I am grateful to be joined by two private practice rock stars, Kelly Higdon and Miranda Palmer, in The Practice of Therapy’s latest episode. Our conversation revolves around the money mindset that we should have as therapists and as private practice owners. The one silver lining that has come out of Covid is that people are finally starting to understand mental health services’ true value. So, join me, Kelly, and Miranda as we talk about what you should be charging, why you should consider outsourcing, and the reason therapists should never compare fees.
Meet Kelly Higdon, LMFT
Kelly Higdon, LMFT is the co-founder of ZynnyMe and co-creator of The Business School Bootcamp for Therapists, a flagship course that helps therapists in all parts of their private practice journey solidify their business foundation and growth. When she isn’t coaching or hosting retreats for her clients, you can find her playing roller derby or spending time with her family. To learn more about Kelly check out kellyhigdon.com and zynnyme.com
On any given day you will find her writing, meeting with her psychotherapy or coaching clients, running a webinar for therapists, providing consultation with private practice owners, and making lots of room for playtime with her family. Kelly’s hair constantly changes. She cares about the people that she works with. AND her most FAVORITE THING is to push, educate and inspire in the Business School Bootcamp.
Meet Miranda Palmer, LMFT
Miranda Palmer built a cash-based private practice during the recession. But, she is most proud that she did it to take care of her family and created a work-life balance that allowed her to avoid the all too common burn-out a lot of therapists experience.
As the co-creator of ZynnyMe.com, she provides how-to articles, free monthly webinars, and co-leads the Business School Bootcamp for Therapists.
Today her primary business is inspiring and teaching therapists private practice marketing. Miranda teaches them business skills, and not because she is all about money. Miranda sees how clinical outcomes, burnout rate, and overall passion can be impacted positively or negatively by how our businesses run.
How Much Is Therapy Worth?
How much is therapy worth? Most of us know that it’s a silly question! Well, people are priceless, and you cannot put a value on a therapy. How are you going to monetize transgenerational trauma and healing? So then that brings us back to, well, how do we know what to charge? What do we need to do good work and to live the life we teach our clients?
Money is a resource; that is part of the outcome that we are working towards. We’re working towards an outcome with our clients, a clinical outcome, and we want them to have a great experience. We want to be able to be present to provide that outcome. So we need to look at our outcome; money is just one resource that we need to get there. Time and energy are also resources that we require as therapists. Now, we start to calculate, what does that number really come out to?
When you take all of this into account, then you no longer feel shame or guilt about how much you charge for your services. So, think about running a business, you need sick time; you need to pay your rent, you need to pay your mortgage, health insurance, vacation, technology, and utilities. All of these things that are part of being a business owner we need to consider. Most of us did not learn how to be business owners in graduate school, we have nonprofit training, and we have this nonprofit mindset. Nonprofit organizations will get grants for millions of dollars; then, they can use that money to pay for their positions. You never really get to see where all of the other money goes.
Stop Comparing Fees
The mental healthcare system is not doing well. Access is challenging. As therapists, we are one part of that system. In order for that system to exist, to be sustainable, we all have to operate from that place of our highest and best. Then, we can raise the bar for these other systems, maybe to change with us.
We should not be looking at our peers and saying, “you charge too much; why are you doing that?” Because at the end of the day, you don’t know someone else’s situation. You don’t know what that therapist needs to run their business. It can be totally different than what you need to run your business. A lot of us live paycheck to paycheck. Would you want your clients to live paycheck to paycheck? No! So, you shouldn’t have to live paycheck to paycheck either.
Private Practice During Covid
Our relationship to money has a lot to do with self-care. Many private practice owners are starting to see their phones ring off the hook because of Covid. However, the clinician will not be able to see everyone that calls their practice. It wouldn’t be fair to the patients or fair to the clinician. The pandemic has only highlighted the issues we have had as a system. Now, we see the cracks in mental healthcare widen. We will be treating anxiety, depression, agoraphobia, medical trauma, and all sorts of things in the next years to come. As therapists, we feel like we have a duty to do extra work during these times because it is such a crisis. However, don’t forget about self-care!
The Importance of Outsourcing
When we get into private practice, we have to look at the bookkeeping, answering the phones, maintaining the website, and dealing with loans. If you are the business owner, you have to budget for those things that you’re outsourcing, or you have to have time for those things that should be outsourcing.
Clinicians think private practice will be great because they are only going to see thirty clients a week. However, they find themselves working sixty or seventy hours a week because of all the extra tasks they have taken on. Unfortunately, Clinicians are a lot of times too slow to outsource stuff. When you don’t outsource things, you’ll be saving money. However, when you do outsource things, it will allow you to enjoy your life. Make outsourcing part of your business plan and charge a fee that covers that instead of stressing out about small things that don’t necessarily matter.
Reevaluate What You Charge During Covid
One silver lining that has happened through Covid that a lot of the stigma around mental health and mental wellbeing is starting to lower. So many of us have experienced anxiety on different levels. More than ever, people are beginning to understand the value of therapy, and they need to pay for what the services are truly worth. We hope that therapists are really looking at those numbers and reevaluating what to charge. For instance, it’s time that therapists start saying no to insurance contracts that are paying $25 or $35 for a session. It’s appalling that those contracts are still out there, and therapists are still signing them. Therapists need to do the math – we have to do the math for ourselves and figure out what works.
Well, hello everyone. And welcome to the practice of therapy podcast. And, um, you can't, you just don't know how excited I am to have these two rock stars of, um, uh, you know, I'm just thinking, Oh, I'm not worthy, uh, of private practice, the private practice world of private practice consulting, Kelly Higdon and Miranda Palmer. Um, Uh, uh, from Zenni me and they are just so much fun to be with. And I'm so excited for you to be part part of this with me in this conversation. So Kelly Miranda welcome. Thanks for having us for having us and having us. Here, you know, and this time in particular and, um, it's, uh, yeah, it's, uh, it's been a tough yet. You know, where as we're recording this, we're recording it towards the end of January of 2021. And it's, uh, you know, all of us are still in kind of the COVID dates. Um, I think right now, and, um, I know you guys have been noticing some trans and some things, but, you know, as I start with everyone before we get into our conversation about the N word, um, I'd like for you all to share a little bit about your private practice journey and how you kind of landed where you've landed, uh, because you guys have been doing it a while now. Yeah, I'll start. Um, I actually came to this and kind of a weird way, which was that I failed a licensing exam by one point many years ago, and I was feeling really dejected and nobody that I gone to grad school with was in the studying process yet. And so I got this brilliant idea, like I'm going to start online study groups. I couldn't find anyone to study with and started this process. And we all sort of talking and connecting. And it was so interesting to realize like, wow, it wasn't just that we were struggling with exams or what study materials to buy. Like, we were really struggling with this whole process between grad school and licensure. And then a couple months later, I get a letter in the mail that says, Oh, actually there's a problem with the exam you passed. And it was this magical space, but it was also a place where I realized like the power of the community. And I really wanted this to keep. You know, to, to keep being a service to people. And so I continue to share it. I didn't realize I was learning how to market. I didn't realize like what I was doing. And then as I went through that process and started providing this like great container and community for people, eventually as I started my private practice during the last recession, the great recession. People started reaching out and asking me, well, wait, how are you doing that? And how are you doing that private pay? And how is this all working? And can you really charge a fair fee? Like during the recession? Like what does this look like? And then I started realizing with all the time I was spending, I needed to charge for my services. So that was the first time I started realizing that. And then I met Kelly and, uh, yeah. Yeah. So then I was working for the County. I actually failed my exam by one point and it wasn't an accident and it wasn't anything like that, which I think is great. So for any of you out there who have failed. You know what down the road, it does not matter just a reminder of that, but, um, I was kinda miserable in my job and I was good at it and I could've stayed and kept climbing, but I, that's not what I went to school for. You know, it was not doing the work I really wanted to do. I was reviewing charts and all of that kind of stuff. So. I started a private practice. Um, and I am a type, a kind of person. I want to do things, right. So I went full force. I got on an insurance panel and I hated it and do it right. So then I met Miranda. Actually I hired Miranda to help me, uh, do my practice well, because if I'm going to spend my time outside of work also on this other. Endeavor it needed to go well, and this is kind of my last ditch effort in the field. If this wasn't going to work, I was going to go back to school and change my career. So in about six months time, I built up the practice as full as I could holding a job. Um, and then I started to make plans to step away and then I got pregnant. So then I went ahead and stepped away with that and that made it, that just kind of put the nail in the coffin. And then I ha I took my maternity leave and I built it. Um, from the part-time to full-time and here we are. I mean, what happened was I said to Miranda, you know, you seem to teach these things to a lot of people. What if you kind of put it into a course or something, so you're not repeating yourself all the time. And she's like, well, what if we did that together? And, um, I blew it off for awhile. And then she said, no, no, I'm serious. And, and we had only met in person once or twice. Yeah, before we had formed a business, don't recommend it, but we were very lucky. We're very, I think people hear our story. A lot of times people assume that we were best friends and we know we were, um, she was my coach first, and then we, the friendship developed out of the business and, uh, we lucked out. We have we coach very differently if you're going to go into partnership, but, uh, because we have seen other people and what they go through. So we're very fortunate. And then I ended up, you know, Miranda moved and I ended up, um, selling my practice a few years ago and doing semi full time because. I mean, I wanted to do this well, like I want to do all things and I was not doing well, riding both horses at the same time, as we say. And, um, I felt like I could do more for my community this way, too. Wow. Wow. Well, I know one of the things that you guys are known for, and it was probably one of the, you know, was an inspiration to me to, uh, quite honestly, was your business bootcamp, um, and putting that together. And so, um, um, I think that was one of the things that was just, um, um, I think for those of us that had stuck our toe in the water in this whole consulting practice, building space, you guys really kind of set the bar for a lot of us getting to where we are. Yeah. It's, you know, that was such a, an experience too, in terms of. It was really born out of having hundreds of hundreds of conversations with therapists and looking at where are people getting stuck? Where are they struggling? What would it really look like to change the dynamic for therapists in private practice and find all those sticking points. And, and it's one of those again, because we both are like, We're repeat for that. Over-deliver and perfectionist. And we want to like really help every time we found a new stack point, you know, then we're, how do we tweak this? How do we change it? How do we add more value into this? So that if somebody comes and they're part of this community that they're really supported through that whole process, I think that's. You know, it's one of the things that we miss when we're most of us, if we got into a good program in graduate school, there's this whole community around you that kind of like helps to kind of push and propel you forward and you feel stuck. And so you go and talk with a faculty or your thesis chair, or another person in your cohort, and you have all this support around you. And then when you get out, you're kind of like on your own. And so every time. Something new happens. You're kind of reinventing the wheel or some issue pops up and you're trying to figure out how to navigate it and making this, you know, the same mistakes everybody needs to make. And just, it's so lovely to see people be able to avoid some of those things and be able to focus on just doing great clinical work, you know, ultimately right. If I can free up someone's energy. From having to, you know, spend 20 hours making a decision and just knowing, Oh, this is, this is the direction to go. And I have to make this small little decision between this and that as best practices and what works for me, then that's 20 hours that they get to spend on their clinical work. Right. Right. Yeah. Well, I know one of the things that we had said, um, before we started. Okay, let me start over here. I hit the mute button by mistake. So what, uh, one of the, what I was going to say is, is one of the, one of the things that we were talking about before we started recording was, um, Um, some of the themes that we have, you know, kind of seen through COVID and this kind of goes back to, I know one of the things that you guys have taught me a lot, it just through your blog and other stuff that you put out there is just around our money mindset and that, um, I think most of us that are in this therapist. World is therapist business. If you will, is that we have a heart for helping people. And I think one of the mindset mistakes we make is, is that if we charge for our services, our charge, what we're worth for our services, where somehow or another, not being kind to people. And so. I'd love for you guys to talk about that and how you've helped other therapists kind of get over that. Well let's can we, can I just, um, Touch on the, what we're worth. What are you worth, Gordon? What am I doing? Yeah. Like people are priceless and I feel like the work that we do as therapists pissed, you cannot put money on that. How are you going to monetize transgenerational trauma, trauma and healing? Yeah. So then that brings us back to, well, how do we, how do you know what to charge? And it goes back to what do we need in order to do good work and to live the life we teach our clients. Yeah. Yeah. Like money, money is a resource. Right. That is part of the outcome that we're working towards. We're working towards an outcome with our clients, a clinical outcome. We want them to have a great experience. We want to be able to be present to provide that outcome. So we need to look at our outcome. And money is just one resource that we need to get there. Right. And it's also happens to be closely tied to time and energy. Right? So once we kind of look at those three pieces of resource money, and time and energy, and we start to calculate, what does that, what does that number really come out to? Then we start to take some of the, like. The shame or even again the values stuff out of it. So like, for example, in bootcamp, we take our clients through this process where they're working in basically a piece of software that we give them where they answer all these questions. It's kind of one page at a time answer questions. Okay. Then they answer some more questions. They answer there's more questions and the software goes, okay. Then on average, this is the fee that you need to. To be receiving and they're consistently like blown away because it takes into account everything that's related to running a business, making sure that you have sick time available so that if you are sick or your child is sick, that you don't go in and see clients because while I have to, or I can't pay my rent or I can't pay my mortgage or. I can't pay for my health insurance, whatever the thing is that you can take regular vacations, that if your computer breaks, that you would be able to replace it, you know, all of the things that are part of being a business owner, that that stuff is calculated. Most of us did not learn. How to be business owners in graduate school, we were trained in nonprofits and we have this non-profit mindset. And yet what's fascinating is if you look at the grants that mom, nonprofits get, these grants are usually for millions of dollars. And the, if you even looked at the fee like the hourly wage, that's. Earmark towards a particular position and how much the person is paid is very different because it has to pay for their office and their sick time and their health coverage and all of these other pieces. Right. So it's just, this, it's this other part that therapists have never been able to see, and we all need to learn that through in some way, shape or form. Right, right. Right. Yeah, I know. And, and some of the coaching I've done is one of the places I like for people to start is to think about their lifestyle, you know, w how they want to live, whatever that is, how do you want to live? And what is the amount of money it's going to take for you to maintain that? And then you. That's your, that's your figure. You kind of work backwards from, and you can, you, you know, you can work backwards from that to know what's, it's going to cost you to keep your office open. What are you going to, if you're a group, are you going to pay your people? Um, you know, what are you going to pay yourself in order to maintain your lifestyle, all those things, and what you come up with is, okay, this is what I've got to charge per session. If I want to have this many sessions or this few sessions or whatever. Um, so yeah, it comes down to what is the amount of sessions you can do and still do good work and that everyone gets equitable care and it's not out of a, I should do this. I have to do this. And instead I think some of those things we need to look at at a larger systemic. Perspective, maybe because of my MFT background, that's important to me. I don't know. But we often as individuals take on the responsibility of greater systems, we have become the scapegoat that we are to fix this system. And no, you know what the mental healthcare system is broken, right? Access is challenging. Um, And we are one part of that system. And what our argument is is that in order for that system to exist, to be sustainable, we all have to operate from that place of our highest and best. And that can raise the bar for these other systems, maybe to change with us. Instead of us looking at our peers and saying, you charged too much. Why are you doing that? Because at the end of the day, you don't know someone else's situation. You don't know like Gordon, your needs may be totally different than my needs. And so I think there is guilt for having need. A lot of us feel like, Oh, lifestyle, I'm used to living paycheck to paycheck, but is that what you want for your clients? Is that what you're teaching them? Like. What does health look like for them? You're looking at them. You got to do the same for you. And then from there, you know, we all have different privileges. So there are, we do know therapists that have full trust funds. They don't have to make a dime so they can charge anything they want to charge. I will argue though, that being all over the map has therapeutic implications, that you should know what you're charging so that you don't have resentment and the therapeutic relationship. But then we have other people who are single parents with kids and no, no other support. And so you're going to say to them, well, you shouldn't charge what you need in order to feed your children. And we can't do that. That's why we don't compare fees because story behind the fee setting a fee is all about what is my highest and best that takes care of me and takes care of the client that win-win. Yeah. And not compare yourselves to a million dollar multi-million dollar budget with a nonprofit. Right, right, right. I love that because I think so many times we get hung up on a figure, whether it's five figures, six figures, seven figures, you know, it really doesn't matter. Um, you know, when, when it comes down to it, of what, you know, what, what sort of, uh, you know, what's gonna work for you is what's important. Yeah, what's going to keep, keep you, like you said, at your best. Six figures in LA looks very different than six figures in Alabama, or so much six figures after expenses and then after taxes or before taxes and all of these other pieces. I want to go back to this idea too, of like comparison. Because one of the places I see comparison is also, well, I can't charge that much, not just because it's, it's more, but it's more than this other person that has more specialty or expertise than I have, or what have you, all these other places. And, you know, the reality is the research is there that says years of experience. Does not. And, you know, years of hours of training, all these other certification things, they do not directly correlate it with clinical outcomes, right? There's not a connection. And again, that person, they may be charging that because they have a spouse who is the primary breadwinner, or they have a trust, or they have, they bought a house. 30 years ago and it's paid off and they don't need to collect a down payment or, you know, all these other pieces, it could be very different. And so ultimately, right, what are we charged with? We're charged with when somebody comes into us, they trust us with their time, time and their energy and their hope for healing. Are we fully taking that in and going? Yeah, I'm going to show up. I'm going to show up fully for this person. I'm not going to. Okay. Gosh, it's been a crazy week and I've already sent 30 clients, but I've got to like push some more people in here because yeah, well they need some people and you know, I got to do it and I got to pay the bills and it feels really good on the bank account. So I'm just going to go ahead and do it and yeah, I'm pretty sleepy, but I'll do my best. Or am I going to go like, no, this person, this is what they've been thinking about all week. They're investing their hard, earned money into this, and I'm going to make sure that I'm like, Fully present. I know their name. I looked at their intake paperwork. I looked at their notes from last session that I am like fully here. And if I am, while we can not promise what the outcomes are. I think what we need to promise and really hold ourselves accountable to as a profession as individuals is, if we are not of what we are doing is not working, that we are going to change it until it does. Or we are going to refer out this idea that, well, this person's bonded to me and they keep coming back. So like something, I mean, it must be good or the person would leave. Sometimes it's symptomatic symptom, symptom magic, sometimes it's symptom an addict, but somebody is continues to come to see you when they are not making progress. And we need to be those gatekeepers to say, you know what I care about you. Here's what you said. You were really looking for. I don't see us making progress. So what do we need to shift? Do we need to be more regular? Do we need to see each other more often? Do you need a change of something? Maybe you need to see someone else in a different style would work for you, right? A lot of integrity, right? If you, all of this comes down to integrity, I think like if all your clients were in a room and shared what they paid for a session with you, would you feel good about the differences and why. Yeah, that's a good question. Yeah, that's a, yeah. That's so, you know, one of the things that I think, uh, you know, I'm hearing and this is, is being able to, um, you know, again, it's a, it's a theme we've had a lot of over the past, past year is just this whole idea of self care. Uh, of really being able to look at, um, you know, our relationship to money, which I think has a lot to do with self care, but also just thinking about, um, how much we're working and, and all of that, because I know for me, You know, on, on the business side of things, you know, our phone's ringing off the hook and we're running out of places to put people, uh, nice, nice problem to have. Uh, but we can also take on more than we are really, you know, we really, I don't want to use the word should, but. Then what is fair for the clients and for the clinician. Right. Right. And I want to just say, I don't think this problem is going away. The pandemic has only highlighted the issues we have had as a system. And now we are seeing the cracks widen. And if you think about it, we are going to be treating anxiety, depression, agoraphobia, medical trauma. All sorts of things in the next years to come. And there's something that happens with us as therapists that we feel like I have to see this person I have, I'm going to overwork and what Miranda and I have been really working with on our clients. You know, we wrote a burnout handbook, for example, and it's like, don't replicate the things that oppress you and other systems in your own business, because in order for you to be able to serve with longevity, you have to pull back and say, gosh, My ability, my resource is different. My ability to sit with clients on zoom is very different than my ability to sit in a room with them. My ability of how many clients I can see is very different. Now I'm homeschooling my kids. Like a lot has changed, and there's this some idea that we don't get to change. We don't get to change our informed consent. We don't change our fee. This is what we said we do. And we're going to do it forever instead of saying, gosh, Something has changed and I want to be here for the long haul. How do I do that in a way that is sustainable and right, right. You know, I, I, I know, uh, Kelly, I know this was your experience as well, working in an agency setting before you went into private practice and I did as well. And it was, we, the, where I had worked before was, uh, A nonprofit organization, working with at-risk children in youth. And we were doing at that time, a form of therapy called mostly multisystemic therapy, which I love that, that particular, that particular modality or whatever, but the demands of, um, Of working in that environment and then having to meet state contracts and, you know, the paperwork and the documentation and, you know, the utilization reviews, all of those kinds of things. And I know when I went into private practice, which you were just saying, reminded me of this, I was thinking, Oh, I've got to perform at that standard. You know, part of that standard, part of that standard was we're just going to give you more and more and more and more like, that's just the way it is. And I mean, my, my clinicians had caseload's of a hundred. It was like, this is ridiculous. Well, or even I worked at a nonprofit that was relatively, relatively kind. Right. I saw 32 clients a week. Right. Which I look back and think, Oh, how did I do that? Right. I only took breaks because when people would no show, that's how I got lunch and breaks and that, but that was my own doing right. My own sense of obligation. I brought my stuff to the table, but when you get into private practice, We have to then look at what about the bookkeeping and answering the phones and maintaining them, the website and dealing with PPP loans or whatever the things are that you have to do outside of the business. I didn't have, have to worry about that stuff. I didn't have to sit and do anything beyond just what was happening with my clients. So in whatever setting you're in, right? If you are the business owner, You have to either one budget for those things that you're outsourcing, or you have to have time for those things that you're outsourcing. So clinicians that will come in thinking, Oh, well this works great because I'm going to see 30 clients a week. And then suddenly they're working 60, 78 hours a week. Enjoy, Oh, wait, I did not budget this appropriately. And then they feel guilt or they feel like they're doing something wrong when it's like, yeah, you can streamline your practice for sure. But it's a business it's going to take time. Right. Right. And I think that's, uh, another, uh, point you make, um, uh, there Miranda is, um, I think people are a lot of times people are too slow to outsource stuff. I know. Um, when I first went into practice and started getting busy and I was trying to do it all, you know, fi you know, where we're located, uh, uh, um, You know, it's, uh, due not to go off on a, too far on a tangent, but really I've made the decision to be an insurance-based practice because of the demographics of our area. And, um, um, I was trying to do at all do too much of it myself. Plus see Carrie, you know, like a higher case load and it's not sustainable. And, um, again, it was leading to burnout and vitally out, you know, so her, some wise people, maybe the Zinni me, people kind of planted the idea that it was a good idea to, uh, to outsource. And, you know, that would be money well spent in terms of return on investment. I think it's one of the things we talk about a lot in our fee setting webinars, how. For every, you know, if he had a case at a 20 for every, uh, $10 that you slide, what is it? Miranda 10 on average, $10,000 a year. And here we are like picking over. I got my credit card processing fee down by 0.1%. I did this. I'm not going to outsource that. Well for 200 bucks, you could outsource it and actually be happier. Enjoy your life. Play it as part of your business plan and charge a fee that covers that instead of like stressing out about these like small things that, that are necessary in your business that are proven to, if you have a credit card processor, you're. Proven to have more retention and, and with clients. So it's just kind of funny where we focus our energy to, with fear and money. And I know people are like, Oh, the pandemic. Now people can't afford my services. I mean, there's, there's always going to be some reason why you can't. I, I just want to say that, um, Go ahead. And I thought that I, when I started my practice during the recession and I did, I did not take insurance. Um, and I remember people saying, Oh my gosh, you know, it's the recession. How can you possibly charge this fee? And honestly, I would be shocked and surprised. I remember, um, a potential client calling me up and they said, Hey, we're looking for couples therapy. We're both unemployed. I'm like, well, let me get you to a sliding scale. And they're like, no, we've already been to the clinics. Like, this is a good investment. We're living with our, you know, their parents right now, so that we can do this. We need to figure out our relationship. That's the most valuable thing that we have. We are happy to come and pay your fee. And I'm trying to convince the person, right? Like go to this clinic over here. I think it's laid down for you. And they're saying, no, this is really valuable. And we did the work and it was, it was very valuable. So it's this place of, we have to start to shift that mindset, right? Because divorces are up right now. Are lawyers going out and signing all their fees for people going in and getting divorced because it's pandemic. No, the medical needs are up. Are the doctors and nurses sliding down their hourly wage and, you know, taking a cut in their salary because no, you know, where are those places where immediately we say, okay, here's what, what I have to do. And ultimately, if we can. Take care of ourselves where we are not sitting and like setting ourselves up for poverty. Then we even have room to give back. We can give back to nonprofits that are set up to do this work. We can go out and spend time doing social justice work to like push, to help with a systemic work. We can hire people and pay them. So green living wages out of positions so that you don't have 20 therapists, you know, working really hard to get this really underpaying position Sevenly non-profits and grants will see that they have to pay more in order to actually attract people. If we can create the economy around what we do, but it does, we are a part of it in private practice in changing this. And again, this part that like blows my mind is people thinking that they have to go into coaching. There are people that are getting graduate degrees today, who are saying, you know, what, what I've been told is I shouldn't get licensed as a therapist because I won't get paid as well as if I just went out and did coaching. That is ridiculous. And that's crazy. There's nothing magical about the word coaching. And they're like, there's all these protections there for therapy and therapy is magical. Does like we have the researchers to prove like how great it works. The only reason that it is not being people aren't paying for it and investing it is because of us and the stuff that we're doing, that we're not putting out there and holding to our values. Yeah. In our contribution to that system is not lowering our fee. It is looking at the bigger thing of how do I stick around and provide great outcomes and provide like, contribute to the economy like Miranda say so that we can actually. Change things across the board in a more global fashion. It is not one lone practice, sliding their feel over the place. That's going to do that. Right. Right. Yeah. I love that. You know, it's, uh, I think one silver lining that has happened. Through COVID is ban the fact that people, I think a lot of the stigma around mental health and mental wellbeing is starting to, um, that stigma is starting to lower some, because I think, uh, so many of us have experienced just anxiety on different levels. Uh, through all of this. And so, uh, yeah, and so I think, you know, I, I'm hopeful that, you know, as a result of that, particularly as an insurance-based practice, that's going to up the bar and that yeah. Need to be paying for what the services are really, really worth. I think there's also, I hope that therapists are really looking at those numbers and. They're starting to say, you know what, this contract for this particular, like, there's more than enough clients out there. And there's insurance companies that are reimbursing at a viable level for my particular area. So I'm going to focus on those insurance contracts that I'm going to say no to contracts that are paying me 25 or $35 for a session. Like the fact that those. Those contracts were still out there and that therapists are signing them. Whether, you know, sometimes they're worded in a way that is, um, just sneaky, right. You know, when the common ones with the APS they'll charge, they will pay $99 per client that you see for up to three sessions, which means you get a hundred dollars. Flat, whether you see them once or whether you see them three times. And I worked with a therapist that like, when I worked at the County, who was like, yeah. So they come to see me once and then I refer them out to someone else and say like, Nope, she's like, I can't see them for more than one time. I'm like, so basically she makes it so they can't use their full EAP, you know, like, Oh, what a nasty practice. You know, as opposed to saying like, no, we're not going to send that contract. That's not okay. Right, right. Yeah. I remember it was very liberating thing. When I, um, got rid of, uh, an EAP company I was contracted with that, um, just would not go up on their fee. And I just said, okay, I can't see any more of the people you refer to me. I'm sorry. They can. Yup. Yup. And I think sometimes therapists think there's something wrong with them, but it's the system like it just the larger players, they need to also change. So, you know, this is about, again, integrity of knowing. I don't want resentment if I'm with a panel or an EAP and it doesn't work for me. And I hate dealing with it. Don't think that that doesn't show up in the therapeutic work. He does, you know, and realize too that like some of like, there are insurance companies, right? A lot of people don't understand that we have this insurance company that we just kinda know their name. And we think of them as this, you know, global company or this United States based company. But those companies are broken up into little. Things for each state. And in some cases they're broken up in two parts of the state. So like for example, Kaiser Northern California, Kaiser in Southern California, Kaiser are completely different corporations with totally different practices, reimbursements, everything, right? So people will look and go, Oh, this is a great insurer to work with. Except they're referring $60 in Los Angeles. For the same CPT code that they're referring a hundred, they're paying $130 in Arkansas. Right. And you look at the cost of living and you go, yeah, wait, why is it that it's so much higher in Arkansas than here? Right? Part of the reason is because we say yes to things that just don't work ultimately. When they are providing insurance and saying, we're going to cover this. If somebody says, Oh, that's absolutely like not doable. And I won't sign that. They have to change the contracts. This isn't about price fixing like, none of that. This is just about like doing math guys. Like we have to just do maths for, for ourselves and figure out what works. And eventually insurance companies have to make shifts and changes just because they don't have enough people paneled. To do the work. So they have to make adjustments, right. And again, we need them to make adjustments just so that it's a livable wages, not just for us, but for our staff. You see people who are like, well, I couldn't live on the wage. I was making as a solo practice owner doing insurance. So I made a group practice. So now I've created this dynamic where I'm making a livable wage. But I'm basically hiring people who can't make a really livable wage. Right. Because there's no way to make a livable wage on this scenario. Right. Like what's the process, everybody, but, you know, that's sort of what happens. Yeah, man. Well, I know we could spend hours talking about this because I know it's something we're all, all passionate about, but I want to be respectful of your time. And, um, so I know that you guys have got some new things coming up. You want to share, share with those are so that people can know about them. For sure. Um, we are going to be doing a. Free four-part master class that is going to have three free CES, um, APA, and NBCC coming up. So if you want to check that out, go to dot com and you can get on our list, um, to get first dibs to do that live masterclass with us. And we'll also send you out great resources, like our free burnout handbook. Um, if you're experiencing that burnout and struggling, like we're there for you. We've got 10 hours of training that you can just tap right into and. Dig into like, this is we, we are not the rock stars of the private practice world in any way, shape or form. But I think we are, we are definitely people who we love to give out and bounty, and we like to provide things for you. So if you need whatever you need and private practice, we probably got a place for you to start. And it's probably there for free sitting on our website over the last 10 years. We've. I'm asked a lot to get. Yes. Well, I, and we'll be sure and have links in the show notes and show summary for all of that. So people can get to it easily. Well, Kelly and Miranda, I am so thrilled to be able to spend this time with you all. And, um, yeah. Any other parting thoughts before we click the button to go? I think it's just important to remember that. Your work is invaluable and that who you are as a person is unique. And that is what makes the therapy unique too. And that if you can just always hold on to that, um, you won't need to get caught up in this, um, some of this money stuff as much, and, and just remember that this work is important and it's a very, to me, it's a very special calling to have. And so, um, Yeah, thanks for letting us share today. Yeah. And as we say in the South, can I get an amen to that? yes. Well, you all, I hope we get to do it again. Yeah. Thank you. It's good to see you.
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