When I tell therapists and counselors about the benefits of counseling private practice they often don't believe me. The idea of making over 10k a month and having freedom over your schedule, while helping people ...well, it all just sounds too good to be true.
That's why I'm excited for today's guest post from Michelle Parrella. I stumbled upon her in mid July when she posted to Facebook her journey from an insurance-based practice to a private pay counseling practice
After reading her post I reached out and asked her to tell you all the full story of her practice launch.
Launching a counseling private practice is really scary and, honestly, it's not for everyone. Some people really love the community of group practice.
But if you know in your heart group practice is for you, then I hope this guest post inspires you to look past your fear and take the first step to owning your own solo counseling practice.
Best,
Jordan (the counselor)
"I remember how scared I was to make the leap from an Insurance based practice to Private Pay"
I want to share some hard data for folks who might be considering making the leap from a group practices/insurance panels to fully private pay.
My name is Michelle Parrella, LCSW and I have a private pay counseling practice I’m passionate about based in Santa Monica, CA. I provide support to folks both online and in person across the state.
I've wanted to share this information for a while because I remember how scared I was to make the leap from an Insurance based practice to Private Pay. I want people to have actual numbers, because I believe in transparency - that we should be open and have more conversations around money. I also know that I have sometimes gotten caught up in my own emotions and coming back to concrete data helps me stay grounded.
I think doing so helps us shed our shame, jealousy and move into a space of abundance for ourselves and others.
I hope someone finds this information helpful.
Working for an online provider and being underpaid and over worked
I’ve always wanted to have a counseling private practice, but after trying once in 2015 and never fully getting off the ground, I had a lot of fear and a scarcity mindset. As a result of circumstances pushing me, I reopened my counseling private practice, Your Best Life Therapy, in Nov of 2021 with a single private pay client and began the process of applying to insurance panels.
I began working with a large and well-known online counseling provider in January 2022. I had a full caseload within a week of starting and, to be honest, it was overwhelming. I wasn’t able to choose the clients I wanted to work with. Sometimes I was paired with clients with high acuity who weren't a good fit for the way services were provided. I was expected to engage in asynchronous text therapy, compensated per word and incentivized for “keeping” clients for certain lengths of time and I was hugely underpaid.
By April 2022 I was paneled with multiple insurance companies and quickly began receiving referrals. I knew that the big box mental health platform wasn’t a fit for me due to my personal and professional ethics, but I wanted to ensure my clients had plenty of time to transition to new providers and so I stayed until July 2022.By the time I terminated with the platform, I had already realized that I needed to leave insurance too. The billing issues, clawbacks and unpaid administrative work lead me to constant frustration and headaches. I gave notice as required by the contracts by Oct 2022 and I officially terminated my last insurance contract by Jan 2023.
Thing's don't always feel like they're working in my private pay counseling practice
It was a journey with very little marketing since my clients followed me either from insurance, big box mental health platforms, and some were referred by current clients. I have had a profile with Psychology Today for a significant amount of time, and am on two other well known therapist referral sites, but haven’t received referrals since I was on insurance panels.
I relaunched my website in May of 2023 and all of my current clients are from BEFORE that launch, but just last week I did receive one new client who found me on Google!
I live in a HIGHLY saturated area. I have only recently started networking more aggressively and have not yet received any referrals as a result of that networking. I share this again to be transparent about the process because things don’t always feel like they’re working. I don’t use social media for marketing and the work I’ve done related to marketing has been at my own pace - which means slowly. I work with intention for my needs.
I have a steady and strong client base, averaging 23 total with an 84% show rate and 55 appointments/month. I work my dream schedule of 10 - 4, no Fridays and half days on Mondays unless I choose otherwise. I only work with people I truly want to work with and declining clients who aren’t a fit for me comes easy now that I know my niche. Just yesterday I simply said no to a prospective client, gave referrals and moved on in my day without guilt or money scarcity mindset.
The picture below illustrates the transition this year away from insurance with the last insurance receipts received in Feb 2023). Each month my income has grown, with my highest month yet at $10,090.
It really motivated me to make the leap when I realized I could see THREE Private Pay clients at a rate of $200/session instead of EIGHT insurance clients at a rate of $68 - $72/session. Say what?
Throughout the course of this journey, I’ve done a lot of deep and honest exploration into fear, scarcity mindsets and what the needs are for myself and my family. When I reopened in November of 2021, my rate was the same as it had been in 2015 - $165. I failed to fully appreciate my own value and see the wealth of knowledge I brought to the table after 20 years of experience in social services, clinical practice and leadership. I’ve come to realize that many of us in this field do this to ourselves, and to each other and that we sacrifice ourselves for the needs of others. I couldn’t reconcile my own personal devaluation as I empowered my clients against the same actions.
This year alone, my private pay counseling practice income has already surpassed 22 income
In the 7 months with the large online therapy platform I made a whopping $6115 working with an average of 15 clients. Between January 2022 and December 2022, I made $35,409 accepting insurance. That’s a total of $41,524 for all of 2022. In February of this year I decided to pursue training in EMDR, a modality I am particularly passionate about and that has changed the way I approach my work. When I looked at the landscape and saw most folks charging higher rates for this specialized training, I saw the investment I was not only making for the sake of my clients, but also for myself and knew I needed to increase my hourly rate. My current rate is $215/session and I am exploring the idea of offering intensives in the future. I am able to offer two sliding scale spots and see one client through a single EAP contract, but the rest of my clients are private pay. This year alone, my income has already surpassed my total income for 2022, currently at $54,226 as of mid-July.
This data includes: one week off for EMDR training, one week of family vacation in January and another week in July, and various days off as I need to support our family needs. I will also be taking more time off later this year to support my family needs and continued professional growth.
I am SO happy I made the leap to a private pay counseling practice
For me it was a quick and fast journey to a fully private pay practice and I am SO happy I made the leap. I love what I do every day. I love working for myself. I love the clients I work with and I love inspiring other clinicians to make the leap too. I don't worry about living the life I need and want and I provide better quality care to the folks I work with.* Taking this action has made me feel happier, healthier and more attuned to myself, my family and my clients.
I hope you make the leap too.
*I do want to acknowledge that I come from a place of privilege as a white woman, with a two-income household, residing in an affluent part of the country, state and city. These things allow me access to other folks of privilege who can and are willing to invest in therapy outside of their insurance benefits and at a higher rate. I understand and appreciate that these factors impact my ability to work as a private pay clinician and do not want to disregard these circumstances.
Feel free to follow up with Michelle at www.YourBestLifeTherapy.com
-Fin-
Free consultation?
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Jordan Harris, Ph.D., LMFT-S, LPC-S received his Doctor of Philosophy in Marriage and Family Therapy from the University of Louisiana Monroe. He is a licensed professional counselor and a licensed marriage and family therapist in the state of Arkansas, USA. In his clinical work he enjoys working with couples. He also runs a blog on deliberate practice for therapists and counselors at Jordanthecounselor.com