Why Private Practice Consultants Talk About Money

I started consulting with other therapists about 10 years ago. At first it wasn’t about private practice at all. I helped them study for exams, get a great resume together, prep for interviews, etc. Eventually, as I successfully started my private practice- people started asking for help in building a private practice. 

I Didn’t Know What I Didn’t Know

People usually asked me for help in specific areas. Can you help me build a website? Can you help me make my website findable? Can you help me make the phone ring? Initially, I would simply provide the help or service that someone specifically asked for. I LOVED being of service- it felt good… Except when it didn’t work. 

The Big Picture

I know how to get a website to show on the first page of Google for search keywords. It isn’t an overnight process, but I can do it and do it well. But some clients told me they were getting phone calls- but nobody was scheduling with them. While others told me they would get phone calls and everyone scheduled with them. I started asking questions and realized it wasn’t about findability or Search Engine Optimization (SEO) at all. It was about the big picture. 

Breaking it Down

Many of you provide holistic assessment and therapy to your clients. You make sure you understand the big picture- because you understand that missing information can make counseling ineffective at best, or damaging at worst. In private practice, here is how a lot of that big picture stuff shows up. 

  1. If your website doesn’t compel people to call you, it doesn’t matter how much traffic you get. This means learning or paying for Google AdWords, SEO, Facebook Ads, etc. doesn’t make sense until the few people who visit your website start actually calling you.
  2. If people who call you don’t feel confident enough to schedule with you, it doesn’t matter how converting your website is. You will get lots of phone calls and looky loos and just get frustrated.
  3. If people who schedule with you don’t work with you and have a transformative experience, they won’t finish therapy with you- and they won’t refer their friends to you.
  4. If people schedule and come to see you regularly and you have a “full” practice but if the income that practice provides doesn’t support you financially- you won’t be able to sustain the practice in the long-term.
  5. If you are struggling financially you won’t be able to afford consultation, trainings, or vacations that allow you to keep your clinical skills fresh and stave off burnout and provide exemplary services.

Private Practice Success

Private practice success is about SO much more than money. However, money is part of the equation.Unless you have a benefactor agreeing to bankroll you- you must think about money. You also have to think about what money really is. It is just a resource. Just like your time. You have to be honest about your time, energy, and money situation so you can put something together that makes sense. It is neither good nor bad- it just is. 

Getting Honest Here

I really didn’t talk about money at all until the next few years of consulting. Why? Because I was taught it wasn’t polite to ask questions about money. It wasn’t polite to share about money. I honestly still feel my stomach drop if someone shares how much money they make a year in a social situation whether it is high, low, or in the middle. However, when I started asking questions about money- I was shocked. 

What I Learned From Talking About Money

Kelly Higdon and I interviewed hundreds (close to a thousand I think) of therapists in about a year. We asked each of them MANY questions including these two questions: What is your goal financially? Where are you at currently financially? It was such a powerful exercise. Most therapists hadn’t ever been given permission to talk about money at all- but 95% of the therapists answered these questions openly and honestly. And here is the truth: A lot of therapists are struggling financially. Some are struggling to pay the rent and in deep debt. Others are paying their bills but are keeping such an insane pace they are burning out or getting sick. 

It Isn’t About the Money

I can’t tell you how many therapists I’ve spoken with that were seeing 30+ clients a week “and then got sick.” I’ve started being more bold and guessing auto-immune issue… and so far I’m right ever time. (Side note: I think someone needs to start researching autoimmune disorder prevalence in the mental health profession.) Talking about money is really about setting boundaries and limits around how many clients we can work with and be great, stay healthy, and provide excellent outcomes! 

My mission in talking about money is to ensure clients get great therapy and therapists stay healthy. This deeper purpose is what helps me overcome my own discomfort in talking about money. 

So yes, I will continue to talk about money. Even if it makes others uncomfortable. It makes me uncomfortable too! But, I care too much about this profession as a whole and about these individual therapists to stop. Click here to watch a free training about how to set fees in private practice.  Need some holistic business support? Join our free mini business school bootcamp for therapists. 


Miranda Palmer

I have successfully built a cash pay psychotherapy practice from scratch on a shoestring budget. I have also failed a licensed exam by 1 point (only to have the licensing board send me a later months later saying I passed), started an online study group to ease my own isolation and have now reached thousands of therapists across the country, helped other therapists market their psychotherapy practices, and helped awesome business owners move from close to closing their doors, to being profitable in less than 6 weeks. I've failed at launching online programs. I've had wild success at launching online programs. I've made mistakes in private practice I've taught others how to avoid my mistakes. You can do this. You were called to this work. Now- go do it! Find some help or inspiration as you need it- but do the work!