Are you thinking about going into private practice or are you just starting out? If so, one of the big questions on your mind is probably “How much do I charge per session?” When I just started out, I actually didn’t think of this because I figured I would just be taking people’s insurance and that no one would be paying me out of pocket for therapy. Well, much to my surprise, my first client in private practice was actually a self-pay client. Even if you take all of the insurances, there are plenty of people who would prefer not to use their insurance or can’t use their insurance for whatever reason.
One of the first things you need to consider when setting your fees are: what is your market and what is your competition? Your market is simply the town or city you practice in. Obviously a therapist in New York City is going to be charging more than a therapist in Missoula, MT. Your competition are the other therapists in private practice in your area. The easiest way to find out all this information is to go to PsychologyToday.com, type in your zip code, and see what comes up. Most therapists put what they charge out of pocket right on their profiles. Make a note of what the lowest fees are and what the highest fees are. The people charging the lowest may be new to private practice, but not always. Those charging the highest may have decades of experience and a rare but sought after specialty, but not always. Look at the credentials of these therapists and make an honest assessment of how you measure up in comparison to each. Which of these therapists is the most like you?
Now that you know the lowest fee and the highest fee for your area, you know your “market”. You can set your fee somewhere within that spectrum and whatever you choose will probably be fine. When I first started out, I was charging the lowest fee in Boston. I figured since I was new in town, I probably should be the lowest. I’ve since given myself a “raise” as I gained more experience and have become a more sought after therapist. You can do the same thing for yourself once you get more settled in private practice.
Something I’ve found, both through my own personal experiences and by talking with other people in private practice, is that you can really only charge as much as you feel comfortable charging. If you feel like your fees are too high, your clients are going to feel that your fees are too high and refuse to pay them. A therapist in private practice I know had her fees completely negotiable. Essentially her clients decided how much they would be willing to pay for each session, and she was willing to go as low as $20. Well, what she found was that she often wasn’t getting paid at all and she had very few clients. Even though she was the best deal in town she couldn’t get any business, and a big part of that was her own discomfort with getting paid for her services. If you find that you are having a hard time getting clients that are willing to pay your fee, part of that may be because you are not confident asking for your fee.
And that brings us to the other side of the extreme, which is asking for too much. One of the things that I truly believe in is that therapy should be accessible to everyone. That’s why I’m still taking insurance. That’s why I’ve always had a few pro-bono (free) clients on my caseload since the very beginning of my career. One of my friends pointed out to me that I could be charging a lot more for some of my services. She’s in business, so of course she looks at it from the numbers, but as a therapist I think it’s important that we always look at it from a human perspective. Now I know that a lot of people are going to disagree with me on this, but I think it’s important that we always look at it from “how much can we help” instead of “how much can we charge”. If you’re going into private practice, consider having a couple slots in your schedule for “pro-bono” or “scholarship” clients. It’s good for the soul and it may even be good for business too.