Hello Centore,

I appreciate you are dedicated to sharing your experience!

My name is Alberto Semedo, I am new in this field and I would like more information about open your own private practice.

I would appreciate it if you contact me directly through my email.

Thank you!

Maybe bob is also considering travel to get to the CEUs. There’s also the added expense of any CEUs necessary for any specialized services (EMDR, play therapy, etc) that yes, also contribute to state required CEUs but increase the cost of CEUs in general.

Hello,

Great info. How do you propose why the cost of living so high when people in general are earning so little in relation to the cost of living. My mother was a CC 30 years ago and earned 40k as an employee, and our house cost 170,000 full detached with 10000 foot back yard. That house is freaking 2 million dollars yet, her daughter as a CC earns 60k 30 years onwards. What has happened? Some thing is seriously wrong. Mental health experts care to chime in, it is extremely disheartening to say the least.

Hello. I am wondering how to calculate how much I’d make in full-time private practice if I saw an average of 20-24 clients per week. I am thinking of doing this rather than continuing to work for community mental health clinics in order to get my $50,000 in student loans forgiven, which I’d have to work in for at least 30 hours a week for 5 more years. I’m now thinking I’d make enough to pay those off myself quicker than 5 years in private practice. I have calculated all of my expenses, but I don’t how much to take out for taxes. Do you know how much I’d have to take out for taxes?

To Sarah and others interested: When you contract with an insurance company, you agree to accept what they pay you. If the company thinks a 55-minute session is worth $100, then that is what you agree to accept, even if your hourly rate is $150. So, insurance may pay you $75 and the client’s copay is $25. That’s all you get. If you ask clients to pay the other $50 (bringing your total to $150) this constitutes fraud.

I’m of 2 minds about responding. 1. I know how our industry and our own desire to help others push us to take less money and to work longer hours. 2. But I have some better ideas that I have proven for myself that you might want to consider. There are no guarantees and this strategy requires some courage. And it requ8ires a lot of faith in yourself and in your abilities.

I’m 69. I am an intern in private practice by myself in marriage and family. I have practiced over the last 20 years under a church umbrella. I also have some specialized training – which you could get if you want to work with trauma.

Fee. This was frustrating. My first supervisor charged $40 for my services. I got $22 of that. After a bit we parted company. I told her I was going into private practice, which my state allows, and what did she think I should charge? She said there was no way I could get more than $50. Hmmm. I didn’t agree but I started at $50 to see what would happen. I got a few clients. But my marketing background told me that clients don’t have a clue what an “intern” is and they don’t really have much of an idea as to what therapy costs. And I found that NEITHER DO THERAPISTS!

Try this in your market. Go on Psychology Today and make a spreadsheet of fees. Note speciality, education, years of experience, brand of therapy (LPC, LMSW, MFT, or whatever other letters you can find). Intern or fully licensed. Now, print the spreadsheet on one page. What do you notice? I’ll tell you what I noticed. With the exception of 2 PhD psychologists who charged $225 each there was no rhyme or reason as to who charged what. Psy D’s and PhD’s were charging $40. Interns were charging $75. Master’s level therapists were charging $100. My therapist charged $150, no insurance, and accepted only cash.

My conclusion? I could charge more, maybe a lot more. So I tried $75 and got 3 clients. The next client I charged $80 and got it. Then I decided I would charge $85. Got it, too. Then I said, “this is stupid. Bite the bullet and charge $125. I got that, too. Everybody didn’t bite. I lost some because I don’t take insurance. And the only clients I lost because of the size of my fee were the ones I wouldn’t have gotten anyway because wanted me to take insurance. I have more to say about the insurance issue, but not now.

My problem was that I was getting only about 7-10 sessions a week. Sometimes less. What to do? Before I decided to go private, I called on a couple of supervisors who had a practice in which they hired interns. They charged $125 and hour. But they only wanted to pay me $40. Reminded me of that scripture in the Bible about not muzzling the ox who’s grinding the grain but to let them eat freely. I learned 2 things from them: 1) that I didn’t want to work for them and 2) how they got clients!

Basically Google AdWords I did the same spending about $200 a week. After about 5 or 6 months I had 16 clients and I didn’t want to pay Google anymore. Plus I had Psychology Today which has been great. But then there was attrition. I found my numbers sliding. What to do?

Well, doofus, have you prayed? Yeah, well, of course. I’m a praying kind of guy. But I hadn’t been praying about my business that I had been working so hard at. So, I prayed. “Father I really need some help would you send me…2 new clients. Who can pay my full fee?’ Within three days, the Lord came through. About a week later I screwed up my courage and my humility and went back to the well. “God, thanks again for those 2 clients but I wonder if you would send me 3 more?” Within a few days I had 3 new clients. I looked at my numbers again and they weren’t were I needed them to be so I asked again for 2 clients. For the 3rd time in a little over 4 weeks God gave me what I asked for. That is basically my acquisition strategy, now. If you don’t like it I suggest you stay with Google AdWords and Psychology Today. I think you will do quite well.

Now ask yourself
1. Why am I charging so little? Do I have the right to get a decent return on my educational investment and my current time investment?
2. Do I want to retire with more than Social Security? Working for yourself you better be making some money and saving as much as you can. Do you really want to be doing therapy when you’re 70? I do but you may not. If not how will you achieve that goal?
3. Can I find the courage to spend a few hundred dollars a month to increase my caseload.

One final thought on caseload. I don’t see 35 clients a week. I couldn’t handle it. My trauma clients are too heavy. I see between 16 and 23. Everybody doesn’t pay $125. I still have a couple of clients at $40, a couple at $75, and one at $25 who I see once a month. If everybody makes this week – and a couple of weeks in August were terrible! – I will gross in excess of $8,000 for August.

Hello Dean and Thriveworks, I’ve been reading on the comments and I think I may be a bit confused. I see a lot of people commenting on 35 people not being realistic because of all the admin work involved. Dean, you pointed out that a good biller is a must to have on hand. My question is, can’t this billing person also help with the admin work while one is doing the face to face sessions alleviating a lot of the additional admin work? I am asking because I live in a town where there is no therapists but the need for one is incredible. People usually travel all the way to San Antonio to go see one. With this in mind my though was hmmm, I can probably work well over 40 hours a week, have the biller/admin help with paperwork and billing so my workload won’t be as large. Am I looking at this wrong? I realize that I will have to be taking notes to continue treating/seeing people, but does the note taking not happen during the sessions where everything is fresh and just happening?

Hello Sarah and all of the above. I am about to start working on my master’s degree. My goal is to work with children once I get my LPC. I have a question however. I see most of these comments were from 2011.I want to fast forward to today, 2018, and see if the numbers have changed any as far as income, what insurances pay, how much a counselor charges, etc. Also I want to stay in the loop with Sarah’s questions as she asked some of the same questions I have as far as having insurance paid clients, cash clients and mixed where you bill the insurance and the client pays what they don’t cover. Thanks!

THRIVEWORKS: I also appreciate the breakdown you outlined. Yes, some figures do vary but in general you have covered all the details. I appreciate what you have presented and would like to see an updated price structure since 2011.

Why bill insurance anyways…Ive read a few articles promoting out of network… if you can do “out of network” you might make more per hour as well…$70-$80 is modest. 33 clients a week is totally doable. Even if you made 90k and subtracted expenses at 20k, you are still looking really good. The big thing is deciding whether you want to be an insurance whore and take any client at a low price. We need to pressure insurance to base line pay $90 an hour for services. $70 is a joke. Especially for how much time, education, debt, and involvement it requires. So the key here is to pressure insurance to raise their rates since they are raising their rates on clients. You can also do a type of insurance where they pay for your hourly rate (lets say a modest $150) and then submit paperwork to their insurance and then their insurance refunds them the amount they are willing to cover. Takes the load off you. Ive heard this is great in regards to time and paperwork, and you still get insurance clients…..I’m not sure which route I want to go. I’d rather be slower, spend more time on 6 clients a day and make $150 a session as “out of network” than have 12 clients a day at $70-$80. Less stress. And insurance often times does cover up to a decent amount… Im weighing the pros and cons. Right now I make 100k a year in a different field of work, but my expenses are well over 40k. So It’s going to be nice once I’m on my feet as a psychotherapist to have way less expenses. When I see people complain about taxes on here, taxes happen to everyone….so I’m not sure what the complaint is here- this is a gross assesment. My question is, can you do both insurance and cash?? Or can you bill a client at $150, the insurance pays $70 and you can have the client cover the rest minus the copay? Curious if thats a thing people do when taking insurance….

Marty, that’s a good question. There’s a lot to consider…more to type in a brief comment here. Our CEO wrote a book called “How to Thrive in Counseling Private Practice” which is on Amazon here: https://www.amazon.com/How-Thrive-Counseling-Private-Practice/dp/0692760512/ref=sr_1_1?ie=UTF8&qid=1504471199&sr=8-1&keywords=anthony+centore Not trying to plug our stuff, but that might actually provide you the thorough advice you’re looking for. Or, if you want lots of mentorship, maybe look into opening a Thriveworks franchise. See: http://Thriveworks.com/counseling-franchise/ (Comment written by Staff, under our CEOs account)

Thanks for sharing your experience, Caid!

Very helpful article and comments. I couldn’t help but notice almost ALL people commenting feel that 35 clients is too much – it can’t be a coincodence. I think one issue you might not be addressing is that 40 hour work week is not actually fully 40 hours of nonstop work, there are bathroom breaks, conversations, checking personal stuff, etc. So a 45 minute session really equals an hour of time. You can’t just see a new client at the end of 45 mins, you have to take a breath, jot a few notes and then clear your head to see the next person at the top of the next hour (I assume?). So I think the 45 minutes with a client be more conservatively calculated as 1 hour of a counselor’s time, not including the admin that is calculated separately.

I have read through many, but not all the comments. I haven’t see you address the emotional toll of seeing a certain amount of clients. I don’t think it’s about the amount of hours working based on a 40 hour work week, but talking to 35 people back to back in one week sounds exhausting. It seems like that’s more of people’s concern – it’s not about 25 hours of face time, which isn’t bad in itself, but it’s about the amount of people you are talking to, processing emotions with, and recalling and analyzing for the next session. Just a thought!

All this said, I love the article and I am starting an MA for counseling in the fall and am in my mid-30s. I am setting my expectations lower at $60k, but higher than the really sad $45k that is mostly discussed (I’ve been making that amount WITHOUT an MA, no kids, in a rented apt, and it’s really hard in San Francisco!)

Thank you for giving us hope, an outline to achieve financial stability in this field, and for publishing comments that do not always agree with you because it helps us better understand the dynamic picture behind your article – and open up dialogue. It also helps people see that financial security is not a selfless goal… it’s critical to our mental health!