September 17, 2025 • 25 mins
In today's podcast, Abundance Community member Ashley and I explore the growth of her Tampa-based private practice, where she’s managing 50 clients and feeling the strain of 32 weekly sessions. We talk through burnout, fee adjustments, and the impact of charging $80 per session in a high-cost area. Ashley shares her interest in refining her ADHD niche, especially with medication-resistant adults, and we discuss balancing strategy work with deeper emotional processing. We also look at ways to build referral networks, incorporate EMDR, and create a more sustainable, values-aligned practice.
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- Ready to fill your practice faster? Join the Abundance Party today and get 75% off your first month with promo code PODCAST: www.abundancepracticebuilding.com/abundanceparty
- Have a question for me about practice building? Submit it via our Ask Allison form, and I'll add it to the queue: https://www.abundancepracticebuilding.com/ask_allison
- Prefer video? This episode is also available to stream on our YouTube channel!
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:08):
(Transcribed by TurboScribe.ai. Go Unlimited to remove this message.) Hi, welcome to the Abundant Practice Podcast.
I'm Allison from Abundance Practice Building.
I have a nearly diagnosable obsession with helping
therapists build sustainable, joy-filled private practices, just
like I've done for tens of thousands of
therapists across the world.
I'm excited to help you too.
If you want to fill your practice with
ideal clients, we have loads of free resources
(00:29):
and paid support.
Go to abundancepracticebuilding.com slash links.
All right, onto the show.
Your practice is full.
That's amazing.
But here's the question.
Is it actually the practice you want?
Because just being full isn't the finish line.
Having the practice you want is.
Inside Limitless Practice, you'll spend 13 weeks making
(00:51):
the changes you've been thinking about for months,
working fewer hours while making more money, creating
a schedule that actually fits your life, and
saying yes only to clients you love working
with.
We're going with a cohort model.
You'll start and finish alongside other full therapists
who are ready for more freedom and joy
in their work.
And spots are limited because I'm personally running
(01:11):
every one-on-one with every person, group
call, and the accountability check-ins that we
do each week.
Doors close September 23rd at midnight.
We start October 1st.
Go to the show notes to join Limitless
Practice before it sells out.
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(01:31):
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(01:53):
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Hey Ashley, how you doing?
Good.
How are you?
I'm good.
I'm good.
I talked to you.
(02:55):
Yeah.
Watched all the videos and it's like, yeah.
I'm real.
I'm live.
Yeah.
What would be helpful today?
Okay.
So yeah, it was actually, every first of
the month, I pretty much try to schedule
in, but of course it takes like by
(03:16):
the time, I don't know, 10, 15 minutes
pass, there's like no appointments available.
So I kind of got lucky this month.
Uh-huh.
Yeah.
And so originally I'm actually doing really well
now as far as clients, but I'm just,
I think it's more about kind of like
looking at where I'm at right now and
(03:38):
seeing kind of where do I need to
go from here maybe.
Okay.
So I've been in private practice since January
24 and that's when I purchased the abundance
package.
And so that was really helpful.
And my niche is adult ADHD, although I
also do enjoy doing adolescence too.
And I'm at a place right now, I
(04:01):
think it's just more kind of like looking
at where I'm at overall.
Of course the first year was a little
bit more of a, I wouldn't say struggle,
but it was definitely more trying to figure
out my position, like branding wise, like who
am I as a therapist?
And so clients were like, you know, I
(04:24):
had enough clients, but it was just, you
know, it's sometimes ebbs and flows, whatever.
Now I'm at a place where I have
a lot of clients.
I have actually like 50 active.
Oh my gosh.
Wow.
Yeah.
How many are you seeing per week?
So I'm seeing about, well, this week is
heavy and this is like 32 sessions a
week.
(04:45):
Yeah.
And I do feel the burnout part of
it too, like from doing all this.
And financially I know that I probably set
my fees a little bit low.
So I'm like seeing my cash fees right
now.
A lot of them are still at 80
bucks a session.
So are you taking insurance also?
I am taking insurance also.
Yeah.
So I'm a lot of my clients are
(05:06):
actually insurance too.
So yeah, I guess I'm maybe to say
here I'm at right now, my website's almost
done.
Not quite, but I actually, you know, I
have that.
I have someone who's doing it for me
and she's actually doing a really good job.
I don't know.
I just feel like I'm, I guess reaching
(05:27):
kind of like a little bit of a
burnout point where like between notes and admin
and sessions and then session planning and all
of that, I feel like overwhelmed.
And do you have ADHD also?
Yes.
Yeah.
So you add the executive functioning stuff that
can also go along with that.
Like it's, that's a lot.
(05:47):
Yeah.
How many clients do you want to see
a week?
Ideally more like I put on a lot
on my plate and I automatically do that.
So I would say actually I'd say ideally
five a day, like five, five days a
week, five a day, like so.
Okay.
So 25.
25 would be good.
Yeah.
(06:07):
I say that, but I also know that
like listening to your videos though too, I
probably could go lower than that if I
wanted to, but there's something about it that
doesn't feel right.
Like I'm kind of like struggling there.
Like, Oh, I only see four clients a
day when I can see like five or
six, you know, I don't know.
I think it's just kind of like figuring
out, I think five a day I do
fine on.
(06:28):
Today, for example, I have seven and it's
like, that's where it gets overwhelming or I'm
waking up and I'm like, Oh my God.
Sessions, session after session after session today.
So, so I guess it's like figuring out
like with my clients now who are at
80 bucks, like I, I don't want to,
they were at 70 and I give them
a raise or I gave my fees a
raise to 80 bucks this, in the beginning
(06:51):
of the year.
So I don't really want to punt them
in a, I don't want to raise them
in their feet, my fees anymore until like
next year, but just kind of like figuring
out how to maybe prevent the burnout part
of it.
Yeah.
How, how much is insurance paying you for
sessions?
And it's like some under a hundred, some
(07:11):
over a hundred, mostly around, I want to
say like around 70 to 80 bucks a
session.
Okay.
Blue cross blue shield here is really good.
And they pay like 120 a session.
But other than that, most of the insurance
companies I have, yeah.
And do you live in a low cost
of living area?
No, I live in Tampa, Florida, which is
(07:33):
a pretty high cost.
Yeah.
Okay.
So you're making low cost of living income
for a therapy practice while seeing a ton
of people.
Yeah.
That's what I'm afraid of putting myself into.
So yeah, I don't know if I should
just stick with this, stick this out for
the next year, or if I should, you
(07:55):
know, there's anything else.
Should I raise my rates?
Even though I already raised my rates, I
feel, I feel bad doing that.
My clinical consultant that I see, she's like,
Oh, I would just start kind of like,
you know, spreading them out.
Like the ones that are 80 bucks.
And especially if they've been with you for
a while and I have a lot of
long-term clients, then spread them, you know,
(08:16):
start like doc, give them back to like
biweekly or monthly or whatever make space for
that.
Yeah.
If it makes sense clinically, or you could
have them all go to a group and
with groups, usually you make twice as much
per hour and they pay a lot less.
Yeah.
It's like a win-win though.
I think the average for groups heard did
this survey and like across the U S
(08:38):
the average amount people are charging for groups
is $80.
So like per person.
Yeah.
Yeah.
Okay.
So that might be a good way for
you to kind of bolster your income.
Some, because this, like, I, I don't know
how it's sustainable without seeing so many clients
with those rates.
Yeah.
(08:58):
That I know that's kind of like, I
feel like I'm doing okay, but yeah, definitely
not as good as I could be.
I'm sure.
You know, I was like my new fees
that I have for new incoming clients, I
have it at one 25.
Good.
So that's good.
And I have two of those.
And in the beginning I recognized like when
(09:21):
I would do the consult calls, it was
hard for me to tell them that it
was $125 a session.
Like I'd find myself kind of like, but
also I can do sliding scale.
Like I'd automatically offer that or suggest that.
Yeah.
Yeah.
But I feel like at the same time
in my, you know, I can tell it
sounds to the client.
Like I am not fully confident in my
(09:43):
fees though.
Cause there I had, I've had a couple
of them.
When I first started my first put my
new fees out there as 125, a couple
of them were like, no, that's okay.
I can do the 125.
And if I'm like, you know what?
Maybe it is okay for people to do
125.
Maybe they are willing to do that on
a weekly basis.
Yes.
And let me look at something real quick.
(10:06):
So the household income, the median household income
in Tampa is $71,302 per year.
That's more than here in Asheville where I'm
charging 300.
Yeah.
Oh, wow.
So there's a lot of room for you
to go up.
I understand the mindset of like, I just
raised it on these folks.
(10:27):
I don't know if I want to raise
it again, especially a significant amount, but I
would start coming up with a plan to
get to stair step them up to 125.
Okay.
So it might be you talk to them
and you say, and we have things in
the, um, what'd you say?
When course they could that like different ways
of going about that.
You could just raise it all at once.
(10:49):
Usually at that price point, I don't recommend
that big of a raise, like 25.
Sure.
That seems like a big, yeah.
But at that price point, you know, if
somebody is going from 200 to 250, I
don't bat an eye, but the folks who
are paying 80 are going to be like,
Oh, with that, with that big of an
increase often.
Now I'll also say we've had lots of
(11:09):
students in limitless practice who were taking insurance
and people are just paying a copay and
then they go to two 50.
And so like, yes, some people leave, but
also some people make it work.
So yeah.
Okay.
It's getting clear.
Cause you have to come at it confidently.
So yeah, I know that's a hard part.
You have to do a lot of practicing
(11:29):
of saying it out loud.
And like when 25 is still like below
average for income for a therapist per session.
Yeah.
That's, I mean, it's good.
It sounds, it's good.
Yeah.
I don't want you to feel like squeamish
for long about one 25.
We always get squeamish when we raise it.
(11:50):
Everybody does even like, I've been doing it
forever.
And when I raised it to 300, I
was like me.
So like, it's normal to feel some anxiety
about it, but I don't want you to
feel like you're asking too much at one
25.
And if that means using the anchor of
like, this is below what the average private
practice client is or private practice therapist is
making per session.
(12:10):
Like if it helps to anchor to that,
so like I shouldn't feel bad then good.
Like you've got something to anchor you.
Okay.
Yeah.
When you said 300 per session, I'm like,
wait, I'm way down there, you know, and
here I was like thinking 125 was a
lot.
But I mean, I remember when I felt
when 25 is a lot too, like it's
just, it's developmentally kind of a part of
(12:31):
the process of being in private practice.
I could definitely not have charged 300 when
I first started, not because of my clinical
skills, but just because of my money mindset.
Right.
Even when I raised it from 70 to
80, I was like, oh, that's sounds like
a lot.
But then I was kind of worried about
losing clients, but every single one of them,
like no one blinked an eye.
Like they just signed the form and was
(12:53):
it, you know, so yeah.
Okay.
Other than that, I feel like, cause before
I had a lot of issues in my
thinking about my branding or my niche, cause
I was like adult ADHD, is that too
broad?
But lately I've been doing really well with
it as far as getting clients who are
just seeking ADHD.
(13:14):
Yeah.
It's such an in demand, especially now that
people are getting diagnosed, whether they're self diagnosing
or they're getting diagnosed through a testing psychologist.
Yeah.
People are like, this explains everything, you know?
Yeah.
That's what they say when they come to
me is, oh my God, now that I
got this diagnosis, this explains everything.
This opens up all the doors in my
life.
(13:34):
So this is the other area I struggled
in with that though, in particular.
So with ADHD, the way I kind of
see it is there's two like two major
areas.
One is like more like strategies and coping,
but the other one is more like the
emotional internal core beliefs and all of that
side to it.
So I think originally I kind of struggled
(13:55):
with, I feel like I do much better
as a therapist on the emotional side of
it, the deeper rooted beliefs and kind of
working with that.
So I think I struggled with like, should
I, in the beginning I was like, should
I really drill it down to adult ADHD
and just like internal core beliefs or is
(14:15):
it okay to leave it as broad as
the internal core beliefs and the kind of
like the coaching strategies that kind of go
along with it?
Yeah.
I mean, I think you can do both
if you enjoy both or if you want
to just focus on one, you could do
that.
But I think both definitely works because it's
more holistic, right?
Yeah.
I think people really, now I'm finding more
(14:36):
and more people are coming to me with
needs for both.
Usually they approach looking for ADHD strategies, but
then when I explain that part to them,
they're like, oh, yeah.
And as they try to implement strategies that
are new to them, all that old stuff's
going to come up too.
It's like, I don't know, it would be
tough to be like, well, we're only talking
(14:57):
about the strategies today.
So you might just be honest to yourself.
Yeah.
Right now I've been kind of, a lot
of my referrals have been coming in through
like referral sites.
So like growth therapy has been really good.
So I think what I want to, that's
the other thing.
(15:18):
What I want to do is, because growth
therapy is good, but it's all insurance clients.
And those are the clients that are like
mostly 70 to 80 bucks a session.
So I think it's also part of it
is my website's almost done.
And so I think part of it is
how to get myself out there.
That's how to get myself out there where
I'm looking.
How do you get the cash clients?
Like where I'm not focused on the referral
(15:40):
sites.
Once my website's done, I know I listened
to one of the videos about how it's
like marketing to all like the doctors, like
the physicians, like sending out emails.
I don't know if you have any other
ideas for like, how do I get my
website out there so people can see, I
guess.
The marketing fundamentals course in there is all
(16:01):
about that.
So we've got marketing fundamentals one, which is
about getting your website, building it out in
a way that actually works.
And it's that and networking.
Those are the two that everybody needs to
be doing.
And the marketing fundamentals two is like all
the other strategies that work really well for
therapists to get people to their website essentially.
(16:22):
Because everybody's going to check out your website
before they call you, right?
Like nobody's just in this day and age,
everybody's checking you out.
So that's why your website needs to be
really on point.
Your copy needs to be really specific.
You need to be talking about their daily
lived experience.
And then your other marketing strategies essentially get
people to it so that they're like, Oh
my God, she's talking about me.
(16:43):
So yeah.
Okay.
I didn't follow your templates on creating the
website.
So yeah.
So that's what I just need to do
is to be able to get that website
out there so people can see it so
I can get those cash clients in.
So I'm not stuck at 70 bucks or
80 bucks.
And for you, I would like are the
(17:03):
majority, well, I guess what percentage of your
clients are getting tested versus self-diagnosing?
Oh yeah.
That's the thing.
I would say a smaller portion of them
than not have been tested.
I get a lot of clients who they
come in self-diagnosing and then we go
(17:24):
over like the criteria and kind of talk
about that.
A lot of times too, I feel like
I can, especially being ADHD myself, I can
kind of pick up on all those little
nuances, but a lot of them just like,
they don't seem to show much interest in
getting tested.
And even more so more of them are
kind of like a little bit medication resistant.
(17:45):
They're more like, I want to do the
therapy first and see how that goes before
getting on any medication.
Yeah.
So is the medication resistant, is that your
favorite flavor of ADHD or do you care?
I think I work well in both.
Yeah.
Actually, I will say in some instances, maybe
even more so with the medication resistant because
(18:09):
I don't know.
I feel like there's like a lot to
kind of, I don't know if this sounds
crazy, but like there's a lot to like
work with if they come to me and
they're like, I really, some people who come
on medication, there's stuff to work on with
them, but then otherwise we're good.
The ones who don't want medication, there's usually
more to work on with them, which actually
I really like to have so much more
(18:29):
work to do.
I guess, does that make sense?
It's kind of like saying a client with
more problems I enjoy working with, but that's
true.
Yeah.
I mean, we all have our favorites, right?
So I think it would be really good
for you to network with testers, even though
that's the minority of who's coming in.
But the last part of any testing is
(18:50):
like, here are the resources.
And so become one of their chosen resources
for the adults with ADHD and also prescribers.
So like psychiatrists, ARNPs, PAs, like the psych
folks that are getting the majority of these
folks, because there are some people who are
medication resistant who are going there first.
(19:13):
They're not going to take the medicine.
They just want to ask their questions.
They want to make sure that their self
-assessment is accurate.
Yeah.
And so for the psychiatrist to have that
conversation and then be like, I don't know
if I really want to take medicine.
I don't think I'm going to do it.
I don't think I want you to write
me the script.
Then they can be like, there's this great
therapist in town who works with folks, whether
(19:33):
or not they take medication on the skills
and some of the emotional heaviness that can
go along with having had ADHD your whole
life.
Yeah.
So become like a preferred referral person for
them could be really great.
Yeah.
That sounds actually a really good idea to
do that.
(19:54):
Do you think I should like, this is
where I'm kind of like, it's not that
big of a deal, but wondering if I
should be more of like ADHD for teens
and adults, or is it better, do you
think, to like drill down to a niche
of?
Who do you, like, do you have a
slight preference for adults over teens?
Yeah.
Like adults over teens.
Yeah.
Yeah.
(20:15):
Okay.
Okay.
Okay.
That's the other thing.
I do want to get EMDR certified.
I don't want it to like blur my,
I guess, blur my niche too much, if
that makes sense.
Well, they don't really care.
Well, sometimes people are looking for EMDR, but
if people are looking for ADHD, they're looking
for ADHD.
And then you have this great tool.
(20:37):
You can use when you get underneath some
of that trauma, you know, like, and you're
like, yeah, it sucks to feel like you're
behind in life.
Like we can work on that with this.
So I don't think you even need to
like advertise it necessarily.
Like I wouldn't have it be a part
of your marketing.
You could, you could have like a, under
your services pages, like a dropdown about EMDR.
(20:57):
And you could talk about the circumstances that
you see where EMDR can be really helpful
for folks with ADHD, but I don't think
it needs to change your messaging.
Okay.
Okay.
Yeah.
Cause that's what I find too, is like,
we get to that part and then they
might even ask me about it.
Like, oh, well I heard about this EMDR
(21:17):
therapy, you know?
And so there's a lot of people lately
who have been hitting me with that.
So yeah, that's something I want to do,
but yeah.
So that's a good idea.
Maybe not like I'm EMDR and ADHD, but
instead it's just more of like a, hey,
when we get to this is also what
I offer.
Yeah.
I do find that though, like with each
(21:37):
client, I, I kind of go all in,
which could be a good thing, but we
like, I find that there's always, there's always,
you know, so much more work to do,
like attachment work.
And there's also a lot of clients come
to me who have ADHD, but also of
course have like childhood trauma.
Or sometimes I wonder if people who come
through with ADHD, I mean, it seems satisfied
(22:01):
with where we're going, but if they, cause
when, when is that happening?
Is it sometimes it derails and it becomes
not so much ADHD focused, but now it's
like trauma focused.
And I was like, you know, I guess
that's pretty normal.
Yeah.
That's great.
I mean, cause I think that happens for
most of us, you know, like working with
eating disorders, it's never just about the eating
disorders.
Almost always trauma.
(22:22):
Um, almost, I mean, not almost, so it's
always veers into anxiety, but I think it,
from your messaging standpoint and your marketing, it
is about like, if most people are coming
in because they want, and if your ideal
client, I should say specifically is coming in
because they want skills and it's their ADHD,
then that's where I want most of your
marketing to focus.
(22:45):
Okay.
Cause that seems that's what usually happens.
It's about the skills and then it blooms
into, Oh, we've got all this stuff too.
Yeah.
So, okay.
Yeah.
And that's true.
That's true too.
Cause a lot of times they're not even
realizing, cause I noticed that when clients come
to me, they're not even realizing that, Oh,
there's so much more that I should be
working through, you know?
(23:06):
And it's just, yeah.
Well, I think it often just takes a
little in the, like the nudge of like,
here's what I see with a lot of
my ADHD clients who are diagnosed late, like
here are all the stories that they believe
about themselves for their whole life.
Yeah.
And then they're like, Oh my God, me
too.
Big thing for like, yeah.
Yeah.
For those who have been lately late diagnosed
(23:27):
compared to like those who have known like
their whole lives, you know?
Okay.
I feel pretty good.
Love it.
Yeah.
I mean, five, six minutes early.
I'll take it.
Yeah.
Yeah.
So yeah, I would just stay on that
messaging, go through that marketing fundamentals to course
and the marketing fundamentals.
(23:48):
One that has the networking section that can
give you some really good ideas of who,
who your ideal clients find before they find
you so that you can get in touch
with them and they can refer to you
and make it easy for your people.
Yeah.
Sounds good.
Awesome.
It was nice to meet you too.
All right.
Take care.
(24:09):
Thanks.
You too.
Bye.
Bye.
Your practice is full.
Congrats.
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(24:30):
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(24:52):
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(Transcribed by TurboScribe.ai. Go Unlimited to remove this message.) Hi, welcome to the Abundant Practice Podcast.
I'm Allison from Abundance Practice Building.
I have a nearly diagnosable obsession with helping
therapists build sustainable, joy-filled private practices, just
like I've done for tens of thousands of
therapists across the world.
I'm excited to help you too.
If you want to fill your practice with
ideal clients, we have loads of free resources
(00:29):
and paid support.
Go to abundancepracticebuilding.com slash links.
All right, onto the show.
Your practice is full.
That's amazing.
But here's the question.
Is it actually the practice you want?
Because just being full isn't the finish line.
Having the practice you want is.
Inside Limitless Practice, you'll spend 13 weeks making
(00:51):
the changes you've been thinking about for months,
working fewer hours while making more money, creating
a schedule that actually fits your life, and
saying yes only to clients you love working
with.
We're going with a cohort model.
You'll start and finish alongside other full therapists
who are ready for more freedom and joy
in their work.
And spots are limited because I'm personally running
(01:11):
every one-on-one with every person, group
call, and the accountability check-ins that we
do each week.
Doors close September 23rd at midnight.
We start October 1st.
Go to the show notes to join Limitless
Practice before it sells out.
So I've talked about therapy notes on here
for years.
(01:31):
I could talk about the features and the
benefits in my sleep, but there are a
couple things I want you to know about
therapy notes that doesn't typically make it into
an ad script.
First is that they actually care if you
like their platform.
They don't only make themselves available on the
phone to troubleshoot so you don't pull your
hair out when you get stuck.
They also take member suggestions and implement those
that there's client demand for, like therapy search,
(01:53):
an included listing service that helps clients find
you, internal and external secure messaging, clinical outcome
measures to keep an eye on how your
clients are progressing, a super smooth super bill
process, real-time eligibility to check on your
client's insurance.
In my conversations with the employees there at
all levels, they all really believe in their
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too.
(02:14):
Second, they are proudly independently owned.
Why should you care about that?
Because as soon as venture capital becomes involved,
the focus shifts from making customers happy to
making investors happy.
Prices go way up, innovation plateaus, making more
money with as little output as possible becomes
the number one focus.
With over a hundred thousand therapists using their
(02:35):
platform, they've been able to stay incredibly successful
and they don't have to sacrifice your experience
to stay there.
You can try two months free at therapynotes
.com with the coupon code ABUNDANT.
Hey Ashley, how you doing?
Good.
How are you?
I'm good.
I'm good.
I talked to you.
(02:55):
Yeah.
Watched all the videos and it's like, yeah.
I'm real.
I'm live.
Yeah.
What would be helpful today?
Okay.
So yeah, it was actually, every first of
the month, I pretty much try to schedule
in, but of course it takes like by
(03:16):
the time, I don't know, 10, 15 minutes
pass, there's like no appointments available.
So I kind of got lucky this month.
Uh-huh.
Yeah.
And so originally I'm actually doing really well
now as far as clients, but I'm just,
I think it's more about kind of like
looking at where I'm at right now and
(03:38):
seeing kind of where do I need to
go from here maybe.
Okay.
So I've been in private practice since January
24 and that's when I purchased the abundance
package.
And so that was really helpful.
And my niche is adult ADHD, although I
also do enjoy doing adolescence too.
And I'm at a place right now, I
(04:01):
think it's just more kind of like looking
at where I'm at overall.
Of course the first year was a little
bit more of a, I wouldn't say struggle,
but it was definitely more trying to figure
out my position, like branding wise, like who
am I as a therapist?
And so clients were like, you know, I
(04:24):
had enough clients, but it was just, you
know, it's sometimes ebbs and flows, whatever.
Now I'm at a place where I have
a lot of clients.
I have actually like 50 active.
Oh my gosh.
Wow.
Yeah.
How many are you seeing per week?
So I'm seeing about, well, this week is
heavy and this is like 32 sessions a
week.
(04:45):
Yeah.
And I do feel the burnout part of
it too, like from doing all this.
And financially I know that I probably set
my fees a little bit low.
So I'm like seeing my cash fees right
now.
A lot of them are still at 80
bucks a session.
So are you taking insurance also?
I am taking insurance also.
Yeah.
So I'm a lot of my clients are
(05:06):
actually insurance too.
So yeah, I guess I'm maybe to say
here I'm at right now, my website's almost
done.
Not quite, but I actually, you know, I
have that.
I have someone who's doing it for me
and she's actually doing a really good job.
I don't know.
I just feel like I'm, I guess reaching
(05:27):
kind of like a little bit of a
burnout point where like between notes and admin
and sessions and then session planning and all
of that, I feel like overwhelmed.
And do you have ADHD also?
Yes.
Yeah.
So you add the executive functioning stuff that
can also go along with that.
Like it's, that's a lot.
(05:47):
Yeah.
How many clients do you want to see
a week?
Ideally more like I put on a lot
on my plate and I automatically do that.
So I would say actually I'd say ideally
five a day, like five, five days a
week, five a day, like so.
Okay.
So 25.
25 would be good.
Yeah.
(06:07):
I say that, but I also know that
like listening to your videos though too, I
probably could go lower than that if I
wanted to, but there's something about it that
doesn't feel right.
Like I'm kind of like struggling there.
Like, Oh, I only see four clients a
day when I can see like five or
six, you know, I don't know.
I think it's just kind of like figuring
out, I think five a day I do
fine on.
(06:28):
Today, for example, I have seven and it's
like, that's where it gets overwhelming or I'm
waking up and I'm like, Oh my God.
Sessions, session after session after session today.
So, so I guess it's like figuring out
like with my clients now who are at
80 bucks, like I, I don't want to,
they were at 70 and I give them
a raise or I gave my fees a
raise to 80 bucks this, in the beginning
(06:51):
of the year.
So I don't really want to punt them
in a, I don't want to raise them
in their feet, my fees anymore until like
next year, but just kind of like figuring
out how to maybe prevent the burnout part
of it.
Yeah.
How, how much is insurance paying you for
sessions?
And it's like some under a hundred, some
(07:11):
over a hundred, mostly around, I want to
say like around 70 to 80 bucks a
session.
Okay.
Blue cross blue shield here is really good.
And they pay like 120 a session.
But other than that, most of the insurance
companies I have, yeah.
And do you live in a low cost
of living area?
No, I live in Tampa, Florida, which is
(07:33):
a pretty high cost.
Yeah.
Okay.
So you're making low cost of living income
for a therapy practice while seeing a ton
of people.
Yeah.
That's what I'm afraid of putting myself into.
So yeah, I don't know if I should
just stick with this, stick this out for
the next year, or if I should, you
(07:55):
know, there's anything else.
Should I raise my rates?
Even though I already raised my rates, I
feel, I feel bad doing that.
My clinical consultant that I see, she's like,
Oh, I would just start kind of like,
you know, spreading them out.
Like the ones that are 80 bucks.
And especially if they've been with you for
a while and I have a lot of
long-term clients, then spread them, you know,
(08:16):
start like doc, give them back to like
biweekly or monthly or whatever make space for
that.
Yeah.
If it makes sense clinically, or you could
have them all go to a group and
with groups, usually you make twice as much
per hour and they pay a lot less.
Yeah.
It's like a win-win though.
I think the average for groups heard did
this survey and like across the U S
(08:38):
the average amount people are charging for groups
is $80.
So like per person.
Yeah.
Yeah.
Okay.
So that might be a good way for
you to kind of bolster your income.
Some, because this, like, I, I don't know
how it's sustainable without seeing so many clients
with those rates.
Yeah.
(08:58):
That I know that's kind of like, I
feel like I'm doing okay, but yeah, definitely
not as good as I could be.
I'm sure.
You know, I was like my new fees
that I have for new incoming clients, I
have it at one 25.
Good.
So that's good.
And I have two of those.
And in the beginning I recognized like when
(09:21):
I would do the consult calls, it was
hard for me to tell them that it
was $125 a session.
Like I'd find myself kind of like, but
also I can do sliding scale.
Like I'd automatically offer that or suggest that.
Yeah.
Yeah.
But I feel like at the same time
in my, you know, I can tell it
sounds to the client.
Like I am not fully confident in my
(09:43):
fees though.
Cause there I had, I've had a couple
of them.
When I first started my first put my
new fees out there as 125, a couple
of them were like, no, that's okay.
I can do the 125.
And if I'm like, you know what?
Maybe it is okay for people to do
125.
Maybe they are willing to do that on
a weekly basis.
Yes.
And let me look at something real quick.
(10:06):
So the household income, the median household income
in Tampa is $71,302 per year.
That's more than here in Asheville where I'm
charging 300.
Yeah.
Oh, wow.
So there's a lot of room for you
to go up.
I understand the mindset of like, I just
raised it on these folks.
(10:27):
I don't know if I want to raise
it again, especially a significant amount, but I
would start coming up with a plan to
get to stair step them up to 125.
Okay.
So it might be you talk to them
and you say, and we have things in
the, um, what'd you say?
When course they could that like different ways
of going about that.
You could just raise it all at once.
(10:49):
Usually at that price point, I don't recommend
that big of a raise, like 25.
Sure.
That seems like a big, yeah.
But at that price point, you know, if
somebody is going from 200 to 250, I
don't bat an eye, but the folks who
are paying 80 are going to be like,
Oh, with that, with that big of an
increase often.
Now I'll also say we've had lots of
(11:09):
students in limitless practice who were taking insurance
and people are just paying a copay and
then they go to two 50.
And so like, yes, some people leave, but
also some people make it work.
So yeah.
Okay.
It's getting clear.
Cause you have to come at it confidently.
So yeah, I know that's a hard part.
You have to do a lot of practicing
(11:29):
of saying it out loud.
And like when 25 is still like below
average for income for a therapist per session.
Yeah.
That's, I mean, it's good.
It sounds, it's good.
Yeah.
I don't want you to feel like squeamish
for long about one 25.
We always get squeamish when we raise it.
(11:50):
Everybody does even like, I've been doing it
forever.
And when I raised it to 300, I
was like me.
So like, it's normal to feel some anxiety
about it, but I don't want you to
feel like you're asking too much at one
25.
And if that means using the anchor of
like, this is below what the average private
practice client is or private practice therapist is
making per session.
(12:10):
Like if it helps to anchor to that,
so like I shouldn't feel bad then good.
Like you've got something to anchor you.
Okay.
Yeah.
When you said 300 per session, I'm like,
wait, I'm way down there, you know, and
here I was like thinking 125 was a
lot.
But I mean, I remember when I felt
when 25 is a lot too, like it's
just, it's developmentally kind of a part of
(12:31):
the process of being in private practice.
I could definitely not have charged 300 when
I first started, not because of my clinical
skills, but just because of my money mindset.
Right.
Even when I raised it from 70 to
80, I was like, oh, that's sounds like
a lot.
But then I was kind of worried about
losing clients, but every single one of them,
like no one blinked an eye.
Like they just signed the form and was
(12:53):
it, you know, so yeah.
Okay.
Other than that, I feel like, cause before
I had a lot of issues in my
thinking about my branding or my niche, cause
I was like adult ADHD, is that too
broad?
But lately I've been doing really well with
it as far as getting clients who are
just seeking ADHD.
(13:14):
Yeah.
It's such an in demand, especially now that
people are getting diagnosed, whether they're self diagnosing
or they're getting diagnosed through a testing psychologist.
Yeah.
People are like, this explains everything, you know?
Yeah.
That's what they say when they come to
me is, oh my God, now that I
got this diagnosis, this explains everything.
This opens up all the doors in my
life.
(13:34):
So this is the other area I struggled
in with that though, in particular.
So with ADHD, the way I kind of
see it is there's two like two major
areas.
One is like more like strategies and coping,
but the other one is more like the
emotional internal core beliefs and all of that
side to it.
So I think originally I kind of struggled
(13:55):
with, I feel like I do much better
as a therapist on the emotional side of
it, the deeper rooted beliefs and kind of
working with that.
So I think I struggled with like, should
I, in the beginning I was like, should
I really drill it down to adult ADHD
and just like internal core beliefs or is
(14:15):
it okay to leave it as broad as
the internal core beliefs and the kind of
like the coaching strategies that kind of go
along with it?
Yeah.
I mean, I think you can do both
if you enjoy both or if you want
to just focus on one, you could do
that.
But I think both definitely works because it's
more holistic, right?
Yeah.
I think people really, now I'm finding more
(14:36):
and more people are coming to me with
needs for both.
Usually they approach looking for ADHD strategies, but
then when I explain that part to them,
they're like, oh, yeah.
And as they try to implement strategies that
are new to them, all that old stuff's
going to come up too.
It's like, I don't know, it would be
tough to be like, well, we're only talking
(14:57):
about the strategies today.
So you might just be honest to yourself.
Yeah.
Right now I've been kind of, a lot
of my referrals have been coming in through
like referral sites.
So like growth therapy has been really good.
So I think what I want to, that's
the other thing.
(15:18):
What I want to do is, because growth
therapy is good, but it's all insurance clients.
And those are the clients that are like
mostly 70 to 80 bucks a session.
So I think it's also part of it
is my website's almost done.
And so I think part of it is
how to get myself out there.
That's how to get myself out there where
I'm looking.
How do you get the cash clients?
Like where I'm not focused on the referral
(15:40):
sites.
Once my website's done, I know I listened
to one of the videos about how it's
like marketing to all like the doctors, like
the physicians, like sending out emails.
I don't know if you have any other
ideas for like, how do I get my
website out there so people can see, I
guess.
The marketing fundamentals course in there is all
(16:01):
about that.
So we've got marketing fundamentals one, which is
about getting your website, building it out in
a way that actually works.
And it's that and networking.
Those are the two that everybody needs to
be doing.
And the marketing fundamentals two is like all
the other strategies that work really well for
therapists to get people to their website essentially.
(16:22):
Because everybody's going to check out your website
before they call you, right?
Like nobody's just in this day and age,
everybody's checking you out.
So that's why your website needs to be
really on point.
Your copy needs to be really specific.
You need to be talking about their daily
lived experience.
And then your other marketing strategies essentially get
people to it so that they're like, Oh
my God, she's talking about me.
(16:43):
So yeah.
Okay.
I didn't follow your templates on creating the
website.
So yeah.
So that's what I just need to do
is to be able to get that website
out there so people can see it so
I can get those cash clients in.
So I'm not stuck at 70 bucks or
80 bucks.
And for you, I would like are the
(17:03):
majority, well, I guess what percentage of your
clients are getting tested versus self-diagnosing?
Oh yeah.
That's the thing.
I would say a smaller portion of them
than not have been tested.
I get a lot of clients who they
come in self-diagnosing and then we go
(17:24):
over like the criteria and kind of talk
about that.
A lot of times too, I feel like
I can, especially being ADHD myself, I can
kind of pick up on all those little
nuances, but a lot of them just like,
they don't seem to show much interest in
getting tested.
And even more so more of them are
kind of like a little bit medication resistant.
(17:45):
They're more like, I want to do the
therapy first and see how that goes before
getting on any medication.
Yeah.
So is the medication resistant, is that your
favorite flavor of ADHD or do you care?
I think I work well in both.
Yeah.
Actually, I will say in some instances, maybe
even more so with the medication resistant because
(18:09):
I don't know.
I feel like there's like a lot to
kind of, I don't know if this sounds
crazy, but like there's a lot to like
work with if they come to me and
they're like, I really, some people who come
on medication, there's stuff to work on with
them, but then otherwise we're good.
The ones who don't want medication, there's usually
more to work on with them, which actually
I really like to have so much more
(18:29):
work to do.
I guess, does that make sense?
It's kind of like saying a client with
more problems I enjoy working with, but that's
true.
Yeah.
I mean, we all have our favorites, right?
So I think it would be really good
for you to network with testers, even though
that's the minority of who's coming in.
But the last part of any testing is
(18:50):
like, here are the resources.
And so become one of their chosen resources
for the adults with ADHD and also prescribers.
So like psychiatrists, ARNPs, PAs, like the psych
folks that are getting the majority of these
folks, because there are some people who are
medication resistant who are going there first.
(19:13):
They're not going to take the medicine.
They just want to ask their questions.
They want to make sure that their self
-assessment is accurate.
Yeah.
And so for the psychiatrist to have that
conversation and then be like, I don't know
if I really want to take medicine.
I don't think I'm going to do it.
I don't think I want you to write
me the script.
Then they can be like, there's this great
therapist in town who works with folks, whether
(19:33):
or not they take medication on the skills
and some of the emotional heaviness that can
go along with having had ADHD your whole
life.
Yeah.
So become like a preferred referral person for
them could be really great.
Yeah.
That sounds actually a really good idea to
do that.
(19:54):
Do you think I should like, this is
where I'm kind of like, it's not that
big of a deal, but wondering if I
should be more of like ADHD for teens
and adults, or is it better, do you
think, to like drill down to a niche
of?
Who do you, like, do you have a
slight preference for adults over teens?
Yeah.
Like adults over teens.
Yeah.
Yeah.
(20:15):
Okay.
Okay.
Okay.
That's the other thing.
I do want to get EMDR certified.
I don't want it to like blur my,
I guess, blur my niche too much, if
that makes sense.
Well, they don't really care.
Well, sometimes people are looking for EMDR, but
if people are looking for ADHD, they're looking
for ADHD.
And then you have this great tool.
(20:37):
You can use when you get underneath some
of that trauma, you know, like, and you're
like, yeah, it sucks to feel like you're
behind in life.
Like we can work on that with this.
So I don't think you even need to
like advertise it necessarily.
Like I wouldn't have it be a part
of your marketing.
You could, you could have like a, under
your services pages, like a dropdown about EMDR.
(20:57):
And you could talk about the circumstances that
you see where EMDR can be really helpful
for folks with ADHD, but I don't think
it needs to change your messaging.
Okay.
Okay.
Yeah.
Cause that's what I find too, is like,
we get to that part and then they
might even ask me about it.
Like, oh, well I heard about this EMDR
(21:17):
therapy, you know?
And so there's a lot of people lately
who have been hitting me with that.
So yeah, that's something I want to do,
but yeah.
So that's a good idea.
Maybe not like I'm EMDR and ADHD, but
instead it's just more of like a, hey,
when we get to this is also what
I offer.
Yeah.
I do find that though, like with each
(21:37):
client, I, I kind of go all in,
which could be a good thing, but we
like, I find that there's always, there's always,
you know, so much more work to do,
like attachment work.
And there's also a lot of clients come
to me who have ADHD, but also of
course have like childhood trauma.
Or sometimes I wonder if people who come
through with ADHD, I mean, it seems satisfied
(22:01):
with where we're going, but if they, cause
when, when is that happening?
Is it sometimes it derails and it becomes
not so much ADHD focused, but now it's
like trauma focused.
And I was like, you know, I guess
that's pretty normal.
Yeah.
That's great.
I mean, cause I think that happens for
most of us, you know, like working with
eating disorders, it's never just about the eating
disorders.
Almost always trauma.
(22:22):
Um, almost, I mean, not almost, so it's
always veers into anxiety, but I think it,
from your messaging standpoint and your marketing, it
is about like, if most people are coming
in because they want, and if your ideal
client, I should say specifically is coming in
because they want skills and it's their ADHD,
then that's where I want most of your
marketing to focus.
(22:45):
Okay.
Cause that seems that's what usually happens.
It's about the skills and then it blooms
into, Oh, we've got all this stuff too.
Yeah.
So, okay.
Yeah.
And that's true.
That's true too.
Cause a lot of times they're not even
realizing, cause I noticed that when clients come
to me, they're not even realizing that, Oh,
there's so much more that I should be
working through, you know?
(23:06):
And it's just, yeah.
Well, I think it often just takes a
little in the, like the nudge of like,
here's what I see with a lot of
my ADHD clients who are diagnosed late, like
here are all the stories that they believe
about themselves for their whole life.
Yeah.
And then they're like, Oh my God, me
too.
Big thing for like, yeah.
Yeah.
For those who have been lately late diagnosed
(23:27):
compared to like those who have known like
their whole lives, you know?
Okay.
I feel pretty good.
Love it.
Yeah.
I mean, five, six minutes early.
I'll take it.
Yeah.
Yeah.
So yeah, I would just stay on that
messaging, go through that marketing fundamentals to course
and the marketing fundamentals.
(23:48):
One that has the networking section that can
give you some really good ideas of who,
who your ideal clients find before they find
you so that you can get in touch
with them and they can refer to you
and make it easy for your people.
Yeah.
Sounds good.
Awesome.
It was nice to meet you too.
All right.
Take care.
(24:09):
Thanks.
You too.
Bye.
Bye.
Your practice is full.
Congrats.
But are you secretly stuck in golden handcuffs?
If you're cramming in 7 PM sessions, glued
to insurance panels, or just whispering, I can't
do this till retirement.
It's time for limitless practice.
In 13 weeks, you'll work less, make more
(24:30):
and enjoy your business again.
Spots are limited.
Doors close September 23rd at midnight.
We start October 1st snag your spot with
the link in the show notes.
If you're ready for a much easier practice,
therapy notes is the way to go.
Go to therapy notes.com and use the
promo code abundant for two months free.
(24:52):
If you're listening, you probably need some support
building your practice.
If you're a super newbie, grab our free
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I'd love for you to follow rate and
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Let's help all our colleagues build what they
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