Therapy and Money - Getting Comfortable With the Business Side

Let’s dive into a subject that sometimes makes us squirm - money. Yep, finances and pricing. You can be amazing at helping your clients, but running a practice also means looking after your business health - because without that, you can’t keep showing up for clients.

The good news? Money talk doesn’t have to feel cold or corporate. Think of it as building the foundations of a safe, sustainable practice. So, let’s break it down - how to set your rates, whether to go insurance or private pay, what to do about quiet months, taxes, and whether you really need that accountant.

1. Setting Your Rates (and Raising Them When Needed)

Here’s the thing - your fee isn’t just a number; it's a reflection of your value, experience, and the service you provide. Too low, and you risk burnout and resentment. Too high without justification, and you may price yourself out of your market.

• Start by researching local averages - what are other practitioners with similar experience charging?
• Factor in your costs, including room rental, supervision, CPD, administrative software, and insurance. Your fee needs to cover these expenses and provide you with a salary.
• Check in with yourself - does this rate feel fair? Does it reflect the value of your work?

And regarding rate increases, clients expect them occasionally. Provide ample notice (a few months is considered reasonable) and clearly frame it. Calm, professional, and no apologies needed.

Budgeting for Quiet Months & Cancellations

Therapy isn’t always predictable with clients - they may move away, take breaks, or suddenly disappear (we've all been there). Having a buffer keeps your business ticking over.

• Rule of thumb: aim to keep 2–3 months' worth of expenses set aside.
• Set clear cancellation policies, and stick to them. This protects your time and income.
• Plan for seasonality - summer holidays, December, or exam periods often experience dips or spikes. Anticipating patterns helps smooth the ride.

Think of your budget as self-care for your practice, it cushions you against wobbles.

Taxes: The Not-So-Scary Basics

Yes, the T-word. If you’re self-employed, you’ll need to set aside tax money regularly. A common trap? Spending everything as it comes in, then panicking in January.

• Set aside 20–30% of each payment into a separate savings account labelled “tax.”
• Track all expenses, including software subscriptions, professional memberships, CPD, and travel for supervision. These can reduce your taxable income.
• Stay organised and log your income and expenses monthly, not just once a year in a stressful panic.

Accountant or Bookkeeper. Do You Need One?

Short answer: probably, yes. Long answer: It depends.

• If your caseload is small and you’re confident with spreadsheets, you can start solo.
• If your business is growing (say, 15+ clients a week), outsourcing saves time and headaches.
• Accountants don’t just file taxes - they can spot savings, keep you compliant, and free your brain for what you’re good at: therapy.

Think of it as paying for peace of mind and fewer sleepless nights over receipts.

Money doesn’t have to feel awkward or intimidating. Setting fair rates, choosing how you want to be paid, planning for slow patches, staying on top of taxes, and knowing when to outsource - it’s all part of building a healthy, sustainable practice.

When your finances are stable, you don’t just survive - you thrive. And that means more energy, presence, and care for the people who need you.