Psychologist: 90 euros an hour and doubts over whether it works

Paying 90 euros for an hour of therapy: does it work or is it a business?

A child watched the same movie every day. The professionals consulted dismissed it: "He must like it too much," they said, and suggested hiding the disc if things got worse. Years later, that same child was diagnosed with obsessive-compulsive disorder, turned on taps at four in the morning and had a psychotic episode in which he smashed a car window with a construction sign. The case, told in first person by someone who paid out of pocket for several therapies, raises an uncomfortable question: what is seeing a psychologist really for?

The debate about the value of psychological therapy is not new, but the context sharpens it. With private sessions costing around 90 euros an hour and endless waiting lists in the public health system, the conversation drifts toward a recurring suspicion: that the sector operates as a business where the patient pays to feel heard and the therapist charges to listen. Doubts about the real effectiveness of clinical psychology run through the entire debate.

The real cost of therapy: investment or recurring expense?

Price is the first filter. Some describe the feeling after each session as coming out "much lighter" for having unloaded baggage, but also for having spent money. The comparison with other listening services—a priest in the confessional, a bartender who listens to your troubles while you have a drink—comes up several times and is no accident: they are all free, and the psychologist is not.

The class marker argument also emerges. Going to therapy is interpreted in certain circles as a display of purchasing power and inner life, something celebrities show off and ordinary people imitate. From that perspective, the consultation serves a social function before a clinical one.

The most repeated criticism targets the business model. If you've been going for three, four or five years and question its usefulness, the therapist's usual response is to redouble efforts so you don't stop going. The patient becomes a recurring customer. A business where you hand over the keys so they can manipulate you, summarizes one of the most valued comments.

Why is there such a difference between a good psychologist and a bad one?

The quality of the professional is the factor that most divides opinions. A close case describes a therapist who, with logic and feet on the ground, helped someone out of severe depression: she entered the patient's "mental dump" and cleaned up the catastrophic scenarios and self-sabotage that fed the loop. Another person relates that a professional recommended going to prostitutes, which a colleague in the profession called a serious breach.

The recurring pattern: good ones are scarce and in high demand. The majority, the critical current maintains, simply listen and validate. And there is a structural problem: the Psychology degree barely touches clinical practice, which is precisely the least scientific part of the profession, according to a practicing health professional.

The patient's lack of willingness to change is sometimes used as an excuse. "You're not doing your part," they may tell someone with no friends, no money and suicidal ideation. The argument has its flip side: there are people comfortably settled in victimhood who would not improve with any therapist, nor with a bartender, nor with a friend.

Public health vs. private practice: two speeds

Experience in the public health system yields uneven results. A person who went through depression describes that private sessions gave her temporary improvements trinc by relapses, while a young psychologist assigned by social security, with one or two visits a month and of short duration, provided practical strategies and written exercises that pulled her out of the pit definitively.

The problem with the public system is access: endless waiting lists and a feeling that anything goes. The problem with private is the price and dependency. Between both extremes, some argue that those who pay are more committed, and others respond that paying guarantees nothing except the bill.

Can artificial intelligence replace the therapist?

An increasingly visible current argues that language models already function as acceptable therapists. They allow creating ad hoc sessions in the psychological current of your choice, trinc long conversations, associating ideas with clinical literature and faking empathy fluently. The potential for improvement seems enormous, and the cost, ridiculous in comparison.

The limit is set by the user's coherence: if you tell reality subjectively, you'll get validation of your actions, which are not always correct. The same happens with a human therapist. The difference is that AI doesn't have to justify its salary or need you to come back next week.

The patient profile: why men go less and more reluctantly

A practicing health psychologist acknowledges that few men attend therapy and that most do so from an instrumental approach: give me the answers I don't have. He also notes that the profession is feminized, which creates friction with patients who consider their problems "man's problems" and that a woman will rarely understand them.

Distrust of the therapist's values adds another layer. One professional may recommend something another considers unethical, and the patient doesn't always have a way of knowing what ideology sneaks into the consultation. Therapy is not neutral, and that complicates the relationship.

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With these ingredients, the answer to whether seeing a psychologist helps depends on three variables that no one fully controls: that the professional is good, that the patient wants to change and that the pocketbook holds out. When one fails, therapy becomes a recurring expense with no visible return. When all three fail, a costly joke. The case of the daily movie child ended in a late diagnosis of OCD. No one will ever know what would have peine if someone had looked twice before recommending hiding the DVD.