Uncomfortable Charging Sustainable Session Fees? Shift Your Paradigm!

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Talking with one of my clients about the discomfort around charging sustainable fees, I offered her the following thought experiment.

Say you had a magic "therapy wand," and could offer your clients two therapy options:

  1. Traditional therapy: They see you for 10 weekly sessions at $200 each, for a total of $2000. Each session, they need to come in and engage in the hard work of therapy. After each session, they have to do the emotionally challenging homework you assign them. Gradually, through two and a half months of hard work, their pain goes away.
  2. Magic therapy: They pay you a one-time upfront fee of $2000, you wave your magic therapy wand, and their pain goes away immediately.

Since this is just a thought experiment, we’ll ignore the fact that option 2 is obviously fictional. For our purposes, we’ll assume it’s every bit as doable and effective as option 1.

Which one do you think your clients would choose?

If I was your client, you can bet your last dollar I’d pick option 2 every time!

Why would anyone possibly prefer to meet with a therapist for seven and a half grueling hours over 10 weeks, engaging in the emotional struggle and hard work of therapy, with yet more hours of emotionally challenging homework; all that, when a quick wave of that magic therapy wand can make their pain go away instantly?!

Change Your Paradigm! Your Clients Are NOT Paying for Your Time!

Once you accept that any client would prefer to pay the same total fee, if not more(!), for an instant resolution of their problem and pain, you can begin to accept that your clients are not paying you for your time in the chair!

They’re not!

They’re paying you because they trust that your expertise and experience will help them make their pain go away. If that takes 10 sessions (or even 100), they’ll do it because that’s what it takes. But if you could do it instantly, that would be much better!

In other words, your clients are paying you for the difference you make for them, not for your time.

If you’re a marriage counselor, they’re paying to help preserve and improve their relationship. If you work with clients who suffered trauma, they’re paying you to help them overcome that trauma so they can get back to being able to deal with life. If your clients are depressed, they’re paying you to help them deal with that depression, so suicide isn’t their only option for stopping the pain.

Your Support Is Worth Much More than You’re Charging

Viewed like I stated it above, how much is your help really worth?

If the alternative to couples therapy is divorce, what would be the resulting emotional toll on your client, her spouse, and any children? Can you even put a dollar figure on all that pain?

How much productive work time would that divorce destroy? If each partner loses a single month of productive work time (a gross underestimate, from personal experience) at say $5000 each, that’s $10,000.

How much would the divorce attorneys charge? Paying two attorneys $350/hour for 100 hours each, would cost your clients $70,000.

How much would the client and her spouse have to pay for setting up two separate households? Again from personal experience, just that portion probably costs over $10,000.

Ignoring the emotional devastation, that’s $90,000 in purely financial costs.

If you charge $200 a session (which not many therapists do), and through 10 sessions can help this couple reconnect and avoid divorcing, you just saved them $88,000, Not to mention the emotional pain.

Still think you’re charging an appropriate fee?

How about if you help a client suffering from depression avoid committing suicide?

According to the Suicide Prevention Resource Center, the average economic cost of a single suicide is over $1.3 million!

Say you charge $200 a session, and manage to avert that suicide through a year-long course of weekly therapy. Your fee total of $10,400 would be less than 1% of the economic cost of that suicide you prevented.

Still think your fees shouldn’t be high enough to be sustainable?

You Owe It to Your Clients to Charge a Sustainable Fee

If taking care of your family and their future means you need to earn $120,000 (a plausible amount for a middle-class family of four in Central Maryland), and you build an efficient practice where you spend just 33% of revenues on business rent, EHR, marketing, etc., you need annual revenues of $180,000.

Charging $120 per session means you need to have 1500 sessions a year. With two weeks off (vacation and/or sick time), that’s 30 weekly sessions on average!  Since clients don’t always fit into your schedule like Tetris blocks, you may have some weeks of 20 sessions, requiring you to have other weeks of up to 40 sessions!

Clearly, that’s not sustainable.

If your fees are $100 a session (like the higher end of insurance reimbursement rates in many places), you might have to see an average of 36 clients a week, with some weeks as high as 48 sessions!

Can you honestly say you’re your best therapist self when you sit in the chair for that 8th session of the day, let alone any more than that? Are clients who see you after you’ve already been drained by 5 or 6 sessions earlier that day really getting what you owe them – the best therapy you’re capable of when you’re fresh?

But what if you started charging $200 (or $250) a session?

Then, you'd need to see an average of 18 weekly sessions (14 at the higher fee). With a schedule that’s so much lighter, your busiest weeks might have 20 sessions (or 16).

How much better a therapist will you be for the last client of a 4-session day than for the last one of an 8-session day?

The Bottom Line

Too many of us struggle with charging what our services are really worth. We have internal conversations with ourselves where we question why anyone would possibly be willing to pay $200 (let alone more than that) for 45-50 minutes of our time.

Our minds hand us the thought, “Who am I to charge so much for my time? ” and silly us, we believe that thought. Do you think an attorney struggles with charging $350, $500, or even $1000 an hour?!

That’s why you need to shift your paradigm and start thinking of your fees as tied to the difference you make. Your clients are not paying for your time. If you couldn’t help them resolve their pain, they wouldn’t pay you a nickel for an hour of your time! They wouldn’t even come see you if you charged nothing!

Until you’re comfortable and confident charging what you need to charge to have a sustainable practice that doesn’t burn you out, and that provides your best therapist self to each of your clients, every session you see them, you won’t be able to provide what you owe your clients.

Financial strategy is all about setting financial goals, crafting a plan to reach them, and doing what's needed to start implementing that plan in both your business and personal life, including charging the right session fees. If you'd like to learn what financial strategy can help you accomplish, email me and we'll coordinate a free, no-strings-attached phone call to explore that possibility.


This article is intended for informational purposes only, and should not be considered financial or legal advice. You should consult a relevant professional before making any major decisions.

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