EMDR Europe Accredited Consultant explains the unseen work, training and ongoing investment that sit behind every session fee — and why “an hour with a therapist” is rarely just an hour.
When prospective clients first see a therapy fee, the maths is understandable: one hour, one price. But of all the professions where the visible work is only a fraction of the actual work, therapy might top the list. The hour you spend with your therapist — in person or online — is the tip of a much larger iceberg.
I’d like to be transparent about what really sits behind a session fee, because I think clients deserve to understand where their money goes.
Years of training that never really ends
Becoming a qualified therapist takes years: a foundation qualification, a postgraduate diploma or masters, hundreds of supervised clinical hours, written case studies, and ongoing assessment before independent practice is permitted. EMDR adds an additional accredited pathway on top — typically another one to two years of training (4 in my case as I took my time), supervised practice and consolidation, then continuing to Consultant Accreditation, more supervised practice, supervision of supervision and more training.
Even after qualifying, all therapists registered with bodies like the BACP, BPS or EMDR Europe must commit to Continuing Professional Development each year — courses, conferences, specialist trainings — usually amounting to several thousand pounds annually.
Accreditation and ethical membership
Annual professional body membership, accreditation renewal, and complaints-procedure cover all carry recurring fees. As an EMDR Europe Accredited Consultant, I pay each year to maintain that standard, and re-accreditation requires evidence of clinical hours, supervision and CPD. These standards exist to protect clients — they’re the difference between a weekend-trained practitioner and a clinician whose practice is independently scrutinised.
Clinical supervision
Every ethical therapist, regardless of seniority, is required to have regular clinical supervision: paid, ongoing consultation with a more experienced clinician to ensure the work is safe, ethical and effective. Supervision typically costs £80–£150 per hour, monthly at minimum. It’s one of the quiet safeguards built into your therapy.
Insurance, regulation and data protection
Professional indemnity insurance, ICO registration, GDPR-compliant note-keeping, encrypted video platforms, secure scheduling — all annual costs that exist so your information and your therapy are properly protected.
The hidden hours per client
For every 50-minute session, there’s usually 30–60 minutes of unseen work: reviewing previous notes, treatment planning, writing up after the session, liaising with GPs or psychiatrists, researching the right intervention, and discussing the case in supervision. None of it is billed separately — it’s woven into the session fee.
The team behind the therapist
Most clients picture therapy as a one-person operation, but running an ethical, responsive practice usually isn’t. I work with a virtual assistant who handles enquiries, scheduling, reminders, invoicing and the steady stream of admin that keeps everything moving. That’s a real, ongoing cost — but it’s the reason emails get answered promptly, sessions start on time, and your therapy hour stays protected for actual therapy rather than admin.
Running a small business
Beyond the team, there are the usual overheads: website, accounting, tax, booking systems, payment processing, email, phone. Necessary, unglamorous, and all of it has to come from session fees.
So what are you actually paying for?
A qualified, accredited, insured, supervised, regulated professional — supported by the quiet infrastructure of admin, supervision and CPD — who has invested years and tens of thousands of pounds in being able to safely sit with you in your hardest moments.
Good therapy isn’t expensive. Bad therapy is — because it costs you time, hope, and sometimes makes things worse.
If cost is a barrier, please still seek support. Charities, NHS Talking Therapies and trainee clinics all offer lower-cost routes. But if you’re choosing private therapy, you deserve to know exactly what you’re investing in.
About the author: Lynne Douglas is an EMDR Europe Accredited Consultant offering online therapy in the UK & abroad, at healthyminds4u.co.uk.