Eating disorders do more than disrupt lives and families. They can be shockingly lethal—in fact, eating disorders kill one person every hour, the highest mortality rate of any mental illness. They are notoriously difficult to treat, with relapse rates of approximately 35 percent for anorexia and bulimia. Treating eating disorders is a high-stakes practice, one that, unsurprisingly, requires therapists to earn an advanced degree and accrue hundreds of hours of supervised clinical practice.
Given all that, you might assume eating disorder therapists—also called eating disorder counselors—would be paid like doctors. They probably should be, given that they work with some of the sickest and most challenging patients. Sadly, they are not. While it's hard to pin down the average eating disorder therapist salary (more on why below), it's telling that Forbes includes mental health counselors on its list of surprisingly low-paying jobs.
Anyone considering becoming an eating disorder therapist or counselor should think very carefully about what they want to get out of this career. Helping people with eating disorders achieve their recovery goals can be extremely rewarding, but so is paying the bills on time from month to month. Knowing your salary prospects will help you determine how much you can afford to invest in your education and how well-off you'll be once you're working.
In this article about eating disorder therapist salaries, we'll answer the following questions:
Eating disorder therapists use psychological and counseling techniques, such as cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT), to help patients with eating disorders identify and eliminate dysfunctional behavioral patterns related to food and eating. Anorexia nervosa and bulimia are the two eating disorders (or EDs) most people are familiar with, but eating disorder therapists also work with patients struggling with disorders like:
Most people assume eating disorder patients are almost always young women. However, therapists who treat eating disorders also work with children, men, and the elderly.
Treating eating disorders is a process that can involve a whole team of ED specialists. The team can include therapists, as well as medical doctors, medical specialists, dietitians, nutritionists, coaches, families, and friends. Eating disorder therapists work in outpatient and inpatient treatment settings, including physicians' offices, private practices, group residential homes, and psychiatric hospitals. They do things like:
There are multiple educational pathways one can take to become an eating disorder specialist in the clinical mental health field. Further complicating matters is the fact that 'therapist' is not an official designation. It can refer to many different practices.
That said, all eating disorder therapists begin their professional journeys by earning a bachelor's degree (typically a psych degree or a social work degree). From here, there are many ways to become an ED therapist. You can become a:
Unfortunately, none of the above paths typically include coursework related specifically to identifying eating disorders in patients, eating disorder treatments, concurrent mental health issues, or other topics relevant to a career in ED therapy. Aspiring psychologists, social workers, and counselors who want to earn the highest-possible eating disorder therapist salary should look for degree programs that offer opportunities to complete an internship and practicum hours in settings where eating disorder patients are treated.
The qualifications eating disorder therapists need vary considerably from state to state. While every state requires therapists and counselors to hold a current license to work with patients, the minimum qualifications necessary for licensure are different. On top of that, there are no specific licensing requirements for eating disorder psychologists or social workers in any state. All licensed professional counselors, licensed clinical psychologists, or licensed clinical social workers can work with people with eating disorders, regardless of whether they're certified or have any additional training in ED therapies.
Some eating disorder therapists do pursue additional training and voluntary certifications. The Institute for Contemporary Psychotherapy's Center for the Study of Anorexia and Bulimia has a two-year Program in the Integrated Treatment of Eating Disorders. Lewis & Clark College offers an on-campus Eating Disorders Certificate program. And the International Association of Eating Disorders Professionals (iaedp) offers the four-course Certified Eating Disorders Specialist (CEDS) credential.
It's tough to give a definitive answer to this question. The US Bureau of Labor Statistics (BLS) doesn't track pay for ED therapists in particular. However, it does publish median pay estimates for behavioral disorder counselors (a category that includes eating disorder therapists). According to the BLS, the average ED therapist might make about $45,000 per year.
PayScale's estimate of eating disorder therapist salaries is pretty close to that, at about $43,000 per year. Salary.com states that the average eating disorder therapist salary falls somewhere between $35,396 and $44,431 per year.
On the other hand, ZipRecruiter reports that the average eating disorder therapist earns closer to $89,000 and that practitioners might earn anywhere from $46,000 to $113,000 in this role. That gap represents a lot of room for error, though given what people in jobs similar to this one self-report online, the BLS and PayScale figures are probably more accurate.
Salaries vary significantly by state. The good news is that it's possible to make more than the average eating disorder therapist salary by settling down in one of the states where therapists are paid more. According to the BLS, behavioral therapists make the most money in:
It's also possible to dig deeper and find the cities and non-metro areas where behavioral therapists—such as eating disorder therapists—are paid the most. The top-paying cities and regions for ED therapists include:
Eating disorder therapists work in many day treatment and residential settings, including:
The BLS reports that eating disorder therapist incomes are highest in government agencies and lowest in residential mental health facilities. The fact remains that the median pay across settings is fairly low, topping out at $51,690 per year. The highest-paid eating disorder therapists are probably those who work independently, opening private practices and setting their own rates while working one-on-one with patients. The lowest-paid may be those running group therapy sessions in state-run residential facilities.
As is the case in almost all disciplines, more education typically means earning more money. An ED therapist with a PhD or PsyD may be able to earn more than one practicing with just a master's degree in psychology or an MSW. Getting additional training and voluntary certifications specific to eating disorder treatment can also lead to higher incomes. That said, there are no guarantees, and having more letters after one's name doesn't always add up to a bigger paycheck.
Jobs for behavioral disorder and mental health counselors, such as ED therapists, will grow by 22 percent between now and 2028, according to the BLS. That's much faster than the average across all occupations, though it doesn't necessarily follow that eating disorder therapists will be in demand. That might not matter for an eating disorder counselor who is willing to explore other avenues in psychology or social work. Because there are so few certification and continuing education programs for ED specialists, therapists in this field are usually generalists. When there aren't jobs for eating disorder therapists or when those jobs don't pay enough, ED therapists can pivot into other areas of counseling.
At the end of the day, however, the people who choose to earn the qualifications necessary to become eating disorder therapists probably aren't in it for the money or for job security. Counseling is not a fast track to riches nor a career with a straightforward advancement path. Working with ED patients, in particular, can be exceedingly tough because only 60 percent of patients with all forms of ED make a full recovery. For some types of EDs, that figure may be as low as 20 percent. For those who can accept all that, however, it's a career worth having.
As Reddit user jmfc77 put it in a thread about why psychologists and counselors are underpaid: "I had nearly $65,000 in student loans after my master's program, and I would not have been able to manage the interest on the payments without my husband's corporate job. We joke that I can afford to be a civil servant because he is a corporate drone. I make a fair bit of money now, but without support, I would have fallen on my face. It is scary, but I'm proud of my decisions. It isn't a straight path, like 'mail room, manager, executive.' There are ways to earn a living, but it isn't a clear road."
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