13 Tips for Overcoming Guilt and Anxiety Around Therapy Fees

As therapists, we’re trained to help clients manage anxious emotions and feelings of guilt.

Remarkably, we’re not taught how to handle our own fears and anxieties. Especially those that surface as being a small business owner in private practice.

Do you have any anxiety about your fees in private practice? 

Are you worried about how much you’re charging your clients? 

You’re not alone. 

It’s very common for these concerns to arise. Take a close look at the reasons behind your anxiety around therapy fees within yourself. This way you can address these fears and design the expansive life and practice you envision. 

Feeling guilty, anxious, or unworthy of charging what you're worth? Here are 13 tips to overcome those negative emotions. 

1. Take into account your financial needs as a therapist

Will your fees allow you the financial freedom and security you deserve? 

You can’t pour from an empty cup. 

When your needs are met, you'll feel more confident and secure in your finances. You'll be able to show up in full for your clients and give them the best support. Growing your financial security can increase your impact. 

Investing in yourself is a radical and loving act. This can help you build a thriving foundation for your practice — and for your clients. 

Take a look at our Charge What You’re Worth Guide for support in determining your fees.

If you’re not taking care of yourself, how can you take care of your clients?

When you’re deciding on your fee schedule, remember that what you want and need matters.  

2. Naturally scale your practice as you gain confidence in charging therapy fees

If you've got significant goals, you don’t want to get stuck in the same place financially year after year. You want to be able to continue growing and expanding your practice. That includes increasing your fees as your business grows. 

This helps you attract higher-paying clients, but it also gives you financial wiggle room to invest in your practice. You can put the money back into marketing, training, and other business-building activities.

For example, many therapists start at a lower rate. Once they get to five to ten clients, they begin to increase their rate. Over time, once you become more confident and feel more secure within your practice, you can raise the bar.

This allows you to create incremental shifts in how you feel and build your confidence as you grow. You can talk to new clients about how your average fee has increased. 

You can also offer a sliding scale to those clients who may need it and are an excellent fit for your practice.

3. Don’t underestimate your clients

One of my favorite parts of the work of therapy is being surprised by my clients. What they each bring to sessions each week is remarkable.

Let your clients surprise you, and don’t project your own insecurities onto them. 

You don’t want to make assumptions about your clients. You want to make sure you’re not bringing your own anxieties into the space. 

Sometimes your clients will surprise you, and this can be very therapeutic. Some clients will also want to compensate you more because you've been their support. It's their way of acknowledging and showing appreciation for the work you've done together. 

I've been pleasantly surprised by clients when I've brought up fee increases. I may have waited a year to ask if we could increase the fee, and usually, the response is along the lines of “Oh my gosh, yeah. Of course, I’ve always thought this was really reasonable and less than what all my friends are paying.”

4. Debunk the myth that higher fees are detrimental to the work 

Do you feel like setting a higher fee feels greedy or wrong? 

This mindset will only hold you back.

There are a lot of myths and stories that we tell ourselves when it comes to money and setting our fees.

The truth is, if you want to make a difference in the world and help as many people as possible, you need to be paid accordingly. Period. 

If you undermine yourself and don’t believe you’re worth it, you’re . It’s time to start owning your value and asking for what you deserve.

You’re not a fraud for asking for more money and setting a higher fee. You owe it to yourself — and your clients. 

5. Remember, you can always repair a conversation

You can facilitate difficult conversations. You can always bounce back if there is a rupture. 

Fees and money can be a delicate topic. Creating the space to continue the conversation can be therapeutic for a client. If a client seems uncomfortable or upset, you can offer a space of support through your work together.

It is equally important to listen to the client’s needs and understand their origin. It may be that the fee is not the only topic that they’re anxious about — there may be other underlying issues at play.

You can use this opportunity to explore those issues further. Help the client understand where their fear is coming from and work through them. 

In the end, this will only serve to strengthen the client-therapist relationship. This may also help the client overcome their anxiety. They can even become more open to discussing other difficult topics.

6. Reaffirm your own needs with a gratitude practice

It’s helpful maintain a practice of gratitude. As therapists, we need a meditative, reaffirming practice for our ourselves. This is to remind ourselves that we’re human and recognize that we have fundamental needs. This includes money. 

Making this practice a habit can be powerful. It’s not one of entitlement or grandiosity but one of appreciation — “I appreciate my work. I’m rewarded for my work emotionally, and I’m also rewarded financially.” 

These can be effective affirmations to reaffirm our own needs within ourselves.

Additionally, it’s helpful to remember that we are not alone in this. Other therapists and many of your colleagues have also struggled with this. You can join us on our therapist community forum where we come together to support one another. We discuss setting fees, reaffirming our needs as practitioners in business, and more.

7. Minimize therapy fee concerns by offering transparency

When it comes to increasing your fees or discussing fees with clients, it’s better to be transparent. You’ll want to either say, “My fee is X dollars”, “I have X-X range of fees”, or “my fees start at X.” 

Avoid the pitfalls of fee secrecy.

I’ve heard horror stories from colleagues of mine. They wouldn't tell new clients their fees over the phone. Many new clients came in to see them with no understanding of their financial obligation. At the end of the session, this particular therapist would say "Oh, my fee is $250." And then the clients would say something like, “Oh my goodness, I can’t afford that!” 

Being grandiose or secretive about your fees isn't reasonable. Making up a clinical excuse for not talking about your fee isn't a good practice. It's also not fair to clients. 

This practice is bait and switch. It’s unethical and dubious. You could even get reported to the board by a disgruntled consult.

If anything, we live in a world with the “no surprise act” with  good faith estimates. You have to provide an estimation of the fee per service throughout the year. This is especially important if someone isn’t using insurance or doesn’t have insurance. You want to make sure you’re complying with best practices within the industry. 

Being transparent about your fees will also help to build trust with your clients. They’ll appreciate your honesty. It'll make it easier for them to make an informed decision about whether they want or can work with you.

8. Find your authenticity within marketing

Does marketing feel intimidating? 

Marketing doesn’t have to be scary. 

If you’re contemplating your fees, marketing can help you reach a larger audience. Connecting with your ideal clients can help you let go of some of the pressure and anxiety. 

By marketing yourself, you’re more likely to be found.

You want to be bolstering yourself up. Represent yourself online in a way that feels authentic, unique, and dynamic. 

People are more likely to say, “Oh, I found you online, and I was really impressed. I’ve spoken to other people. I’m intrigued by your approach, and I’m happy to pay your full fee because you’ve stood out to me.”

Authenticity is key in marketing — you don’t want to be like everyone else. You want to find your unique voice and use it to reach out to potential clients.

Plus, clients appreciate it when therapists are open and share a little about themselves. It helps them feel more comfortable and makes the whole process less daunting.

9. Be mindful of your own core beliefs causing anxiety around therapy fees

Be especially mindful of the stories you tell yourself. Do you hold any negative core beliefs?

Common misbeliefs I hear from therapists include “I’m too young”, “I’m not sophisticated enough”, or “I’m not worth it”. 

You want to be aware of those core beliefs, so they don’t run the show. 

Your clients can sense when you’re holding back or when you don’t think you’re good enough. It will affect the quality of your work and make it harder for you to build trust with clients.

Some can even absorb your negative core beliefs as their own. Be careful what you say to yourself, and ensure that your core beliefs serve you well.

10. Deepen your own mindset and model abundance

Spend time modeling an abundant and expansive, liberated mindset. Your clients will sense this unconsciously. It’s not as much in your words as it is in how you show up, so it’s not anything you need to be explicit about.

They’ll sense it and pick up on it even on a subconscious level. 

Part of our work is modeling these healthy behaviors for our clients. If you've able to do this, clients will be thinking of you even after your work together is complete. 

Remember that clients often struggle with their own mindset of scarcity. Modeling abundance can help them shift their thinking. They can also start making efforts to move towards a positive outlook. 

11. Let go of this transactional notion that’s keeping you up at night

You don’t need to look at your fees and rates as being transactional.

Altruism is work. If you’re worried about the alliance being hurt, there are ways to prepare for that. There are many creative ways of doing our personal work through our own therapy. You can even talk to supervisors or colleagues. 

You can also jump into the Clarity Cooperative Therapist Community to find support.  

12. Facilitate conversations with your clients

Focus on how you plan to facilitate the conversation with clients about money. You'll want to discuss what is reasonable, the value you bring to the sessions, and the investment. You’re both invested. 

By charging a reasonable fee, you’re saying to them, “I believe in myself, and I believe in you and doing this work.” 

You don’t want to communicate to the client tat they're getting an impoverished experience of therapy. Find a balance where it’s affordable for both of you. Remember that your financial needs as a therapist are important. 

13. Consider pro bono and sliding scale to address therapy fee concerns

You’re allowed to have specific clients who have the means and are able and willing to pay a full fee. Then, you can open up space in your practice to see clients for a lower rate or pro bono. 

By doing this, you’re providing a service to the world. You can have a full range of clients who pay a different rate based on what they can. 

Remember that Your Financial Needs as a Therapist Matter as you Grow Your Confidence in Charging Therapy Fees

When it comes to setting fees, there’s no right or wrong answer. You’ll want to find what works for you and your clients while considering your own personal relationship with money.

But remember above all else - you are allowed to want to make a healthy living that takes care of your needs and allows you to work and live comfortably . 

There are many ways to get there with less fear, less guilt, and more financial freedom.

It’s about finding a way to balance the equation that may be slightly unbalanced by guilt, conflict, and impoverishment around money. You can have abundance and also be a generous heart-focused practitioner and entrepreneur.