I really wish I had a good answer to this question! This is such an individual thing. It depends on things like what else is going on in your life, how much time and money you have to invest, what your experience is like during sessions, and last but not least, what your individual process is: How do you think and feel? How much do you reflect between sessions? What role does therapy play in your life? What are your specific concerns and goals?

In general I believe we wont benefit from rushing your process. I work by following your goals, your readiness and comfort for insight and change - your self in the context of your life. Letting this process unfold at its own pace is essential, I think, for real and lasting insight to emerge. 

I have had some people feel they get what they need and meet their goals after just a few sessions spread over several months, and others who I see most weeks for years. I love working at both cadences, and want more than anything to be as flexible on this as you need. 

All of this to say that how often will be a decision I encourage you to make based on your own unique needs and preferences, and I will be happy to help guide you in thinking this through if you would like me to.

I use Jane App to handle my scheduling, record-keeping, and payments. Jane let’s you self-schedule for sessions (based on my availability) through this booking page. Choose the type of session you want from the menu on the left, and my open availability will display on the calendar for you to click. Once you have successfully booked in you will receive an email confirmation from Jane (check your junk mail if not, or send me an email). 

Jane also has a helpful waitlist feature - if you aren’t seeing a time that works for you, please do add yourself to the waitlist or email me directly to see if I have any extra availability (I can often make it work). 

For those who prefer, I am also very happy to book you in from my end. You can send me an email asking to coordinate, or we can talk about it during your session. 

I accept e-transfer (to kateburtistherapy@gmail.com) and credit card payments (through Jane App). Jane will prompt you to add a credit card when you complete your intake and consent forms, and I can either charge it directly following sessions, or I can send you a link to complete payment yourself. 

An e-receipt will be automatically generated and sent to your email on file once payment is processed. 

As a Registered Psychotherapist (RP) my services are covered by many extended health benefits plans. Some plans only cover mental health services provided by Psychologists or Social Workers - in these cases I would not be covered. 

Plans usually offer only a certain amount of coverage: sometimes this will be a maximum amount per session, a max percent of each session, or a max total within a time period.

If you aren’t sure, it is always worth making the call to your insurance provider to find out if my services are covered. Unfortunately I cannot reimburse you for a session if your claim is denied.

Occasionally I encounter an insurance provider who requires clients’ practitioners to be specifically registered under their own provider registry. When this happens I am always glad to sign up, but note that they often take multiple weeks to process new registrants. 

Eventually I expect some insurance providers to begin covering mental health services provided by Registered Nurses (RNs). So far I have not encountered this, but if you do happen to have this coverage our sessions should meet criteria.

Unfortunately I don’t. Direct billing can be quite complicated for psychotherapists, and to save myself the admin time (and ultimately keep service fees low) I require you to pay for your session directly. In an effort to keep therapy more accessible though, I do accept credit cards at no extra service fee.

(Okay, no one has ever actually asked me this question, but I think it’s a good one! Read on only if you’re interested in hearing about the pay structure of private practice)

Therapists rely on what clients pay for sessions to make up their entire income.

Most therapists in private practice work as independent contractors and don’t receive subsidies or base salaries, regardless of whether they are part of a group practice or work on their own. We earn what we charge per session, period.

While it may seem like a therapist must make upwards of $150/hr, in reality there are a lot of hidden costs to working in private practice.

A client’s session fee also needs to cover: 

• Time spent preparing for and documenting their session, possibly also emailing with them to coordinate, send resources, etc. 

• Rent for in-person space. This is where a huge proportion of clients’ fees are going for those of us who choose to offer in-person sessions.

• Ongoing professional development (keeping up to date is ethically essential. It’s also required by our regulatory college). Any courses, supervision, learning materials, etc, cost money as well as time (time when we can’t run sessions to earn income).

• A good percentage, as you likely know from your own work experience, goes to paying taxes (I’m personally so happy to pay taxes. Very worth it. But I do have to account for this when I set my rates).

• Rate subsidies. I have worked out a regular rate that lets me offer some reduced-rate spots for people who can’t otherwise afford therapy. Mental health concerns tend to be compounded by living on low-incomes, so offering rate-reductions is an important way of getting support to those who need it. This is very important to me. Every client who pays my full rate is providing a slight subsidy to a lower-rate client, sharing the cost of charging less for my time, and allowing me to make my services more accessible.

Being a therapist is actually quite mentally and emotionally demanding. To keep up with delivering high quality, emotionally attuned mental health care, we have to be careful about balancing quantity of sessions offered.

This fact, plus the time needed for administration and professional development, means that for most therapists a “full-time” work week is somewhere around 20 sessions. That has to add up to a reasonable income.

Maybe! I’m so glad you asked.

My capacity to offer reduced rates is limited (see above: Why is therapy so expensive? to understand more about why), so I ask clients to complete an application form to help me make sure I am giving these spots out fairly.

Therapists have a lot of different philosophies on rate reductions, and there are big conversations we can have about how to do rate-reduction policies best, and even whether to offer reduced rates at all. There are a lot of ways to look at it, and I’m glad to discuss it further if you have questions. Financial access is something I think about a lot, and I love to talk about it.

My current practice is to consider reduced rates only for those who do not have private benefits for psychotherapy (or who have run out of coverage for the year). From there, I try to take your specific income, expenses, dependents, etc. into account to determine how much of a discount I can offer.

This is a complex and case-by-case balance, so I do not have a hard-and-fast rule for a sliding scale-by-income, but in most cases I do not offer reductions to those who earn more than $64,000/yr.

When a client fills out a rate reduction form I review it, let them know what I feel could be fair, and check in with them to see if they feel this will be manageable. I’m glad if we can make this a conversation, and I aim for us to find a rate together that feels reasonable for both of us.

I think it is very, very hard for us to know whether we should ask for a rate reduction or not. What feels like a lot of money for one person feels like less for another, and it doesn’t always correlate with income at all. In fact, it is often those with the least disposable income who feel least entitled to rate reductions.

This infographic provides some helpful guidance, I think. It doesn’t capture every individual situation, but it may help you think more objectively about where you are at financially to consider whether you should ask for a reduced rate or not (I highly recommend the accompanying Worts and Cunning blog post for further discussion re sliding scales and economic justice).

You might ask yourself, do I have a lot of disposable income for nights out, aesthetic treatments, travel for pleasure? How am I valuing a session compared with a meal out, for example? Am I choosing between paying for therapy and paying for rent, groceries, or other essentials? What counts as essential? Do I have someone like a parent or partner who supports me financially? Do others depend on my income for essentials? Would less frequent sessions work just as well for me?

I welcome these discussions and overall hope to help facilitate your access to therapy in a way that is sustainable for me as well. Please don’t hesitate to bring your questions.