Cost Considerations in Psychedelic Therapy

Psychedelic-assisted psychotherapy with mental health specialists might be with one therapist, or a second therapist during the medicine session. One or both of those people, or a third therapist, in some cases your own ongoing therapist, will help you integrate the medicine experience beyond the chemical activity in your body to apply it to your ongoing mental health practice. How much each of the people may charge per hour depends on their training, experience and overhead in the area in which they live. Their hourly jobs, which are often as small business owners, are to help support you in your transformation from suffering and trauma to not needing a constant medication and a chance of an improved quality of life.

How much should that person make? Should they have to do it for free? Should they get a subsidized education (scholarships, student loan repayment, grants) for doing this work? What about healthcare? How much does that person need to make to have a chance at financial health, savings, a retirement? If they took student loans out to do this work, should those be forgiven? These are the people TREATING the vets, first responders, the abused, the hopeless, the traumatized. These are the people trying to create a container for an experience that may lead to a transformation that it’s been described with phrases like “mystical” or “near-death experience”. Without this support, it’s also described as an adverse effect, terrifying, useless, a funny feeling, dissociation, or something like psychosis.

More money is made on selling a lifelong daily pill or a weekly in-office visit. There are clinicians charging upwards of $250, often more, for a 15 minute appointment, sometimes scheduling 5 appointments per hour while their nurse or staff watch you take $800 sniffs of eskatamine while monitoring for a bad reaction. Another version of this is upwards of $500 for a 40 minute iv visit with racemic ketamine, a generic medicine, when other routes of administration are available.

Many find benefit in the psycholytic dose where you’re able to work on that newfound cognitive flexibility in a therapy session, while others find that the psychedelic approach, where you talk before and after the medicine while experiencing its acute effects. The therapist/s may also sit with you in every medicine session, or just in the preparation and integration sessions. Some study has been done on types of psychotherapy practices that may work during a window period after taking the medicine, such as CBT, Internal Family Systems, and non-directive approaches. To be a psychotherapist in the US requires at least a Masters Degree in most cases. Psychotherapists at the Masters level are required to be licensed by most states as Counselors, Marriage and Family Therapists, Social Workers, Creative Arts Therapists or Nurse Practitioners.

These people are also the unmentioned stakeholders in the news coverage of psychedelic therapy costs and insurance coverage. Most insurances reimburse masters level therapists right around $100 an hour, but can range from 65-125 or so. A PhD for the same procedure code? A few dollars more than that. An MD for the same code? A few dollars more than that. So whatever an individual clinician’s training, debt, fancy school, housing situation, or business overhead (marketing, malpractice insurance) may be beyond that, insurance corporations declare how much they’re paying different licensed experts for their time for the same “procedure code” per hour (which is actually 45-50 minutes because it builds in ten minutes to do a note, cry, stretch, pee, etc between clients). The mean yearly income for a masters level LMFT - $ 30.44 per hour or $ 63,300 per year — https://www.bls.gov/oes/current/oes211013.htm . Salaries recently listed on Indeed for MD level prescribing clinicians $300-400k per year.

Random news here- CA just voted to pay fast food workers $20 an hour. Wild that university plus 2 years, then 2-3 years supervision for licensure, then specialized training at MAPS, PRATI, Sage, and CIIS at $10k or so per program that it took for that person to help you through what may be your most vulnerable and transformative experience in healing has a take-home pay ten dollars above a fast food worker. Mad props to workers. Therapists are also workers. Therapists aren’t “above” fast-food workers. But it seems like a question of pay for skilled vs unskilled labor, especially considering what it takes to do the work and the number of people willing to do the work. Fast-food workers need to be able to access psychedelic therapy as much as any one else. Psychotherapists have specialized training at the graduate level with ongoing continuing education requirements to achieve and maintain licensure, with speciality training in psychedelics beyond that.

I wonder what value the humans that are called to do THIS work are given in all of those minor policy details that are actually very important to the quality of life of the person providing mental health support, and how their very important work is supported. Should they make $800 an hour?! But also, should they do it for free?! Their personal branding, online clout, or the branding of their educational or professional background, their office location or decor– is not what makes them more or less valuable (or effective) in this process. Whether this happens at a retreat, in a fancy designer office, or in community mental health or via telehealth - these folks have very specialized training in order to do their work. How much do THOSE workers need to make?

Ketamine as a generic medicine from an accredited compounding pharmacy is as affordable as those pharmacies decide to sell it based on their overhead and the supply and demand of the medicine, and has not been shown to be inferior to the brand released by J & J. It seems to work even better with a supportive wisdom approach, with psychedelic-assisted psychotherapy being one approach studied by various fields employing various medicines since the late 1800’s.

Do we minimize the value of the humans doing this work by outsourcing their gifts to AI and underpaying them or removing their value by distilling it down to brain chemistry and cutting out the human aspects covered in counseling and therapy? Not the Muskovian reality many of us want to live in.

It’s a great convo to have, especially considering the various strikes happening around the country and around the world as society is deciding the value of our roles and gifts balanced with the possibility of making a living in 2024 and beyond.

Updated cost-effectiveness of MDMA-assisted therapy for the treatment of posttraumatic stress disorder in the United States: Findings from a phase 3 trial (Marseille, et al, 2022)

$11357 was the cost in the study over 42 treatment hours hours (two therapist model) and at about $270 an hour or about $135 per therapist hour.

The medical visit involves a different provider, who will have to be paid for their time and craft, same as the therapists, pharmacist and manufacturer of the medicine.

This study found that this IS cost-effective, and comes with great societal benefit. I’ve found this work comes with the responsibility of educating and advocating for cost-transparency and fair pay.

Is psychedelic-assisted psychotherapy for depression more cost-effective than conventional treatments? (2023)

Utah MDMA-Assisted Therapy & Psilocybin Therapy for hospital setting only, requiring facility fees and higher cost of staffing, however using existing medical infrastructure may facilitate insurance reimbursements.


What Psilocybin Costs

MSN

August 2024: "What Psilocybin Costs-- It is estimated that the average journey costs about US$1,500. That includes $500-$2,000 for the facilitator, $300-$600 for the room, and $150-$200 for the psilocybin itself. For more intensive facilitation at pricier facilities, costs can be upward of $5,000 per journey."

Psychedelic-Assisted Psychotherapy — Rates, Referrals & Registration
Psychotherapy via telehealth from the Psychedelic Institute of Mental Health & Family Therapy is available for residents of CA, NY, UT and VT. Local appointments available in the Greater Palm Springs | Joshua Tree area.

18 hour programs over 9 weeks from $3150. Sliding Scale and Group Rates available

Ketamine + Psychotherapy
Ketamine assisted psychotherapy, ketamine preparation, integration, and support via telehealth | Licensed psychotherapist (LMFT) CA, NY, UT, VT | On location in Palm Springs / Joshua Tree / Coachella, California

Ketamine journeys last from 40 minutes to two hours depending on route of administration.