Will Therapists Kill or Save Our Profession in 2025?

Recently, Miranda posed this question on Facebook:

“What do you think is the biggest problem today for therapists?” 🤔

The responses poured in—overwhelmingly, you pointed to insurance companies and terrible reimbursement rates.

You’re not wrong. The system IS broken.
But, it’s also wildly profitable.

In 2023 alone, the top 5 health insurance companies made over 44 BILLION dollars in profit.

Meanwhile, therapists are living at poverty wages, working themselves to the bone, and sinking under student loans while barely staying afloat. Many of you shared stories about being in debt, working multiple jobs, and not having a vacation in years.

But here’s the hard truth…

We’re Feeding the Beast.

Every time we say yes to a contract that doesn’t pay us enough to survive—let alone thrive—we’re tossing another meal to the insurance system. Hoping it will change. Hoping someone will fix it.

But beasts don’t get smaller when you feed them.
They get bigger, hungrier, and more powerful.

And right now, that beast is feasting on $44 billion of pure profit.

Insurance companies count on us to keep showing up.
They know therapists are compassionate, dedicated people who want care to be accessible. They know you care about clients who are already paying for premiums.

But, here’s the kicker:
​The laws are on the clients’ side.

If therapists said “no” to unsustainable contracts, insurance companies wouldn’t be off the hook. By law, they’d still have to provide access to care. They’d have two choices:

1. Raise their rates so therapists want to be on their panels.

2. Reimburse clients for out-of-network care.

The system would be forced to adapt.

Instead, we keep showing up.

We keep feeding the beast.

Are We Protecting Clients or Just the System?

I know this isn’t an easy conversation to have. Many of us entered this profession to help people, and the thought of saying no to clients who can’t pay out-of-pocket is gut-wrenching. But as long as we keep enabling this system, we’re complicit in our own burnout and the destruction of our profession.

• Therapists on insurance panels are burning out.

• Therapists are struggling to survive financially and many are leaving the profession.

• We have more people leaving the profession than entering it.

• We continue to be the worst paid master’s degrees.

• Clients, even with insurance, are struggling to pay high deductibles, copays, and coinsurance (and many underpaid therapists are waiving those too even though they are being underpaid!)

And still, 44 billion dollars in profit for the insurance companies.

The math isn’t adding up, and the system isn’t changing because we haven’t made it change.

What If We Stopped? 🛑

What if we collectively decided to stop feeding the beast?
What if we:

• Said no to contracts that don’t pay sustainable rates?

• Advocated for clients to use out-of-network benefits?

• Built practices where we could show up fully and provide the quality care we know people need?

We know it’s scary. We also know it’s possible.

And we know that if therapists don’t take a stand, we’re walking ourselves (and our clients) straight into a professional crisis.

This isn’t about abandoning clients. It’s about fighting for a better system—for them, and for us.

Are you ready to stop feeding the beast?

We have two options to support you today:

• Check out this free on-demand training where we’ll share how therapists can build practices that thrive outside the insurance system. It’s time for real change.

• We know this is scary, if you need or want support in making big changes, consider joining Business School for Therapists.