E6: How having a chronic illness has led Sandra to charge MORE while working with marginalized populations

In this episode of The Money Sessions, we’re diving in deep with Sandra Seaman. Sandra is a Seattle based therapist who works with populations that many therapists say cannot afford premium fees. She defies the odds and has found a way to build a cash pay, premium fee practice while working with marginalized individuals. By getting real about the reality of her needs due to having a chronic illness, Sandra was able to step it up and challenge her Millennial clients to do the same.

She now charges $200/90-minute session with plans to raise her fees soon.

All this and she doesn’t even have a website!


Listen to the episode:


In this episode, Sandra will share:

  • How having MS has informed her fee-setting decisions
  • How she manages the guilt and shame she experiences around having privilege when so many folks do not
  • How doing her own money work allowed her to approach her Millennial clients in new and helpful ways
  • How being willing to let go of sliding scale clients changed the game for her practice – both clinically and financially
  • How raising her fees made her realize how she needed to narrow her already narrow niche even more
  • How addressing her financial realities has allowed her to delegate out more so she can really focus in on her clinical work
  • How she challenged the norm by creating a practice that fights the notion that therapists who work with traumatized or marginalized communities *must* lower their fees
This is hidden

Tiffany 0:00
In today’s episode of the money sessions we are diving deep with Sandra seaman. Sandra is a Seattle based therapist who works with populations that many therapists they cannot afford premium fees. She defies the odds and has found a way to build a cash pay premium fee practice while working with marginalized individuals who she is called to serve. By getting real about the reality of her needs due to having a chronic illness, Sandra was able to step it up and challenge her millennial clients to do the same. Let’s dive in.

Okay, folks, welcome to another episode of the money sessions. I’m very excited for this one, and you will find out why as we go. But first, before I even get into any of that, please tell us who you are where you practice. Oh,

Sandra 1:32
I am Sandra seaman. I practice in Seattle, Washington.

Tiffany 1:35
Fantastic. Welcome, Sandra. Hello. So we’re gonna focus on two things today. And then we’re gonna do some deep diving. But even before we started, you had some exciting news. But we’ll wait. We’ll wait on that. Let’s start by talking about raising your fees. So tell us just briefly what were your fees before? And then what are they now that you’ve raised them.

Sandra 1:56
Um, I started my practice as my internship, actually. So everyone was sliding scale. And the bottom, my sliding scale was $25. I was actually surprised by how many people when I started, were able to pay my full fee, which was $120. So I or no, it was $100 When I started, and I had a fair number of people actually just start paying full fee, which surprised the heck out of me. But I still have a number of people about seven or eight who are sliding scale of about 10 or 11 clients. So that’s a process and I do 90 minute sessions, so. So those are very lovely. So I’ve just raised my fees, I now have $150 for an hour and $200 for 90 minute sessions. And I’m gonna go up from here, but that’s where I’m at right now.

Tiffany 2:45
That is fantastic. Okay, so we’re gonna back up a little bit. I know you because you took a lead and make bank. That’s why I got to know you. That’s how I got to know more about your journey. So let’s talk a little bit about that journey. Before you raise your fees before you’ve started to take these lifts to implement. What were some of the fears you had about raising your fees?

Sandra 3:05
Um, I think I had some of the really standard fears that it was just sort of that I would lose all my clients and then have a hard time getting them back. But I also think I had, I was less afraid of that my money hangups were not the same as everybody else’s. I think a lot of people have those. I’ll be greedy. And people won’t respect me kind of for years, and I don’t have so much of that. But what I did have, I have a major disability, so I have multiple sclerosis. So a lot of my fears around money have a lot of if I’m not making money right now, when will I be making money? Because I’m not sure how long I’ll be able to be in practice. So a lot of my money hang ups have a lot to do with Oh, no, I have to make money right now. And then the other thing is that I come from a family that had you know, a decent amount of money, not crazy money. And my partner is in tech. So I have some hangups around sort of guilt and shame around sort of the privilege that I have, oh, that’s sort of where my other money hangups come from.

Tiffany 4:02
Very interesting. So what were some of the things and we’re gonna dive into the fact you have a disability, I think that’s really important for this work. And there are a lot of therapists who have different kinds of challenges that they actually often hold them back from making these changes. Whereas you actually said I need to make the changes because of it. We’ll dive into that later.

Sandra 4:22
I wish more therapists would think about the fact that they could become disabled when they’re doing their financial planning.

Tiffany 4:27
This is why I want to hear your your point you’re bringing the reality of what we don’t know we don’t know what’s gonna happen to us. And so your representation of like you can’t you don’t know what your life’s gonna be like five years you better start fucking making some changes now. Yep. So you were you were aware that you had some money hanging up to a little bit different than other people other therapists Yes. Was there anything you were surprised to learn like, holy smokes, I didn’t know that was looking back there. I didn’t know that was something that was holding me back.

Sandra 4:54
Honestly. I was kind of surprised to find out I had any money so Finding out that that was connected to the disability stuff was actually kind of shocking for me. Like I knew a little bit about the shame around the privilege, but not a ton about it. And so being in I mean, our limb group was really, really diverse. It was a really diverse group of people, and a lot of them came from not a lot of money. And so it was really shocking to me to see how I sort of measured up against other people. And there are many hang ups. But it was also really informative. So for me, I was sort of surprised to find out that those were my hang ups. And then also, it was surprising to me how much just having insight into them really made a big difference for me.

Tiffany 5:34
Interesting. So Well, let’s talk about that they had some of these fears, but you were able to overcome them, you had some of these shame or guilt things you were surprised to know about yourself, how were you able to overcome them to implement raising your feet even so? Well,

Sandra 5:48
I work with a lot of clients who are low fee, and not just low fee, but also low income. Even some of my clients were paying full fee or actually low income. And I think a lot of the work that we did in Lean and make bank had a lot of us had a lot of us questioning our assumptions about people. And one of my fundamental sort of clinical approaches, like I believe in holding on to the autonomy of my clients and believing that my clients are, you know, grown up capable people who are able to understand their own circumstances and make good choices in their own on their own behalf. And so extending that sort of clinical approach to the financial part of my practice was very, it was a natural fit. But it wasn’t something that had occurred to me before. So I think a lot of the insight that I got from lean and make bank really made a big difference in terms of how I changed my financial approach in my practice.

Tiffany 6:37
I want to highlight this, what you said is so important. And this is one of the reasons I wanted to have you because you have all these insights, you did very deep work in the program, you are talking about therapists often unknowingly infantilize their clients, I’m gonna low my lower my fee, because they can’t afford my feast, I need to take care of them, you’re actually talking about charging fees, you need to charge to be able to show up and do your work and empowering your clients to make a choice to take responsibility for whether that’s something they want to do or don’t want to do, and work with them to make that happen. As opposed to saying, let me take care of you and sacrifice myself.

Sandra 7:11
Absolutely. I also think a lot of my clients, a lot of them struggle with sort of limits and boundaries, and not so much that they have problems with interpersonal boundaries. But understanding that there are things in their lives that they have to work towards in ways that are not easy. And sometimes that can be really difficult for some of them to like, understand that it’s okay to want all of these things, it’s okay to want everything and to want it all to be easy. And that doesn’t mean that it’s going to happen that way. So working with my clients on this, I might not actually be a good fit for them all the time. My practice might not be ideal for them, they might be better off in a lower fee, practice or clinic somewhere. And so part of the work that I’m doing around raising my fees is working with my clients and saying, Maybe this isn’t a good fit for you. And what would it look like? If this wasn’t a good fit for you? What can we do to find a better fit for you? And how is that going to measure up with what you feel like you need right now?

Tiffany 8:06
This is great. So this brings us into this next question, what’s an example of a conversation you had with a client about raising fees that was difficult to go into? How did you tackle it? What resulted from it?

Sandra 8:16
I have a client who’s been at the pretty close to the bottom of my sliding scale the entire time, I live in Seattle, there’s a healthy tech community here. This was a client who worked in that kind of field. And it was a little frustrating for me for this client to be at the bottom of my sliding scale. And this client had a lot of issues going on in their life. And I really wanted to support them through this. And I kind of had this feeling like I’m not sure that I’m the best fit for this client. And so ultimately, I came to this client with my my fee increase and said, This is how things are going. And they were like, I can’t afford that. And I was like, Okay, well, if you can’t afford that, then I can find you a referral. Because I wasn’t going to bend on it. And ultimately, I have referred this client out. But what was interesting was we decided we were going to set an end date, it wasn’t an immediate end of therapy. And the therapy got so much deeper. immediately, as soon as we understood that there was an endpoint. And I know that happens with some clients regardless, but there’s a sense that, oh, therapy is anything now I have to really dig in. But I think part of this also had to do with this sense of, you know, let’s really dig on my end. Like for me, I really felt more responsible for doing the really good work and really digging in and doing hard work with this client, knowing that they were leaving, but also knowing that when I replaced them, I would be replacing them with a full fee client really interesting.

Tiffany 9:46
By raising your fees. It was also some way that you were invested more in showing up or had the capacity more to show up and do hard clinical work, maybe things you had been avoiding when the fee is low.

Sandra 9:56
I think both of those things are true. I think I was both sort of more obligated to show up like I was more invested in being there and really doing the work. But then I think there was also a part of me that was more freed to do that work, I was more liberated to do that work by the sense of like, okay, now I’ve stepped up, I’m doing this. And maybe I can take these chances. Maybe this is part of who I can be as a therapist now, because I think in my training, I think for most of us in our training, we start off really sort of hand holding, and we got taught like, we have to be really kind to our clients, we have to be really careful with our clients, we have to wrap them in cotton wool and be really careful. And I don’t think that’s actually really productive therapy a lot of time. So I think with this client, this client benefited from a lot more challenge, and a lot more sort of, you know, more directedness that I think I was afraid to engage with earlier because I was afraid of being like, but if I upset this client, then what, you know, I think I infantilized this client more when they were Loafie client. And then as soon as I recognized like, you know what, that’s not who I want to be as a therapist, it changed how I was in the room.

Tiffany 11:00
I love what you say, everywhere you go. And it’s fantastic. So I’m thinking about one of the things so in by raising your fee, you are you also to get clear about your niche, or niche niching down narrowing down getting clear about that. So let’s talk a little bit about that. Because that’s something therapists often struggle with, or they think, if I raise my fees, then what nobody’s gonna come see me anymore, you really leaned in and solve this problem in an interesting way. So let’s talk about it.

Sandra 11:23
Well, I started off kind of having an idea. Like when I first went to grad school, I was like, You know what I want to do, I want to be a therapist. And I actually want to be a therapist who specializes with the LGBTQ community. Like I knew that going into grad school that that was really where I wanted to live. And then that kind of crystallized and got even more clear over time. And now that I’ve raised my fees, I’m actually going to have to dig down even further and make it even more specific than that. I live in Seattle, as I’ve said, I think in most cities, I would have what is considered a very, very small niche, which is that right now I have, I work with LGBTQ clients, trans and non binary clients, the polyamorous and kink communities, the furry community, and I work with sex workers. And then in addition to that, I also work with people who are chronically ill. And that seems fairly specific. In Seattle, there are really, really a lot like there are probably dozens of us who work with these communities. Uh, huh. Dozens. So I’m thinking of actually making it even more specific, I’m thinking of drilling down a little bit more and saying, specifically people who tend to be really cognitive, which, on the one side, I mean, tech people. So that’s good on a business side. But also, I actually my partner is in tech, a lot of my friends are in tech, so I’m very sort of dialed in to the tech community in Seattle. So I think it’s actually a really good fit for me, because I do tend to work really well. Because I myself tend to be a more cognitive person. And I, you know, emotions are uncomfortable, and I don’t like them. And so a lot of my specialties have to do with body comfort, and getting past body alienation. And so I think incorporating that into like, Okay, you’re a trans or non binary person, you’re a queer or poly person. And there are parts and a lot of these people are trauma survivors. And so taking these things and saying, and how do you live in your body? How do you experience the world via this vessel that you are in? And so drilling down even further and saying, Okay, you’re a cognitive person who has all of these same problems.

Tiffany 13:23
super interesting. So it sounds like raising your feet has actually required you to narrow even further. Yeah, how has your practice changed now that you’re charging more premium fees?

Sandra 13:36
Um, well, I’m still it’s in process. But I think I continue to be more committed to my practice, really, I think I mean, I’m committed to the, to the work in, I mean, I always was, but in this way, I’m suddenly feeling more like I really want to be more on the ball, I really want to be more willing to dig in and do the hard work in the therapy sessions. Which means if I want to do those sessions like that, I want to scale back how many clients I’m seeing, which means I need to raise my fees even more. But it does mean that I’m doing really good work a lot of the time, not not 100% of the time, I’m still a human. But I think I spend a lot of time being really concerned about not only the the clinical side, but also the professional side. And so I’m really trying to get, you know, my finances together, I’m trying to get my paperwork together, I’m trying to get all of these things, you know, like, all of those sort of running a business entrepreneur side things, which I never thought I was terrible at. But at this point, I’m like, You know what, there’s all these ways that I can get this together even further. And so I’m, I’m going to be consulting this week with Francis from my solution services. So I’m going to be doing some looking into like, How can I outsource some of these things? How can I make my practice run itself more smoothly, so that I can really focus on the clinical side of things. But I’m really excited about the business side all of a sudden too.

Tiffany 14:57
Interesting. So we’re gonna just jump into the deep dive and incorporate some Are these other questions, but I want to get in there now, because I’m noticing, as you’re talking about yourself who you are now and how you’re thinking about your professional self now, as compared to back when your fee was 100, or $25, there is a way almost, I’m seeing this parallel process, you started saying, oh, I need to challenge my clients to step up more, as you also challenging yourself to step up more. And I’m wondering if you also noticing something around when you actually said, I’m going to do this charge these fees? I’m going to take care of myself. If you notice a change in your clinical work.

Sandra 15:31
Almost immediately. Yeah, no, I mean, honestly, it was, I think it was on your second or third week in Lina MC bank, when you started talking about the clinical side of things, and immediately it just clicked.

Tiffany 15:42
Oh, well, for people who are like, I don’t know what your you guys even talking about what clicked?

Sandra 15:48
I think one of the big lessons I learned early on in Lean In.MAKE BANK. was this idea that the financial side of our practice, our business side of our practice, is so present in the room all the time. And that wasn’t something that was ever anywhere in my training, like at all. And so I think the idea that my resentment about my sliding scale clients was in the room. And I mean, I love my clients, the reason that I chose my niche that I chose was because those were the clients that energize me, the clients that I love working with, and that’s I think, honestly, a foolproof way to choose your niche, is find what you love to do. And what energizes you to do and then do that, because that’s great. But so that’s what I was doing. But then, I think noticing the ways that money was in the room already, and then articulating that created a lot of depth in the work. And that happened so fast. And it was so important that we went into that. And that was something that I didn’t actually expect, I really thought that Lena make bank was going to be very much about sort of the the business side of things, I thought it was going to be like, here’s how to get your finances in order. And I was like, I guess I have to take that. But then I was so taken with the class because there was so much of the clinical material there. And that was really engaging for me in a way that I was not expecting at all.

Tiffany 17:03
And you definitely for folks who are listening, Sandra just dived in, it was so cool to see how you worked and thought about your clients and thought about yourself and really went deep with the work, which not everyone does, or has to but you definitely did. And the growth was immense.

Sandra 17:17
Yeah, and I think we had a really great community was part of it, our cohort was, was really willing to support each other and doing that kind of work. So that was pretty great.

Tiffany 17:27
I want to come back to something I’m going to, I’m going to challenge you on this or not challenge you but pick your brain because it’s something that I hear from therapists a lot. And I really, I think you’re going to be have some insights about this. And I don’t even know how to think about, you’re talking about wanting to serve a particular community, LGBTQ community, queer community, trans community, for a community even and then also, but also behind this kind of an underlay of trauma. And also people with disability. So often, when I hear therapists who don’t raise your fees, or have put this in quotes for people just listening excuses why they don’t raise their fees, they say, because I work with people with disabilities. And so they have to, I have to have a lower fee, or because I work with people in the LGBT community. So therefore, or people of color, I have to lower my fee. And you’re actually saying something completely different than that. Can you talk about how you will respond to folks who say, I have to lower my feet because I work with trauma.

Sandra 18:22
Um, I think that trauma is everywhere. i The more that I have been trained in trauma, the more that I see that trauma is fairly ubiquitous. So I don’t think that all trauma survivors are living in poverty, I think there’s a lot of trauma and people who are living in poverty, definitely. But I also don’t think those are the only people experiencing trauma. In fact, I just got my fully fi client, and this is somebody who is clearly has an enormous, huge trauma background. And is honestly the closest I’ve had for the last couple of years to the clients that I used to have when I was in community mental health, in terms of sort of how that presents for her, then, honestly, it doesn’t make a difference that she has money, it doesn’t change her experience of her trauma significantly. Same thing with I’ve trans clients who work in the tech industry and are doing okay for themselves. And their experience as a trans person is different from those of trans people who are living in poverty, certainly, but they are still trans people, and they are still experiencing that kind of body alienation. They’ve still experienced trauma significantly. So I don’t think I think we sometimes have assumptions about those groups and that population. But the fact of the matter is, there are plenty of people who are trans who are making money, there are plenty of people who are trauma survivors who are making money. And I’m not saying we shouldn’t do that I’m keeping a couple of sliding scale spots specifically because I do want to be able to make a difference for these communities and not just for the members, these communities are making a ton of money. But it’s very much that I want to be able to support the members of those communities while also supporting myself because if I’m working with people that disagree Woody, I’m working with myself also, right? Like I have to inhabit this space. And I want to encourage my disabled clients and my clients with chronic illnesses to take care of themselves in the ways that they need to. And part of that is modeling me prioritizing myself.

Tiffany 20:12
Absolutely. I love that there’s so many therapists who are, you know, saying 30 client hours a week and don’t have time for their families and stressed out, and yet they’re showing up theoretically trying to help their clients have a different kind of life. Meanwhile, they’re unable to do it for themselves. So you’re talking about not only figuring out what you need for yourself, but also modeling that for your clients as you’re doing it for yourself. And you’re also not making assumptions that it’s such a strange way to think about it. A lot of therapists who are social justice minded, really want to help diverse communities, they make assumptions about what that means in terms of what diversity can afford. And then they lower their fees as if there are no people of color or people with disabilities or people in the LGBTQ community, who can also afford and are willing to invest in changing their lives and doing it with therapists.

Sandra 20:58
Also, I find that with a lot of my clients, when I’m modeling this kind of thing, even when I was in community mental health, I saw a lot of my clients move in a really upwardly mobile kind of way, a lot of the clients that I was working with at least two or three of them went on to go to grad school. While I was seeing them. I said, I saw a lot of my clients in community mental health, move towards really bettering their circumstances and making a lot more money. And I think that that’s kind of fantastic. I love seeing that happen. And if that happens with my Lo Fi clients, then they become fulfilled clients. Great. That’s fantastic. But I mean, it’s fantastic for both of us. And, you know, when I’m dealing with sort of the discomfort and weirdness and emptiness, of moving towards making my life something that I can occupy and be comfortable in and move towards something that meets my needs. You know, I can bring that to my sessions with my clients, I can bring that sense of like, what am I doing to take care of myself, and how am I not taking care of myself, and I can see how uncomfortable it is to need more than I have. You know, and that’s something that my clients and I can relate to together. And that has a kind of authenticity in the room.

Tiffany 22:06
Say something more about this, this, I guess you use a couple of words to describe this growth, this growing part of needing more than you currently have tell us a little more about that feeling.

Sandra 22:17
So one of the things that I do that’s unique in my practice, is that I have very, very strict policies about not coming in sick. And that’s because I’m actually on immune suppressant drugs as part of my condition. So I really get sick very easily, and it hits me really hard. So one of the things that I need to do is set a really hard edge about that. And with my other chronic illness clients, they understand that a lot and my clients who aren’t, who don’t have chronic illness, they still understand it. And so we sort of walk along this edge of, you need to ask for what you need from people, and you need to know what you need in order to ask for it. And so I’m able to take some of that the discomfort of saying like I don’t like not wanting to see my clients, I don’t like having my clients show up sick and me saying like, you’re sick, I need you to go home, which is something that I actually do, I don’t really care for that I would prefer to be, you know, being rude, good health all the time, that would be great. I would love that. But unfortunately, that’s not where I live. And so there’s a kind of grief that comes with having a major disability and having a major chronic illness. And when I’m sort of stuck in this, like, I need to make things work for me because the world isn’t going to change to make my life easier. I need to make my life better by doing what I can do. So I think all of my clients on some level relate to that. This idea that it’s unfair, and it sucks that the world is the way that it is. And we need to do what we can do in our lives and take control and use our autonomy in the ways that benefit us.

Tiffany 23:48
I love that very empowered and empowering to hear that kind of message. Let me ask you. Earlier, I tagged this, this word you used liberating liberation. If something felt liberating about going through this process. Can you talk a little bit more about that?

Sandra 24:06
I think it has a lot to do with the ways that we’re taught to relate to clients. I think in our field we have a lot of hangups have to do with our profession as a whole. And so one of those things is that we’re not supposed to make money. One of those other things is that we’re really supposed to infantilize our clients, I don’t think we realize that that’s what we’re supposed to be doing. But I think that’s the subtext of a lot of our learning in our in our training programs, is that you know, what, if you think about like, for instance, our ethics, our professional ethics are really built around this idea of we have to watch out for everything for our clients, because they’re incapable of really understanding the power dynamic that’s happening between us. They’re incapable of really understanding the implications of things that might happen. And I don’t think that’s necessarily true. I think it’s important that we watch out for our clients. I think having professional ethics are important. But I think we also need to have a conversation about how our conversations about ethics, impact how we’re thinking about our clients and and whether or not we’re infantilizing our clients. So for instance, I’ve worked with a lot of clients who’ve had active suicidality. And I know a lot of people are really terrified to work with clients with active suicidality. And I don’t think I find it as terrifying as other people do. Because on some level, I understand that there’s a point where I don’t have any control over my clients, they have control over themselves. And so when I have clients who are actively suicidal, I say, Listen, I care about you, I would miss you. If you were not here. And I want to see you next week, can you please come back next week. But you know, do what you can to take care of yourself in between, but I can’t keep you from hurting yourself, if you decide that that’s what you want to do. And I think that on some level, my clients respect that, I understand that they’re in charge of themselves. No, I can’t be mommy to my clients, I don’t really want to be honestly. So it’s very liberating in some ways to think about the financial side of things. Because it’s another way of really digging into the idea of my clients having their own autonomy. And when I think of my clients having their own autonomy, it’s actually really enriching. For me, it’s empowering for me to empower them in that way, the more that I can think of my clients as being capable of making meaningful change in their lives. Because when they can make meaningful change in their lives, and they don’t feel it’s stuck, and I don’t feel as stuck being with them when they’re stuck. That’s right.

Tiffany 26:14
That’s right, you’re making me think about, we’re dropping deep into this, folks. One of the things we talked about with Lena and Meg bank is the reality of our limitations, and ultimately, realities of death. You know, and I think a lot of therapists are, you talked about mourning particular losses, a lot of therapists do all kinds of bending over backwards to deny the reality of loss. So a client is sick and cancels or their kid is sick or something, you know, a therapist won’t enforce their cancellation policy because they feel bad for their client, or therapists will maybe wave a fear lower fee without being paying attention to the reality of their real needs. And they can kind of put it off or put it in the background, which is a denial of it’s doing the opposite of what you’re saying. It’s not letting clients actually come up against reality morning, and you’d be there with them. And you work with them to understand what it means to mourn a loss. So you had made a comment earlier on in our interview about something about frustration with people who were what was that called? You don’t I’m talking about?

Sandra 27:19
I do, I was talking about being frustrated with my clients on the sliding scale. And I think this mostly hit me, this is a client who I no longer see and who I still have a great deal of affection for. But this client, I have been saving up to buy a house, I finally bought a house this year, almost 40. But I’ve been saving up for like 20 years to do this. And my client who was paying the lowest spot on my sliding scale, bought a condo. I’m very happy for this person. I’m glad that they were able to do this. And it was jarring for me personally, and a little frustrating for me. And I think part of what’s been really liberating about this process has been being able to own the fact that I do sometimes have resentment for my clients, which is another thing that we’re really not supposed to say. But I think the more that we can own what we’re not supposed to say and just be humans in the room with other humans, the more we’re authentic in our work. And I think authenticity is like one of the number one things that our clients are looking for. In order to be trustworthy, we have to be authentic. And so I think the more that I can recognize the ways that there are ugly things in the room, and I’m not just a kindergarten teacher, I’m not just giving you cookies and patting your head, you know, the more that I can be with some of the the uncomfortable stuff that’s going on between us, you know, that process stuff, the more I’m able to do really good work. But also the more that my clients are able to know me as a person. And the more than my clients are able to know me as a person and see the authentic parts of me where I’m doing uncomfortable things in the room, you know, and where we can connect. So I mean, sometimes I fuck up. And I’ll say like, oh, sorry, I fucked that up. And lets you know, and I’ll apologize or we’ll have that conversation. But it’s so much more liberating to do that than to feel like I have to always be perfect.

Tiffany 29:14
One of the things we talked about in the program, and one of the things you’re really good at is this thing around, not having to be the good guy who’s always taking care of others. But also having a sense of it’s not a zero sum game, the more you’re able to take care of yourself. The more your clients you can share and your clients wins, but also face the difficult times with them as well, because you’re on the same road challenging yourself to grow even as they are.

Sandra 29:40
No, I definitely agree. I think that a lot of the ways that I’m more present with my clients now than I was before. I think I’m more willing to be courageous in those ways. And courage is what I want from my clients in this work. I really want my clients to be courageous and to be willing to really do Take chances and to be with me in ways that are uncomfortable and scary for them. And that requires me to be with them in ways that are uncomfortable and scary for me, sometimes you have to go first. Yeah. And you I mean, you mentioned specifically like death anxiety. I’m an existential therapist, that’s part of what I do so. So I mean, I, I’m a big believer in going to the uncomfortable places. But even when you theoretically believe in it, it can still be really hard to do it in the room, and like, just really go there. And so having the community from Lehman make bank and really having a strong community of colleagues who support you, and not just in the kind of lip service, the kind of way that we sometimes get in our fields. Having that is really helpful in terms of being more willing to be more courageous and take more chances, which I think makes me a much better therapist. So

Tiffany 30:51
I want to know, let’s say we have somebody who is charging $100 an hour, they’ve listened to this conversation, they feel like, Oh, I do want to raise my fees, I feel like it’s important. That’s what I was gonna say. My the lie of leading big bank is the marketing thing I say is you’re gonna make more money on the other side, then you may come in, that’s actually true. But really, what we’re talking about is money as a symbol of limitations, death, reality, aggression. And if you can go into a conversation with your client about these things, or even face it within yourself and make a concrete change, you’re forced to have this kind of conversation, that most human beings avoid period, much less therapists were the people who are supposed to be able to have the most difficult conversations. And yet therapists avoid it and play the nice guy and lower their fees so as not to hurt their clients feelings, thereby missing a whole world of existential conversation that people humans need to be having and desperately want to be having, but don’t know how to have.

Sandra 31:51
Absolutely, I also think that sometimes when we’re lowering our fees and lowering our fees, we’re really doing our clients a huge disservice when we bend over backwards, and we allow our clients to cancel on us with no consequences. When we do these things. We’re not teaching our clients, we’re not giving our clients an opportunity to really experience what impact they’re having on other people. And that’s critical. You know, we need to know how we’re impacting other people, we need to know how other people are experiencing us because that’s, we’re social animals, we know we have to do that. So I think that it’s vitally important that we, you know, first of all, don’t do that disservice to our clients, by failing to do that. But then I also think they really do want to have these these deep existential conversations. They do want to have a place where they can unpack stuff. And I think a lot of the reasons that people do some really screwed up stuff, is because they have a lot of pain that they’re carrying around. And they don’t know what to do with it. And it doesn’t seem like it makes sense to them. I think a lot of people want to figure out who to blame so that they have a reason for the pain that they’re feeling. And sometimes pain is just the human condition. Yes. Sometimes we’re just in pain and stuff sucks. And if we can have a space where it’s okay to feel really shitty, even if there’s not a reason for it,

Tiffany 33:07
Yeah, yeah, it makes me think this idea of therapists lowering our fees, or not enforcing cancellation policies or bending over backwards, it’s, it’s buying into a fantasy that there are things in life, there are not things that just suck, and you’re saying the reality of some things just suck and no amount of mowing your feet or not enforcing a policy or bending over backwards, will take away the reality of death, the reality that life ends and that things suck at times.

Sandra 33:32
And I think a lot of therapists want to fix their clients, they want to fix things for their clients and make their lives better. And I don’t care how many times I lower my fee, their life isn’t immediately gonna get better. My clients lives are better because they’re paying $25 a session instead of $50 a session that doesn’t change the things that are causing real damage.

Tiffany 33:51
Such a great companies, I’ve kept you over to become more and more and more so. So my final question, final question. So we have someone who’s who whose fees are $100. They know they want to raise them, they know it’s time but they’re afraid to do it. What is one concrete, either strategic action steps they could take, or mindset, reframe, or shift you could offer them that would help this therapist shift from I’m gonna lose all my clients, I feel guilty, I’m hurting others to some other way of thinking that allows them to raise their fee.

Sandra 34:21
Well, unless they’re practicing it like McMurdo Station, they’re not the only therapist around. So I think that’s always good to keep in mind that you’re a good therapist fit for your a good therapeutic fit for some people, but not for everybody. And you don’t have to be the perfect therapeutic fit for everybody. There’s not only five clients in your area, there never will be. And you’re not the only therapist in your area. Probably keep in mind teletherapy as a thing. There are other options that people have. So if you raise your fees and people can’t see you anymore, that’s not really the end of the world. It might feel like it is but it’s probably not. So I think that’s really important. And then the other thing is, I think in the might have been your other question, sorry. But I think when people talk about their niches they’re afraid to like sort of narrow down. Because they’re afraid of alienating people. I’ve never had that problem I have people call me who aren’t part of my niche all the time. So there’s that. But also, I think that the more narrow Daniel are, the more people see what they’re looking for. So I mean, when’s the last time you bought, you know, groceries or a mattress or shoes? You know, you don’t go in just being like, well, they should go on my feet. And that’s about it. Right? Like, that’s, that’s not what you’re thinking, you have some idea of what you want. And the more you can see that this thing is the thing that you want, the more likely you are to buy that specific thing. And pay for it. Absolutely. And the more you’re willing to pay for it. Yeah. So you know, I think I read so many Psychology Today, profiles, they’re like, Are you in pain sometimes? Do you have trouble with your family? Is your career discouraging? And I’m like, yes, these people are human, obviously, all of those things apply. But that also doesn’t say anything to people. And so I am done with those frickin conversational questions. I’m done with them. I’m sick of them. I want people to have declarative statements, tell me who you are. And then I’ll know if you’re the person I’m looking for. You don’t need to tell me about me. I know about me. That’s fantastic. So my Psychology Today program or profile starts with something like I work with sexual and gender outsiders. Great. And that’s like how I start. It’s very specific. And I think that’s probably why I have such a good response. Right?

Tiffany 36:30
So I know that there are people who are listening to you today who are inspired by you today who are who want to know, like, can I how do I check out where this person is? What do they look like in the online world? You have a website of some some where people can go to read more, but do not actually do this. Have a website and like I don’t yet know I’m working on it. Amazing. But you have a lot of Psychology Today.

Sandra 36:52
I do. I have a Psychology Today profile. I’m on there, as Sandra Seaman and Seattle. I’m also it might be under as barefoot psychotherapy, which is the name of my practice.

Tiffany 37:00
This is fantastic. So you fees to a very high premium fee, you set clear boundaries, and you don’t even have a website, you know, this is I think this is so important, because so many therapists are like, well, I can’t do anything until XYZ all these things are in place. And all those things are just distractions from actually doing the thing, putting yourself out there making bank.


More about Sandra

Sandra Seaman is a psychotherapist working in Seattle, WA, working with the LGBTQ, Poly, Kink, and Sex Worker communities, and has an additional clinical focus on individuals with chronic illness. She works from an Existential-Feminist perspective. She hopes one day to publish her many, many books relevant to her clinical interests, now taking up far too much space in her brain. This year she is getting a humongous dog and is extremely excited.

Most popular episodes

How Getting Real About Her Financial Reality Led Audrey To Charge $200 Dollars Per Session

From $80/session to $210/session in less than a year

How a $15,000 Dollar Reality Check Led Erica To Drop Insurance Panels

How Susannah Started Private Practice And Became The Primary Breadwinner

How Vanessa Went From Charging $85 Per Client To $250 Premium Fees Per Session

About the podcast

The Money Sessions podcast by Tiffany McLain, LMFT is full of deep, thoughtful, and sometimes raw conversations with real therapists who are in the midst of leaning into raising fees and making bank – all while working with the clients they are passionate about serving.

Enjoyed the show?
Click here to leave us a review!

Tune in to all episodes

Set your fee the right way

Get access to “The Fun with Fees Calculator”

What if you could take the guilt, shame, and anguish out of setting your therapy or social work private practice fees? Use our proven formula to charge exactly what you need in your current season of life and business.

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