Tending the chair
Crisis support is free and does not depend on money. In the US call or text 988. In the UK and Ireland, Samaritans on 116 123. In Canada, 1-866-585-0445. 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.
Costs are indicative and change. Verify current numbers with each provider before relying on them. For what full-price therapy costs by country, per session and per year, see how much therapy costs in 2026. If you have no coverage at all, start with therapy without insurance.
Many therapists hold a few reduced-fee slots and never advertise them. This is the single most under-used option on this list, because people assume the listed price is the price.
A non-profit that connects lower and middle income clients with therapists who have agreed to reduced rates. Verify current rates on their site before relying on these numbers.
Graduate students delivering therapy under close supervision. Often more attentive than an overloaded private practice, because they are being assessed. Sessions may be recorded for supervision and your therapist will eventually finish their placement.
Widely available and widely forgotten. Short-term by design, so best for a specific situation rather than long-term work. Check the confidentiality terms of your specific provider.
Publicly funded and means-tested. Waiting lists are usually long, and they are often the only route to psychiatry for uninsured people.
Peer-led groups, in person and online, for specific conditions and for family members. Group rather than individual, and the experience varies with the facilitator.
Phone lines for talking to someone before things reach crisis. Staffed by people with lived experience. Badly under-known, and one of the most useful entries on this list.
Trained volunteer listeners available immediately. Training is variable and you rarely get the same person twice, but it is free and it is there at 3am.
For crisis, and increasingly for pre-crisis distress too. Call or text 988 in the US, Samaritans on 116 123 in the UK and Ireland.
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 $715 | At the US average of $165 a session. $430 to $1,080 across the usual $100 to $250 range. Licensed clinician, in person or online. | Yes | Our cost guide |
| Private therapy, every two weeks | About $360 | Same clinician, half the frequency. $215 to $540 across the usual range. | 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 August 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.
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 routes above. Not sure which you need? We wrote a guide for that.
Ask your therapist directly about a sliding scale, since many hold reduced-fee slots they do not advertise. Look at Open Path Psychotherapy Collective, where sessions run roughly $30 to $60 after a one-time membership fee. Check whether your employer offers an EAP, which typically covers a few free sessions. University training clinics offer supervised sessions at low cost. NAMI and similar organisations run free peer support groups. Warmlines offer free phone support before crisis point.
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.
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 options on this page.