fee setting for private practice

Therapists! When you’re doing things right, but the money is tight.

You’ve done all the right things!

  • Applied and accepted to grad school: Check
  • Graduated with an advanced degree: Check
  • Knocked out all your requirements for licensure: Check
  • Started a private practice: Check
  • Actually found paying clients: Check

You’ve done everything you were supposed to do and yet… you’re not seeing the numbers on your bank statement reflecting all that effort.

(If, ahem, let’s be real, you are even looking at your bank statement.)

As a therapist, as someone who really cares about doing good work, it can feel discouraging to have followed all the steps and yet, at the end of the day, still feel overwhelmed, tired and financially strapped.

As a Clinical Fee Strategist, I have specialized in working with thousands of therapists over the past 5 years. In this time, I have found that most therapists struggle when it comes to fee setting. 

If you avoid looking at your private practice numbers and secretly dread calls with your Wellness Fi Advisor, you are not the only one. I promise. 

Here’s the thing, while grad school did a good job at preparing you to help people, it did not equip you with the skills you need to create a private practice that also ensures your needs (and desires) are taken care of in the process. 

In fact, therapists face a triple whammy when it comes to building a practice that not only helps your clients, but also financially supports you and your family along the way.

Why We Therapists Avoid Money: A Triple Whammy

Let’s start with your family of origin. 

According to psychologist Ella Laskey, most therapists served as the “helper” in their family of origin. That means, you were likely highly attuned to the emotions of your family members and prioritized making sure others were taken care of, often at the expense of your own needs.

Then, comes the messaging you received from the broader society. If you are a person from a marginalized community or you come from a working class family, the broader societal message has been that you must work very hard and put others first. As we all know, wealth is distributed  unequally along race, gender and class divides. If you start out behind financially, the odds are stacked against you.

This leads to conflicting feelings when it comes to money. A big part of you would like the ease, safety and impact that money could provide to you, your family and your community – while also feeling guilty, greedy and “capitalist” for taking the actions necessary to increase your financial resources. 

Finally, you enter the field of psychology or social work and the zero sum game money messages are amped up to epic proportions – by professors, colleagues, supervisors and all the people around you who have been caught up in this scarcity mentality.

You hear things like: 

  • “I didn’t enter this field to make money.”
  • “You must be accessible to everyone.”
  • “If you make money in private practice, you are taking advantage of people who need your help.”
  • “It’s selfish to go into private practice.”

Over and over, our profession reinforces the message that you got from your earliest experiences. From your family of origin to the wider society and then your professional community, you get the message that you must sacrifice your personal ambitions, needs and desires in order to ensure that everyone else meets theirs. 

So, it’s no wonder that you’re struggling to even look at your private practice finances, much less believe financial freedom is possible for you.

The Real Cost of Avoiding Your Practice Finances

The fact is, you got into private practice because you wanted to help people, sure. But you also wanted more time and money, more freedom to work how you want, when you want and to earn a good living. This all can be true at the same time. You can actually help people and make money.


If you’re avoiding your numbers, chances are you’re not doing either.

Even if you do have more time, your internal space is filled up with anxiety about how much money you are not making in the hours you aren’t seeing clients.

Your stress and money avoidance leads you to fill your clinical hours with clients without ever getting clear about how much you need (and WANT) to be earning and whether your fees are even close to getting you there. 

The idea of moving beyond “getting by” and moving into “abundance” or even “wealth” feels like a betrayal of your values.

Maybe you’re making more than you ever thought possible, but you’re still feeling anxious and resentful when your clients can afford to go on vacation because you haven’t taken a day off in months.

The number one way to increase your private practice income in a way that allows you to show up fully, calmly and to truly be present for yourself and your clients is by charging more per session.

But for many therapists, considering raising fees by more than $5 or $10 is unthinkable. We would rather bend over backwards, skip lunches to see more clients, miss picking our own kids up from school, never pay off student loans and ignore putting money into our own retirement accounts than even imagine having a fee conversation with our clients. 

If this is resonating with you, take a deep breath. You’re not alone.

And, things can change. 

The First Step to Earning More In Your Practice

Here are 3 simple things you can do right now to create a practice that leaves you feeling calm, present and financially safe – one where you can see your income increase while seeing fewer clients and doing better clinical work.

  1. Acknowledge the Feels: Look, money is stressful. If you feel guilty, greedy, insecure, ashamed or just plain avoidant when imagining addressing your fees, you’re in the right place. I encourage you to make space to experience how the exchange of money between you and your client feels in your body- with as little self-judgment as you can muster.
  1. Find Your Fee: Once you’ve made room for the feelings. It’s time to get in touch with reality. You must get crystal clear on what your fee needs to be in order for you to have a sustainable private practice. Assessing your fee structure doesn’t have to be awful and, in fact, it can be fun.

    I’ve created a free Fun with Fee Calculator that will help you decide EXACTLY what your fee needs to be. Click here to get the free Fun with Fee Calculator.

    You put in the numbers, I’ll do the math.
  • Phone-a-Friend: If you fill out the calculator honestly, you are likely going to have some sticker shock. The difference between what you are currently charging and what you need to be charging might be large.

    I encourage you to find a trusted friend, someone who does not buy into scarcity messaging, but instead wishes for YOU to have everything good in life. Share the dreams and hopes that went into your Fee Calculator, along with the resulting fee. Take some time to talk with them about all the feelings that came up as you went through the exercise. 

 

These steps will transform your practice from a space where you are trying to help people at the cost of your own wellbeing, to a true business, where you are actually supporting the transformation of your clients, while also finally making the choice to take care of the Little You who has spent a lifetime ignoring her own needs. 

 

Start Here 👉🏽 Download the Fun with Fee Calculator