Why is psychological counseling so expensive?

Many people think that hundreds or even thousands of dollars per hour of psychological counseling is a proper "IQ tax", but in fact the core of this pricing is to spread the hidden training costs of counselors for several years, the unpaid labor behind a single consultation, and the current industry supply and demand gap into this standard 50 minutes.

I know a dynamic counselor who works in adult cases in Hangzhou. I have calculated my investment in the first 7 years of my career: studying for a master's degree in clinical psychology for three years cost nearly 200,000 yuan. After graduation, I did two years of personal experience - that is, the counselor first consulted with a more senior practitioner as a client, twice a week, 400 yuan each time, which is 80,000 yuan. After going out, there will be individual supervision once a week and group supervision once every two weeks. The supervision fee alone has cost more than 70,000 yuan after five years of doing it. Adding in the annual training and workshop fees of at least 20,000 yuan, the net investment in the first seven years was almost 400,000 yuan. In the first two years after taking the case, she only charged 200 yuan per hour, and she could not even make back the monthly supervision fee.

Of course, some people say that psychological counseling is expensive because of the sky-high prices charged by the industry. This complaint is not unreasonable. At present, the entry threshold for the industry has not been fully standardized. Many people spend thousands of yuan to get a fake certificate that is not recognized by the Ministry of Human Resources and Social Security. They rent a small room and open a consulting room. They have no personal experience or regular supervision and dare to charge 8,000 an hour. They just rely on the public’s poor information on psychological counseling. This is the core reason why many people feel that it is “not worth it” after completing the consultation.

Don't think that a counselor's work only lasts for 50 minutes face-to-face. I was chatting with a colleague last week. The day before, she received a visit from a teenager who was prone to self-injury. After that, she spent more than an hour just sorting out the case records and adjusting the follow-up intervention plan. She also made a 20-minute phone call with the supervisor to confirm the risk intervention process. These hours will not be charged for the visit. In order to ensure the status of consultation, mature consultants can take up to 4 cases a day, and spend the remaining time doing supervision, taking professional courses, and dealing with emergencies of cases. The time when they can actually generate income is actually very limited, and they can only rely on single pricing to cover these hidden costs.

To put it bluntly, it's a bit like asking an experienced traditional Chinese medicine doctor to take your pulse and he'll prescribe you a prescription within 3 minutes of taking your pulse. You can't just count these 3 minutes of labor. Behind it is his decades of experience accumulated from reading medical books and sitting in clinics. In addition, there are only tens of thousands of formally qualified counselors in China who can independently handle cases, corresponding to tens of millions of people who need psychological counseling. The gap between supply and demand is here, and appointments with reliable counselors are scheduled for two or three months, so the pricing will naturally not be too low.

Oh, and not all counseling is ridiculously expensive. Psychological counseling centers in colleges and universities are basically free for students. Many neighborhoods and communities also provide public welfare psychological counseling services. There are also novice counselors who are accumulating casework hours. The fees are often 100-200 yuan per hour. However, these resources either have identity thresholds or require time to screen for qualifications. Not everyone can come across them. Many people think it is “expensive” because they are looking for the wrong channel. When they come up, they search for internet celebrity consultation rooms that are ranked first on the business platform. The price will naturally be much higher.