Hello, welcome to today's episode of The Money Sessions.I am your host, Tiffany McClain, and today we are doing an Ask Tiffany episode.We got a listener question from therapist Leah, and I loved it.
Leah is currently working for a group practice where the expectation is to see between 37 and 42 clients per week and to earn very little money for doing so.Leah doesn't want to live this way.
She believes that another way of life is possible, but she's struggling with
the question of whether what she wants for herself to be charging $150 per session, to be able to set up a practice where she's seeing a smaller caseload, where she can do transformational work but not at the expense of her own financial well-being, the financial well-being of her family, and where the work she's doing is truly valued by virtue of her getting paid well for her work.
But how can she do that when the expectation is therapist C, 40 people a week?When so many people on her caseload will not be able to pay $150 per session.
If she goes out in her own private practice, she may be saying goodbye to a large portion of her current caseload, the people she loves, the people she wants to work with.
In this episode, I talk with Leah about deconstruct the various elements of Leah's struggle
And I talk Leah through four specific components she needs to be paying attention to and tactical, actionable steps she can take in order to set herself up for the practice she truly wants, where she can really do transformational work for her clients.
Because she's not only talking the talk, but she's literally walking the walk in her daily life, a practice that has clear boundaries, that takes reality into account and where she's able to actually value who she is and what she has to offer.
And in so doing, she can truly show up and model that reality for the clients she's passionate about serving.Let's dive in.
Hello, my name is Leah and I'm a newly licensed therapist.
I currently work in private practice and the normal patient load for my supervisors and my colleagues is expected to be somewhere around 37 to 42 patients scheduled a week and I'm just finding it not sustainable for me and really looking
to have a lower caseload and get paid more.I feel underpaid and overworked, but I also live in a lower socioeconomic area where people don't make as much money, and so I am ready to start my own thing, but I am trying to rationalize in my head
how the patients I have now I know couldn't afford it, and how to serve that population as well, but also meet the financial needs that I have with my family and what I believe that my services are worth.So, yeah, thank you.
Leah, thank you so much for submitting this question.I love it.And I love it for a variety of reasons, but one of the things that I like the most about it is that it's such a common question.I want to start by saying you are not alone with this.
It makes sense that you're struggling with it.And it's something that a lot of therapists write in and talk to me about or email me about or say in my DMs on Instagram, how is this supposed to work given all of the elements that you laid out.
So actually, let's start by articulating the various elements at play in your struggle to go out on your own in private practice, charge the fee you need to charge, which by the way, folks who are listening, folks who are watching, I did
respond to Leah and ask, you know, what is that fee?It's 150.Leah, in order to have the life she wants, to be able to support herself financially, and to do transformational work, needs to be charging 150 per session.
So let's pay attention to the things that are getting in your way.Number one, let's talk about the current community norms, the professional norms.
The people who are surrounding Leah, the story is that a typical therapist should see 37 to 42 clients per week.This is just what we do.This is standard practice.This is the expectation.That's number one.Number two, there are the community norms.
We're in a rural town. We don't earn a lot.We can't afford a lot.You know, people around here, they don't make a lot of money.
So, you know, we're not the kind of people who have the resources or are interested in investing the resources we have into therapy.That's number two.Third, there is a reality of Leah's current caseload.
Leah, where you're at right now, where you're working, It sounds like a substantial number of clients who are on your current caseload, they don't actually have the resources to pay $150 per session.As far as you know, they can't pay that.
We haven't checked with them, by the way.
If you're seeing 37 to 42 people a week, chances are some small percentage of those could either pay $150 out of pocket, or they have access to PPO insurance that would reimburse them a substantial amount of the fee.
that aside the biggest part uh the biggest influence here the biggest factor we're paying attention to is that Leah you are currently swimming in water where this expectation is simply this is what we do 37 to 42 clients a week make 50 cents an hour that's what we do right the water you swim in
It's very difficult to be surrounded by a community, people you love, people you respect.
It's everything you've ever known who have a particular way of belief, a particular belief system, a particular way of engaging in the world that doesn't fit you.
I'm going to give you an example of a social interaction I had probably about a year ago now. Um, I was hanging out with a group of people and they asked me, one woman in the group asked me, you know, where did you meet your partner?
You know, how did you meet partners?Or, you know, how did you find dating partners back in the day when you were out and about, lay down the town?And I was like, Oh, I don't, I guess I don't really know.
And she was like, well, you went to clubs, of course. Huh?
And this is a person who's typical, the water they swim in is you go to the club, you have long nails, you got a nice booty, you maybe have breast implants, potentially a lot of folks have blonde hair, and you go out to the club, right, and you find a partner there, you dance, you're sexy, you have, you know, short tops on and booty shorts, that's the ideal.
You're thin, probably, with a thick top and a thick booty.You go out into the world, you're really sexy, that's kind of the, the mode, the MO.That is not me.Holy mackerel.
I've had enough time in the world to be around enough people for whom that's also not their dating pool.That's not how you go out and engage with people.But this person looked at me when I said I wasn't like a person who went to clubs.
They looked at me like I was an alien, like I was some kind of anomaly that they literally couldn't quite wrap their head around.Like, well, what did you do for fun? How did you meet people if you didn't go to clubs?
Like they literally couldn't understand my way of life.That's a hard situation to be in.And I suspect many therapists, maybe you included, Leah, grew up in an environment where you had thoughts,
a perspective on reality, you were in tune with feelings and emotions in a way that the people around you were not.
And if you were a weirdo, or in some way you were an outsider, even if you could fit into that mold, you could go through the motions, some part of you, some part of your gut, someone inside of you said, this isn't actually who I am or how I engage.
But it's really hard to reconcile those parts when everyone around you is saying this is reality, And what you're feeling is like, oh, I don't fit into that reality at all.
So when we're talking about community norms and you're surrounded by people who say you should be making very little money and seeing 42 people a week, it's really hard to hold your own perspective and get to know your own mind or even trust that there's a different.
potential out there.That's the first part, the norms.Now we also want to make sure we're talking about the internal conflict.
It's not just a social surround, but it's also what's coming up for you internally, which of course is fed by the social surround, but you also are bringing in your own element of history, your own relational dynamics, your own attachment styles.
So your internal conflict includes the desire to continue serving folks who cannot pay your full fee, right?You're working with people right now.
If you go into private practice, when you go into private practice, when you charge $150, you are aware that a lot of those people won't be able to go with you and pay those fees.You would like to be able to serve them.
and on the other side is your desire to earn enough money to take care of your family coupled with the belief that the transformational work you're doing in order to actually keep it up and to continue doing a good job it's worth 150 dollars per session at least that's the work is worth that so you have this conflict the desire to
serve folks who cannot afford $150 per session, and the desire to take care of your family, yourself financially, and do get paid for the work you're doing, for your expertise, for your experience as a licensed mental health professional.Fabulous.
So, here's how we're gonna think about these.We're gonna think about these both in terms of the underlying dynamics and strategic next steps.So, in reality,
The current norms, your societal norms, what you're used to, it's important first for you to understand that that's not the only way.In fact, you're listening to this podcast right now.You sent me a DM.You asked me this question.
So you know that you have some sense of like, OK, there is another way to do it.People are doing it another way.That's number one.So we need to think about the strategic steps with that.
Number one, you need to get clear about what your norms and expectations are.What kind of life you want to live so you can fully show up and do your best work.Work that you know is transformational.
work that you know is going to change people's lives.And it's not going to come at the expense of yourself, your family.Um, it's not, you're not going to be a martyr.
You're not going to buy into the martyrdom mentality that your wider community that you've heretofore been around has put out or put upon you.
You need to get clear about what your reality is going to be, what your norms and expectations are going to be. For those of you who are listening to this episode, if you have not yet downloaded our Fun With Fee Calculator, do that.It's free.
You can go to leaninmakebank.com forward slash
free, because the calculator is free, and we actually walk you through the exercise of determining what you want your life to look like, how you wanna show up, what kind of energy you wanna have, what hours you wanna work, and then we give you the fee that is in line with what you actually want your life to look like.
So that's what, you already have done that in terms of your $150 fee, Leah.We want you to do that in terms of your workload, how many hours you're working, how you wanna feel at the end of each day.
Get clear about your own personal norms and expectations.Then you need to embed yourself into community that is deeply and staunchly aligned with your norms and expectations as you have set them for yourself.
and you can't just do it once you can't like listen to a one money sessions podcast although it's fabulous that you do keep it up but you also need to find people who are happily paying a hundred um charging 150 200 250 dollars per session even in a rural town
even in a small town, who believe in the importance of doing it, who understand why it needs to be done.If you don't have that community, if you don't know where to find it, join us in the Lean In Make Make Academy.That is what we do.
Those are the people we bring into the program.Those are the people you're going to be surrounded with. and it cannot be a one-off.You have to actually engage with these folks consistently for a prolonged period of time.
You need to have these people become the people who are the water you're swimming in to counteract the pull of your old thoughts and beliefs, the old thoughts and beliefs of the community you previously spent your time with. Number three.
Now this is a, this is a difficult one.This has to do with your psychology.It has to do with your internal process.You must make friends with reality.Even when reality is uncomfortable or upsetting.
In fact, Leah, you can serve those who cannot afford your full fee.That is true.You can do that. And you can set up a business that provides for you, provides for your children, and also reflects the transformational level of the work you do.
You can set up a business that takes care of you financially.You can also do that, but you cannot do both of these things at the same time.This is something. therapists often don't realize.
We leave community mental health, you go into your own private practice, and then you try to have it both ways.
You try to have the community mental health model where you're serving everybody who needs it, who can't afford to pay, bending over backwards, charging 25 cents, not enforcing your cancellation policy because you want to give back, while also holding the belief, I want to be my own boss, I want to make money, I want to have a business on my own terms, I want to create a life that actually gives me flexibility and freedom.
You can't do it.You can't do it.You can't do both.You cannot have two priorities that are in opposition at the same time.You can't do it.It's difficult to know this, but it is the truth.
Unless you have a wealthy spouse, and we're gonna assume you're never gonna divorce that spouse, you're gonna have them for life, which we cannot guarantee, or you are a trust fund baby, if you are, fabulous. Good on you.
Without funding that comes from an alternate source, if you want to have a business that provides for you financially and respects your emotional well-being, you must set up a business that serves people who can easily, eagerly, and comfortably afford your full fee for the duration of your work together.
That is simply a fact. That is a fact, which brings us to my final point, our final bullet in terms of how we actually move forward, the feelings.
Whenever we contend with reality, whenever we recognize the reality that we can't both help the people who can't afford us while building a business that takes care of us financially, when we realize we can't do both at the same time,
we contend with reality, our long-standing unconscious patterns, our wounds, our attachment dynamics, rear their beautifully sweet little heads, I have a lot of empathy.
the parts of ourselves who were not met, who were neglected, who had to take care of everyone else at the expense of ourselves and were in danger or rejected or emotionally cut off from when we actually asserted our needs, those parts are going to come up and they're going to start having something to say about your desire to go out and take care of yourself financially.
You must have a space to process those feelings, articulate those feelings, make them go from unconscious to conscious.Otherwise, those little guys, those parts of ourselves, are going to drive the bus.
They're going to be making your business decisions.They're going to be saying, don't enforce that cancellation policy.Yeah, maybe you should see 30 people a week.How dare you actually charge $150 when so many people can't afford you?
How dare you leave this group practice to go out on your own and say goodbye or say know to some of your current clients simply because they can't afford it?Who do you think you are?
In all kinds of ways, those people, those parts of ourselves are going to arise.We need to know about them.We need to make space for them.We need to take care of them while we continue to make business decisions that are in line with our reality.
The reality of what it is we want to accomplish in our lives.Go to Lean in, makebank.com forward slash free.Download our fun with fee calculator.
Folks who are listening, if you want to understand, okay, I've been doing this community mental health thing.I've been doing this group practice thing.It's clearly not working for me.I can't see 40 people a week.
I wanna have my practice run in my own way.I wanna make enough money to actually live a life that affords me freedom, ease, presence of mind to show up with my family, presence of mind to show up with myself and my clients.
If you want to understand what you actually need to be charging to have that life, download our fun with fee calculator and we will walk you through the steps.Leah, this is a brave question.This is a courageous impulse.
You are stepping out of familial systems that tell you to sacrifice yourself on behalf of everyone else.You're stepping out of larger societal systems that say,
Your job as a woman is to take care of everyone else, keep your mouth shut, take care of other people, and be happy with what you got.
And then you're also stepping out of a larger professional system that has for decades, especially since women and minorities have come into the field, our professional educational system, our wider profession, who tells us that it's our job to sacrifice ourselves, give back.
you know, burnout, take care of others without ever considering our own well-being, our own needs, financial and otherwise.It says you're greedy for doing so.The fact, Leah, that you're allowing yourself to imagine
a world in which you can set your own norms and expectations.You can set your own life up how you want it to be set up and then move towards it.That's a courageous act.So thank you for writing in.
Thank you for not just keeping it inside, but actually putting it out there so that we could all learn with you together. Now, make sure, Leah, write in.Let me know what your next steps are.
I'm excited to hear about your journey, and perhaps we can post a follow-up.Or, even perhaps, we can have you on the money sessions one day, and you can share what this journey was like for you.All right, whatever you're doing, I want you to pause.
If you're driving, pull over.If you're chopping a carrot, put that knife away.If you're making sweet love to your woman, Well, I mean, that's kind of flattering in a weird way.You can just go ahead and you can keep doing that.
But for the rest of you, if you learned even just one thing of value today, please share this episode with even just one therapist who can benefit from the message.Here's how.
If you're listening on iTunes, click on the episode and you'll see a small purple circle with three dots. Click on those dots and you're going to see the option to share at the bottom of the list.
Click that and you can just go ahead and share it on Facebook or you can even just text it to one therapist who you know needs to hear it.If you're listening on Stitcher, just tap the triangle icon on the upper right corner.
It's next to the menu that displays your upcoming playlist.You'll see the option to share the episode you're currently listening to right on Facebook. Look, it's time to get the word out.We gotta spread the message.
Thank you so much, and we'll join each other again soon.
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