When therapists tell themselves, “I live in a rural area, so premium fees aren’t possible here,” Leah Harlan is living proof that assumption isn’t true.
In just 8 months, Leah increased her annual revenue by more than $40,000 while cutting her caseload nearly in half.
And she did it in rural Virginia.
In this conversation, Leah shares what it looked like to move from exhaustion and overwork into a practice that actually supports the life they want to live. They open up about the fears, mindset shifts, fee increases, and practical decisions that made this transformation possible—and why geography wasn’t the barrier they once thought it was.
If you’ve been convinced your location, market, or community can’t support Life First Fees, this episode is a must-listen.
Listen to the episode:
In this episode we cover:
- Why rural therapists often underestimate what clients are willing to invest in therapy
- The mindset shifts Leah had to make before raising their fee
- How they increased revenue by over $40,000 in less than a year
- What happened when they reduced their caseload instead of adding more sessions
- The fears that surfaced throughout the fee-raising process
- How Life First Fees created more sustainability inside and outside the therapy room
- The connection between therapist burnout and undercharging
- Why premium-fee clients exist in every community—including rural areas
- What changed in Leah’s confidence, boundaries, and clinical work as their practice evolved
- Advice for therapists who believe their market “can’t support” higher fees
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More about Leah
Leah Harlan is a Licensed Professional Counselor and private practice owner of Harlan Therapy in Virginia specializing in traumatic birth experiences. She helps women process what happened during birth so they can feel safe in their bodies again, move out of fear, and approach future pregnancies or motherhood with greater clarity and support. In her spare time, Leah writes children’s books, paints, and spends time with her littles and husband at home, building a slower, more intentional life together.
