024: The Ethics of Therapy Pricing: Money Roundup and July Previews

July 1, 2024
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Today, we’re going to do a quick recap of June and give you a sneak peek of what’s coming in July. Last month, we dove deep into the topic of money. We explored money scripts, how therapists can move from money shame and financial burnout to awareness. If you missed it, definitely go back and check out episode 22—it’s full of great insights!

Key Highlights from June

  • Money Scripts: In episode 22, we discussed how therapists can overcome money shame and financial burnout. This sparked a lively discussion on LinkedIn—if you’re not connected with me there, come find me! I post a lot of content there, and I’d love to chat with you. Just look up Jennifer Blanchett, licensed psychologist, host of the Therapist Burnout podcast.
  • Therapists Judging Each Other: We also talked about how tough it can be out there in the therapy community. I shared a story about raising my fees during the pandemic and the backlash that came from some fellow therapists. It’s a reminder that we need to support each other and not tear each other down, especially when it comes to financial decisions.
  • Ethical Principles: We touched on the ethical principles of social workers and psychologists, emphasizing that while we should strive to help others, there’s no enforceable rule that says we must take low fees or accept insurance. It’s about finding a balance that allows us to provide some pro bono services while also making a living.

Upcoming in July

  • Therapist Burnout Deep Dive: I’m excited (and a little nervous) to finally tackle a mega episode on therapist burnout. This has been on my mind for a while, and I want to break it down into three key points to avoid overwhelming you. We’ll look at why so many therapists are burning out, with a focus on administrative burdens and other contributing factors.
  • LinkedIn Conversations: Our discussions on LinkedIn have been so rich and engaging. We’ve talked about the undervaluation of mental health work, the financial challenges therapists face, and the sacrifices we make early in our careers. If you haven’t joined the conversation, now’s the time!

Looking Ahead to August

  • Self-Care: In August, we’ll dive into the concept of self-care, backed by research. I’m also planning to discuss the idea of “weaponized self-care”—the notion that if we just take more bubble baths or breaks, we can avoid burnout. Spoiler: it’s not that simple. We’ll explore realistic, research-backed ways to care for ourselves and prevent burnout.

Stay Connected

  • LinkedIn: I’m very active on LinkedIn, and it’s a great place to continue the conversation. Find me under Jennifer Blanchette, with two t’s and an e.
  • Consult Calls: If you’re feeling stuck in your career, whether you’re considering starting a private practice, need help with burnout, or are thinking of leaving therapy for a while, I’m here to support you. Book your Career Refresh consult call to figure out the first steps in making a change here

Email me: info@drjenblanchette.com

More from Jen: Grab my free guide for therapists who are done with 1:1 therapy here!

Links to my free 20-minute consult, and the rest of my free stuff: 


Speaker A: Welcome to the Therapist Burnout podcast, episode number 24. Hey, therapist, welcome back to the program. Today I’m talking with you, a little bit of a recap from June, as well as previewing what I’m talking about in July. So if you’ve listened to the podcast in June, you know, I did a money focus. And so I talked a little bit about money scripts. Go back to that episode. It is really, really great. And so in episode 22, I talked a little bit about therapist money scripts, how therapists can move from money shame in financial burnout to awareness. And I really liked the discussion that we had on LinkedIn. So that’s where I post, by the way. So if you are on LinkedIn, come find me. I’m Jennifer Blanchette’s id, licensed psychologist, host of the therapist word on podcast. That’s me. So you can find me. That’s Jennifer Blanchette. That’s with two t’s and a e. Find me there. I’d love to talk with you. So I posted from that episode, and my hook was kind of from a discussion that I had with Felicia, the bad therapist. But I think I just have these things that hang in my mind, these sayings. And so I start out by saying in this post, it’s hard out there in those therapy streets. Y’all, let’s talk for a minute about therapists judging each other. If you’ve been around Facebook at all in therapists groups, you know exactly what I’m talking about. And it boils my blood. I have to get southern when I talk about boiling my blood because I just don’t know why therapists are so nasty to each other. I don’t understand it. So in the pandemic, I raised my fees when I was still in private practice at the time. And I remember all the mind drama I had about that, about what are people going to think? What are my clients going to say? What’s going to happen? And I think that fear was realized when I would be scrolling in some of these Facebook groups and certain therapists would make comments about it was so inappropriate for me to, not me specifically, for a therapist to charge exorbitant, quote unquote exorbitant fees for their services. And, you know, one particular therapist who’s actually local to me came into my mind when I thought about this. And so what I said was, here I was in a local therapist group just scrolling where a therapist was advertising their practice. Okay? They’re just like, hey, I am Sally therapist, and I’m advertising that. I’m taking on these types of clients. You know, here we go. This other therapist, totally unsolicited, commented and told them they shouldn’t be charging the rate they were charging, and it was their duty as a social worker, and I’m not sure if that person was a social worker. The person making the comment was a social worker, that it was their ethical imperative to accept insurance for accessibility. My question is, when did we receive the message that we had to accept insurance and low fees as part of our ethical imperative? And so I kind of, you know, wanted to put a pin in that and think about answering that question. So I’m referencing the national Social workers code of ethics summary of major principles. So in their ethical principles, they’re based on the core values of social service, social justice, dignity, and worth of the person. And so these are ideals which all social workers should aspire. So these are not enforceable ethical imperatives, okay? These are ideals to which we should aspire. Okay? So this value is service. Ethical principle. Social workers primary goal is to help people in need and to address social problems. Social workers elevate service to others above self interest. Social workers draw on their knowledge, values, and skills to help people to address social problems. Social workers are encouraged to volunteer some portion of their professional skills, with no exception of. With no expectation, excuse me, of significant financial return. Pro bono service, okay? It doesn’t say what proportion of service should be pro bono. It doesn’t say that we have to take low fee insurance. Nothing of that nature. I’m with that. I’m with that. So I also pulled the ethical principles for psychologists because I’m a psychologist, and we have principle B, fidelity and responsibility. This is not our enforceable standards, by the way. So this is aspirational. And so I think we need to think about how we can aspire to do this. So principle B is fidelity and responsibility. So part of that principle is that psychologists strive to contribute a portion of their professional time for little or no compensation or personal advantage. So I think we also need to think about what services we might provide as part of that professional time. So for me, this podcast, I benefit very little financially from it currently, and I really do see it as a service that I’m providing as part of my time, my professional time, to provide education, education support to other therapists. So you might consider any educational opportunities you’re providing to your community. And in the past, I provided free consultation to my church, for example. So that is a free consultation service that I provided. I didn’t really think I’m like, okay, I’m providing this free consultation service to this church, but that’s something that I do. I also volunteered my time in a recent crisis that we had here in the state of Maine, where we had a mass shooting. And so I would have you think about what you’re actually doing, because you may be volunteering your time, and that’s part of those services you’re providing that are free or low cost to other people. It doesn’t necessarily have to be the individual therapy hour either. Maybe you consider a group program or a. A limited time program with someone. I think I’ve seen another therapist where they offered a eight week program to some people, or they offer, like, six sessions, for example, at reduced cost or a low fee. I think the trouble we can get in if we have certain slots where we just have, like, an undetermined amount of time where we’re saying, like, okay, you can have this free session or reduced fee session, and it’s in. There’s no end date on that. Right. I think that can set us up for some financial difficulties. So we have to think and look at our math. Say, is this something I can really do, and in what capacity can I really do it? So just have you think about all of that. Anyways, that was a little bit of a rant, but it had me think about our ethical imperative for our profession. I didn’t look up all the ethical codes, but that’s two of those, mine and social works. So I shared during the pandemic anthem, decided not to pay me for six months. They were my largest payer at the time when I was in private practice. And the games they were playing with the dying claims over the course of a year led me to drop the panel and ultimately stop taking insurance. It was part of my decision to close my practice. I had to dedicate ten to 15 hours per month of another employee’s time to call them, bill them, and handle rejected claims. And instead of playing the game, I got out. And a lot of people resonated with my statement. And I recently saw maybe I even have this tab. So many **** tabs open. I do have the tab open. Yay. So in, I’ve quoted this before, so it’s simple practices 2023 survey on therapists are burning out. And here’s why, what the impact is and how to help in that survey results. The 2023 State of therapist wellbeing report they talked about. Over half of mental health professionals report experiencing burnout, and they talked about some of the reasons I’ll go over. So I’m going to do a therapist burnout deep dive in the month of July. So I’m going to have like a mega therapist burnout episode, which I’ve been wanting to do for nearly a year. But honestly, it just felt so big and I couldn’t get my brain around what do I want to talk about? How do I want to talk about burnout for therapists? I know the name of this podcast is the Therapist Burnout podcast, but they just, it just felt to me like so much. And for me to get my ideas around how I conceptualize it now, I think took some time. This is my version of therapist Burnout, the talk. This is the 1.0, right? This is the 1.0 talk. And I had to tell myself that you can put it out there. You are not needing to uncover every stone in this episode. In fact, it’s better if you don’t because I’ve really found out in podcasting that simple is better. And I thought the opposite was true because in our training, we present all of the research all of the time. So we really try to, you know, provide a fast overview of the research that’s overwhelming to a lot of brains. So I’m trying to think of like three points that I really want to take, have you take away from my talk on burnout that’s upcoming. So the reasons contributing to therapists feeling burnout one of the top reasons, like number two. So one of the top reasons contributing to therapists feeling burnout was the administrative burdens of running a practice. Over 55% of us say said that that was one of the things. There’s other ones, I’ll wait till they burnout episode to present that. But I was really shocked by that. That was one of the biggest contributors contributors to burnouthen. Okay, going back to that post, I get just a riff off of this post forever. Anyway, so instead of playing the game, I got out and I’d have to say that I found that it was hard for me to want to have a practice where I didn’t accept insurance because I felt I was doing something wrong, that I was being quote unquote mean by not accepting insurance or not being accessible if I’m being honest. And that goes right along with this post. There’s a pervasive stigma that financially successful therapists are quote unquote bad. The stigma is perpetuated within our professional circles, where therapists often judge each other for charging higher fees, even if it’s that one therapist, Sally Jones therapist in our mind, who we think is going to have a problem with that. We forget just how much we’re socialized to believe that our fees shouldn’t be high and that it’s important we’re accessible to all. So check out that post on not Instagram. I don’t post on Instagram anymore. Oh, my gosh, Jen. LinkedIn. I like the vibe on LinkedIn, too. I mean, I feel like it’s. There’s less trolls so far. There’s less people. There are people trying to sell stuff, you know, that’s there. I just think that’s the Internet. Right? But the way I operate my LinkedIn profile is that, you know, I had some people, you know, making inappropriate comment. Like, I just block and delete. Like, it’s like ******* on my lawn. Like, I just have zero time for that. I just don’t, you know, it’s my page. You’re going to **** on my lawn? You got to get out. Just gotta go. Not dealing with it anyways, so previewing that was a little overview. I didn’t give the whole overview. That’s okay. Find me on LinkedIn to see the conversations that we had. That was one of my favorite conversations we had. We also had another great one, if I can find it. Oh, yeah. So also, love the way I started this one out. So I started my career in 2001, making $7 an hour at a residential treatment center. That experience taught me a lot about the undervaluation of mental health work. I didn’t think for a minute at 21, in my junior year of college about asking for more. In fact, I spent the next nearly 20 years making less than I needed. Will not even get into what I wanted. And so I also, when we think of this money discussion, we also have to think about the sacrifices that we’ve had to give in order to be where we are in our careers. And that was in some of the comments of this particular post, is that therapists were talking about what about all those years where I spent not making really any money at all? So for me, you know, my first year providing services was in my school’s clinic. And again, I feel like that was a great training experience. I didn’t have a really any qualms about doing that. I think it was the next two years where, yeah, my services were billed kind of at full rates and for testing for a psychologist, we can kind of do the grunt work of doing the test administration, and then a senior level psychologist can supervise us writing that report. Really, I did everything start to finish when I was on my externship. I don’t even know what they call them anymore anyway. So, you know, I spent a good three years working, providing services at no fee or very, very low fee, like minimum wage. I think my. My internship stipend was 15k for a whole year of work, where I expected to have around 25 clinical hours for communal, in a community mental health internship. If we spent many years of our career making low to no fees, we have to think about the financial implications of the trajectory of our life as I’m now solidly in midlife. Welcome. Pandemic. You’re in midlife. I have to think about my financial trajectory and what goals that I have to meet to make sure I’m set up now in retirement, because I don’t want to work past 60, really? I might have to work to 65, but I don’t want to work beyond that. I just don’t. So I think we have to really think about the sacrifices early in our careers and that all of the work we provided for, low cost or no cost, early in our careers and why we might need to make more now. And that’s completely okay. And we could still look to providing those pro bono services, those low cost ways, doing something like a talk, doing something like this where you’re hosting, I’m not telling you to have a podcast because that’s a whole lot of work. If you have a question about podcasting, however, I’m open to that. Certainly reach out to me. I’ve been podcasting almost three years now, which is crazy. I had a podcast before this, um, on my other. On my. On my niche when I was in private practice. I’m a certified brain injury professional, and so I had. My practice was focused on folks after a brain injury. So, yeah, so certainly talking about that niche, you know, not many people are therapists who work with people with brain injuries. So I provided a lot of education in that area, and I want to continue to bring that into the podcast. So I do have a little, you know, some ideas about bringing in some clinical topics that we may not be exposed to. So I think that would be great to know. What do you want to know about? I think some of my clinical expertise currently is providing risk assessments. So that’s what I do. You know, when I’m not doing, when I’m not podcasting, I do psychological assessment and risk assessment. I just. I don’t think we have that training and suicide risk assessment as therapists. At least no one gave it to me. It wasn’t class. And I just don’t understand why we don’t get that training. So I think I’d really like to provide some education on the podcast regarding that, because it’s an area of stress and burnout when we have clients facing those issues. Yeah, that was another great thread where we had a lot of people commenting just on, really, the value of our work. I’ve said this a bunch of times, but your worth is infinite. Your services have value, and the true worth of your services as a therapist, we cannot put a number on. Okay. I think about my son having heart surgery. I might have said this before on the podcast, but the worth of that surgeon doing a corrective surgery on my son’s heart so he could live is infinite. I have a child who has a normal childhood now. I can’t put a monetary value on that. It had a monetary value that was like 50k. Okay, maybe it was 40. I don’t remember at the time. It was over ten years ago. And, yeah, I mean, I looked at it and I was like, that’s a lot of money. I guess that’s what saving a life costs. That’s what we do, though. We save lives. And I think, you know, to view as, like, okay, like surgery, 40k therapy, a lot less, even though we provide life saving treatment. And it’s apples and oranges. But I think it goes into the valuation of the work that we do versus the work that a surgeon does. For example, both of the worth of each service is infinite. The value is based on something historical. So it’s the valuation that our society puts on caring professions. And I think I just need to do a whole podcast on that. I’m writing that down right now. I had some comments, so. Brandon Grill. Grill, is that your name? Brandon Grill? Anyway, said, I’d love. I would love to see an experienced therapist give a financial wellness talk to a class of grad students. It burns me up inside knowing that so many therapists have to put up with the culture of serving without being served, giving without receiving, and it’s time to rewrite the script. Yes. Mic drop. And then, so another therapist mentioned. Thank you for speaking out about this. I came to therapy as a second career after starting in engineering. After starting in engineering and getting an MBA, doing one to one therapy is so much more difficult and taxing than anything I did in my old career. And it’s also incredibly fulfilling. But the money problem grabbed me. Even from grad school, 1000 hours of unpaid internships sets the stage for accepting low pay after graduation. I know my worth, and I also know it isn’t sustainable for me to see 30 plus clients a week just to make a livable wage. Another person said, I started in this field when I was 25. Similarly, I started in residential treatment. So I started my career in residential treatment. That was the $7 an hour job. I think that it takes time to get to a point where we realize love alone cannot pay the bills. That was a quote from me. At one point in my career I burned out. It took a global pandemic to wake me up again. I am on year 15 and I am glad to experience to teach counselors in training and new counselors what the industry is like. As I go through my final year working towards becoming a counseling professor. I desire to teach students what I know. I hope this becomes an ongoing conversation. I hope so too. I’m reading another one. They’re just so good. So this person says, as a rural provider, around 90% of my client base is on Medicaid and frequently call in due to illness, childcare conflicts, or transportation difficulties. These are all problems congruent with poverty. I don’t get reimbursed for those sessions. We’re consistently hearing the rhetoric that we’re in a mental health crisis, but providers aren’t being incentivized to stay in the field. This includes not being compensated fairly. We compare salaries of jobs and similar of similar education and training levels like physical therapies like physical therapists or nurse practitioners. Providers like myself struggle to be financially secure enough to want to risk their own communities where the most at need clients, Medicaid clients, are inconsistent with showing up and are already undercompensated. Insurance claims become non existent. Because this is a helping profession, we’re used to viewing our work as altruistic, when really we need to get better at lobbying. So true. I loved that comment. I could go on and on and tell you some more of those comments, but I will let you read them on my LinkedIn profile. I’d love to have you comment in there and just weigh in. Like, how are you feeling about these these topics? So anywho, that’s kind of the recap of the series that I did on money, and so I’m going to be talking about again, therapist burnout I’m going to do my my 1.0 therapist burnout episode. Wish me luck. Let me know your thoughts. Let me know if there’s anything that you think that we need to talk about. And then in August, I’m going to talk all things self care. I know that word has a lot of weighted meaning right now. So I really want to dive into, like, the literature, what is self care? What from research do we know is helpful for burnout and compassion fatigue, and what is the conception that we have about self care? And I’d like to have someone on who talks a little bit about weaponized self care if I can get them on, which would be great because I think that has been coming out a lot, that if you were only doing so many bubble baths or, you know, taking all your breaks as therapists that you could not deal with burnout, which I think is just not true. So I’m going to talk about that. But I do want to provide, you know, what are some things we can do? What are some ways that we can prevent burnout? And I think we can get creative about that because if you want to stay in this field, I want you to stay in this field. Technically, I’m still in the field. I just do assessment for my day job. I’m not a therapy owner, private practice owner currently. So we’ll dive into that into August and we’ll continue on. All right, I hope you enjoyed this recap episode. I’ll be doing these maybe start of the month, end of the month. We’ll see. Trying to record weekly for you guys. So wish me luck in that. We might have some archival episodes I’m going to be looking at as I round up the year on podcasting for this podcast, what have been your favorites? So you can certainly let me know that you can send me a message on LinkedIn. You can also email me@infojenblanchot.com I’ll include that email in the show notes today. So if you just want to shoot me an email, the link will be in the show notes. And if you also wanted to grab my money guide, I talked about that a lot last month. I’m going to be looking at doing a burnout guide, which I, again, get so much mind drama about. Like, what can I say? That’s unique? Like, how is it different? I just need to put it out there, right? Yeah. So anyway, I’ll be working on that and putting that out for next month and we’ll go from there. All right, thanks. Also, if you’re a therapist in private practice or you’re a therapist, an agency, wherever you are and you are done, you feel like you need to quit and you need some support getting through that, I can definitely help you. I’ve been in a lot of the roles agency, private practice. I closed a private practice and really pivoted my career and so if you need some support with that, I’m here for you. I’m here for all the things, whether it be I can’t do agency and maybe I’m thinking about starting a private practice to kind of help with that burnout, or I am just done with therapy for a while. I got you. So certainly look at the link in the show notes to get on a consult call with me and we can talk about if it’s a good fit to work together. All right. Thanks.

Speaker B: Thank you for listening to the Joy after Burnout podcast. Be the first to hear new episodes by following the podcast in your podcast player. This is an informational podcast only. Any information expressed by the host or guest is not a substitute for legal, medical, or financial advice.


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