Gross fees are not income. Here is what different caseloads and fees actually leave a self-employed CBT therapist once tax, National Insurance and practice costs come out.
The honest answer is that it depends on three things: what you charge, how many clients you see, and what your practice costs to run. Most pages answering this question stop at gross fees, which is the least useful number — it is not what reaches your bank account. Below is what different caseloads actually leave a self-employed CBT therapist after income tax, National Insurance and running costs.
| Clients | Gross fees | Costs | Tax & NI | Take-home | Per month |
|---|---|---|---|---|---|
| 6 a week | £19,320 | £3,600 | £819 | £14,901 | £1,242 |
| 10 a week | £32,200 | £3,600 | £4,168 | £24,432 | £2,036 |
| 14 a week | £45,080 | £3,600 | £7,517 | £33,963 | £2,830 |
| 18 a week | £57,960 | £3,600 | £11,520 | £42,840 | £3,570 |
| 22 a week | £70,840 | £3,600 | £16,929 | £50,311 | £4,193 |
At £70 a session, seeing 14 clients a week grosses £45,080 a year and leaves £33,963 — about £2,830 a month. A full caseload of 22 grosses £70,840 and leaves £50,311. The gap between those two numbers is smaller than the gap in gross fees, because more income means a higher share goes in tax.
At a steady 14 clients a week:
| Fee | Gross fees | Tax & NI | Take-home | Per month |
|---|---|---|---|---|
| £50 a session | £32,200 | £4,168 | £24,432 | £2,036 |
| £70 a session | £45,080 | £7,517 | £33,963 | £2,830 |
| £95 a session | £61,180 | £12,872 | £44,708 | £3,726 |
| £120 a session | £77,280 | £19,634 | £54,046 | £4,504 |
Raising your fee is worth more than adding clients, because it costs you no extra hours and no extra room hire. Going from £50 to £120 a session at the same caseload changes take-home by £29,614 a year.
Change the fee, the caseload and the costs to match your own practice — three questions, about a minute, no sign-up.
Calculate my take-home →Running costs are the part most CBT therapists underestimate when setting a fee. The worked example above uses £300 a month; yours may be higher or lower, and these are the usual lines:
As a sole trader you pay income tax and Class 4 National Insurance on your profit — fees after allowable costs — not on your turnover. At 14 clients a week in the example above that is £41,480 of profit, £5,782 of income tax and £1,735 of Class 4 NI. Setting aside about £12 per session covers it, which is the number worth knowing before January arrives.
One thing on the horizon: Making Tax Digital for Income Tax is phased in by gross income, not profit. A full caseload at this fee grosses £70,840, which would bring you into MTD from April 2026 — quarterly digital updates rather than one annual return.