Therapist Pay Transparency Project Results

Cultivate Care conducted a 2025 Therapist Pay Transparency Survey. The goal was simple: understand what therapists are earning across settings and license levels and how that compares to what clinicians themselves believe is fair.

What emerged was not confusion or unrealistic expectations. It was consistency. Across settings and states, both fully licensed and associate therapists reported similar patterns of misalignment between current pay and perceived fair pay. The size of the gap, however, differed substantially by license level.

How this survey was conducted

The 2025 Therapist Pay Transparency Survey collected self-reported responses from therapists working in a range of settings, including private practice, community mental health, hospitals, residential and IOP programs, and embedded or corporate behavioral health roles.

Participants shared their license status, primary work setting, employment type, average weekly client-facing clinical hours, current annual gross pay, what they believe their role should be paid, and what benefits or supports were included.

Because income was reported in ranges, averages were estimated using midpoints. The intent of this analysis is to highlight patterns and trends, not to establish rigid national benchmarks.

What therapists are earning by setting and license level

Clear patterns emerged when comparing compensation for fully licensed therapists and associate or provisionally licensed therapists.

Fully licensed therapists

Among fully licensed therapists, compensation varied by setting but followed consistent trends.

Fully licensed therapists in solo private practice reported the highest average earnings. Based on survey midpoints, typical annual pay clustered between approximately $105,000 and $120,000 for clinicians providing roughly 11 to 28 client-facing hours per week. Even so, many solo practitioners identified fair pay as closer to $120,000 to $150,000 or more once unpaid administrative labor and business overhead were considered.

In group private practice, fully licensed therapists reported lower average pay than solo owners. Annual earnings clustered around $90,000 to $100,000 for those carrying 21 to 35 clinical hours per week. Many clinicians in these roles believed fair pay should fall meaningfully higher, particularly given productivity expectations and limited control over fees.

Fully licensed therapists working in community agency and nonprofit settings reported average annual pay in the $65,000 to $70,000 range. While benefits were common, clinicians frequently identified fair pay as closer to $80,000 to $100,000, citing caseload size, documentation demands, and emotional labor.

In hospital, residential, PHP, or IOP settings, fully licensed therapists reported average earnings between $75,000 and $85,000. These roles often involve higher acuity and complexity, and many respondents believed fair compensation would fall closer to $100,000 to $120,000.

Fully licensed therapists in embedded medical, corporate, or EAP roles reported average annual pay between approximately $85,000 and $90,000. These roles showed closer alignment between current pay and perceived value, though many clinicians still identified a gap.

Across settings, fully licensed therapists most often identified a gap of $20,000 to $40,000 between current pay and what they believe reflects fair compensation.

Associate and provisionally licensed therapists

Associate and provisionally licensed therapists reported substantially lower pay across all settings, even when clinical hours were similar to those of fully licensed peers.

In group private practice, associate therapists commonly reported annual earnings under $40,000 to $45,000 while providing 11 to 20 client-facing hours per week. Many believed fair pay for these roles would fall between $60,000 and $80,000, particularly when supervision requirements and revenue generation were considered.

In community agency and nonprofit roles, associate therapists reported similar pay levels, often clustering between $40,000 and $45,000. Fair pay expectations were typically $50,000 to $70,000, reflecting the intensity of caseloads and limited schedule flexibility.

Associate therapists working in hospital, residential, or IOP settings reported slightly higher average pay, generally between $50,000 and $55,000. Even in these settings, many identified fair pay as closer to $65,000 to $80,000.

Across settings, associate therapists consistently experienced the largest gap between current pay and perceived fair pay. The data suggests this gap is not driven by unrealistic expectations, but by structural arrangements that place associates in revenue-generating roles without corresponding compensation or bargaining power.

How these findings compare to national therapist pay data

These findings align closely with broader workforce research while adding important role-level detail.

According to the U.S. Bureau of Labor Statistics, average annual pay for mental health counselors and marriage and family therapists falls in the mid-$60,000 to low-$70,000 range nationally. This data provides a broad snapshot of therapist compensation across the United States, but it aggregates across settings, experience levels, and employment models, which can obscure meaningful differences within the field.

Therapist-facing analyses, such as income reviews published by TherapyDen, further show that therapist pay varies widely depending on practice setting, geography, and business model. Their reporting highlights how private practice, group practice, and agency roles can produce dramatically different earnings, even among clinicians with similar training and licensure.

Workforce research from Ensora Health, including the Future of Therapy report, connects compensation directly to burnout and turnover. According to Ensora’s findings, low or unfair pay is one of the most commonly reported stressors among therapists and is closely tied to workforce instability, particularly for early-career and associate clinicians.

Taken together, these national sources show that therapist underpayment is a well-documented issue. What the Cultivate Care Therapist Pay Transparency Survey adds is role-level clarity. Our data shows that significant pay differences exist within the same license levels, states, and settings, and that both associate and fully licensed therapists share a strong consensus about what fair pay looks like. The gap is not driven by inflated expectations, but by how compensation systems are structured in practice.

Why pay transparency alone is not enough

Pay transparency matters, but transparency without structure can leave inequities intact. Many therapists already understand the value of their work and the tradeoffs they make for flexibility, benefits, or stability.

What is often missing is a shared framework that explains how compensation should scale with license level, experience, workload, and responsibility. Without that framework, early-career clinicians and associate therapists are most vulnerable to underpayment.

Using this data to inform a fair pay calculator

Based on survey averages, Cultivate Care recommends anchoring compensation tools to clear baseline ranges rather than aspirational ceilings.

For associate therapists, the data supports fair-pay floors in the $55,000 to $65,000 range for approximately 15 to 20 client-facing hours per week, with transparent progression tied to licensure advancement and supervision requirements.

For fully licensed therapists, the data supports fair-pay floors in the $80,000 to $90,000 range for approximately 20 to 25 client-facing hours per week, with predictable scaling for increased workload, leadership responsibilities, or specialty roles.

A calculator grounded in real-world data can help organizations and clinicians make compensation decisions that are transparent, ethical, and sustainable.

How integrated behavioral health can help close the gap

One of the most notable findings from the survey is that embedded and integrated behavioral health roles come closer to aligning pay with perceived value than many traditional therapy settings.

Integrated behavioral health models offer more predictable revenue, reduced reliance on volume-only productivity models, and clearer compensation structures. These models also create opportunities for associate therapists to earn fair, stable pay while progressing toward licensure.

While not a solution for every organization, integrated care represents one of the clearest opportunities to address long-standing compensation gaps across license levels.

Moving forward

Therapist pay dissatisfaction is not a motivation problem. It is a systems problem. Across settings, both associate and fully licensed therapists show strong agreement about what fair pay looks like. What is missing are structures that make that fairness achievable.

Pay transparency, paired with clear compensation frameworks and integrated care models, offers a path toward sustainability rather than burnout.

Cultivate Care remains committed to helping clinicians and organizations translate transparency into ethical, workable compensation systems.