You assessed the market, did you?
Unless you’ve spent tons of hours using these metrics to pull together a stunning portfolio with indicators about the viability of therapy in your area… you haven’t really assessed the market.
You’re terrified (I know, I’ve been there) to sit down and figure out what you need (and want) from your private practice and then plan your business accordingly.
For those of you who feel ashamed admitting that you’re scared to set your fees, breathe a tiny sigh of relief. You actually have a bit of an advantage over those who proudly declare that they’ve set their fee after “assessing the market.”
99.999% of therapists* who argue that their fees are appropriate because they “assessed the market” first actually set
their fees based on anxiety, guilt and insecurity – but they’ve developed an elaborate web of illusion and sparkles to convince themselves otherwise. Because it’s too uncomfortable to tolerate their money anxiety, they found some fancy business term like “assessing the market” to justify their fee setting.
While assessing the market actually entails hours upon hours of complex work, what those therapists who claim to have “assessed the market” really did was look at a couple of Psychology Today profiles and asked a few friends what they charge – in order to justify the fee that they had already internally decided before doing said “market research.”
In reality pretending to “assess the market” is just a handy way to brush away any anxiety you feel about setting fees that line up with your current and projected financial needs because it’s scary to:
1) Actually sit down with a budget and see how much you need to be charging in order to cover your current and projected financial needs (yes, this includes student loans, retirement, healthcare, and that trip to Thailand) and then;
2) Charge that fee.
Miranda Palmer, co-founder of Zynnyme.Com and creator of the Business School Bootcamp for Therapists shared this pearl of wisdom with me,
“Setting your fee based on what others are charging is no guarantee of success. In fact, if the other people aren’t making a livable wage from that fee- it simply guarantees you won’t make a livable wage either. It is time for therapists to unite and embrace the math of a business plan based on expenses and plausible income.”
* There are those some who have actually assessed the market – created a thorough business plan, with hours of market research – and it’s likely that these therapists moved into therapy after having spent many years in corporate America. And, even more likely, these therapists are not reading this article because they have quickly established a thriving practice that takes care of their financial needs and, at this moment, are preparing for their third Ted Talk.
Kudos to you, the Esther Perels, LMFTs of the world, who illustrate the limitless nature of our profession!
If you’ve been relying on the argument that you assessed the market, but are now realizing that maybe you haven’t, do not fear. Read on. I’ll take you through the step-by-step process of setting your fee based on YOUR needs and then show you how to carve out your own market.
Myth #2: I have to wait until I am “experienced” enough to charge my full fee
The truth is, you’ll never be experience enough… or smart enough or brave enough or ‘perty’ enough, because, well, you’re kind of a perfectionist.
You’re always striving to do better, to grow, to achieve – and that’s so awesome!
Untiiiil…. It gets in the way of your business.
The idea that you have to wait to get to some fantasied point before you are “qualified enough” is one of the ways you hold yourself back.
We all do this in some form.
You see a world that is saturated with people who have higher degrees than you, who have certifications in things like “Targeted Radial Electromagnetic Focusing for Survivors of Emotive Bruising,” who definitely have more years under their belts and then you think,
“Damn! Who am I to be charging $200 per session?!”
Maybe some handy dandy facts are in order.
In my survey of over 100 people who have been in therapy, “finding a therapist that I trust” was far and away the number one thing clients looked for.
Yup – even over a therapist’s “level of experience” and “cost” of therapy.
While you’re sitting around, picking that pesky scab on your elbow, and worrying that you don’t have enough experience to charge your full fee, someone out there is desperately wishing they could find you! YOU – the therapist who they trust.
Why would they trust you, over all of their options?
I don’t freaking know!
We are drawn to people based on a magical combination of smell and hopping cells and weird childhood experiences.
Who are you to question it?! The fact is, there are people out there who just want to find a therapist they can trust. Someone just like you.
I’m not going to promise you that you are enough already because I know you won’t believe me. But I will say let you in on a little secret.
By honestly determining (and then charging) appropriate fees, you will grow into being enough.
Remember, there are people out there who really need help, who have had terrible experiences in therapy and are really desperate to find someone they trust. By making sure you’re taken care of, in terms of your own financial stability and emotional well being, you’ll be prepared to put yourself out there with confidence.
If you’re not quite sure how to figure out what your fee needs to be, rest easy. I’ve put together a “Fun with Fees” worksheet and video guide. Sign up and I’ll send it to your inbox.
Myth #3: I have to be on insurance panels when first starting out
Who told you that?!
You might choose to be on insurance panels because you’re anxious and you want clients yesterday and you don’t trust that you have what it takes to bring them in without being on a panel.
But keep in mind, this is a choice.
The fact is, you can build a full-fee, cash-pay practice that let’s you thrive financially.
People do it all the time. People like Molly and Dori and Aden and Katherine.
Sure, you certainly have to do more than sit back and wait for your phone to ring -and maybe doing a little marketing and a some coffee dates and joining a training or two isn’t worth it for you. That’s totally okay.
Just be honest about your choices.
For me, and a lot of therapists who are successfully running their practices, the idea of taking a small co-pay, and being beholden to the constraints of insurance policies and doing all that damn paperwork isn’t worth it. For others, the security of knowing you’re going to get steady clients, even if the pay isn’t all that great, is all you need.
Whatever you decide, remember it is a decision.
Sometimes our choices don’t actually feel like choices. I often hear therapists talk about being at the mercy of insurance companies and it really feels like they have no other options.
If you find that you’re feeling frustrated and hopeless by the offerings of insurance panels, talk to colleagues who have successfully built up a private practice without being on insurance panels and ask them how they did it.
One of the best ways to discover that it is possible is by talking to others who have done it!
There are plenty of examples of therapists who opted to skip the panels and quickly built up financially rewarding practices… like Chris and Christina and Erika.
If you’re on Facebook, you can also find tons of encouraging communities where therapists are happy to offer encouragement and support around building up cash pay private practices. For starters, check out Deborah Owen’s “Full Fee Private Practice Lounge” FB!
Myth #4: It’s my ethical obligation to offer a sliding scale as a way of “giving back.”
This is one of the most harmful myths of our field. The idea that the only way we can give back is through lowering our fees in our business.
It is time for a paradigm shift around this one.
When I’m talking to therapists, I So.
“I became a therapist because I want to help people and give back. I want to offer sliding scale spots because I want to work with all kinds of clients, including those who cannot afford $175 per session.”
Then I go on to ask you all kinds of other questions, specifically around your quality of life-
And what do I find?
You’re overworked, burnt out, frustrated with your low-fee clients, wishing you could charge more, but you’re worried no one will come.
Then I ask my favorite question of all. Take a moment to answer it for yourself. Don’t worry, no one will hear you, it’s between you, your computer and…well, maybe that harsh superego sitting there on your shoulder.
If I could give you 10 $180 clients right now, would you take them?
Well, would you?
The fact is, even though we say we offer a sliding scale to “give back,” the reality is, we offer a sliding scale because we’re afraid – afraid to take a look at how much money we need to live a rich life (whatever that means for you) and then charge that fee.
I whole-heartedly believe in keeping one or two sliding scale spots open in your practice if you want.
But, in reality, having a couple of sliding scale spot is a luxury.
It is what you do once you are paying off all your bills, putting money towards your retirement, taking your friends out to dinner, investing in your kiddo’s college education and making regular trips up to see the folks.
It doesn’t make sense to offer a sliding scale or, more likely, to have the majority of your practice made up of sliding scale clients, when you feel like you are drowning, overwhelmed, stressed about money, worried about whether you can even pay your bills.
When I asked Miranda Kelly, the other half of the glorious Zynnyme duo to contribute to this article. She was eager to debunk the myth that we must only contribute to society by lowering our fees. She said,
“Your fee is set so you can be a sustainable, impactful business. When your business thrives you are truly able to give back to your community which is the opposite of limiting who and how you help. There are many ways to give back beyond the sliding scale model without sacrificing the survival of your practice.”
By encouraging our therapists to start with a sliding scale we’ve gotten this backwards. It makes more sense to run your practice like the Virgin America song says, “Put your mask on first before you offer assistance.”
(I literally had to pause the writing of this article to go watch the Virgin America safety video. Again.)
Check out what the amazing Barbara Sheehan-Zeidler, LPC with Creative and Caring Counseling in Littleton, Colorado had to say about finding a way to give back that also fell in line with her value about maintaining her own financial well-being,
“I came to a place of peace around this topic by volunteering with Mental Health America Colorado and offering two pro bono sessions per week and doing community outreach via free public speaking engagements on topics related to mental health. In this way, I am able to have the lifestyle I want for my family and I, while honoring my heart and values of giving back.”
Build up your practice with clients that can financially support your business first. In order for you to create a private practice that will thrive in the long run, it is imperative that your emotional, physical and financial needs are provided for.
Make a list of all the ways you can give back that do not compromise your well-being. Here are a few to get you started:
- Volunteer as a Big Brother or a Big Sister.
- Offer to teach a workshop for graduate students.
- Organize a monthly trash pick-up with your friends and colleagues.
- Walk dogs at the local animal shelter
- Send care packages to college youth who have aged out of the foster care system
Myth #5: I can’t charge more than my consultant (supervisor, therapist…)
Let’s all pretend we’re five years old for a second and ask ourselves “Why.” [go to 1:07]
Why can’t you charge more than your supervisor or consultant or even your own therapist? And why to that answer? And to the next?
What happens when you imagine setting your fees equal to or above your respected mentors?
It’s like this old scene where Bart (yes, that’s right, I went there) is haunted, only rather than creepy old ladies, you’ve got your supervisors, beloved professors – all kinds of internal figures – whirling around your head, demanding, “Who do you think you are?”
In reality, who the fuck gets to tell you what you get to charge?
The answer… well, no one.
It’s your business! And, despite the voices in your head, if your respected elders are worth their salt, then in real life they will be proud of you for taking care of yourself.
If not, then likely they’ve got a bit of envy going on and, though that’s hard to see, it’s better to recognize this kind of dynamic sooner rather than later.
I’m always surprised to see people who have been in the field for twenty years who are still charging pretty low fees. But really, it’s none of my business. I don’t know much at all about the reality of their situation.
- Maybe they come from wealth and do therapy for professional esteem, rather than as a source of primary income.
- Maybe they have conflicts about setting their fees based on their own difficult relationship with money.
- Maybe they slipped on a banana peel while wearing a bathrobe and..wait, what?
People set their fees based for all kinds of whacky, unknown reasons. It does not behoove you to set your fee based on the fees of others – yes, this even includes very idealized others.
Sure, it will be hard to set a fee equal to or (heaven forbid) higher than your respected advisor.
Yes it will bring up all kinds of internalized conflicts about surpassing your parents, taking responsibility, moving forward as an adult in the world (*gulp*).
And, yes, it is necessary for you find ways to play out your psychic conflicts outside of your primary source of income, like, I don’t know – in your own therapy.
Sit down and figure out your fee based on your rent, your grocery bill, your dreams, your costs of living. Get anxious just thinking about it? You don’t have to do it alone. Check out the “Fun with Fees Worksheet,” plus video tutorial. I’ll walk you through it, step-by-bloody-step.
Myth #6: I should set my fee based on what I “deserve.”
The idea that your personal worth should be the metric by which you set your fee is a very slippery slope, indeed. You will be heading into a dark tunnel of Trump-ish proportions if you imagine that your fee should be tied to your value as a human being.
Because, that would mean that men are more valuable than women, white folk are more valuable than black folk, and Switzerland is more valuable than Greece.
The fact is, you can’t set your fee based on some ambiguous sense of self worth. At the end of the day, it’s just not good business practice.
So…one way to set your fee that can give us a more “objective” viewpoint is to set our fees based on…well, our current and projected expenses.
“HUH, Tiffany?! Setting my fees based on my…income needs?!”
I know, sounds totally random, right? But really, your business is there to support your quality of life, so outside of all the conflicts you have about good and bad, right or wrong, rich and poor, you’ve actually got to pay your bills, along with all the costs necessary to be a quality therapist (things like, physical health, emotional well-being and ongoing training).
You can keep all of those internal conflicts. Shoot, they make for an interesting character. But play them out in therapy, rather than in your business.
Sit down with pen & paper and write down your monthly expenses and projected expens – okay, okay. I know. BOE-RING.
So, if you haven’t already, sign up to download the worksheet. Yeah, yeah. I’m driving this home, but if you can’t do it alone, why not get some help?
Myth #7: No one will pay my full fee
This is an easy one to debunk with this little fact.
Fact: Yes. They will.
HA! I crack myself up.
But really. They will.
Don’t take my word for it. There are people out there who really value the work we do and they are willing to pay for it because they see the benefits. In response to my survey about being in therapy, one person responded:
“It’s still hugely expensive in the context of my budget, but I’ve realized it’s just worth it. I once stopped seeing [my therapist] for a bit in order to try to find someone cheaper, and I tried out a couple other therapists, but we just didn’t work well together and I didn’t want to keep parading all my vulnerabilities to tons more people in order to find someone. I simply had to recognize that the fit matters tremendously, and the work we do together is worth it, even if it creates financial pressure.”
Much of our disbelief about the potential of people paying our full fee arises from our own difficulty imagining what it would be like to pay that much for therapy.
You guessed it – projection!
A lot of us therapists have gotten so used to working for next to nothing during internships – barely scraping by, forced to choose between a cappuccino or lunch, and relying on our own therapists to slide their fee for us – that we forget that there is an entire range of the population who chose a different path.
Let me give you an example.
I just randomly checked out the salary for a “technical employee” at SalesForce and saw that the average salary was about $120,000 per year. I happen to live in a tech city, so there are a lot of young rapscallions who make this kind of money. That means that, each month, this person – let’s call her Sally – is taking home about $6,461 per month after taxes. This means that, unlike you, Sally is not being forced to choose between things like paying for therapy or paying for rent. She is likely choosing between paying for therapy and paying for that really cute new pair of shoes. Well, really, just one shoe because Sally has expensive taste. But she’ll make sure to get the pair even though it’s double your session fee.
There are a whole lot of Sally’s all over the country who have plenty of disposable income. Just because they are not in your friend circles (which are composed largely of therapists and starving artists) does not mean she is not everywhere, all around you, desperately wishing she could put her money towards something that will actually improve her life in a way that lasts long beyond that pair of designer pumps.
Just in case you struggle to imagine that there are enough individuals out there who are willing to pay full fee for therapy… check out therapists like Lindsay and Jodie and Ryan. They’ve set fees commensurate with the standard of living…and they’ve successfully found an entire practice worth of clients who are eager to pay those fees.
Find other therapists who do charge their full fee and find the clients who can pay for these fees, who are able to both thrive professionally, while also giving back.
I know I talked about this earlier in the article, but I cannot stress enough how important it is to find people who are already doing what you strive to do. Study them, interview them, write them thank-you cards for inspiring you, ask them how they did it!
Nothing is more motivating than talking with kind people who are making it happen, who believe that you, too, can join the financially successful therapist club.
Myth #8: I should set my fees based on what I feel I can ask for
I hear this one a lot. Therapists come up with a random fee – usually about $150 – that they “feel” they can ask for, just based on, well…just that.
I can weigh in personally on this one. When I was deciding to set my full fee upon getting licensed, I planned on stating the requisite $150. I felt this was a fee I could easily get behind. Then, I had a flash in my head about charging more and I was filled with panic.
I could NEVER charge something like…gulp… $180. And that number began kicking itself around in my brain for the mere fact that it was terrifying.
Then I decided to give myself a challenge. I decided to charge $180 per session because of the fact that the only thing keeping me from doing so was, well…fear.
I tended to live my life such that a feeling like fear was a good enough answer for why I wouldn’t take certain risks. I don’t mean risks like hanging around in dark alleys waiting to comprehend bad guys. I mean risks that would only serve to benefit me and my practice, but that just scared the bejeesus out of me.
I justified this fear as a concrete, reasonable fact.
I realized that if I really wanted to move forward in life, I’d have to find something beyond terror to keep me from activities that would lead to growth.
In the beginning, I attempted to justify my less than $180 fee idea with reasons like “assessing the market,” basing my fees on supervisor’s fees and the sanctimonious, yet vague declaration, “SOCIAL JUSTICE”…but behind it all, was really just fear.
So, I said, “fuck it!” and tried something new.
The fact is, money anxiety doesn’t go away. In my survey research, 70% of therapists reported feeling “anxiety, guilt and conflict” when thinking about money.
Not surprisingly, the percentage of therapists who were in their first two years of working in a private practice setting were more likely to experience anxiety and guilt when thinking about money matters, with about 77% saying “yes” to money anxiety.
But even of those clinicians who have had over eight years of experience, 59% still reported that they had feelings of anxiety and guilt when it comes to thinking about money.
This means that if you’re waiting for your anxiety about your money to decrease, waiting for the moment when you “feel” ready to charge your full fee, you’ll have a long wait ahead of you.
You would be wise to figure out your fee based on your financial needs and then work with your therapist or honest colleagues or successful mentors to start charging your full fee sooner rather than later. Yes, even before you feel comfortable charging it.
Take time to acknowledge your fears about charging the fee that you need to in order to have the life of your dreams. Recognize the feelings of inferiority, doubt, terror, guilt. If you’re really into these little fear buddies, make them a little bed, feed them kernels of frozen corn, kiss them sweetly.
BUT DON’T LET THEM KEEP YOU FROM SETTING YOUR FEES.
Determine your fee using the worksheet and video guide and then charge those fees.
Don’t have it yet? Get it.
Myth #9: If my fees are low, I’m bad. I should be mightily castigated. Hourly
As you’re reading this article, it is hiiiighly possible that you’re beating yourself up for not having summoned the courage or pizazz or whatever you imagine it is one needs to:
1) Know what fees you should be charging based on your financial needs and then
2) Charge those fees.
I’m going to step out of my role of shaming, ball-buster (or vag-buster as the case may be) and give you this little nugget: Be kind to yourself.
Really, despite my no-nonsense, shit talking style, the only way any of this can really work is if you’re kind and patient with your delicate little heart.
This stuff isn’t easy.
If it were, you’d have done it a long time ago. You’d be some private practice wunderkind, like this adorable knucklehead.
I greatly admire the therapist podcast aficionado, Melvin Varghese – creator of the top-rated podcast Selling the Couch. I was surprised and relieved to hear that even Melvin struggles with anxiety with reconciling our desire to help people and our need to get paid for our expertise. After reading this article, Melvin wanted to share this with us:
“Many healers (myself included) believe that we’re “just nice people.” The thought of being a caring soul AND charging what we’re worth doesn’t seem to line up despite our years of highly specialized training. But our abilities are not the norm; the world would be a much better place if they were. Our work as healers is vital to this hurting world. Our work matters.”
We all do our best at the pace that we can. One of the reasons that I love writing for therapists is because we all came from some kind of struggle. We’re all working to level up, change, grow, make a difference and help people in the ways that we so desperately wished someone had been there to help us.
So, cut yourself some slack from the you-bashing.
Rather than criticizing yourself, just do the thing – fill out the form, figure out your fee, and then charge it.
If you’re struggling to take action, reach out! Talk to a friend, a colleague, a mentor – even me.
You don’t have to be alone with this stuff.
Myth #10: If my fee is high, it limits who I can work with
Actually, quite the opposite is true!
What really limits who you can work with is… burnout!
If you’re stretched to your max, trying to see 30 hours of low-fee clients, barely able to pay your bills, much less having money or energy for your loans or spin class or little Jimmy’s first grade knickers or little Jimmy himself (!), then you’re surely not doing your best work as a therapist.
By having a primarily low-fee practice that leaves you struggling to make ends meet, you’re actually perpetuating a system in which those who are at the bottom of the economic barrel get bottom-of-the-barrel treatment.
Painful, but true.
Check it out, if you have a high fee that allows you to pay for the trainings, personal therapy, organic carrots, awesome consultation, trips to the hot springs and all the other things you need in order to show up as your best therapist self…then you will have more than enough energy, time, and financial well being to really serve those who fall into your population of passion.
Though it feels counterintuitive, what really limits who you can work with are your own feelings of stress, overwhelm, anxiety and sense of lack. By setting yourself up with a stable financial foundation, you will have more capacity to serve whomever you want, not less.
Remember, you must start with step one (self-care and financial stability) before you get to step eight (giving back with a fully bursting heart).
The Facts About Fee-Setting
- One of the most thrilling things about private practice is that there is no limit to what you can do!
- You get to choose what hours you want to work. Seriously! You get to work whenever you want!
[And I don’t want to hear anything like, “Nuh uh, Tiffany. I can’t work at 2am!” YES YOU CAN. And I bet you’d discover awesome niche around swing shifters, insomniacs and new parents.]
- You get to choose what you earn.
There is no conceivable cap on your earnings beyond the cap you place on yourself.
- You get to choose to work with whomever you want.
Really. Is it possible to work with underprivileged youth and make $200,000?
Sounds ridiculous, right?!
But, guess what, you are your own boss, so if you can conceive of how to do this… then yes. There is no one to fire you or demote you or give you a harsh talking to. Well, besides yourself.
Check out some of these amazing clinicians who have broadened their practice beyond the fee. They have found ways to bring in a basic income that is not reliant on fee-for-service clients, thus freeing them up to make more expansive decisions about the kinds of fees they accept in their private practice without compromising their financial wellbeing.
Miranda and Kelly are two amazing clinicians who have created increased their financial foundation by creating an online Private Practice Boot Camp that helps therapists up their private practice game. They have also created the Most Awesome Conference in collaboration with some other brilliant therapists in order to give back, while also creating a stable financial foundation.
Therapist Development Center.Com
A lot of you have heard of Amanda Rowan, LCSW. She created online training programs to help therapists pass their licensing exams. What you probably haven’t considered is that she is a clinician who made the choice to create an additional income stream that could take some of the economic pressure off of her private practice, thus freeing her up to take on low-fee clients, if she so chooses, without making sacrifices to her bottom line.
Perhaps you’ve heard of Melvin Varghese – an early career psychologist turned podcaster who busted onto the scene with over 65,000 downloads in less than year! Melvin is another amazing example of what we can do as clinicians if we allow ourselves to expand beyond the fee for service model. Melvin has created an online podcasting workshop and membership community, both of which provide freedom and flexibility in terms of his finances. I don’t think Melvin has yet to open his practice, but when he does, he will certainly be starting with a HUGE referral network and plenty of options about his fee range, because he’s already done the work up front to establish a solid financial foundation.
The Next Step
Okay, guys, I know this article was long, but here’s what you got:
- You’ve learned to tell the difference between myths and fact when setting your fees.
- You can now recognize when your fears are getting in the way of your professional success.
- You have some solutions that can help you take action even when you’re afraid.
If you’re having a hard time setting fees based on objective reality, then definitely download the “Fun with Fee’s worksheet.
In it, I’ll walk you step-by-step through:
- Setting your Fee based on your current expenses
- Knowing what you need to charge in order to have the lifestyle that you dream about
- Figuring out how to set your fees so that you can keep the sliding scale clients you already have without compromising your professional and personal goals
If you happen to be one of those people who has a pretty good idea about what you need to charge, but you still find yourself stuck, sign up and stayed tuned.
I’ll be sending you a video course that will knock your socks off.
And you know what, it’s all free! WHY? Because I have set up my practice so that I can give back. Cool, huh?
Set Your Fee