The Money & Private Practice Megapost — Go Bloom | Website Templates for Therapists (2024)

Jump to the topic you want to learn about!

1. How to Set Your Fee in Private Practice

2. How to Talk to Your Clients About Raising Your Fee

3. How Much Money Does A Private Practice Therapist Make

4. How Much Do You Actually Make Per Session

5. What Does “Full-Time” in Private Practice Actually Mean?

Now, let’s talk about the feelings for a second

How do you feel about that number? Is it surprising? What shows up for you when you see it? Do you have the urge to tweak the numbers to bring down the fee? Or maybe it’s lower than you thought? Either way, you are probably going to feel some things. And these would be fruitful to talk about in your own therapy. But don’t work through these feelings with your fee.

This fee might not happen right away, but now you know what your goal is

You might have clients who came in at a lower rate, and that’s OK. You can have conversations with those clients, if you’d like, about your new fee and whether they can increase what they are paying you, and meanwhile, you can start charging the new rate to new clients as they come in.

Want to learn more about private practice and money?

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Mind Money Balance

How to Talk to Your Clients About Raising Your Fee

So, you’ve crunched the numbers, and realized it’s time to raise your fee. But how exactly do you have that conversation with your clients?

First thing, let’s get that mindset on point:

• Your fee is a business decision. It has to do with calculations related to your unique circ*mstances.

• You don’t have to give a long explanation to anyone.

• If you’ve put the effort into crunching those numbers and figuring it out, that’s enough.

• It has nothing to do with what other people charge (or what other people think you should charge).

• People’s objections to your fee has to do with their stuff.

• With your clients, you can work through that stuff. And with other therapists, you don’t need to engage.

• We don’t need to protect or save our clients from their own feelings, or from difficult conversations.

• 95% of the time the reactions you imagine that your clients will have are just not going to happen. The way the conversation usually goes is something like this:

  Therapist: I need to raise my fee.

  Client: OK, no prob.

Our clients generally get it. And no matter what, you can work through it with them. They may decide to go elsewhere, and ultimately that’s OK. That might be a disappointment to you. But your client has the right as an adult human to make that decision for themselves.

Strategies for the talk

Here are the things that have worked best for me when I have these discussions with my clients:

• Make the announcement at the beginning of the session, otherwise, it’s prone to get lost, or not having enough time to process.

• Frame the announcement as a business decision about your practice. That’s it.

• Be calm, and confident. If you are wavering, it’s going to create unnecessary anxiety for your client.

• Be clear. Don’t over-explain. If you need to (and I have totally done this), write it down and practice saying it out loud.

• Go slowly. If I’m nervous, I speak a mile a minute. Slowing down cues me to relax. Also, give your client space to respond, don’t give a whole 5-minute spiel, and then ask for their reactions That’s a lot to digest and not super fair to them.

  See Also

  HOW MANY PRIVATE PRACTICE CLIENTS SHOULD I SEE IN A WEEK?

• Breathe. Breathing is always good. Relax those hands, unclench the jaw, and roll those shoulders down away from your ears. Ahhh, doesn’t that feel better?

A sample of some language you can use

• “I wanted to let you know that I will be raising my rate from (amount) to (amount) as of (date).”

• “Do you have any questions or concerns about this change?

• “Sometimes people have feelings about me raising my rates, and I want you to know that I really want to hear about any feelings you might have about this, either now or if they come up in the future.”

If it’s the first time you are ever raising your fee, and this will be something new for some long-time clients, you can add a little something like this:

• “I wanted to let you know that after reviewing the finances for my business, I need to do a rate increase from (amount) to (amount), starting (date).”

Notice that all of the above are short and sweet. They are sending clear messages about the business side of the work while making space for the therapeutic side of the work.

Remember: In the therapeutic space, all feelings are allowed and can be talked about. But, in order to do that, the boundaries have to be clear. So by setting really clear boundaries about the business side, you are actually making room for better therapeutic work.

Not to mention, money is one of the hardest things to talk about, so if you and your client can go there, you can go anywhere!

And I think you’ll really feel that too. Whenever I have had conversations with my clients about money it has always strengthened and deepened my work.

Some further strategy tips to implement

1) Make it a regular practice and put it in your initial paperwork. Make sure you let your clients know that you re-evaluate your business for each fiscal year and make a rate increase, that way they (and you) are prepared.

2) Write it down in an official letter from your practice. It’s good practice to write down any changes you are making to your business, and hand it out (or send it digitally) to all of your clients.

3) Let your insurance clients know about the rate change even if it doesn’t impact them. So, send them the letter too.

4) Give a heads-up before the increase. It’s up to you how long of a notice you’d like to give.

People often choose October/November to announce the increase for January 1, and that’s because this time of year is often when companies are asking their employees to make selections for insurance plans, and for Health Savings Accounts.

5) Be prepared to talk about what actually comes up in the therapeutic work. I have often done prep work in supervision if there is someone that I think might have a tough time, and parse that out in that setting. This would help me feel more confident approaching the conversation, because I had a better understanding of what was being stirred up in me, as well as what might be getting stirred up in the client, given historical info.

SIDE NOTE: Usually the people you prepare for and think will have a hard time turn out to be the ones that are like “OK, no problem”. So you can prepare, but just remember, you never know how people will actually react. The best preparation is really clarity on your end about your decision.

6) Notice if you’re not talking about it. Another way to use supervision is if you notice yourself not having the conversation with certain clients, or putting it off altogether. There is likely something JUICY to explore there! It might be good work for your own personal therapy as well.

Final Thoughts

It’s a process, and you’re going to learn something new each phase of it. If you’re having a hard time, remember to break it down into smaller steps. You don’t have to do some huge overhaul of everything to be “doing it right”.

Remember the part about “this isn’t about success and failure”, and it’s not even necessarily about money. It’s really about learning to take care of yourself, so you can do your best work!

How Much Money Does a Private Practice Therapist Make?

When it comes to private practice therapist income, just like everything in the therapy world, the answer is: “it depends.” Today talk about some things to consider.

What are the factors that influence a therapist’s income?

• Does the therapist take insurance? When you are on an insurance panel, you must accept the contracted rate for your services. There is no set rate for how much insurance companies pay. It varies from company-to-company, and state-to-state.

• What are the expenses for the business? If you have your own office, you need to factor in things like rent, office supplies cleaning fees, furniture, insurances, supervision, consultation, training, etc. If you are subletting your space (aka renting some hours per week from another therapist), these costs will be baked into your rent, but overall, your business overhead is generally going to be much lower than if you rent out an office suite.

• How many hours do you want to work and how many weeks a year? As you can imagine, more work hours =more money. But, most of us are NOT going to do 40 clinical hours per week. Usually people working 5 days are seeing somewhere between 20-30 people a week (so 4 or 6 people a day). But, it really varies from therapist to therapist.

• Do you have a niche, or some expertise that will allow you to charge a higher fee for certain services? If you are doing niche work, usually it’s because you’ve spent hours in training or hours of your life building up the experience to do it, so you definitely should be charging a higher fee for those services!

• Do you work in a certain modality that will up your hourly rate? Group therapy and couples therapy are both examples of modalities that can up your hourly income, but also you have to consider the energetic output for both. Some sessions need longer time buffers in-between, require more documentation, or you are just maxed out after doing a certain amount of it each day/week.

• Do you want to do things outside the therapy room? Teaching, writing, selling a book, research, speaking engagements, online workshops, providing supervision, consulting, or something else outside the box. There’s a bunch of options out there. Some of these things you might do for money, OR you do them because you love them, but that often means time away from your practice, so they need to be factored in.

• Do you have a group practice, where you hire clinicians and get a percentage of each fee they collect, in exchange for doing their marketing and getting them clients?

Final Thoughts

Ultimately, it’s your business, so you get to grow it (or shrink it) as you see fit. The extent to which you might want to do either of those things is related to what is going on in your life.

There may be times you are feeling high energy and you want to take on more clients, or new projects, and then there will be times when you need to pull back and conserve your energy, or put it elsewhere.

The beauty of private practice is having the flexibility to make changes when you need to make them!

How Much Do You Actually Make Per Session

If you’re like many clinicians out there, your clients might be paying you a variety of rates which makes it tricky to know how much you’re making per session.

It can feel good to say “My full fee is $____”, but are you close to that number when you break it down? Today I will give you the steps to figure it out (with a free spreadsheet to make it super easy). And then, we’ll talk about how to make that number mean something for your business.

First things first, grab your freebie spreadsheet (no email or sign-up required, it’s just free)!

get my spreadsheet!

Next, you are going to do the following steps:

1. Enter your client initials (or group name, if you run groups, see more on that below).

2. Enter their rate (what you actually collect from them per session).

3. Enter what type of service it is (individual, couples, family, etc). For group therapy, you would just enter in the amount you are making total for the group when you add up how much all of the members are paying.

4. Assign a “sessions per week rating” (it’s a 1” if they are every week, it’s“0.5” for every other week, and so on)

5. Repeat for each client.

6. Let the spreadsheet work its magic! Once you’ve entered each client what you’ll see in the end is your “per session average.”

P.S. There’s also a way to break it down to your actual “per hour average”, and if you want to do that instead, the instructions are there for you in the download!

Great, I got my number, so now what?

First, take a moment to reflect on that number.

• How do you feel about that number?

• How close is it to your actual fee?

Next, if you’re not happy with this number, take a minute to reflect on what is bringing your number down.

• How many people are you charging less than your full fee?

• What are your reasons for charging them less? For example, maybe they are a long-term client who came in at a previous lower rate, and you just never changed it. Or maybe you are giving them a sliding scale due to financial hardship? If that’s the case, how did you determine the sliding scale fee? How long has it been that they have been paying that rate, and could it be time for a review? How do you feel about the rate you are charging them? Do those feelings ever impact your work with them?

• Look at the types of services you are doing. Most people charge a higher fee for things like couples and family work, or for specialty services, for example, things like EMDR. Could you be doing more of the premium services? If not, what is standing in the way? Is it a hard limit, or are there things you could do to free up the time and energy to do more of those things?

  These are things only you can know the answer to!

This exercise is not about making you feel bad about where you’re at, but it is about taking an honest appraisal of where you are.

As therapists, we often tend to:

• Put our clients needs before our own

• Not think of ourselves as business owners

• Not feel comfortable putting a price tag on helping

• Bring a lot of emotion (aka, usually guilt or anxiety) into collecting money for our services

• Undervalue ourselves and our work

Taking an honest look at the numbers is about having a clear, reality-based starting point. In essence, it’s asking the question:

“Am I being taken care of by my business?”

And if you’re not, what’s going on with that? Are you OK with that, and if you are OK with it, why? Is it possible that you are repeating some old patterns?

You create your business model. Are you subconsciously setting things up to not work for your adult self?

There might be practical changes you can make, but sometimes (as you know all to well, I’m sure) the changes we need to make are on the inside.

One thing I’ve learned is that understanding, self-compassion, and acceptance usually lead to a more fulfilling and financially healthy business!

What Does "Full-Time" in Private Practice Mean?

When you work at an agency 40 hours a week often means you are doing close to 40 clinical hours. In private practice “full-time” usually takes on a different meaning because you are doing allll the jobs and wearing allll the hats.

What is considered “full-time” in private practice?

In general, when private practice therapists say “full-time,” they are usually talking about somewhere between 15-30 clinical hours per week. That’s a pretty big range!

However, here are some of the things that you need to do as a private practitioner that you don’t get paid for:

• Notes

• Billing

• Insurance company follow-up calls and paperwork

• Client scheduling

• Fielding new client inquiries

• Marketing

• Networking

• Getting clinical supervision

• Completing training/education

• Personal therapy/coach/business consultant

• Peer supervision/consultation

When you work for yourself, you are taking on the roles that are typically shared by others in an agency.

Therapists need flexibility.

The nature of the work makes it very hard to do consistently, back-to-back for hours and hours. You’re a human being, not a product, or a computer program.

And as a private practice business owner, what you are selling is your ability to be present, and engaged, and not just sit with a tremendous amount of pain, but actually move toward it, and not avoid it.

Additionally, you might want to do other things. Imagine that!

Being a therapist, sometimes we can feel very locked into that as the definition of who we are. But, the truth is, you’re a multi-faceted human being.

Most people have multiple careers in their life, multiple things that they are good at and interest them. So why can’t we pursue those things, just because of our profession? You might want to teach, write a book, do a podcast, become a famous actor-who knows!

The great thing is, running your own business you have options.