Therapists often focus on the size of their caseload, the weekly fluctuations of sessions, and money going in and out of the bank.

When I talk with many of you on the phone, I hear a common stressor…I can’t seem to get ahead financially.

As a small business owner, meeting your financial goals is not always about bringing new business in the door or keeping your caseload steady every week; it’s also about managing the business efficiently that’s already in front of you.

If you’re one of those therapists that feels like you’re not motivated by money, this article won’t help you. It’s difficult to get ahead financially if you feel you have no reason to.

However, I recommend reading this article if you want to see where you’re losing up to ten thousand dollars a year, by not having taken these three simple actions.

  1. Tell The “Right” Clients to See You More…

There is a misunderstanding among many therapists that your client is in charge of how often they come. This is only true to some extent. You are responsible for your client’s treatment plan and holding them accountable to it.

Therapists often hesitate when it comes to strongly recommending treatment two, three or even four times a week in clinically relevant cases. I’ve worked with enough therapists to know that it’s not their clinical judgement stopping them from making these recommendations.

What often occurs is your own perception around your service, what it’s worth, fears of rejection, abandonment, and that the client might perceive that you are taking advantage of them. Clients want to get better. You need to act on their behalf of what will get them better.

The paradox of not recommending more sessions when it’s needed is the client ends up resenting you later that they aren’t seeing enough results in a short enough time.

If you see twenty clients a week, and three to five of them genuinely need extra support, you help them by seeing them more often, and you literally earn thousands of dollars more a year that you were losing to your own emotional struggle with selling your therapeutic services efficiently. This alone could be costing you ten thousand dollars a year if you do the math.

Exercise: Review your caseload. Are there any clients that need more frequency in order to achieve the goals they set out with you. These types of clients often struggle with addictive behaviors, complex trauma, personality disorders, episodic mood disorders, and higher functioning goal oriented individuals.

  1. Charge Your Client’s for Every Service You Provide

Here’s another way therapists can give away their precious time, and all of those years of education, supervised hours and training at institutes for free.

Do you have a clear policy around communication outside the office?

Do you charge for phone calls that extend beyond a certain time frame and stick to it?

Nowadays, many therapists are actually texting with clients. If you’re doing that make sure your HIPAA compliant, but on a more important note, are you charging for this service if it ends up taking a significant amount of time with all of your clients combined?

Do you do hospital visits, depositions, home visits, out-of-the-office mentoring, new parent home visits, etc.? These services cost you more money, so charge more money. You have to travel, which takes away time from seeing clients.

You’re running a business. There’s a balance between providing good customer service and monetizing services that are genuinely helping your clients.

Exercise: Review your practices around communication outside the session, texting, outside visitation, off-hour emergencies, etc. Think about services you could be offering that you either give away or haven’t provided yet. Again, you help clients more when you provide the services that will help them get better. You hurt yourself when you lose thousands a year, because you give too much away out of sympathy.

  1. Recommending Additional Interventions

Do you see teenagers? Do you offer parent coaching and sometimes insist on it as part of the treatment plan? How many times have you done great work with these teenagers, only to have that work undone by the parents.

Do you see individuals having relationship issues? In clinically appropriate situations, do you see the individual and have them also do extra sessions with their partner, because it will support the work you are doing with the individual?

How about clients suffering from social anxiety, addiction, or mood disorders? If you have enough of a single population in your practice, what about getting a group going…again you have to work out whether this is clinically appropriate, but there are plenty of therapists that see clients in group work and individual work.

Exercise: Make a list of interventions you’re not recommending enough or not offering that would help your clients achieve their goals quicker.

If you flex the muscle of running your private practice like a profit driven, mission-oriented business, you will monetize your services more efficiently, your clients will get better quicker, and you will see the ten thousand dollars in your bank that you might not have known you were losing.


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Keith Kurlander

Keith Kurlander is the founder of Higher Practice, a company dedicated to helping therapists achieve their highest potential in private practice. He has two decades of combined experience in business administration, group facilitation, teaching at the undergraduate and graduate level, yoga instruction and as a licensed professional counselor in private practice.

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