Ask Tiffany: How do I make charging full fees sustainable?

As part of our ongoing money series, I am answering YOUR questions about money and private practice.

This week I’m diving into a question from Therapist Heather who wrote in and said:

“How long to full fee clients tend to stay in treatment? Have there been any studies on that? I am able to get a full fee client in my area, but after about 2 months they tend to decrease to every other week and then once month (even saying they wish they could come more but can’t afford it). I’m worried my area just doesn’t have the population to support full fee ($120) for an extended period of time. I’ve tried looking up Fresno and it seems we have higher poverty levels here which may affect my ability to take full fee and fill a practice. When I wasn’t taking insurance I struggled to get even 1 new client a month and could not sustain my practice.” 

It’s a great question and one I’m absolutely certain many of you have!

Is it really possible to have full fee clients who are willing to invest in long term psychotherapy?!

Jump down to the comments section and share YOUR thoughts with the community.


  1. Tressa Porter

    Tell it to us straight Tiffany! So true…I have some inner work to do…a few stones left unturned..I realize that I am not 100% behind the value that I offer. Thank you!

    • Tiffany

      AMEN, Tressa! Get IN there. Get behind that offer. What would it take for you to feel extremely clear that what you are offering is worth the price you *need* to charge to be in line with your financial integrity? Get out there, BOLDLY. If you can reach even just a few of your ideal clients and really find out if they want what you are offering (how would you know? If they happily and willingly pay your full fee), then you just need to keep doing that.

      If you are out there boldly and you are getting crickets, it means you need to work on sharpening up your marketing message and making sure that what you are offering and the words you are using to describe it resonate deeply with your peeps.

      You got this!


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About the Author

Hey, I’m Tiffany McLain, LMFT, and I teach you how to charge good money for the good work you do.  I’m the founder of Lean In. MAKE BANK. Academy, a group program that empowers therapists and social workers like you to reimagine your relationship with money, offering the tools and community support to not just earn more but to fundamentally change your life and the lives of those you serve.

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