13 Tips for Overcoming Guilt and Anxiety Around Therapy Fees

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13 Tips for Overcoming Guilt and Anxiety Around Therapy Fees

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Published: Jul 05 2023

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

Remarkably, we’re not necessarily taught how to handle our own fears and anxieties 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. Addressing the reason behind the anxiety around therapy fees within yourself will help you design the expansive life and practice you envision.  

If you’re feeling guilty, anxious, or unworthy when thinking about your fees, here are 13 considerations to keep in mind.

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

When you feel confident and secure in your finances, you’ll be able to show up more fully for your clients and offer them the best possible support. Growing your financial security can increase your impact.

Investing in yourself is a radical and loving act that 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

As someone with significant goals, you don’t want to stay stuck in the same place financially year after year. You want to be able to continue growing and expanding your practice — and that includes increasing your fees as your business grows. 

Not only will this help you attract higher-paying clients, but it will also give you the financial wiggle room to invest in marketing, future trainings, and other business-building activities.

For example, many people start at a lower rate, and then 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 slowly 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 truly 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 and you want to make sure you’re not bringing your own anxieties into the space. 

Sometimes you will be surprised by them, which can be very therapeutic. Also, clients may want to compensate you more because you’ve been there for them, and it’s a way they can acknowledge and show appreciation for the work you’ve done together.

Personally, I have been pleasantly surprised by clients when revisiting rates. 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? 

It’s time to start owning your value and asking for what you deserve.

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 doing a disservice to yourself. 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, and you can always bounce back if there is a rupture. 

Fees and money can be a delicate topic and creating a space to continue the conversation can sometimes be therapeutic for a client. If a client seems uncomfortable or upset, you can offer a space for support through the work you’re both doing 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 and help the client understand 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 and become more open to discussing other difficult topics.

6. Reaffirm your own needs with a gratitude practice

It’s helpful to have a gratitude practice — a meditative, reaffirming practice of our own needs — to remind ourselves that we’re human and have fundamental needs, which include 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 in setting fees, reaffirming our own 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 about colleagues of mine who wouldn’t tell their clients their fees over the phone. The clients would come in and she would have no understanding of what their financial situation was. And then at the end of the session, this person would say, “Oh, my fee is $250.” And then the client would say, “Oh my goodness, I can’t afford that!” 

You also don’t want to be grandiose or secretive or try to make some excuse that for clinical reasons you don’t talk about your fee. I just don’t see that as reasonable in the modern world. I don’t think it’s a good practice. I don’t think it’s fair to clients. 

This practice is bait and switch. It’s highly unethical and dubious, and could even result in you getting reported to the board by a disgruntled consult.

If anything, we live in a world with the “no surprise act” with good faith estimates where you have to provide an estimation of the fee per service throughout the year. This is especially important if someone isn’t using their 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, making it easier for them to make an informed decision about whether or not they want or can work with you.

8. Find your authenticity within marketing

Does marketing feel intimidating? 

Authenticity is key in marketing.

Marketing doesn’t have to be scary. 

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

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

You want to be bolstering yourself up, and you want to be representing 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 willing to be open and share a little about themselves. It helps them to 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 and perhaps some of the negative core beliefs you hold.

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

As much as you can, spend time modeling an abundant and expansive mindset, a 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 say all the time explicitly.

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

Part of our work is modeling these healthy behaviors, and if you’re able to model this for your clients, then they’ll be thinking of you even after your work is done.

It’s important to remember that clients often struggle with their own scarcity mindset, so by modeling abundance, you can help them shift their thinking and start moving towards a more 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 overly 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 or supervision by talking with 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, what is reasonable, the value you both bring into the room, and the investment you’re bringing into the world. 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 that they need some impoverished experience of therapy. Find a balance where it’s affordable for both of you, and 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.

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