For Therapists in The Middle of Changing Their Private Practices
In 2021 I recognized that I could not sustain the level I was operating at in my private practice. I had too many clients and was emotionally exhausted. Although I looked successful from the outside (a waiting list and 10K/month income), internally it didn’t feel successful.
So I decided to make changes in my business to honor my needs. It is now over a year since I implemented those changes. I have never felt more rested, nourished, energized, and creative. It feels so good that I sometimes forget how it felt as I went through the growing pains of changing my business.
What follows is an essay I wrote while I was in the middle of implementing changes - raising fees, changing policies, shrinking my caseload, and more. I am sharing this for therapists who are in the thick of it. Struggling. Feeling the weight of heavy change. May you know you are not alone.
I write this essay as if I’m making my way through some jungle, barely surviving, barely enough food and water.
Out of breath. Hacking my way through until I finally see people and say, “I did it.” Like holy shit I kept going and I did it.
It is of course not that bad.
As I write this I sit on my couch with my soft blanket, bottle of water, and plate of food at my side.
But I did do it.
The past two months have been brutal. BRUTAL.
Scared out of my mind. Without the usual people I turn to.
Knowing certain conversations would be difficult and upsetting… and having them anyway.
Informing my clients of my raised fee.
Telling my supervisors, who charge far less than my new fee.
Telling my closest friend who runs a non--profit and provides all services for free.
Telling my family who struggle with money and hustle culture.
And then all of this not being one time conversations.
Having them again and again and again with clients as they decide if they want to continue with me or not.
And then taking all of this deeper.
Like selecting a schedule that fits my needs. And not budging on that.
And then not letting clients who need weekly meetings to decrease to less. Standing by the frequency of care I feel they need … and providing referrals if that doesn’t work for them.
And then getting honest about clients who aren’t a good fit for me and referring them out.
And then crafting a no cancellation policy.
And then deciding I’m not going to see any new teens.
And then taking it a step further and deciding to conclude with current teens.
It is a lot. A LOT.
And in the midst of this, the power to start honoring myself in my personal life is rising. Speaking my truth and setting boundaries.
Shifting my money beliefs. Being willing to spend money on myself.
All while learning and reading and immersing myself in courses and self-education and therapy to support the work I’m doing.
All while still having my regular dreams, daily life, friendships, and the like.
To the outside, it simply looks like I raised my prices.
To me, it’s that I went from working 27 hrs/week of clients hours to 7. 33 clients to 8. 10 adolescents to 0. An average of $84/50 min to $200/50 min. A 24 hr cancellation policy to no cancellation. Working M-F and seeing 5-7 clients a day to Monday-Thursday and seeing two a day.
This is a massive shift.
And it’s not done yet.
So yeah, I’m coming out of the bush hacking and breathing hard.
But I can see the clearing and can begin to laugh and have joy and bewilderment that I’ve actually made it. For this has been a process of facing my deepest fears. Of turning ingrained beliefs (“You must use your gifts to help others” and “You must always be serving”) into something new.
Of finding and building the support I need around me.
I am incredibly proud of myself. I could have built a little fort and waited for someone to come rescue me.
But I rescued myself.
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