For many people coming into the mental health profession, a huge source of motivation is the desire to help and serve others especially in moments of profound pain and loss. Rarely does one consider entering this profession to reap its voluminous financial benefits or to join the 1% net worth of the population. One consequence of this has been a discomfort among practitioners over the issue of raising fees. Of course, it will be up to one’s discernment when it might be appropriate to raise fees. But, when you’re having this discussion with yourself or others, I suggest you consider these five possible reasons to raise your fees.
1) Because you’ve gained more experience. Experience counts! The longer you are “in the field”, the more opportunities you’ve had to work with clients. During that time, you’ve hopefully learned more about yourself as a person and therapist, developed your working style and technique, worked on your strengths and weaknesses; all in all making you a more effective therapist. Of course, in some locations, therapists are also required to stay updated through Continuing Education classes, so presumably, you know more than when you were starting to establish your practice.
2) Because you run the business. Especially in private practice, partially true in other settings also, you are expected to not only be the clinical expert, to also be one’s own business manager. With obvious oversimplification, one’s business income is determined by both increasing the amount of money you take in and lowering your expenses. Many clinicians tend to find it easier to regulate the latter than the former. For the former, it usually means opening up more work hours. Of course, another way to increase one’s financial input is by increasing your fees on your current clients. For example, some clinicians include language in their practice policy that fees are re-explored at a regular interval (e.g., every January of the year, one year since starting date of service).
3) Because of the economy. It’s the economy, stupid! Well, no, you’re not stupid. But sometimes we all need to be reminded of the larger context wherein we operate. On the basic level, there is the concept of inflation. The value of currency goes down as the overall supply increases due to economic activity and growth. Practically, this means that you probably had to face increases in your expenses such as rent, electricity, water, licensure renewal fees, food, magazine subscription, printer ink, etc. In addition, local economic realities need to be considered such as cost of rent in the local area, local taxes and fees that increase one’s expenses, and perhaps the necessity of renting a parking space for you and your clients.
4) Because you’ve received additional “niche” training. As you well know, receiving that graduate degree by no means meant the end of your training. Multiple places offer additional trainings and certifications in specific approaches such as dialectical-behavior therapy (DBT), eye-movement desensitization and reprocessing (EMDR), and psychoanalytic psychotherapy, or professional competence certifications such as the American Board of Professional Psychology (ABPP) for psychologists. For some, this might even lead to a particular niche such as learning the Developmental, Individual-differences, Relationship-based (DIR) approach for working with clients with autism or gaining the ability to administer and interpret specific tests for neuropsychological assessment. Whatever it may be, you’ve grown your expertise, and your fees should reflect that.
5) Because you’ve gone back to school. The idea here is similar to the one above, but it bears separate mentioning due to the increased commitment it requires. Most items covered in reason four require less time (a weekend to a year) and money. Going back to school to gain a higher degree requires so much more. For those with masters level education seeking a doctorate degree, it usually requires three to five more years and expenses related to schooling such as tuition, book expenses, etc. For those inclined, there is also training in psychoanalysis (which can include a PsyD or PhD degree) that also tends to take around four to seven years. In this case, psychoanalytic candidates are, in addition to common school expenses, required pay for their own analysis (seeing a psychoanalyst 4-5 times a week) and supervision for one’s control cases. Getting additional education is not only a worthwhile investment in oneself, but also a good reason to raise your fees.
Have you struggled with raising your fees? How did you ultimately resolve that tension? How have you thought about fee raising? Please tell us about it in the comments below.