Setting appropriate fees in private practice is crucial for maintaining a sustainable and ethical counselling private practice. Josephine Hughes explores the challenges therapists face regarding client attendance and the impact on income. She argues that a well-structured fee system allows therapists to absorb seasonal fluctuations and client cancellations without undue pressure. This enables counsellors to focus on their clients' well-being rather than their personal financial concerns. Throughout the episode, Josephine addresses common money blocks that can hinder therapists from charging what they’re worth, highlighting the need to recognise the value of their services. By adopting a more strategic approach to fee setting, therapists can create a practice that not only supports their financial needs but also fosters a healthy therapeutic relationship with their clients.

Takeaways:

• Setting your fees requires a business mindset to sustain your private practice effectively.
• Understanding your cancellation rates can inform more accurate fee setting strategies for clients.
• It's essential to factor in seasonal fluctuations and client cancellations when determining your fees.
• Avoid making pricing decisions based solely on what others in your area charge.
• Being confident in your value as a therapist allows you to charge appropriately for your services.
• You are not exploiting clients by charging for your services; you are providing valuable support.

Keywords

private practice, counselling fees, client attendance, cancellation policy, therapist income, fee setting, therapy pricing, client no-shows, counselling marketing, self-care for therapists, therapist profit margin, client appointment management

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You can also find me here:

The Good Enough Counsellors Facebook Group

Josephine Hughes on Facebook

Josephine Hughes on YouTube

My website: josephinehughes.com

The information contained in Good Enough Counsellors is provided for information purposes only. The contents of this podcast are not intended to amount to advice and you should not rely on any of the contents of this podcast. Professional advice should be obtained before taking or refraining from taking any action as a result of the contents of this podcast.

Josephine Hughes disclaims all liability and responsibility arising from any reliance placed on any of the contents of this podcast.

Josephine Hughes: 00:00:01

Does this sound familiar?

Josephine Hughes: 00:00:03

Clients let you know they're on holiday next week or they cancel their appointment just hours before your 48 hour cancellation charge.

Josephine Hughes: 00:00:12

You're left feeling out of pocket and decide to take on more clients and work more hours to make ends meet.

Josephine Hughes: 00:00:20

But that just exhausts you.

Josephine Hughes: 00:00:22

How can you build a sustainable private practice when client attendance varies so much?

Josephine Hughes: 00:00:37

Welcome to the Good Enough Counsellors Podcast.

Josephine Hughes: 00:00:40

I'm Josephine Hughes and today we're going to discuss something that comes up virtually every week in counselling Facebook groups.

Josephine Hughes: 00:00:50

What can you do about client attendance or the lack of it and the impact this has on your income?

Josephine Hughes: 00:00:58

Usually the question is framed in terms of cancellation policy.

Josephine Hughes: 00:01:03

How can I ensure that clients pay?

Josephine Hughes: 00:01:06

But actually, I saw a question recently that really got me thinking about what the heart of the problem is here.

Josephine Hughes: 00:01:15

And the person asked, in a counselling Facebook group, what do you do about your cancellation policies?

Josephine Hughes: 00:01:22

Would, would you charge a week in advance?

Josephine Hughes: 00:01:25

Because I have clients that say at the end of the session, oh, I'm not going to be able to come in next week.

Josephine Hughes: 00:01:32

And that's a space that I'm not going to be able to fill because it's their normal space.

Josephine Hughes: 00:01:38

So the questioner wanted to know if it would be acceptable to actually charge a client that far in advance for cancellation.

Josephine Hughes: 00:01:48

Now, the beauty of private practice is you are able to set your own policies and you can think through how you would like to run your private practice.

Josephine Hughes: 00:01:59

You can make the choices that work for you.

Josephine Hughes: 00:02:02

But I think when we do consider our policies, it's not just about what we need in our business, but it's also about what our clients need in terms of putting the client first and looking after them.

Josephine Hughes: 00:02:16

I actually think we need to approach fee setting with a business mindset because that will help you to sustain your practice.

Josephine Hughes: 00:02:25

And it's actually the more ethical approach, because I think what we can be in danger of doing is putting our business needs onto our clients.

Josephine Hughes: 00:02:36

And I believe that isn't an ethical approach.

Josephine Hughes: 00:02:39

Bear with me.

Josephine Hughes: 00:02:40

I'll explain this a little bit more.

Josephine Hughes: 00:02:42

I think it's really important to think about fees in terms of how they can sustain us, because when we set our fees at a rate that sustains us, that actually means we're responsible for looking after ourselves and we're not making our clients responsible for that process.

Josephine Hughes: 00:03:02

We're less likely to pressurise clients when we have fees that actually sustain our private practice.

Josephine Hughes: 00:03:11

And this is what I'm going to spend a little bit of time untangling and explaining in this podcast.

Josephine Hughes: 00:03:17

So I wonder what your response is to that question.

Josephine Hughes: 00:03:20

Is it okay to charge my clients a week in advance so that if they decide they're not coming in next week, I still get paid?

Josephine Hughes: 00:03:30

I've seen different approaches and I think sometimes it can be part of a particular modality to include those charges.

Josephine Hughes: 00:03:40

Certainly I've seen policies from psychodynamic practitioners where the client has to pay every week unless the therapist is on holiday.

Josephine Hughes: 00:03:50

So that's one particular approach from a particular modality where the contract is very boundaried.

Josephine Hughes: 00:03:56

I wonder how that sits with you.

Josephine Hughes: 00:03:58

Whatever your modality is, would that be something that you'd like to contract with your clients?

Josephine Hughes: 00:04:04

I think many of us acknowledge that clients will be missing sessions for various reasons such as holidays, and the majority of us don't tend to charge.

Josephine Hughes: 00:04:15

When we're given advance notice of that, we tend to absorb it.

Josephine Hughes: 00:04:18

What are the other options?

Josephine Hughes: 00:04:20

Here's a thought from outside the box.

Josephine Hughes: 00:04:22

As counsellors we often connect our fees to an hourly rate, but the coaching world actually divorces itself from the hourly rate and offers instead a package.

Josephine Hughes: 00:04:34

And you could perhaps offer a package of psychological support over a certain period of time and this then wouldn't connect you to the number of hours.

Josephine Hughes: 00:04:44

You could say that it's for a certain amount of time, for example three months and that a three month package costs X.

Josephine Hughes: 00:04:52

You could say that it would include instead of 12 weeks support, you could say it includes 10 sessions.

Josephine Hughes: 00:04:59

That allows you an extra two sessions where the client can't attend.

Josephine Hughes: 00:05:03

But it might also introduce the thought that the client could contact you between sessions for extra psychological support.

Josephine Hughes: 00:05:12

They might say, for example, if they're on holiday.

Josephine Hughes: 00:05:14

Well, can I email you that week I'm on holiday.

Josephine Hughes: 00:05:17

So it's something thinking outside the box.

Josephine Hughes: 00:05:20

I'm just putting it out there because it's a different way of working and it's one that we don't necessarily consider.

Josephine Hughes: 00:05:26

But again, there's ethical considerations that we do need to include when we're considering something like that.

Josephine Hughes: 00:05:34

But it's another way of working.

Josephine Hughes: 00:05:36

But I think the interesting thing about it is the allowance for the cancellations.

Josephine Hughes: 00:05:42

Now I was talking to a member of Therapy Growth Group yesterday about her fee setting and something she's been doing since I suggested it to her is she's actually been keeping a weekly record of all her figures.

Josephine Hughes: 00:05:55

So she was able to tell me straight away that her cancellations average out at 10% each week.

Josephine Hughes: 00:06:02

That's a really useful figure to be able to work with.

Josephine Hughes: 00:06:06

And I wonder if you know that, I wonder if you could go back over your diary and work it out.

Josephine Hughes: 00:06:11

What is your cancellation rate?

Josephine Hughes: 00:06:13

I think what we tend to do, and this is part of the problem of what we're doing, is we tend to work out our fees if we actually put any thought into them, apart from just looking at what everybody else is charging and putting a pin in a figure and just picking it out of the blanket.

Josephine Hughes: 00:06:30

If we do tend to think about our fees and what we're going to charge, we often make the mistake of assuming that we'll have 100% attendance rate.

Josephine Hughes: 00:06:39

So, for example, you might charge 60 pounds per session.

Josephine Hughes: 00:06:44

You want to have 15 clients a week, and that works out at 3,600 pounds per month, and you base your figures on a full practice of 15 clients a week.

Josephine Hughes: 00:06:56

But of course, we know that those 15 clients are going to be going on holiday, cancelling outside our cancellation charge window, that to a certain extent there's going to be a perhaps 10% cancellation rate.

Josephine Hughes: 00:07:11

So rather than making: 3600

Josephine Hughes: 00:07:19

And we don't tend to build that into our fee setting.

Josephine Hughes: 00:07:23

Let's just step back a moment to that little side comment I make, because I think a lot of people don't know how to set their fees and what they tend to do is they have a look at what everyone else is charging and depending on how much experience you've got, is you think, well, I'm just starting out.

Josephine Hughes: 00:07:43

So it's people there who've been working for longer than me and they're charging, say, £50.

Josephine Hughes: 00:07:49

So I can't charge as much as that because I'm not as experienced as them.

Josephine Hughes: 00:07:53

So I'll charge 40.

Josephine Hughes: 00:07:55

And that is not taking into account how many hours you're going to work, how much time you've got, what your different costs are.

Josephine Hughes: 00:08:03

You're just basing it on what everybody else is charging.

Josephine Hughes: 00:08:06

I think you should put your charges up each year, at least to keep up with inflation, if nothing else.

Josephine Hughes: 00:08:12

But also, you know, to add on extra if you've got extra experiences.

Josephine Hughes: 00:08:16

Now, I haven't got a problem with that at all.

Josephine Hughes: 00:08:17

But what I have got a problem with is the assumption that then people would look at someone who's been in practice for a while, who's maybe a supervisor, who's maybe been working in private practice for 10 years, looks at their figure and thinks, I can't charge as much as that because effectively what you're doing there is you're basing your figures on someone else's money blocks.

Josephine Hughes: 00:08:42

Many of us have money blocks.

Josephine Hughes: 00:08:44

We don't think about our figures.

Josephine Hughes: 00:08:46

We're perhaps in different circumstances.

Josephine Hughes: 00:08:49

For example, you could have someone who's not really doing it because they're making a full time income from it.

Josephine Hughes: 00:08:57

They're just doing it as an add on where perhaps it isn't as important to them to be charging a market rate.

Josephine Hughes: 00:09:03

And you could compare yourself to them and think that you can't charge as much as them.

Josephine Hughes: 00:09:08

And historically this is the way it's been for a lot of counsellors.

Josephine Hughes: 00:09:11

They haven't charged the market rate.

Josephine Hughes: 00:09:13

And if you're a counsellor who is working full time, you've just graduated, this is going to be your full time income.

Josephine Hughes: 00:09:21

Why should you be held back by someone's historic rate?

Josephine Hughes: 00:09:25

And so I think the notion of basing your fee on your rate of experience compared to what you perceive everyone else's experience to be is, is actually not very helpful.

Josephine Hughes: 00:09:37

I think you have to approach it with a much more businesslike sense.

Josephine Hughes: 00:09:42

And I'm going to give another example of a question that came up in one of my Facebook groups recently and this was someone saying, I can't afford to pay my room rental, so I'm going to have to go online.

Josephine Hughes: 00:09:55

Will I be able to make a successful private practice if I'm just working online?

Josephine Hughes: 00:10:00

I mean, as far as I'm concerned, yes, you can have a successful online private practice.

Josephine Hughes: 00:10:06

But there's an assumption underlying that statement.

Josephine Hughes: 00:10:10

I can't afford my room rental.

Josephine Hughes: 00:10:13

And that assumption is I cannot afford to charge my clients more.

Josephine Hughes: 00:10:17

Quite simply, business is all about bringing in enough money to make a profit and pay your costs.

Josephine Hughes: 00:10:25

So you have a certain amount of costs.

Josephine Hughes: 00:10:27

You're going to have costs for supervision, you're going to have costs for your room rental, you're going to going to have costs for your insurance, your professional membership body.

Josephine Hughes: 00:10:35

These are all costs.

Josephine Hughes: 00:10:37

Your CPD is another example.

Josephine Hughes: 00:10:39

Your information Commissioner's office fee that comes up every year.

Josephine Hughes: 00:10:44

You have some fixed costs and you also have maybe costs that things you would love to afford, like an expensive cpd, for example.

Josephine Hughes: 00:10:53

Now these are your costs.

Josephine Hughes: 00:10:55

You need to have enough money coming in to cover those costs.

Josephine Hughes: 00:10:59

But also you're not doing this for free.

Josephine Hughes: 00:11:01

You need to include profit so that you can take an income from your profit.

Josephine Hughes: 00:11:06

And can I just say, you need to make enough profit so that the months that you're busier, you can afford to put money aside to cover the months when you're quieter.

Josephine Hughes: 00:11:18

Because we do work in a business that tends to be seasonal.

Josephine Hughes: 00:11:22

So I'm recording this just before Christmas.

Josephine Hughes: 00:11:25

Some people are really busy because they've got clients who are desperate to see them before they go home for the Christmas holidays.

Josephine Hughes: 00:11:31

And others are quieter because their clients are maybe at work busier, doing parties.

Josephine Hughes: 00:11:37

I don't know.

Josephine Hughes: 00:11:38

It's just some people are busy, some people aren't.

Josephine Hughes: 00:11:40

But the fact is, is that we all have seasonal quiet times and we need to earn enough to cover those seasonal quiet times.

Josephine Hughes: 00:11:50

So when you're setting your fees, you need to allow a buffer so that you can put money aside.

Josephine Hughes: 00:11:57

So in the quieter months or those weeks where everybody's got flu, you're covered.

Josephine Hughes: 00:12:02

You've still got some money that you can use to pay your bills.

Josephine Hughes: 00:12:06

And historically, I've got a real bee in my bonnet about this.

Josephine Hughes: 00:12:10

As you can hear, historically, we just haven't approached our fee setting from a business mindset.

Josephine Hughes: 00:12:16

We just put a pin in a figure and pluck it out of thin air, and we think that's what we should charge.

Josephine Hughes: 00:12:24

Now, I do have a fee calculator available on my website.

Josephine Hughes: 00:12:29

It's very simple because if you make it too complicated, it gets overwhelming.

Josephine Hughes: 00:12:34

But go on there and work out your fees.

Josephine Hughes: 00:12:37

I'll pop the link into the show notes.

Josephine Hughes: 00:12:40

You need to allow for your holidays, you need to allow for your sickness.

Josephine Hughes: 00:12:45

You need to allow for the fact that 10 to 20% of your clients will not be turning up each week.

Josephine Hughes: 00:12:53

It's thinking about, am I making enough money to be able to pay myself?

Josephine Hughes: 00:12:59

When you've got your fees set at a reasonable level, that means that you have that buffer for the slow months.

Josephine Hughes: 00:13:06

That means you have that buffer for the cancellations and the no shows.

Josephine Hughes: 00:13:11

That means that you can relax into your practice knowing that you are looked after.

Josephine Hughes: 00:13:16

And the reason why I think this is ethical is it means that we don't put undue pressure on our clients to attend.

Josephine Hughes: 00:13:25

Personally, for me, I think it's unreasonable to charge a cancellation policy a week in advance.

Josephine Hughes: 00:13:32

I wouldn't do it.

Josephine Hughes: 00:13:33

That is where I'm coming from.

Josephine Hughes: 00:13:35

Your ethics might be different to mine.

Josephine Hughes: 00:13:37

We all have to work on our own ethics and how we understand it.

Josephine Hughes: 00:13:40

But for me, I wouldn't want to put that pressure on my clients.

Josephine Hughes: 00:13:44

I want to be able to absorb that cost of them saying, I'm not going to be here next week.

Josephine Hughes: 00:13:50

I want to be able to say, okay, let's book you in the week after or whenever you're back from holiday.

Josephine Hughes: 00:13:54

And for there to be no drama about it.

Josephine Hughes: 00:13:58

A coach of mine came out with this phrase, and I often quote it, it's maths or drama.

Josephine Hughes: 00:14:05

Where do you want to be with your clients?

Josephine Hughes: 00:14:07

Will you put the work in on the maths?

Josephine Hughes: 00:14:09

Let's face it, maths is horrible.

Josephine Hughes: 00:14:12

I don't like it anyway and I'd much rather prefer to be seeing clients than working out my fees.

Josephine Hughes: 00:14:18

But actually, maths is just maths.

Josephine Hughes: 00:14:21

It's just working it out, sitting down, looking through it, doing a few calculations.

Josephine Hughes: 00:14:27

And as I say, you can use my fee calculator to help you if.

Josephine Hughes: 00:14:30

If you're not a mathematician.

Josephine Hughes: 00:14:31

My husband is and he set up the fee calculator just for us counsellors who don't like maths.

Josephine Hughes: 00:14:36

But, yeah, you know, you can do the maths or you can get involved in the drama.

Josephine Hughes: 00:14:40

You can get into the drama of worrying each week, will I have enough money this week?

Josephine Hughes: 00:14:45

You can get into the drama of trying to persuade your clients that they shouldn't finish or that they should pay you.

Josephine Hughes: 00:14:52

You can get into the drama of trying to think about, do I need to extend my cancer cancellation policy?

Josephine Hughes: 00:14:58

If you've got enough money coming in, you're looking after yourself and you can set your boundaries accordingly.

Josephine Hughes: 00:15:05

It stops you being in a drama triangle.

Josephine Hughes: 00:15:09

So fee setting, although it's something that we don't like to talk about, it is really important to both our self care and the care of our clients.

Josephine Hughes: 00:15:21

We really don't talk about it enough.

Josephine Hughes: 00:15:23

And that's why I've got a bit of a bee in my bonnet about it now.

Josephine Hughes: 00:15:26

I know that we can get incredibly uncomfortable talking about fees and the next part of what I'm going to say is actually addressing that discomfort.

Josephine Hughes: 00:15:37

And believe me, this is not something that I'm talking about from an academic viewpoint.

Josephine Hughes: 00:15:43

I have been there.

Josephine Hughes: 00:15:45

When I first started in private practice, I did just that.

Josephine Hughes: 00:15:48

I looked around, I saw what everyone else was charging and I tried to work it out and I thought, well, I think I'm worth more than 35 pounds, which was the sort of lower end of what people were charging at that point.

Josephine Hughes: 00:16:00

I'm going to charge £40.

Josephine Hughes: 00:16:02

So I bravely put 40 into my counselling directory entry.

Josephine Hughes: 00:16:07

And then I didn't get any inquiries for a few weeks and I looked around and I thought, well, there's so many people charging pound 35.

Josephine Hughes: 00:16:13

There's so many people who are charging 40.

Josephine Hughes: 00:16:15

I think I'll go down to 35.

Josephine Hughes: 00:16:17

And, yeah, I did get clients at 35, but what happened is that I actually, in order to make ends meet, and because I found it difficult to say no, I actually found that I was seeing more and more clients, and I ended up getting a little bit burned out.

Josephine Hughes: 00:16:34

And what happened eventually is I did put my fees up and, wow, what a difference that made.

Josephine Hughes: 00:16:43

I couldn't believe it because I.

Josephine Hughes: 00:16:45

I actually had a lot more space in my diary, but I was earning the same amount of money as before.

Josephine Hughes: 00:16:53

And honestly, I really think that made such a difference to me.

Josephine Hughes: 00:16:58

It meant that I could enjoy my work.

Josephine Hughes: 00:17:00

It meant I had space.

Josephine Hughes: 00:17:02

And I think it made a difference to the clients because I had time to reflect, I had time to think.

Josephine Hughes: 00:17:11

I would turn up for their sessions refreshed and ready to spend time with them.

Josephine Hughes: 00:17:17

It wasn't like, you know, oh, another client.

Josephine Hughes: 00:17:20

It was a joy.

Josephine Hughes: 00:17:22

And I think this is what fee setting, the math side of it, rather than the drama, actually gives us.

Josephine Hughes: 00:17:30

It helps us to look after ourselves and it helps us to look after our clients, and that's why it's so important.

Josephine Hughes: 00:17:39

So why did I worry about it?

Josephine Hughes: 00:17:42

Why did I find it so very difficult to put up my fees?

Josephine Hughes: 00:17:48

I know this is an uncomfortable subject for many of us, and let's just unravel that a little bit.

Josephine Hughes: 00:17:55

First off, I think there is that whole thing about being in a helping profession.

Josephine Hughes: 00:18:00

And also for many of us who.

Josephine Hughes: 00:18:02

Who are women, we get a message that we aren't worth as much, and that helping professions, because they're dominated by women, that they historically haven't been valued as much.

Josephine Hughes: 00:18:14

And I think that's just part of what we learn, that what we're doing isn't as valuable as other professions.

Josephine Hughes: 00:18:24

And I think that might even be something that pervades throughout society.

Josephine Hughes: 00:18:29

And it's difficult to think I'm worth more than this.

Josephine Hughes: 00:18:34

I think another aspect of this is that money can be a bit of a dirty word in the helping professions.

Josephine Hughes: 00:18:42

And I'm sure you're aware that many people who are brave enough to maybe do an advert on Facebook about their private practice can get replies saying, oh, you're making money out of other people's misery.

Josephine Hughes: 00:18:58

And that upsets us.

Josephine Hughes: 00:19:00

We find that hard to be accused of exploiting people's pain.

Josephine Hughes: 00:19:07

And that's the way it's often framed, isn't it?

Josephine Hughes: 00:19:09

You're exploiting people for your own ends.

Josephine Hughes: 00:19:12

What I think is important to say at this point is someone who thinks that is never going to be a private practice client of yours.

Josephine Hughes: 00:19:22

And I think it's really important that we recognise that some people just have an axe to grind and that they can grind the axe when they see your Facebook advert.

Josephine Hughes: 00:19:35

But let's just reframe it.

Josephine Hughes: 00:19:37

You're gifted, you're trained.

Josephine Hughes: 00:19:41

Why shouldn't you be paid for doing something for that helps people?

Josephine Hughes: 00:19:47

That makes a huge difference to them, to their friends, their family, their work colleagues.

Josephine Hughes: 00:19:55

That makes a huge difference to society.

Josephine Hughes: 00:19:59

We know that therapy changes lives.

Josephine Hughes: 00:20:03

It helps people be more fully themselves.

Josephine Hughes: 00:20:08

And you're gifted in offering therapy.

Josephine Hughes: 00:20:11

If you weren't paid for offering therapy, how would it be for you?

Josephine Hughes: 00:20:17

You'd have to work elsewhere to be able to earn your income.

Josephine Hughes: 00:20:22

You'd be fitting in your practice around all your other commitments.

Josephine Hughes: 00:20:28

You'd have to take a pay cut elsewhere, perhaps, to be able to fit it in.

Josephine Hughes: 00:20:34

What good does that do you?

Josephine Hughes: 00:20:36

And why should you expect to suffer as a result of the work that you're doing?

Josephine Hughes: 00:20:45

So you're not exploiting people's pain, you're actually getting paid for releasing them into a new way of being that benefits all of us.

Josephine Hughes: 00:20:56

What a fantastic gift.

Josephine Hughes: 00:20:58

We don't expect doctors to work for free.

Josephine Hughes: 00:21:01

We don't expect teachers to work for free, don't expect nurses to work for free.

Josephine Hughes: 00:21:09

So why are counsellors expected to work for free?

Josephine Hughes: 00:21:14

Let's knock that one on the head and move on.

Josephine Hughes: 00:21:17

There's several different money stories that we can have going on in our heads, and one of them is related to our own backgrounds.

Josephine Hughes: 00:21:25

And often, if we've come from a background where perhaps we haven't had a lot of money in our background, it's difficult for us to imagine a situation where people can easily afford therapy.

Josephine Hughes: 00:21:37

And if we're in a situation where, quite frankly, affording therapy is a bit of a challenge, it's difficult for us to imagine that other people might be able to afford therapy and it not be a challenge.

Josephine Hughes: 00:21:50

But I used to feel guilty about the fact that I come from quite a wealthy background.

Josephine Hughes: 00:21:57

I have a childhood where material things were mainly catered for.

Josephine Hughes: 00:22:03

And sometimes when I've worked with therapists who haven't had that sort of background, I felt a bit shy about admitting that.

Josephine Hughes: 00:22:11

But what I've realised is, actually, it's a bit of a gift, because I do know that there are people out there who can afford to pay for therapy where it can get absorbed into their household expenses, and it's just another expense that they can Cover.

Josephine Hughes: 00:22:30

And I think often if you haven't got that sort of background, you can actually think to yourself, well, I can't afford to charge this much because people won't be able to pay for it.

Josephine Hughes: 00:22:42

It's thinking instead, I may not be able to afford this, but there are people out there who can afford it.

Josephine Hughes: 00:22:49

So I just want you to think about that one a little bit and maybe you might even like to go away and journal on that.

Josephine Hughes: 00:22:55

You know, how much has my past experience of finances and household income impacted my thinking around fees?

Josephine Hughes: 00:23:06

Another aspect that I've touched on is the thought of I can't charge more than other people.

Josephine Hughes: 00:23:14

And this particularly comes up, as I say, with this notion of expertise.

Josephine Hughes: 00:23:19

I can't charge more than my supervisor.

Josephine Hughes: 00:23:21

But why should you be held back by other people's money blocks?

Josephine Hughes: 00:23:27

That's the drama.

Josephine Hughes: 00:23:29

The maths is that you go away and you work out actually how much you need to charge in order to cover your costs, to give you an income and to give you that buffer.

Josephine Hughes: 00:23:40

A money block that I had to get over when I first started in private practice was the thought that I don't have to be affordable for everybody.

Josephine Hughes: 00:23:50

And I think this is another money block that many of us have.

Josephine Hughes: 00:23:55

We think if people tell us they can't afford to pay, that means we're charging too much.

Josephine Hughes: 00:24:00

And what really helped me with this was talking to my brother in law who's a very senior businessman who was initially trained in marketing.

Josephine Hughes: 00:24:09

And he told me that if you're not turning away about 20% of clients on the basis of affordability, you're probably not charging enough.

Josephine Hughes: 00:24:18

So his expectation was that about 20% of clients should be saying, I'm sorry, I can't afford that.

Josephine Hughes: 00:24:25

Now for us, that probably feels like I can't afford to turn away 20% of my clients.

Josephine Hughes: 00:24:32

I won't have enough clients.

Josephine Hughes: 00:24:34

And that leads you onto a whole other money block.

Josephine Hughes: 00:24:38

And the money block is that there aren't enough clients who can afford me.

Josephine Hughes: 00:24:43

And you think I've got to take on everyone.

Josephine Hughes: 00:24:47

And you bend over backwards and do all sorts of acrobatics trying to fit in people who can't really afford you.

Josephine Hughes: 00:24:55

For example, you might offer concessionary rates or you might offer free sessions.

Josephine Hughes: 00:25:01

It's up to you whether or not you do that.

Josephine Hughes: 00:25:04

But again, what I would suggest is that you need to bring in the maths and you need to think to yourself, okay, if I'm doing a certain number of free spaces, how does that impact my other work?

Josephine Hughes: 00:25:16

I Made the decision a while back that my private practice is actually a business and that if I earn enough in my business, I can then make charitable donations.

Josephine Hughes: 00:25:30

And actually that was going to be my voluntary contribution to society, that I wasn't going to use my counselling work as my contribution.

Josephine Hughes: 00:25:40

In terms of how I'm going to volunteer, that was my choice.

Josephine Hughes: 00:25:44

Other people choose differently.

Josephine Hughes: 00:25:46

It's obviously your choice, but what I would say is it's really important to factor in that price and how you're going to absorb the cost of seeing people for free or for reduced price within your overall income.

Josephine Hughes: 00:26:02

Because with my business hat on, again, I think it does come back to the maths or drama.

Josephine Hughes: 00:26:08

We therapists are really sensitive to people's needs and I think we find it really hard to see other people suffer.

Josephine Hughes: 00:26:16

And we're very aware of the mental health crisis that is happening in this country, for example, amongst young people.

Josephine Hughes: 00:26:24

We're very aware that people perhaps are making decisions that harm them, that harm the people they love, that ultimately harm society, and that therapy would make a real difference.

Josephine Hughes: 00:26:39

And sometimes what we do is we take on that responsibility for them to be helped into our private practice.

Josephine Hughes: 00:26:48

And I think sometimes, unless we're very careful about it, this can be problematic to us.

Josephine Hughes: 00:26:55

The fact is, we aren't responsible for other people's mental health problems.

Josephine Hughes: 00:27:00

We aren't responsible for the lack of provision of mental health care.

Josephine Hughes: 00:27:05

We don't necessarily have to try and resolve this by seeing people who need help.

Josephine Hughes: 00:27:11

Just think outside the box.

Josephine Hughes: 00:27:13

If you had time, you could do other things, such as campaigning or like me doing a podcast, to reach out to parents of transgender adults.

Josephine Hughes: 00:27:27

There's lots of other ways that you can make a contribution to society that doesn't have to be at the cost of, of your business, your private practice and your own mental well being.

Josephine Hughes: 00:27:41

But let's move on to what I think is actually a real fundamental difficulty that we have with either raising our fees or setting our fees at a higher rate than perhaps people around us.

Josephine Hughes: 00:27:55

And that's the thought that if I charge more, I won't be able to get enough clients.

Josephine Hughes: 00:28:02

Let me just say in passing that if you are charging more, you can see fewer clients.

Josephine Hughes: 00:28:09

Fewer clients who pay more, give you more time and space, and they also enable you to be able to afford to do things like your cpd, for example.

Josephine Hughes: 00:28:19

I worked with someone a few years ago now who was completely rushed off her feet with clients.

Josephine Hughes: 00:28:26

She wanted to be able to do her cpd, but she was working so hard and what we did is we gradually introduced higher fees into her practice with the result that she got her life back.

Josephine Hughes: 00:28:39

She charged more because she was quite specialist.

Josephine Hughes: 00:28:42

She saw fewer clients, but she was able to do the CPD that really helped those particular clients.

Josephine Hughes: 00:28:49

And for her it was just a win win situation.

Josephine Hughes: 00:28:53

She was able to have a sustainable practice.

Josephine Hughes: 00:28:57

She had fewer clients, they paid more, but she was able to do the work to support them in between.

Josephine Hughes: 00:29:04

She's still working, she's still charging higher fees, but she's made that practice long term sustainable to her.

Josephine Hughes: 00:29:13

It's a really brave step to take, isn't it, to know that you'll be able to still attract clients even if you put your prices up.

Josephine Hughes: 00:29:22

And I think fundamentally it's a question of confidence.

Josephine Hughes: 00:29:28

Am I good enough to be able to market myself and attract clients who will pay me more?

Josephine Hughes: 00:29:35

But if you think about it, if you are charging more, you don't need to work so hard at your marketing.

Josephine Hughes: 00:29:42

You'll have more time to work at your marketing because you're not seeing loads of clients every week.

Josephine Hughes: 00:29:48

But you don't need to attract as many either.

Josephine Hughes: 00:29:51

So it can be a win win situation.

Josephine Hughes: 00:29:54

But we don't tend to think of it like that.

Josephine Hughes: 00:29:56

What I'd like to ask you to consider is this what's making you stuck.

Josephine Hughes: 00:30:03

Is it because you don't have the confidence and the self belief to know that if you put your prices up, you'll still be able to attract clients?

Josephine Hughes: 00:30:13

This is something that I help people with in my coaching work.

Josephine Hughes: 00:30:18

So I have a membership group called Therapy Growth Group where we do spend time working out how we can make this happen.

Josephine Hughes: 00:30:27

The lady who I mentioned earlier, who has a 10% cancellation rate is also seeing 30 clients a week.

Josephine Hughes: 00:30:36

Since she came on my make youe Profile Work program in the summer, she's changed her marketing and that's been the result.

Josephine Hughes: 00:30:44

And in fact this all came up because we're recognizing she's attracting too many clients.

Josephine Hughes: 00:30:49

And one of the ways that you can control the flow of clients is to put your prices up.

Josephine Hughes: 00:30:55

But she's an example of someone for whom my make youe Profile work training has really helped.

Josephine Hughes: 00:31:02

And the reason it can help people is that it helps you to know who it is that you're trying to reach out to.

Josephine Hughes: 00:31:10

And I have a structured program to help you know how to communicate with the people that you work really well with, how to talk to them so that they get booked in with you, how to talk to them so they don't send out all these speculative enquiries to loads of counsellors, but actually get in touch with you because they want to work with just you.

Josephine Hughes: 00:31:34

And that's the position you want to be in.

Josephine Hughes: 00:31:37

Because when people just want to work with you, then they're usually prepared to pay a little bit extra in order to do so.

Josephine Hughes: 00:31:45

So that's something that I can support you with in therapy growth group.

Josephine Hughes: 00:31:50

And I've got my next make youe Profile work training coming up in February.

Josephine Hughes: 00:31:56

So if you're interested in joining with that, please do click on the links that I'll put in the show notes to tell you a little bit more about it.

Josephine Hughes: 00:32:04

So as we reach the end of the episode, let's have a little recap.

Josephine Hughes: 00:32:08

We've talked about how setting our fees can be about maths or drama.

Josephine Hughes: 00:32:14

It's really helpful when you're thinking about your fees to not just pick a figure out of three thin air or out of what everyone else is charging in your area, but to sit down and think about your costs.

Josephine Hughes: 00:32:27

How much do you anticipate spending per client?

Josephine Hughes: 00:32:32

How much does it cost for you in terms of your supervision fees, your room costs, your insurance, your cpd, all the things that you have to spend money on in order to make your business work?

Josephine Hughes: 00:32:45

Those are your costs.

Josephine Hughes: 00:32:46

And on top of that, you need to allow a profit.

Josephine Hughes: 00:32:50

And within your profit margins, you need to allow for people to cancel for holidays, both your holidays and their holidays and your sickness and their sickness, and to allow for those seasonal fluctuations that can happen in our practice, so that each month you know that you've got that buffer so you can cover your costs and your bills and have some money, even if you haven't got a lot of clients coming in and allowing for your better months to fund your slower months.

Josephine Hughes: 00:33:25

This is the maths.

Josephine Hughes: 00:33:26

It doesn't have to be drama, but the drama comes in when we haven't set our fees at a rate that sustains us.

Josephine Hughes: 00:33:35

And that means that we may well be more tempted to pressurise our clients with things like long cancellation policies, or trying to persuade them to stay for an extra session, or getting a bit resentful if they do cancel.

Josephine Hughes: 00:33:55

The drama also comes in when we're not prepared to acknowledge that we have money blocks.

Josephine Hughes: 00:34:03

And those money blocks can be things like the guilt around taking responsibility for society's ills and thinking that we should be providing free therapy services.

Josephine Hughes: 00:34:15

There's the drama of thinking that if we can't afford it, that means that our clients won't be able to afford it.

Josephine Hughes: 00:34:22

There's the whole drama of thinking that we know what other people's money situation is.

Josephine Hughes: 00:34:29

There's thinking that if people say they can't afford me, that means I'm charging too much.

Josephine Hughes: 00:34:36

And there's that thought of I've got to take on all the clients that come to me and I've got to accommodate them even if they can't afford me.

Josephine Hughes: 00:34:44

But I think what's really important to consider is how can I build a practice that is sustainable, where I'm able to relax into seeing my clients, where I've got enough space to be able to spend time reflecting on them, where if I need to, I can afford to pay for extra supervision, where I can give myself time to go on that expensive CPD course and know that it's okay if it impacts client sessions that week, it's okay because I can afford not to have a client income that week.

Josephine Hughes: 00:35:20

I think fee setting is a flat, fundamental building block of our private practices, and unless we're prepared to talk about it more and to consider the math side of fee setting, we do get into a lot of drama.

Josephine Hughes: 00:35:38

I hope this episode has helped you to think about what might be getting in the way of your fee setting and help you to provide both an ethical and sustainable private practice.

Josephine Hughes: 00:35:52

There's clients out there who need the service that you're providing, and let's make that service something that you'll be able to go on providing for years to come, however long you want to be in private practice.

Josephine Hughes: 00:36:07

Thanks for listening.

Josephine Hughes: 00:36:09

Do come and join my Facebook community.

Josephine Hughes: 00:36:11

Good enough counsellors and for more information about how how I can help you develop your private practice, please Visit my website JosephineHughes.com if you found this episode helpful, I'd love it if you could share it with a fellow therapist or leave a review on your podcast app.

Josephine Hughes: 00:36:30

And in closing, I'd love to remind you that every single step you make gets you closer to your dream.

Josephine Hughes: 00:36:39

I really believe you can do it.