How to Make $200k as a Therapist in Private Practice

“Right now, I just feel stuck.”

Claudia, a recently licensed therapist reached out to me via email. She told me she was caught off guard by the grueling hours she was expected to keep working for a group practice.

“I literally can’t keep seeing 40 clients every week, but I don’t see any other way to make enough money. Honestly, the money I’m making is still not enough.”

In the group practice where she worked, the expectation was that therapists see 39-42 clients every week.

Now that she was licensed, Claudia felt pulled to start her private practice. As a mom of two young children, she was desperate to have a schedule that worked for her, but she also needed to earn enough money to take care of her family.

Her desired revenue: $200k per year. Every year.

She wondered how a therapist in private practice could actually earn this type of revenue. She’s not alone.

Can a Therapist Make Six Figures?

I’ve heard from many therapists who want to earn well over six figures, but they aren’t sure if it’s possible.

After studying premium fee therapists for the past 7 years, I can say with confidence that a 200k practice is within reach.

But to build it, you must get crystal clear about what you want your practice to look like and then take the steps to make it happen.

For example, a therapist could choose to earn $200k annually while seeing forty clients each week and taking two weeks of vacation each year.

This would require a very different strategy than choosing to build a practice with twelve consistent weekly clients while taking six weeks off each year.

For Claudia, family is everything. She wanted to design a practice that allowed her to pick her children up from preschool each day, while still having enough energy in the evenings to engage fully with them.

Claudia benefited from a dual-income household, but her husband worked in a physically demanding industry, and his days in his current profession were limited.

This meant there was some urgency for Claudia to build a solid private practice within the next 3-5 years so she could support her husband’s career transition.

Given this, Claudia decided she wanted to see twenty consistent clients each week while taking six weeks off each year.

A private practice that brought in two hundred thousand annually would give the family enough income that she and her spouse could start paying down debt, while also building up a comfortable cushion to allow him to shift careers without causing a strain on the family.

Using my private practice fee calculator, Claudia discovered that she would need to charge approximately $220/session to reach her goal.

So, What’s Possible for Private Practice Income?

Once you know the numbers, the step-by-step plan for building a $200k/year practice is simple.

However, just like for Claudia, most therapists who reach out to me for help with money mindset and fee-setting have a brain freeze moment when I tell them $200k/year is very doable.

Claudia has never worked with a client who paid more than $80/session.

Given that she works in a group practice, she is used to earning only a fraction of that session fee. Thus, the idea of earning almost five times her current session amount was way outside of her comfort zone.

It is uncommon for licensed mental health therapists to feel confident in their ability to earn a high six-figure salary.

Many of the therapists who come to me for help because they are feeling financially strapped, despite having large caseloads, are upwardly mobile. That means they may be the first in their families to earn an advanced degree or open their own business. Thus, they don’t have close family members who they can lean on for support. Nor did they have the benefit of early financial education.

In graduate school, and the wider professional community, you’ve no doubt gotten the message that financially secure practice owners are greedy, selfish, and uncaring.

Thus, it makes sense that the idea of being well compensated for your work feels uncomfortable and, perhaps, impossible.

After working with thousands of therapists, I’ve found that the problem for licensed mental health therapists isn’t that they don’t know how to build a two hundred thousand dollar per year practice, but rather, they don’t know how it’s possible for them.

Steps (and Common Obstacles) to $200k+ Per Year

For this reason, it’s not only important that I tell you the practical steps to build a 200k private practice, but that I also address the common obstacles that come up for therapists at each stage of the journey, based on my experience helping thousands of therapists significantly increase their annual private practice revenue.

In this next section, I’ll tell you the step-by-step strategy to attract clients who can pay you premium fees, while also addressing the barriers that keep therapists just like you from taking action at each stage. Then, I’ll give you one simple thing you do to move through each barrier.

Step One: Use the Fun with Fees Private Practice Fee Calculator to set your fee.

Just like Claudia, you need to understand HOW you want to reach your $200k practice goals.

Do you want to hunker down and see 40 clients a week, but take 3 months off to travel each year?
Do you want to see 20 clients a week and take all holidays, weekends, and evenings off so you can spend maximum time with your kids?
Do you want a boutique practice where you see no more than 12 clients per week so you can prioritize other aspects of your life?

Your path to $200k will look very different, depending on how you want to work.

This is the time to get crystal clear on what type of schedule works with your energy levels, priorities, and season of life.

Common Obstacles: At this phase, I see many therapists who dream big while filling out the Fun with Fees Calculator, and then, just like Claudia, collapse when they see the number they need to charge to reach their goals. This number may feel so out of reach, that you slam the book shut on your financial goals and dive into a pint of Van Leeuwen Peanut Butter Brownie Honeycomb for a binge session of The Golden Bachelor.

Action: You must allow yourself that pint of ice cream (we’re big fans) and make room for all the feelings. Don’t shut your feelings down and, even more importantly, don’t shut your dream down.

If you find yourself freaking out at the thought of having to charge $250/session to achieve your dream practice, take 5 minutes to write down all the feelings you’re experiencing along and then take another 5 minutes to write down your why.

What is it that is not working in your current work life and what will it feel like when you achieve your ideal private practice with the 200k revenue?

Step Two: Identify the person who can easefully and eagerly pay your full fee weekly.

To earn $200k annually, you need to work with clients who have the resources to easefully pay your full fee consistently and who are willing to invest to solve the problem that is leading them to seek therapy in the first place.

When identifying a niche, you need to focus on high earners or people who have access to PPO insurance through their employer. PPO insurance often reimburses anywhere from 50-100% of a person’s therapy sessions. And as many readers know, Thrizer can aid clients in the reimbursement process.

You also need to identify the issue that is leading your ideal client to seek therapy right now, instead of solely focusing on the symptoms that they are experiencing.

Do you love working with people-pleasing women? Then focus on a people-pleasing woman in a dual-income household who keeps getting signs that her husband is cheating, but is afraid of making accusations.

Do you love working with transgender youth? Then focus on helping high net worth families in private schools who are struggling to reconcile their midwestern, conservative values with their child’s gender identity.

Do you love working with narcissistic men? Then focus on helping highly ambitious male venture capitalists who are suddenly having panic attacks in the middle of high-stakes negotiations and need a solution now.

Take the population you love to work with and identify who within this population has the financial resources to work at a premium fee, plus what type of crossroads they are currently at that is forcing them to take action right now.

Common Obstacles: This is the phase in building a premium fee practice where the complex therapist’s unconscious money stories and childhood little “t” traumas arise. Some readers are likely experiencing it right now.

This may take the form of, “Am I really good enough to work with these types of people?” OR “Am I a sellout for working only with rich people?”

That is, all the conscious and unconscious associations you have with money - your need for it and your discomfort with it, show up in this moment.

These feelings have intergenerational roots, running deep in your family history. They also have roots in our wider culture and societal structures, which have created inequitable systems determining who “deserves” to have wealth and who does not.

Action: It’s time for some deep money work.

For you to fully embrace your $200k goals, while also doing ethically appropriate clinical work, you must understand your unconscious beliefs and emotions around money, paying particular attention to the areas of physical tension or discomfort.

Grab your journal and take a few minutes to notice your internal contradictions when it comes to money.

Do you experience wealthy people as selfish and entitled, while also feeling envious of what they have?

Were your childhood experiences replete with messages around “blessed are the meek”, while also witnessing your parents praying for the privileges that financial security affords?

Do you feel comfortable working with clients who are struggling financially and find yourself feeling intimidated at the prospect of working with someone who could easily pay you $11,000 out of pocket for a year of therapy?

Over and over, I have found that it is not that therapists don’t know what types of clients can pay premium fees so that they can reach their 200k annual revenue goals, but instead, deep-seated feelings of insecurity, ambivalence, fear, guilt, anger, and envy keep them from taking steps towards finding the clients who can support a 200k practice.

You must pay close attention to the stories you are telling yourself that tie personal value and worth to financial status.

Step Three: Network within communities and professional circles where financial security is the norm.

To attract and work with clients who can easefully and eagerly pay your full fee, you must be connected to people who experience financial ease as par for the course.

So often I talk with therapists who say they’re networking to grow their referral base, but when I dig further, I find that they are doing this networking with other therapists who are paneled with insurance or charging low fees, feeling burnt out and doubtful about the possibility of building wealth as a private practice therapist.

→ This type of networking doesn’t work ←

You must start embedding yourself in a different social and professional circle.

This looks like networking with financial advisors who serve high net-worth individuals; connecting with real estate professionals who advertise in the ‘nicer’ neighborhoods in your city; or contacting lawyers who post high rates on their websites.

This might even look like running workshops at the private schools in your town or volunteering to do a presentation at the well-established industrial sectors in your state.

Common Obstacles: Feelings. Feelings. Feelings.

Are you starting to sense a theme here?

Remember when I told you that many therapists are upwardly mobile? If this is true of you, it means you did not grow up with financial abundance and, as a result, you continue to find yourself surrounded by folks who are struggling financially or, at most, experience financial stability, but are far from financial abundance.

You struggle to imagine paying your own therapist $250 per session comfortably, and I’d guess most of your closest friends and colleagues are in the same position.

Thus, when I say that you need to build relationships with individuals who can easily afford to pay $250 per session or have out-of-network insurance that reimburses them, you likely find yourself falling back into the anxiety spiral, wondering, “Do I want to be around people who have that kind of money?” or “What will these people think of me?”

Actually, let’s be honest. For many therapists, their first response at the thought of calling up the local million-dollar realtor is a clenched stomach, a sinking feeling in the gut, and an immediate desire to reach for that Van Leeuwen.

If that’s your experience, take a deep breath. I got you. The fact that you are reading this article right now means you’ve already taken the first step towards change.

Action: After you take 5 minutes to scroll Instagram and enjoy that bowl of brown sugar chunk, come back to me, and let’s work this through together.

Remember Dr. Carol Dweck’s fabulous insights about Fixed vs. Growth Mindset?

When we fall into a Fixed Mindset, we feel like people are either born with skills, talents, and abilities or they aren’t.

If you find yourself falling into compare-and-despair when thinking about connecting with financially secure individuals, notice that you may have fallen into a Fixed Mindset moment.

It’s normal to experience feelings of uncertainty and anxiety when trying something new.

I want to remind you of the basic tenets of the Growth Mindset. That is, talents and abilities are learned.

Even though it feels scary, you can learn to cope with the big feelings that come up at the thought of networking with high-networth individuals.

You can learn how to reach out and what to say to set up a first meeting. You can develop the skills to confidently sit across from Rich Realtor and build a relationship.

In fact, you are already really good at the relationship-building part. This is what you do for a living.

Lean into that fact and remember that folks with money are just like folks without money…only richer.

Choosing to Lean In. MAKE BANK.

The fact is, you can build a $200k per year practice if that’s what motivates you.

It isn’t about whether or not you have the innate ability, but instead, whether you’re willing to face the difficult feelings that come with big challenges and find the support, knowledge, and resources you need to play the long game.

The biggest factor, I have found, in therapists actually being able to achieve premium fee, cash pay practices, is their ability to

Identify what your premium fee practice looks like by filling out the Fun with Fees Private Practice Calculator
Lean into the difficult feelings and learn from them
Embed yourself in a community of supportive premium fee therapists who have figured it out
Get help identifying the unconscious barriers to taking action.

If you follow these steps and get support, guidance, and direct feedback along the way, a $200k per year private practice is possible.

Yes, especially for you.

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This blog post is provided for informational purposes only and is not intended as legal, business, medical, or insurance advice. Laws relating to health insurance and coverage are complex, and their application can vary widely depending on individual circumstances and state laws. Similarly, decisions regarding mental health care should be made with the guidance of qualified health care providers. We strongly recommend consulting with a qualified attorney or legal advisor, insurance representative, and/or medical professional to discuss your specific situation and how the laws apply to you or your situation.