Tending the chair
Tending the chair
If you need therapy and cannot pay full price, here is what to do next, in order, starting with one email you can send today. Several of the routes are free, and one of them is simply asking.
Crisis support is free and does not depend on money. In the US and Canada call or text 988. In the UK and Ireland, Samaritans on 116 123. More on our crisis page.
Before anything else on this page: ask the therapist you already want to see whether they have a sliding scale.
Many therapists keep a small number of reduced-fee places and never list them anywhere. People skip this step because the price on the website looks like a fixed fact. It frequently is not.
Words you can copy
“I am interested in working with you, but your full fee is out of reach for me right now. Do you have any sliding scale or reduced fee openings? If not, could you point me toward someone who does?”
Therapists are asked this regularly and it does not offend them. The worst realistic outcome is a no and a referral, which still moves you forward. We wrote a full guide to asking, including phone and mid-treatment versions and what to do when the answer is no.
Work down the list. Each step is cheaper or faster than what most people try first. For every low-cost option side by side, with current prices, see cheap therapy options, with real prices. For what full-price therapy costs by country, see how much therapy costs in 2026. If you have no coverage at all, read affordable therapy without insurance.
Do this first, with the therapist you actually want. The words are above. Many therapists keep reduced-fee places they never advertise, and people skip this because the listed price looks fixed.
An employer EAP (employee assistance programme) usually covers a few free sessions and is separate from health insurance, so ask HR even if you are not on the company plan. If your income is low, check Medicaid in your state, which can cover therapy at little or no cost. If you are a student, start with your college counselling centre.
Open Path Collective connects people without adequate coverage to licensed therapists at $40 to $70 a session after a one-time $65 membership (checked 24 October 2026). University training clinics offer therapy from closely supervised graduate students, often free or close to it. Sessions may be recorded for supervision, and your therapist leaves when their placement ends.
Certified Community Behavioral Health Clinics must serve anyone regardless of ability to pay, and there are more than 500 of them. Federally funded health centres charge on a sliding fee scale, do not deny care for inability to pay, and many offer mental health care. Waits can be long, so call now even if you start somewhere else. The free SAMHSA National Helpline, 1-800-662-4357, can point you to state-funded and sliding-fee programmes near you.
In England, refer yourself to NHS Talking Therapies. In Ontario, Ontario Structured Psychotherapy offers free short-term CBT to adults by self-referral, with no health card needed. Routes and waits differ in other provinces and UK nations.
Warmlines are free, peer-staffed phone lines for talking before things reach crisis, and about 30 states have one. NAMI Connection runs free 90-minute peer-led groups, many of them online. 7 Cups has free volunteer listeners at 3am. None of these is therapy, and all of them are there tonight.
Call or text 988 in the US and Canada, or call Samaritans on 116 123 in the UK and Ireland. In the US, 988 is for emotional distress too, not only for suicidal thoughts.
Hearth is on this table, and it is not the cheapest thing on it. Read the clinical-care column before the price column: the cheap rows and the clinical rows are different products.
| Option | Per month | What you get | Clinical care? | Source |
|---|---|---|---|---|
| Hearth, Hearthside | $39 | One Keeper, matched by hand and kept. A Sit every two weeks, unlimited Long Talk, a written note every Friday. | No | Hearth pricing |
| Hearth, Hearth Deep | $99 | Everything in Hearthside, with a Sit every week and priority replies on the Long Talk. | No | Hearth pricing |
| Online therapy subscription | $260 to $520 | $60 to $120 a week, billed monthly or every four weeks. A licensed therapist, usually one live session a week plus messaging. The therapist can change. Some platforms accept US insurance. | Yes | BetterHelp FAQ, Talkspace pricing |
| Private therapy, weekly | About $620 | At the US cash-pay average of $143 a session (Zhu et al., 2024). $530 to $985 across state averages of $122 to $227. Licensed clinician, in person or online. | Yes | Zhu et al. 2024, SimplePractice |
| Private therapy, every two weeks | About $310 | Same clinician, half the frequency. $265 to $490 across state averages. | Yes | Our cost guide |
| Free listener services | Free | Trained volunteer listeners, available now, a different person each time. Not clinicians. Some offer a separate paid therapy tier. | No | 7 Cups |
Figures as of 24 October 2026. Subscription prices change and vary by location and promotion; the sources are each provider’s own pricing page, checked on that date. Hearth is peer support, not therapy. Keepers do not diagnose, treat or prescribe, and a cheaper non-clinical service does not meet a clinical need.
Hearth is a peer-support membership from $39 a month. You are matched with one Keeper, a trained peer companion rather than a clinician, and you keep the same person rather than starting over with someone new each time.
That is cheaper than most private therapy, and cheaper than the subscription therapy platforms, which we broke down in Hearth vs. therapy apps. It is also considerably more expensive than free, and several of the options above cost nothing. If a warmline, a NAMI group or 7 Cups fits what you are carrying, use them. We would rather you got the right help than our help.
If what you want is not clinical care but someone to talk to, we compared the alternatives to therapy honestly, and explained what peer support is and what it is not.
The important caveat. Peer support costs less than therapy because it is a different thing, not a discounted version of the same thing. Keepers do not diagnose, treat or prescribe. If what you need is clinical care, a cheaper non-clinical service does not meet that need, and the right move is to keep working the low-cost therapy steps above. Not sure which you need? We wrote a guide for that.
Work through it in order. First, ask the therapist you want whether they have a sliding scale. Second, check what you may already have: an employer EAP, Medicaid if your income qualifies, or student counselling. Third, look at Open Path Collective, where sessions are $40 to $70 after a one-time $65 membership, or a university training clinic. Fourth, contact a community mental health clinic or federally funded health centre, which do not turn people away for inability to pay. While you wait, warmlines and NAMI groups are free.
Say it plainly at first contact: 'I am interested in working with you but your full fee is out of reach for me. Do you have any sliding scale or reduced fee openings, and if not, could you point me toward someone who does?' Therapists are asked this regularly and most are not offended. The worst realistic outcome is a no and a referral, which is still useful.
In England, NHS Talking Therapies is free and you can refer yourself without going through a GP. In Ontario, Ontario Structured Psychotherapy offers free short-term CBT to adults by self-referral, and you do not need a health card. Other provinces and UK nations have their own routes, and waits vary by area.
Low-cost is not the same as low-quality. University training clinics are staffed by graduate students who are closely supervised, often bring more time and attention than an overloaded private practice, and are being actively assessed on their work. The genuine trade-offs are that you may see a less experienced clinician, sessions may be recorded for supervision, and your therapist may leave when their placement ends.
Reputable EAP providers keep session content confidential and report only aggregate usage data to the employer, not names or notes. That said, confidentiality terms vary by provider, so read the specific policy before you start rather than assuming. If it matters to you, ask the provider directly what is reported and to whom.
No. Peer support costs less because it is a different thing, not a discounted version of the same thing. Peer supporters do not diagnose, treat or prescribe. If you need clinical care, a cheaper non-clinical service does not meet that need, and the honest move is to keep working the low-cost therapy steps on this page.