Taking Back Your Cake: Mindset Shifts for Therapists Building a Private Practice
So, you’re thinking of starting a private practice, or maybe you’re already knee-deep filing your own paperwork, staring at your fees spreadsheet at 11pm, wondering why your student loan balance goes up when you blink, and doomscrolling through therapy TikTok for camaraderie. If you’re reading this, let us say: pop the kettle on, kick off your shoes, and let’s have a real talk, therapist-to-therapist.
Today, we’re taking cues straight from Kelly Higdon and Miranda Palmer: clinical, business, and community-building powerhouses based on their conversation from the latest Starting a Counseling Practice Success Stories podcast. It’s less “here’s a blueprint” and more “let’s call out the cake thieves, name what’s not working, and get you refilled and ready for what’s next.”
Because this? Building your dream practice? It’s no longer just about fees and marketing plans. It’s about survival, sustainability, and, yep, joy.
Let’s dig into some lessons, mindset pivots, and a few belly laughs along the way.
There’s a Cake Thief in the House: The Modern VC-Insurance-Platform Tangle
Let’s start with some real talk about those “convenient” therapy platforms and insurance panels. You might think they’re offering you salvation (“Set your own hours! $100,000 a year! Flexible life!”), but as Miranda Palmer lays it out, the promise is often a shiny shell around a scrambled, exploitative egg:
“They have done a really good job of marketing themselves as the only way. They have done a really good job of marketing themselves as a savior. Hey, we have a $500 signing bonus. We have $1,000 signing bonus. Look, you can make $100,000 a year and have a flexible schedule. They’ve had all of these recruiters and therapists are not used to working with recruiters.”
Here’s the kicker: these platform models often mirror and amplify the very same issues therapists faced with traditional insurance. Only now, the “middleman” is wearing a techy hoodie and running on VC cash.
Takeaway: Know who controls the terms of your work and your labor. Because, as Kelly Higdon puts it, “who has the power? They do. And then they’re going to cut back the rates, slowly chip away. Those really change. Then they’re actually starting to control what they will cover…”
Tip: Before you sign anything…pause. Reread the contract. Ask the hard questions. Take it to a lawyer or consultant who knows the industry. If something feels “off” in your gut, trust that. (More on that soon.)
The Power—and Pitfalls—of the 1099 Life
Maybe you’re lured by the 1099 “contractor” life: you’ll be your own boss! Set your own hours! Problem is, as Miranda Palmer points out, most therapists haven’t been taught to run a business, much less account for the real costs of self-employment:
“All of the protections and all of the benefits of being an employee are gone. Those are wiped away when you become a 1099 contractor. And so therapists are looking at these, at this math and going, 'Well, when I worked for this group practice, I only got 30 or 40% of the fee. Like, this one, I’m getting 50% or maybe I’m getting 60%.' But it’s not comparing apples to oranges because we’re not taking the self employment taxes that are 15.3%. And then your vacation time, your sick time, your benefits, CEUs, office space, collegiality, supervision, clinical support… are just gone by the wayside.”
Takeaway: Owning your business means owning all of your numbers. The fee split that seemed “better” might, after expenses, actually be worse.
Tip: Sit down and write out not just your fee split, but all the things you previously took for granted as an employee (taxes, sick days, support, insurance, etc.). Then do the “real math”. What would you need to charge in private practice to actually cover all those pieces, plus retirement and debt, plus, you know, living life?
Burnout Is Not a Badge of Honor
Let’s address the cortisol-soaked elephant in the room: therapists, collectively, are exhausted. (Seriously, when’s the last time you peed without taking your phone into the bathroom just to catch up on emails?)
Kelly Higdon sees it everywhere:
“I’m seeing like a lot of the comments of like, I just, I’m working so hard at such a low wage, I can’t get out of this cycle. And there is, we see more people’s body shutting down, autoimmune conditions on the rise, those kinds of things. And it’s why I feel like the embodiment piece is so important, not to cope with, but to be able to transform, you know, systems around us.”
Takeaway: Burnout isn’t just fatigue. It’s a system screaming for a reset. And rest isn’t just self-care. It’s rebellion.
Tip: Block off time for real rest and reflection. Drink some actual water (not just coffee, sorry). Take somatic and embodiment work seriously. “We are literally drained,” echoes Miranda Palmer—so don’t just pour from your cup, refill it, or, heck, upgrade to a pitcher.
Integrity Check: Money, Fees, and Your Knowing
Let’s talk money, maybe the rawest nerve in therapists’ private practice talk. There’s nothing more clarifying (or terrifying) than setting your own fee, but as Kelly Higdon underscores, clarity on why you charge what you charge is vital:
“Those are like cues. Like your body is cueing you of, like, hey, we’re not in integrity here. We gave bits of our power away. I’m all for just coming back to your sovereignty and your decision making and using all of you to come to your knowing on what’s right for you. Because when you’re in that place, no matter what people say, it really doesn’t matter because you are in your truth and you’re knowing.”
Here’s another piece: many therapists wind up with high private pay rates not out of greed, but necessity:
“Part of the reason that it [private pay] is so expensive is because insurance are underpaying. And there is a scenario where that has to shift. The other reason why private pay becomes so expensive… is also because when you are in a therapist who’s been underpaid, drowning in student loan debt, no savings, no retirement, now you’re 40, let’s say you’re 45, or you’re 55 and you’re like, I actually really need a plan. I can’t trust the government. I haven’t been able to put anything towards retirement for my whole life.”
Takeaway: Your fee isn’t “just” your hourly time. It’s your experience, your training, your retirement, your debt, your rent, your refill time. It isn’t selfish to put yourself in the equation: “If we create something that’s just for the other, that is a recipe for a lot of resentment and a lot of pain and strife in the long run.”
Tip: Do a quarterly check-in. Ask: “Are my fees aligned with what I actually need, not just what feels comfy or what insurance allows?” If it’s time to shift, embrace it. Your future self will thank you.
Reinventing the Model: Group Work, Community, and Actual Accessibility
Here’s an inheritance from the “do it all myself and alone” myth: thinking private practice has to be 100% one-on-one. Not so. In the new landscape (especially with looming insurance shifts, as both Kelly Higdon and Miranda Palmer discuss), community-based and group models matter more than ever:
“Are we going to be offering more community based or group work that I think is actually really needed, like in terms of like connection and community and also can create more accessibility for people in terms of being able to offer something at a lower price point?”
And, added Kelly Higdon, “[Group therapy] can be just as equally as powerful. It’s just an amazing way to work with people… and it makes it more accessible for people.”
Takeaway: The solo hero myth is just that…a myth. Group work is not only powerful for clients, but for you as a business owner. It’s also a cure for isolation (the therapist’s secret poison).
Tip: Explore what forms of connection: workshops, therapy groups, communities, you can add to your practice. Not just for the money, but for the sustainability and sanity.
Stand Up (& Take Your Cake Back): Let’s Be Brave, Together
Here’s the big mindset pivot—and maybe the anthem of this episode: you CAN say no to contracts, platforms, and companies that don’t serve you. And? Clients may be ready for the revolution, too. Miranda Palmer puts it bluntly:
“These insurance companies, they cannot exist without your labor.”
So if you’re quietly handing over half the cake you baked to someone in a suit, maybe it’s time to… stop?
“Can you imagine if you were like, baking cakes all day and then didn’t get a chance to stop and eat, and people were just like, thank you, and they just took the cake, and you were like, no, I’m actually trying to make myself lunch. And you were just eating little bits of crumbs off the thing. Although I like a crumb. But you would just get frustrated after a while.”
Takeaway: You are essential. Your labor is the product, the magic, the everything. Don’t let someone else take your cake and run.
Tip: Reach out to community, business school, or even your favorite therapy TikTok creators (#HeyKellyAndMiranda) to talk out your next moves.
Closing Thoughts: This Is Your Invitation
Building a private practice today isn’t just about surviving insurance audits and “figuring out marketing.” It’s about redefining what care, business, and self-respect look like in a very noisy world. It’s about daring to trust your guts, honor your whole self, and step forward with a community at your back.
Here’s how Kelly Higdon sums it up:
“You have to factor you into the equation.”
Now’s the time: look at your fees. Check in with your body’s cues. Question old contracts and mentalities. Dream bigger: of group work, new models, true rest, and saying no to thieves with cake boxes.
And hey, if you want permission: You can have your cake. And eat it, too.
Ready to Stand Up for Yourself and Your Practice?
Let this be your nudge: Don’t let another quarter go by without sitting with your numbers, your contracts, and your dreams for what comes next. Reread that contract. Get in touch with your business basics. Reach out to community. Take a break. And if you need a pep talk, head over to the full episode or find Kelly Higdon & Miranda Palmer on TikTok.
You deserve a thriving practice…and all the cake you can eat.
Resources:
Free training with Person Centered Tech & Strom Consulting (mentioned in the episode)
Business School for Therapists (the community Kelly & Miranda run)
Connect on TikTok for real-time conversations & tips: @zynnyme
Here’s to the revolution, the replenishment, and the remembering: You matter, and so does your business.
Go reclaim your cake, therapist friends. We’re cheering for you.
Looking for more wisdom from Kelly & Miranda? Check out their episode archives or join the conversation on TikTok. Big hugs, replenishment, and full slices of cake to you!
About the Authors: Kelly Higdon and Miranda Palmer are the co-founders of ZynnyMe and creators of Business School for Therapists. Since 2010, they've helped tens of thousands of therapists build sustainable practices through organic digital marketing strategies that actually work—without wasting money on ads or time on tactics that don't convert. Because your practice deserves to be found by the people who need you most. Learn more here.