How to tip my therapist?
August 18, 2009 1:45 PM   Subscribe

How to tip my therapist?

It came up in and end-of-meal conversation recently that while we tip a waitress for services, we don't tip our doctors for services. I've been seeing a therapist for some time, and she's given me a lot of help and advice about how to live my life. How can I show my appreciation? Money seems inappropriate. Flowers would be creepy (right?). Does anyone have ideas for something in the $50-100 that would be appropriate and personal and not awkward?
posted by tacit_urn to Human Relations (30 answers total) 2 users marked this as a favorite
I think anything more than a card is inappropriate. Even that's pushing it.
posted by Cat Pie Hurts at 1:48 PM on August 18, 2009

Here's a tip: any gift seems weird.
posted by fixedgear at 1:49 PM on August 18, 2009

I would say "don't", but I'm a little more into boundaries than some people.

I think a thank you card with 'your insights have helped me a lot' would be nice, if you want to do something. Therapists (that I've known) generally don't see themselves as 'providing a service'--that's something anyone could do, and I think they feel they're providing something intimate and unique.
posted by A Terrible Llama at 1:49 PM on August 18, 2009

You pay your waitress to bring you a hamburger. You pay your therapist to keep you from killing yourself or others. You do not need to tip your therapist. Doing so crosses a line, IMO.

Read this. You could also be putting your therapist in a very awkward situation. It's much better to just tell the therapist, very sincerely, how much she's helped you.
posted by mudpuppie at 1:49 PM on August 18, 2009

You tip waitstaff because that's how they get paid; their wages are near-zero. Doctors charge what they need to make a living; there's no need for a tip.
posted by Tomorrowful at 1:50 PM on August 18, 2009 [3 favorites]

Waitresses make about $2.50 an hour without tips; therapists make something like $80-150 an hour, so tipping really isn't necessary.

Aside from telling your therapist directly how helpful she's been, or writing a card, I think the best gift you can give her is to continue living your life well and improving yourself. IANAT, but I'd imagine having made a real, positive difference in a patient's life would be worth more than any amount of flowers or gift cards.
posted by Metroid Baby at 1:57 PM on August 18, 2009

Make a donation to a local mental health charity in their honor.
posted by JohnnyGunn at 1:57 PM on August 18, 2009 [13 favorites]

Yeah, it's weird, boundary-wise. A therapist can't help you properly if the line between "client" and "friend" gets too blurred.

Why not show your gratitude by donating to some charity that helps under-served people get mental health help?
posted by drjimmy11 at 1:58 PM on August 18, 2009 [3 favorites]

I don't think this is appropriate at all. Your waitress is making less than minimum wage because it's understood in America that customers tip for service. Some places pay their service employees a living wage and do not allow them to accept tips (I'm thinking of certain grocery stores that pay their baggers a decent wage).

Massage therapists working in doctor's offices frequently do not accept tips. Massage therapists working in spas do. They are paid differently, and tips make up a large part of the difference.

Also think of this: you do not tip the owner of a salon. Many therapists are effectively entrepreneurs running their own businesses, so it's not appropriate to tip them in that context.

A genuine, heartfelt thank you and at most a card is appropriate for your therapist, nothing more (and I'd personally only go for the card at the conclusion of therapy or maybe, maybe at a holiday you know he or she observes).

On preview, I love Dr. Jimmy's idea of donating so others can receive mental health care. Another great way to express thanks to service people who don't/can't accept tips is to recommend their services to others.
posted by peanut_mcgillicuty at 2:00 PM on August 18, 2009

A tip for you: print your question and talk about it at your next session.
posted by Carol Anne at 2:03 PM on August 18, 2009 [2 favorites]

Does your therapist know how much she has helped you? Can you tell her how much you appreciate it? Have you done so? Does it not seem enough? Why is that? Can you tell her that telling her doesn't seem enough? This is something you need to work on with her.
posted by Obscure Reference at 2:11 PM on August 18, 2009

posted by Perplexity at 2:18 PM on August 18, 2009 [5 favorites]

When did American society become so tip-obsessed? It seems like more and more people both expect tips, and expect *to* tip than ever before.

As noted above, restaurant staff get tips because that's a very large part of how they are paid. I usually try to tip them generously without so much as a thought.

Some professions are hit/miss. I would tip movers, bellhops, and the like... but maybe not, oh, I store clerks. Basically, it's sort of customary to tip service people who perform any sort of manual labor for you.

I sometimes feel sorta extorted by baristas when it comes to tipping. I am an enthusiastic tipper at the locallly owned coffee shop, where some pride is taken in a cup of coffee. I feel a bit taken advantage of, though, at customer-mill chain stores such as Starbucks, where the employees make a fair wage, get decent benefits, and get free bags of coffee beans...and basically assembly-line my mass-produced coffee. I still tip them due to societal pressures, but eh... I think the tip jar at Starbucks is as tacky as putting one in a McDonald's.

It would never, ever cross my mind, though, to tip a professional such as a doctor/lawyer/therapist/etc. They charge me the wage they deem appropriate. Tipping would seem awkward, and giving a gift outside of the holidays would seem borderline inappropriate.

I think a card is the best bet. The idea of a charitable donation in their name might also work, perhaps...if you simply must do something beyond a card and a "thank you".
posted by kaseijin at 2:21 PM on August 18, 2009

Data point: My mother's a psychologist by trade, and she regularly gets cards, letters, thank you notes, wine bottles and handmade trinkets from her clients. Usually, most of the gifts come after regular therapy sessions have ended as a sort of "Thanks for everything!" gesture, but some come from current clients.

IMO, if your therapist is any good, you'll start feeling very close to the person, almost as if they were a family member. It's customary to give gifts to people you love, so it's completely normal to want to give your therapist a gift. That being said, I wouldn't go for anything more elaborate or complicated than a bottle of wine.

Note that it should only be a onetime gift, and you should be doing it as a gesture of thankfulness. As many other posters have pointed out, the therapist charges you a significant fee for his services, so tipping is unnecessary.
posted by Mons Veneris at 2:46 PM on August 18, 2009

nthing Charity.
posted by Rolandkorn at 2:48 PM on August 18, 2009

nthing the idea that it would put the therapist in an awkward position if you attempt to tip.
nthing the idea that a donation to a mental health charity in leiu of a tip is a great idea.
posted by Quizicalcoatl at 2:55 PM on August 18, 2009

Second referrals. It's worth much more than a tip, anyway.
posted by rokusan at 3:26 PM on August 18, 2009 [1 favorite]

Interesting question. I have a passel of relatives who are psychologists, as well as two MFT's in the family. Right now, in this economy, no one is getting referrals. If you refer someone, particularly with good insurance (Blue Cross), or even more so a cash patient, that will be the most significant 'thank you' you could give.

OTOH, at Christmas all of my family members collect an assortment of small tokens from their patients.

It is all about boundaries- you have a close, almost intimate relationship with them, so it feels like you're almost family, but in most therapy relationships, you know little or nothing about your therapist. If you wish to recognize the relationship and appreciate them, do so with an appropriate gift- nothing that you wouldn't give to a professional colleague or client, nothing personal.
posted by arnicae at 3:49 PM on August 18, 2009

Just tell her.,
posted by xammerboy at 3:57 PM on August 18, 2009

I don't think it´s that big of a deal.

If you're still seeing her, you can just tell her that you really appreciate the work she´s doing with you and all the things you´ve learned. Whether you want to address it in a session, or before/after is up to you.

Therapists are people, too. Gratitude is pretty healthy. (Just remember to give youself credit and a gift or two for all the work you´ve done!)

If you are done seeing her, then I think a small token is appropriate. I think of things like a pendant on a chain, a fancy bookmark, a small tasteful figurine/knick-knack, or some other keepsake.
posted by Locochona at 4:29 PM on August 18, 2009

One of the things that therapists are good at is establishing boundaries with their clients. Most therapists would probably have a policy to not accept any gifts from clients. Seems that asking she/he first would be very appropriate. Gives you a chance to express your feelings and find out what his/her policy on gifts. But I nth the notion that a "tip" is not needed at all in this case, but also for all professionals in general. Their compensation is not reliant on considering tips as part of the equation like wait staff, et al.
posted by buzzv at 4:36 PM on August 18, 2009

How can I show my appreciation? Money seems inappropriate. Flowers would be creepy (right?). Does anyone have ideas for something in the $50-100 that would be appropriate and personal and not awkward?

Money is definitely inappropriate, as is anything that money was spent on. As others have said, gift-giving crosses the therapeutic relationship bounds, and speaking as someone who has received some training for clinical practice I would advise you not to pursue any kind of gift-giving because it would even serve to cheapen the relationship and be counter-productive for you.

You could make a card yourself, but if you're going down that road you would be just as well off expressing your debt of gratitude in person. Honestly, therapists are in it for the people, so this way would probably even hit home the strongest.
posted by tybeet at 5:16 PM on August 18, 2009

As everyone has already said, you don't tip your therapist.

Now, how do you show appreciation? To sum up, any (or any combination) of the below forms of appropriate:

- A thoughtful card with a message of appreciation.
- A small but carefully chosen gift, preferably something consumable like a fruit basket or expensive balsamic vinegar or fancy soaps for the office washroom or a "house plant of the month" or whatever
- A donation in his or her honor to a charity
- A positive review on Yelp, Angie's List, HealthGrades, or similar
- Refer friends who are looking for therapy to that therapist
- If the therapist works for an HMO or other large practice, writing a letter of appreciation to the appropriate management
posted by Sidhedevil at 5:19 PM on August 18, 2009

There is no clear, across-the-board answer to this question, even among therapists. :) A lot of us feel gifts are outside of the scope of what is appropriate to the therapeutic relationship, no matter what the gift. Some of us do feel comfortable accepting a small gift or one that is not a hugely personal thing (for example, chocolate or other treats have often been given to me, especially at the winter holidays time--and most often by parents of children I see who also probably give their kids' teachers gifts, and in that context, I feel it inappropriate to refuse because I don't want to cause any offense or appear as though I'm rejecting them). My personal thought is that a $50-100 gifts is WILDLY extravagant and would be inappropriate, and I would absolutely not feel it appropriate to accept a gift like that, even from a person I know to be wealthy. (Also keep in mind that if you're in therapy because of any interpersonal difficulties, any gift-giving attempts will be likely and fair game for discussion in session!)

I have really loved getting feedback from clients (especially while we are still working together) about how they feel therapy has been helpful, and most especially, what has NOT been helpful. It's a good practice to do this regularly with your therapist anyway, but in case you don't discuss it regularly, any time would be good to make it known that you'd like to talk about it. Often times, the best gift a therapist can receive is the knowledge that the work you are doing together is going toward a positive end, and that you are reaping its benefits! I realize that sounds silly and soppy, but it's very true.
posted by so_gracefully at 5:55 PM on August 18, 2009

In my therapist past, our agency disallowed any gifts over a certain small dollar amount altogether. I had to tell my supervisor of any gift I got. Those that were unable to be returned for some reason were given to charity. ("Gifts" from pharmaceutical companies were rampant and acceptable, however. DO NOT get me started on this ridiculous practice.)

Now cards were wonderful--I cherish those I received over the years.
posted by thebrokedown at 6:22 PM on August 18, 2009

Only small gifts that are special and meaningful to you.
I gave my therapist a wooden tissue box cover to celebrate the opening of her new office and she seemed touched.

Never a tip.
posted by SLC Mom at 6:25 PM on August 18, 2009

Don't do it.
posted by rahnefan at 7:08 PM on August 18, 2009

Nthing the folded-piece-of-paper route. Nice matters, and you don't have to spend a lot - or deal with impropriety issues - to say thanks here.
posted by Citrus at 9:02 AM on August 19, 2009

A card.

I gave my therapist a copy of her favorite book that she mentioned she didn't have anymore. It was only $6. She loved it. If you do something, make it small like that.
posted by IndigoRain at 12:30 PM on August 19, 2009

I agree your therapist doesn't need it. However a small gift wouldn't seem that inappropriate: home baked cookies, flower basket, card, that sort of thing. I have to ask: if this bothers you, why aren't you talking to your therapist about it?
posted by chairface at 3:01 PM on August 23, 2009

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