Ask Tiffany: Why Clients Won’t Pay Your Full Fee

Have you ever had a client call who could use their out of network insurance to pay you, but choose to just… well, not. And they go find another therapist?

Or, have you ever had a client who clearly had the resources to pay you an extra $10 a week, buuuUUUUuuuut, when you mentioned a potential fee raise he balked?

Or, that client who comes in with a bomb-ass handbag that you KNOW cost a pretty penny, but when you even imagined raising your rates, you were filled with dread because you knew she would quit?

This week’s episode of Ask Tiffany is right up your frickin’ alley! I’m going to give you three concrete things you can do to make your clients EAGER to pay your full fee.

Check the lesson below.

What is one thing YOU can do to go first and invest in your future client before they invest in you? Share with us in the comment section below.


  1. Natasha Williot

    I’ve been wanting to find a therapist and felt like I had ‘no reason to’. This is another little reminder of the importance of investing in myself, even more so if I expect others to do it as well!

    • Tiffany

      YES! Renee! I’m so glad. 😀

  2. Samantha

    I am committing to getting a clearer description of my ideal client. I know what my ideal client looks like in essence but have a hard time putting it into words. I thought about it but never really made a move towards it due to loving my current therapist who accepts my insurance company. I think it would be worth taking a break or moving forward to find a therapist in my local area that runs a full-fee practice. In Hawaii, I haven’t heard of a full-fee cash-only practice yet. I know some therapists do take cash clients but still base majority of their practice on insurance claims. I haven’t had to refuse to see anyone yet because no one has called but I know that once I do the other steps I have faith that I will have a ton of calls! Thanks for being you. I absolutely love your style!

    • Tiffany

      Thanks for writing in and sharing your experience, Samantha! It is VITAL that you find other therapists – either in your area, OR online – who are doing what you want to do and then LEARN FROM THEM. It is absolutely possible to create a cash-pay, premium fee practice in Hawaii. You can pave the way for other therapists who *want* to do it, but need to follow in someone’s footsteps first. Let’s get your footprints out there!

  3. Tamara Powell, LMHC

    Nailed it (as always! My favorite – “You have to say no to the 99.9% so you can say yes to the 1 person.” Hell yes.

    • Tiffany



Submit a Comment

Your email address will not be published. Required fields are marked *

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.

Get Access to Our Free Fees Calculator

& confidently set your private practice fees the right way!

Browse Related Posts

Therapist with a Garden Hoe or a Netflix Show?

After over 7 years of working with therapists in private practice around fee setting strategies, I’ve observed that there are two types of private practice therapists: Therapists with a Garden Hoe & Therapists with a Netflix Show. It’s vital that you understand...

Breaking Free: Why Therapists Don’t Have to Accept Insurance

Many therapists believe that they're obligated to accept insurance as if it's an unwritten rule etched in stone. It's a myth that has circulated within the therapy world for years, casting a shadow of uncertainty over both therapists and potential clients. But let's...

Learn how to charge premium fees while increasing the quality of care for your clients

Because therapists with more money have more capacity to make change