5 Signs It's Time To Raise Your Fees

It's common for therapists in private practice to have anxiety around money issues like how much to charge per session, how to ask clients for payment, and when to raise your fees. Getting comfortable talking about fees with clients is crucial to private practice success. After all, you own a business. In general, I think therapists charge too little for their services.

Several years ago, I resigned from managed care and I raised my psychotherapy fees at the same time. Fortunately, my practice didn't suffer financially from those decisions. What surprised me most about raising my per session fee was that the perceived value of my services went up. "You don't take insurance and charge a lot? You must be really good," was a sentiment that I heard frequently from potential clients.

Interestingly, I've found that clients tend to invest more in the therapy process because they are investing more money out of their own pocket for treatment.

If you're considering raising your fees, consider these 5 signs that the time has come to raise your fees.

1) You haven't raised your psychotherapy rate in over 5 years

If it's been over five years since you've raised your therapy fees, it's time to revisit the issue. Your cost of living goes up approximately 2% every year due to inflation. If you haven't raised your fees you are likely making less than you made five years ago.

2) Your full fee is equal to insurance reimbursement

If you set your fees based on what insurance companies are willing to reimburse, then your fees are too low. Historically, insurance companies reimburse at a much lower rate than the providers full fee.

3) You aren't making enough money to pay your bills

Your private practice needs to serve your clients and provide a sufficient income for you. If you are not making ends meet in your practice or your personal life you may need to reduces expenses and increase your rates.

4) You have a waiting list

A waiting list is a sign that your services are in demand and that clients will pay more for your services.

5) You've completed specialized training or certification

Your added expertise deserves additional compensation. If you have recently completed advanced training, like certification in DBT or Emotionally Focused Couples therapy, for example, you may want to charge more.

When is the last time you raised your rates? How do you decide when to increase your fees?

photo credit: Corey Holms

How To Find Top Student Interns To Grow Your Practice

There is an "it" factor when looking for interns to train in your private practice.

Here's how I've found amazing interns that stay at my clinic even after graduation.

Over the past several years I have trained and mentored many graduate students and new graduates working toward clinical licensure. Working with interns has been a great way to build my practice, leverage my time, and satisfy the part of me that loves mentoring.

Most graduate students who train at my clinic during school are offered a therapist position after graduation which creates a win-win situation -- the student gets a job they're already trained for and I get to add talented and enthusiastic therapists to my team! After interviewing several therapists, I've learned to be very selective about who I bring on at Wasatch Family Therapy.

I recently consulted with a private practice therapist who has a waiting list for new clients. As we started exploring the option of hiring a graduate student to train she expressed some concerns. Her biggest questions were:

• How do you find talented graduates students?
• When interviewing potential student interns, what qualities do you look for?
• How do you know if they're going to be a good therapist and work well with your private practice clientele?

So, here's what I've learned after several years of interviewing and hiring student interns...

How do you find gifted graduate students?

• Contact local graduate programs in your discipline and see if they are  looking for internship/practicum placements for their students.
• Fill out the necessary paperwork to be an approved placement at local schools, even if you're not quite ready to bring on a student. When you're ready to train an intern you'll already be approved.
• Reach out to traditional and for-profit schools. I've found that the for-profit programs (Argosy University and University of Phoenix in UT) are more flexible in terms of internship start times and the number of clinical hours per week required. I have been very pleased with the caliber of students from private, for-profit universities.

When interviewing potential student interns, what qualities do you look for?

• After interviewing grad students for several years now, the biggest "it" factor I look for is likeability. I know that sounds simple, but it's true. If I enjoy talking to them and I trust them during the interview process, then it's likely they will quickly put clients at ease, too.
• I look for people were "born" therapists and just need the formal credentials and trainig in order to actually to all themselves a therapist.
• I look for people who have long-term goals that include working in a private practice setting, like mine, beyond the internship.
• I always ask about their style of handling conflict, feedback, or direction in work settings and discuss several scenarios that might arise in private practice.

How do you know if they're going to be a good therapist and work well with your private practice clientele?

• You don't. There's no guarantee that someone will be an effective clinician. I suggest that you make sure that there is a clause in your contract that you can stop training a grad student that isn't working well with your clientele.
• I often require that interested graduate students volunteer at my clinic for several months before securing a clinical internship. There is such a high demand for interns in my area that we can be extremely selective. This volunteer time gives us both a chance to make sure it's a good fit.
• A 3-step interview process helps screen potential interns before bringing on.  I do an initial interview, a second interview, and a "mock" case presentation at team meeting. While I ultimately decide which intern we will "hire," I trust my team's input as to whether the student would be a good fit.

While it's always a risk bringing on a new student to my team, I find comfort in the fact that the number one predictor of client outcome is the strength of the therapeutic alliance. Generally, if it's easy for me and my team to connect with a grad student in the interview process, it's safe to say that clients will feel the same way about them. Ultimately, it's your practice and your reputation on the line as the owner of your practice.

Have you trained interns in your private practice? I'd love to hear about where you find them, how you screen them, and if it's worked to build your practice!

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(c) Can Stock Photo

A Day In The Life: Meet Relationship Expert Dr. Meredith Hansen

When I "met" Dr. Meredith Hansen on Facebook and Twitter recently I was struck by her cohesive online presence. Rarely have I come across such an impeccable private practice website and a therapist who has such clarity in her private practice message: "Helping individuals and couples find love, get love, and keep love."

If you want to see an example of a powerful practice website and clear practice message visit DrMeredithHansen.com. Dr. Hansen projects a nice blend of accessibility and professionalism that make me feel confident referring clients to her practice.

I'm not the only one who feels confident in Dr. Hansen's skills. Professional men and women in their late 20’s to early 40’s who are hoping to find love, coping with a relationship breakup, or want to improve their current love relationship are seeking her clinical services.

Dr. Hansen also offers pre-marital and newlywed counseling and enjoys helping couples adjust to married life. With a waiting list of new clients Dr. Hansen's plans to on bring on a psychological assistant to supervise who will see her overflow clients.  What does it take to build a relationship focused private practice? Look into "a day in the life" of relationship expert Dr. Hansen.

A Day In The Life

January 9, 2012

6:30AM – 8:00AM

Woke up early and headed out to the gym. I didn’t want to go today, my bed was warm and comfortable, but I knew it would make me feel energized and ready for the busy day ahead.

8:00AM – 8:30AM

Came home and made my favorite green smoothie for breakfast. Checked in with my husband before he left for work and responded to a few client emails requesting appointment changes during the week.

8:30AM – 9:30AM

Showered and got dressed.

9:45AM – 10:00AM

Drove to work and listened to my new website “opt-in” recording.

10:00AM – 11:00AM

Arrived at my office and reviewed my caseload for the day. Entered weekly sessions into www.officeally.com, entered billing information, paid a few private practice bills (Farmer’s office insurance and Sparkletts), completed unfinished progress notes, returned a phone call from a potential new patient requesting an appointment, updated my practice waiting list in Google Docs.

11:00AM – 12:00PM

Worked on new relationship improvement product that I will launch next month. Recorded 7 short audios and finalized the corresponding handouts. Sent an email to my friends who are “testing” the program in order to get their feedback on the content so far.

12:00PM – 1:00PM

Grabbed lunch from a little deli down the street and reviewed content from a business training program I am participating in. Ate my sandwich while listening to the training recordings and made a “To Do”/goal list for the week. Visited my Facebook Page to respond to any comments or posts by my followers and checked in on Twitter to build online relationships.

1:00PM – 7:00PM

Saw 6 therapy clients. Wrote progress notes between sessions in order to reduce my paperwork during the week. (This is always a goal. Some days I am better at this than others.)

7:00PM – 7:15PM

Drove home and listened to the rest of my new website opt-in recording.

7:15PM – 8:00PM

Arrived home and made dinner with my husband. Asked about his day, discussed our schedule for the month, and cleaned up the kitchen.

8:00PM – 9:15PM

Watched TV with my husband. Checked in on Facebook again to respond to any evening comments or posts. Reviewed schedule for tomorrow. Responded to a recent request for a guest blog post. Reviewed the website of the woman requesting the post in order to assess if it would be a good match. Brainstormed some ideas for this post and outlined my next blog post.

9:15PM – 10:15PM

Got ready for bed and read a book a psychology focused book (I can’t get away from them). Listened to a brief mediation by Melanie Roche (always relaxes me and helps clear my mind). Kissed my husband and went to sleep…

Find out more about Dr. Meredith Hansen visit her private practice website.