Overcoming the Secret Barrier to Making Money in Your Practice

Recently, a friend invited me to a gathering at a local joint where she and some other high-powered professionals often convene after work to unwind. I arrived just as an attorney was saying, “I won the case! I enjoyed it so much, I probably won’t charge the client for all of my time; besides, I feel bad accepting money when I’m really just trying to help.”

“I know!” said another friend, a stockbroker. “Today I made this one couple enough money for a down payment on their dream house— I’d hate to charge them my full fee when they’ll have moving costs now. That’ll be really hard for them.”

“Yeah, I just feel guilty accepting the check after a deal is finished. I mean, real estate brokerage is more of a soul-calling for me, and it feels kind of dirty to get money for it,” said another.

An exhausted-looking surgeon piped in: “I just don’t know if I’m worth it, for all this money they’re paying me. I mean, who am I to act like I’m a big deal when saving lives is something lots of physicians do?” she sighed, “Besides, I feel like a jerk driving such a nice car.” She stirred her drink sullenly and stared at the floor.

So…does this story sound a little… off?

Money Shame?

You’re very perceptive: it’s a total fabrication. Well, not total: all of these are actual phrases I hear all the time, only they are spoken by therapists discussing money in their private practice, not other skilled, educated professionals.

Money shame is a very real problem for many counselors and other therapists in private practice; it is also a reason many practices fail. We may couch it in the language of caring and concern for our clients, but frequently our money shame also touches on some very deep issues around our own worthiness and fear.

A new private practitioner I’ve been working with recently shared, “I learned early in life that my worth and value was only what I could provide or offer to others – often without them even knowing they needed it. I convinced myself that I wasn’t doing anything either, it was just who I was. So the natural conclusion is that my services can’t actually be worth that much money.”

Sound familiar? The very thing that makes us great counselors (empathy, intuiting the others’ needs and experience) makes us not-so-great business-people, because helping comes so naturally to us that we think, “meh, that’s just me being me, it’s not actually a valuable service.”

On a deeper level, while we may be genuinely caring, compassionate people, we may also be serving our fear and feelings of worthlessness, rather than truly serving our clients, when we under-charge, act guilty for getting paid for our valuable work, or treat financial tasks with distaste and avoidance.

Shift Your Mindset

So what do we do about it? Money-shame in private practice is a significant issue that take time and support to overcome. However, there are a few steps you can start with now to start shifting your mindset around money in your practice:

  • Examine your attitude about money and fees. What are your thoughts and patterns? Is this article triggering anything for you?
  • Pay attention to the underlying “shoulds” within the culture of the counseling profession. What kind of money-shame are we perpetuating among one another? (ex. “Who does she think she is, charging that?” or “out-martyring” each other)
  • Set and hold your boundaries regarding money and fees. What’s the maximum number of reduced-fee clients you’ll have? How will you handle late-cancellations? etc.
  • Reflect on the ways that charging enough is actually serving clients: It’s modeling the concept of “knowing your worth.” It’s encouraging clients’ active engagement in counseling, since having “skin in the game” (investing $) makes us value something more. It’s encouraging our clients to know what it’s like to invest in themselves and affirm their own deserving of self-care.
  • Trust yourself, that if you make good money you won’t automatically turn into an arrogant, greedy narcissist who is indifferent to the plight of those less fortunate. Many therapists secretly fear this fate and judge themselves before they’ve ever accepted their first payment. (If this fear persists, take a moment to visualize yourself writing a huge check to the charity of your choice…. because you can afford to).

Mastering your mindset around money is a key component of loving your private practice and running it well. Take some time, sit with a journal (or trusted colleagues), and reflect on the steps listed above. If you are struggling with entrenched money shame, get some help and support through counseling or business coaching. You’re worth it.

What is one of your biggest challenges when it comes to money-mindset in your practice? Or, what is something that has helped you overcome money-shame? Share in the comments below.

Hand with money photo available from Shutterstock

Overcoming the Secret Barrier to Making Money in Your Practice

Jane Carter, M.Ed., LPC

Jane Carter, LPC is president and founder of the National Association of Counselors in Private Practice, an organization committed to the growth and success of counselors and other therapists in private practice by providing a supportive community, marketing & business skills, and key mindset strategies. You can download a free Ideal Private Practice Visualization Tool at


APA Reference
Carter, J. (2015). Overcoming the Secret Barrier to Making Money in Your Practice. Psych Central. Retrieved on September 18, 2020, from


Scientifically Reviewed
Last updated: 15 Oct 2015
Last reviewed: By John M. Grohol, Psy.D. on 15 Oct 2015
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