Private Practice Prices: Rescuing Clients


Private practice prices: are you in danger of rescuing your clients?

Counsellors and therapists rarely choose their career for financial benefits.  Yes, they would like to earn a living doing what they love – but they choose therapy because they believe in its value.

They are acutely aware of the emotional pain that many people suffer.  They’re in business to help people and they don’t want money to get in the way. This can lead to difficulty in charging what they’re worth because of concern for their clients’ financial situations.

However, this concern may put them in danger of rescuing clients and prolonging their difficulties.

Pricing: is it a Drama?

Steve Karpman’s drama triangle is a theory about the games that people play.  He sees people as being in roles such as victim, persecutor and rescuer.  In a game, people move between the roles.

A rescuer is someone is sees others as not OK, and one-down.  The rescuer will offer help to the victim as they don’t believe they are able to help themselves. They discount other people’s ability to think for themselves and they take responsibility for them.

Does this apply to your pricing strategy?

  • Do you believe your clients can’t afford you?
  • Do you keep your prices low in order to help them?
  • Do you find it difficult to keep your boundaries around cancellations?

Do you find yourself becoming resentful:

  • When low fee clients let you down?
  • If a client describes spending their money on something you can’t afford?
  • That you have to see a lot of clients in order to earn a living?

Resentment is a sign of moving around the drama triangle to the place of the victim.  Alternatively, you may move into persecutor role and become punitive towards clients if they let you down.

Realistic Private Practice Pricing

In order to live, it is necessary for therapists to set their fees at a sustainable level.  This means allowing for all their expenses, for holidays and sick leave, and not to be working for so many hours that their self-care is diminished.  Use this simple Pricing Tool to work out a viable fee to charge.

This can bring up an issue of concern that the pricing is too high.  Something that sustains the counsellor may be seen as unfeasible for the client.

It is certainly true that not everyone will be able to afford private practice fees.  This is hard when all you want to do is help people.  Unfortunately, the people who cannot afford your fees are actually not your ideal clients.

However, charging a sustainable fee may enable you to help them in other ways, as I have described in my previous blog: Fees for Private Practice: What is Affordable?

Rescuing Clients: Some Questions to Consider

Although it is understandable that counsellors are concerned about less advantaged people in society, here are some possible questions to be reflect on about keeping fees low to help them.

  1. Are you taking responsibility for other people’s spending decisions?
  2. Are you trying to second guess what people are willing and able to pay?
  3. Are you deciding how much value potential clients should place on therapy?

And finally, if you are doing this, how does that fit with client autonomy?

Clients are adults.  Are they being treated as charity cases?  Are they aware they’re receiving patronage from the counsellor?



Power in the Therapy Room

There is already an imbalance of power in the therapy room.  However hard the counsellor may try and address the dynamic, they are in the position of “helper” or “expert” and the client is cast in a position of “helpee” or “novice”.

When a client decides to pay for counselling they are engaging in an exchange of value.  The value of money for the value of an hour’s therapy.  This helps to address the power dynamic.

The notion that fees are being discounted in order to “help” them may not be something they want because it undermines the distribution of power between client and therapist.  It keeps the counsellor in a one-up position. This is because there is still an element of giving or charity within the relationship.

Where a therapist is clear about the value of their work – that in order to live sustainably they need to charge a certain amount – they are making a clear offer to the client.  It is then the client’s decision about the value of therapy for them personally.

It affords the client their autonomy and choice.


So what do I do About my private practice pricing?

The fear in setting higher fees is that not enough clients will be able to afford you.  But ask yourself, can you afford to set lower fees? What effect does it have on you, and your clients?

When you have a clear offer to your potential clients you will be surprised how many of them decide you are worth your fee.  It’s about being able to stand out from the crowd so that you are the obvious choice.

If you’d like some help in attracting clients and making yourself stand out, do take a look at joining The Therapy Growth Group to get marketing help so that clients queue up to work with you. Find out more below