, there is no clear answer to this question.

Simply because there is a higher Medicare rebate with a clinical psychologist does not mean they are cheaper. In fact, we are usually more expensive. Beyond your Medicare rebate, you will see differences in gap fees. The following are some of the reasons why our fees may vary.

Expenses, especially lease costs

The psychologists located in busy metropolitan areas, near train lines, with a bigger square footage, multiple rooms, and lift access etc. will pay a higher rental cost. This may mean that expenses are quite high just for the location. Consider also insurance, professional registration, internet/website costs, reception staff etc. The cost can add up, which also pushes up the gap fee.

Client load

Psychologists with higher charges usually see fewer clients so that they can spend time focusing on and thinking about their client’s cases, preparing for sessions, reading new studies, and sourcing materials for their clients. If a psychologist is bulk-billing and trying to make an income beyond business expenses, they may have to see more clients to be able to make a salary or just to break-even. This may mean that they have less time to focus on your case.

Qualifications and waiting lists

Sometimes, the fees are high because the psychologist is simply excellent at their work. They build a waiting list and clients are willing to pay more because of recommendations from other people. Moreover, the GPs usually prefer these psychologists because of a good collaborative relationship and excellent feedback from their patients.

Individual differences in values and priorities

Some psychologists bulk bill because they strongly believe that mental health care and service should be accessible to everyone. This can be cheaper for their clients but often, not so great for the psychologists’ wellbeing and practice if they are struggling to cover expenses. However, there are some great psychologists offering bulk billing services and don’t struggling with financial constraints or wellbeing issues, and I have a great respect for these colleagues.

Does this mean that psychologists with a high gap fee are money-grabbing grubs with no interest in community? Unlikely. It may be because they value their families more and would like to provide more opportunities for their loved ones (e.g., travel, extracurricular activities). Don’t forget that many psychologists engage in service outside of their practice for free or at significantly reduced rates such as research, free talks at community events, volunteer work, outreach projects, peer review for science publications etc.

Dr Carol Newall’s reasons for her rates

I try to charge in a manner that is consistent with other clinical psychologists in the area. I’ve tipped it upward a little because I also have a PhD and postdoctoral fellowship under my belt in the area of anxiety disorders. Finally, I want to see fewer clients and still be able to cover my expenses comfortably. Given my academic background, I want to spend more time researching my clients' presentation and incorporate the latest evidence-based techniques or innovations into our treatment program. This means that I'm working on their treatment even when I'm not seeing my clients face-to-face.

How do I find the right psychologist?

Visit their website and read about their background. If qualifications matter to you, then check out their career trajectory. Personally, I think it’s far more important that these pages give you a sense of who they are. Does it sound like a cold professional resume? Do you get a sense of warmth, sincerity, humour and accessibility in their profiles? Could you share with them your secrets and know that you will feel supported and cared for by this psychologist?

Speak to your local GP

GPs have a preferred psychologist, but they also have a number of options available. They also get feedback from clients about a psychologist’s style or expertise, and this can critically determine a GP’s recommendation to a psychologist.

Try the psychologist out but don’t be discouraged if they are not the one. Even the most skilled and popular psychologist will have clients who don’t quite gel with them. The evidence for improving your mental health through psychological support is pretty good, especially for issues like anxiety, oppositional defiant/conduct disorder, and mild to moderate depression.

Don’t give up because the right psychologist is waiting to meet you and help you change your life. There’s no right price for your wellbeing as it is rather priceless. Hopefully, the right psychologist will help you discover your resilience and improve your wellbeing.

Clinical Psychologist

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