The exchange of money for services is an inherent part of the therapeutic process. However, many therapists struggle when it comes to addressing their fees or collecting money for their services. The fact is that most graduate programs offer little or no formal training on how to deal with money issues with clients. Nonetheless, to be successful in private practice, providers must learn how to master the art of money collection. This is particularly true for therapists who are new to private practice and do not have the financial resources needed to hire administrative staff. The onus is on them to manage the day-to-day business operations along with their service delivery. Remember: a private practice is a business, and a business needs money to remain viable.
Asking a person for money (especially face-to-face) is an acquired skill. Few people are comfortable doing it initially; in fact, most people are downright afraid of it. As humans, we assign strong emotional value to the topic of money.
It is important to understand that everything we think and feel about money is learned. The truth is that many children are taught that money is one of those “taboo” topics not to be discussed in polite society. For example, as children we may have learned that it is impolite to ask someone how much money they have or make or how much something costs.
Unfortunately, when we are taught at a young age to avoid discussing certain topics, we end up training our brains to react automatically when those topics are brought up. As therapists, we know that our underlying core beliefs drive certain emotions, which leads us to generate certain responses. Many of these emotions and subsequent responses do not serve us well and can even prevent us from being effective business owners.
Are your subconscious beliefs about money getting in the way of you running a successful practice?
“What if they say no?” “What if I upset them?” “What if they don’t come back?” “Isn’t some money better than nothing?” Have you ever found yourself pondering these very same questions? As long as you continue to harbor negative beliefs surrounding money, you will ultimately sabotage your chance of building a successful, profitable business. To mitigate this risk, it is necessary to address those underlying beliefs and put systems into place that will make the process easier.
The following five strategies are designed to help you overcome that dreaded discomfort when it comes time to collect money from clients.
1. Shift your mindset
It is no surprise that many mental health professionals struggle with the idea of collecting money for their services. After all, most therapists would agree that they entered into this field out of a sincere desire to help others live a more fulfilled life. As such, asking clients for money stands in direct conflict of the notion of “helping others.”
The dissonance that many therapists experience often leads them to automatically assume they will receive pushback when it comes time to collect payment for their services. This belief may encourage providers to give discounts just to avoid having to experience guilt or discomfort over asking for money. Unfortunately, this can also lead to a host of other problems down the road. Some therapists may choose to see more and more clients just to make up the difference, which becomes a one-way ticket to burnout. Even worse, when you fail to collect the money that you are owed, you run the risk of becoming resentful towards your clients, especially if they openly talk about other purchases they have made or upcoming vacations they are excited to take.
Instead, I invite you to challenge your beliefs surrounding money and practice being assertive with your clients. The truth is, you may compromise the therapeutic relationship by not holding your clients financially responsible for the services they receive. When we ask to be compensated for our work, we are modeling a healthy, normal interaction to our clients, letting them know that our time is worth something. We are worth something.
2. Verify insurance prior to the first session
I highly recommend requesting all insurance information prior to a client’s first session. That way, you are able to check their benefits and calculate how much money to collect before the appointment, and this also means that you can submit claims as soon as possible to be reimbursed for your service by insurance. If you find that the client has a high deductible plan, you can have a conversation with them prior to the appointment. For many people, a lack of understanding of how insurance works leads them to be more resistant when it comes time to pay. A simple phone call explaining this information prior to their first visit can ward off unnecessary confusion when it comes time to collect your fees. This is a particularly great habit to get into at the beginning of the year when most insurance deductibles start over.
3. Set your financial expectation upfront
It is good practice to include a thorough explanation of your financial policies in your informed consent. At my group practice, we have all new clients initial that they have read and understand our financial policy prior to being seen. The policy clearly outlines our procedure of collecting co-payments and deductible amounts at the time of service. By setting those expectations upfront, you will experience much less resistance from clients throughout the course of treatment.
4. Collect payment at the time of service
One of the biggest mistakes I ever made as a practice owner was to bill clients at a later date. I quickly discovered how much more difficult it was to collect that money once the client left the office. For those that struggle with having conversations surrounding money, it will only be that much more difficult when it comes time to try and collect larger amounts from clients at a later date. Make it your policy to collect upfront. After all, isn’t that the expectation for many other services? Very few people question when they have to pay for a haircut, meal, braces, or home repairs at the time of service. There is no confusion regarding when to pay because we have come to expect it. Set the same expectation for your practice.
Tools like credit card processing can be a huge help for reliably collecting payments. If you have a system that can securely store credit card information, all you need to do is swipe the client's card at their first visit, and you have the ability to charge their card for subsequent sessions without asking for the card each time.
5. Know your worth
Finally, and most importantly, know your worth. It is critical to remember that therapy is a very complex process, involving technical skill and theoretical application. Unfortunately, therapists frequently lose sight of the skill and training they offer.
We went into this field to help people, and that is what we do. Every single day. We save marriages, help people build confidence, coach them on how to improve their relationships, help them perform better at work or school, and we even save lives at times. We provide outcomes for people that are absolutely priceless. As such, we deserve to be compensated for our time without feeling guilty about it.* The content of this post is intended to serve as general advice and information. It is not to be taken as legal advice and may not account for all rules and regulations in every jurisdiction. For legal advice, please contact an attorney.