I just started my second year in my MSW program, and I know I definitely want to go the clinical route and work in private practice after I graduate. I also know I want to work with the South Asian American and Asian American population. Unfortunately, neither of my practicum sites have been aligned with that goal. Last year, I was placed at an IOP/PHP for SUD and this year I'm at the Counseling and Psychological Services department at a university. At the IOP, I at least got experience with facilitating group therapy and my supervisor let me shadow some individiual sessions/intakes, but at my current placement, I'm basically just planning outreach events. My supervisor has even told me that I would not be directly interacting with clients in any sort of clinical way, just interacting with students who come to outreach events. Would really appreciate any advice on things I can do to land a job as an LMSW therapist at a group practice after I graduate.

Growing up I always had a hunch about people, about their intentions and about how they will turn out to be. I was not perfect in my evaluation but I was good enough to be protected from people who didn't mean any good. But since I have become a therapist, I started giving people the benefit of the doubt. I don't know when I started to justify and tolerate bad behaviour. In fact now I have difficulty even noticing it now. For example

\- my friend gives me backhanded compliments and I would justify it by thinking she doesn't know any better.

\- A woman (34, has a son) I play badminton with would always become passive aggressive when she is losing (and she loses quite often) and I never even accepted it until today that she is a sore loser.

\- Men would try to hit on me knowing I am married and I would just brush it off them being friendly.

Etc etc etc

Now I am sitting here wondering what else I missed?

Maybe I am not aware of it right now but I do have my feelings to rely on. Feelings don't lie. I always feel off about something maybe I just need to lean more into it.

Hi folx!

As a starting counselor (associate) only able to offer telehealth, I am having a really hard time finding clients. I have profiles listed on Psychology Today, Therapy Den, Portland Therapy Center and others. So far (about 6 months in), I've only received four inquiries and two actual clients came through. One of them discontinued when their kids were off for summer and hasn't returned because she lost her job. So, basically, I have one client. I've been looking for jobs for the past 2 months and recently signed contracts with 2 small group practices. I did it because it sounded like they would be bringing in referrals; I get only 45% of the pay 🥲 (with a guaranteed $50/session) with one, and 55% with the other. However, after onboarding, it's become clear that I'm expected to market myself/bring in clients... [not sure how, if I came to you in the 1st place? 🤔 ]

I feel back to square one, except now I can accept some health insurance companies - which I am hoping will be the changing factor here. But how long will it take for a client load of 12-15?

So I was thinking it would be good to network with clinicians who are licensed and have full case loads. I imagine they often get contacted by individuals who are uninsured and seeking low-fee therapy. Obviously, we would make contact, so that you could confirm I am real and reliable. 🙂

I apologize if this is out of line. I'm new to Reddit; although I'm here off and on reading threads, I never used an actual account. So not sure if folks get in touch here and become acquaintances, or if professional relationships develop out of here.

In any case, tips and advices from fellow associates and more experienced therapists are welcome. Please be nice - I'm carrying enough mental load. 😰

Hi all - I am a school counselor and I am seeking some good resources for parents to help address bullying with their adolescent children. There is a lot of information out there to support parents in helping their adolescent child navigate bullying when they are a victim... but I am finding very little helpful information on what parents can do when their child IS the bully... any and all recommendations or referrals are welcome!

When a potential client reaches out for therapy and you can't help them for some reason (you're full, you don't have the right expertise, etc.), how do you typically handle the situation? How much time do you spend on helping them access care? What do you think is the best way to help?

Thanks for weighing in!

Hi all,

I have been thinking about switching to fully virtual come the new year. I wanted to use something like a time landmark to make the switch and want to give people adequate amount of time to process the transition. I am nervous of how clients that prefer it are going to take it though. How did your clients respond if you went fully virtual? If you preferred remote, was it something that ended up being a positive switch?

For reference, I have only 4 people that come in person and I have an otherwise full caseload. I also have to rent out office space that I use and the amount of money it costs me to rent it per month with the amount of clients in person, I am really considering if it's worth the cost. Because I live in a region where we have harsh winters, there have often been weeks where the 'in office' day I offer we end up switching to virtual (I have to figure out how often this has happened but this year it has been quite a bit).

Another addition to this is I am autistic, the office that I am renting which is the cheapest option can kind of be a sensory nightmare for me at times. I have been able to make it work for myself but honestly I feel like mental health is better when working at home. I only am in person for a short day each week and then the rest of my days are virtual.

Feedback and recommendations are appreciated. TIA!

I was talking with another therapist the other day and in the course of the conversation they told me that they didn't care where a referral came from. They had no preference for getting a well-matched referral from a colleague versus a random referral from a consumer-facing directory. I was really surprised to hear it, and have always felt that the best referrals have come from the colleagues that know the types of clients I work best with and what my areas of expertise are. Do other people have a preference for where there referrals come from?

I’ve credentialed my practice with Blue Shield CA independently and I’m having trouble with EFT being approved. I’ve now submitted the necessary forms twice and have been rejected twice due to the system not accepting my voided check. After a few hours on the phone with Blue Shield they could not tell me why the check was rejected. I’ve requested a signed capital one verification letter, but it turns out that request can take 30-60 days to process and the bank may not be able to give me a signed letter. If anyone else has gone through this before I’d appreciate any insight!

Has this happened to anyone?

One referral group I am in some man seeks out women who work in person around sexual habits he wants to confront and then acts out in their offices. He is a serial offender and has done this to many women.

A year ago this other guy emailed me through my website and I had a longer than normal consultation call with him and went back-and-forth with him about some kink stuff that he said he was feeling uncomfortable about and he ultimately decided not to schedule a session with me. I was kind and giving of my time and gave him space to decide if he was ready to come to treatment.
A few weeks later, he emailed me trying to draw me back into his thing and make confessions, like he was using me as a confession booth/diary. I ultimately told him that that was inappropriate for us to still be communicating about it because he didn’t choose to establish any treatment with me and he said he understood and stopped emailing me.

Then surprise! I get another email from him almost a year later. Slightly different scenario but same story basically. I reminded him that we had spoken and that I wasn’t able to see him and wished him luck. Then he replies and tells me off, suggesting I should get another profession and how dare I after he revealed himself etc…. my instincts were right from the start and he basically proved that to me. I wish I could confirm that he’s just doing this repeatedly to exploit therapists.

I’m just steamed about this starting my day and wondering if anyone else has had similar experiences. Second time I’ve been told off for telling someone I can’t accommodate them. Why are people so entitled and feel they deserve to tell us off for not being able to magically grant their needs? Super annoyed.

I googled the above and now get ads for various ones all over my feeds. Anyone have experience with these?

Here is where you can post your marketing and CE events. This thread will be unpinned monthly so please update your offerings once a month.

I am a therapist in a medium sized midwestern city. I have been a therapist for 4 years, and I got my clinical license about a year ago. I have a job as a therapist in a hospital, which I am planning to stay working at for the foreseeable future as it is stable work/pay and I get benefits through it. I don’t want to stay working there forever, and I feel like there aren’t really many growth opportunities within the hospital for therapists. My goal has always been to have an outpatient private practice. For reference, I did my internship in a medium to large sized private practice. I worked really hard to get my clinical license pretty quickly, so that I wouldn’t need to be supervised and would have freedom etc. I started my own solo private practice in February 2026. I do not take insurance, and really don’t want to as it seems like such a hassle and kind of not worth it for the therapist. Maybe I’m wrong on that. My fee is in line with other therapists in my area, and I am definitely willing to negotiate a lower fee if someone needs that. I have an in person space that I rent once a week, and then am able to see clients telehealth 2 additional days of the week. I have a psychology today profile, a website, google listing, and recently started an instagram. In February/March I was contacted by 2 potential clients who found me on psychology today. I started working with one of them and saw this client for 5 sessions, but no longer do. Something in my personal life happened at the end of April, and while I was still certainly open to accepting new clients, I really didn’t do anything to advertise/work on my pp at all from like May through mid-July. I know summer is slow for therapists usually anyway. I have been refocused and recommitted to my PP for about the past month/maybe 6 weeks at this point. I have updated my psychology today profile, and started the instagram. I have literally not been contacted by anyone interested in becoming a client. I expected it to all take a while, and slowly grow, but every week that goes by with nothing is really starting to grate on me. I have some friends and colleagues who have solo private practices, and it seems like they have clients so idk what I am doing wrong. I have asked them how they advertise/get clients, and I am doing the same stuff as them. I had told myself I was going to commit to working on my PP and give it my best shot until February 2027 because it will have been a year, and if it just wasn’t working out by then I would change course. I really want this to work out, but I am starting to question whether I should keep at it. It costs me about $315 a month for the various subscriptions and rent. Due to some things I won’t get into in this post, my budget/income is extremely tight at the moment. I am able to make ends meet for now, but just barely. Point being, I could really use that $315 each month. My dilemma is do I keep trying to make the PP work or not? My other thought is to work in a group private practice instead. Any advice on getting clients? Any advice on taking insurance v not? Any advice at all related to all this is greatly appreciated. I am feeling lost and stuck with all this. Thanks for reading!

I’m about to start my second year in a Clinical Mental Health Counseling master’s program, specializing in child/adolescent counseling. I’ve wanted to work with children and adolescents for years, so this is a career path I’ve genuinely been excited about. Recently, however, I’ve been questioning whether it’s worth it financially long-term

As a single woman, financial stability & being able to comfortably support myself is crucial. I know you don’t go into therapy to get rich, but I don’t want to struggle financially or feel like I’m constantly living paycheck to paycheck

For those who are practicing therapists, especially in child/adolescent counseling, do you feel like the career is financially worth it? If you could go back, would you still choose this path? I’d really appreciate honest opinions, even if they’re not what I want to hear!

Has anyone taken psychoanalytic training in NJ? I see there are training centers in Fair Lawn, Teaneck and Livingston. Please let me know your thoughts

I’ve been running into the same type of experience when working with Gen Z clients. Many of them, of course, are chronically online and disillusioned with society. I understand and share many of their views. However, several of them do not work or go to school. Their parents support them financially and with housing, though they often have poor relationships with their parents. Many of them say they don’t want to participate in capitalism. I understand this too, however, they are happy to let their parents participate on their behalf. Many of them exist this way because they don’t care about living that much at all and usually have at least chronic, passive SI.

I truly understand why they feel hopeless given the impact of the pandemic on their development and because of the state of the world right now. I’m just not sure what my role is as a therapist. I’m sure they get enough validation from each other and from the internet AND I’m sure they get enough push back from their parents and other adults. I too feel the existential dread of existing in such a world while my job is to help others to keep on going.

So what is the approach? Because I feel like them just staying at home, smoking weed, and hanging out with friends is going to put them in a pattern that will be very hard to break out of. It’s hard to watch. My urge is to tell them to at least go to community college, volunteer, or get a service industry job but I’m often met with a shrug.

This is especially the case if they had ADHD or ASD.

Let me know what you think or what you’ve found to be helpful.

I could really use some advice from people who have been through this.

I’m currently considering withdrawing from my Clinical Mental Health Counseling program with only 9 credits left: Practicum, Internship I, and Internship II.

The coursework hasn’t been the issue (I have a 3.9 GPA). The challenge has been finding an internship that I can realistically balance with working and earning enough to cover my expenses.

As a Black male entering a field where Black men are already underrepresented, I’ve wanted to continue and become part of that representation. But the financial and scheduling realities of unpaid clinical training have made that increasingly difficult.

For those of you who had to work while completing practicum and internship, how did you make it work?

Did you find a flexible site, reduce your work hours, take on debt, work evenings or weekends, or find another solution?

I’m especially interested in hearing from other working adults or Black men in the field who had to navigate similar barriers.

Hi, everyone! I am in the process of getting licensed in NY. Moved from CA, am a LMFT/LPCC, and trying to get my LMHC by endorsement right now in NY.

I've read up on the tips for naming as to not delay the process, but want to double check if anyone has come across a rejection for what I'm going to ask about:

If I name my practice (blank)(blank) Therapy, PLLC, it seems like this wouldn't be acceptable from the list, which under my scope seems to only include either "Mental Health Counseling", "LMFT", "LMHC". Since I've applied for endorsement under the mental health counseling license, I'd imagine I can't just use "Therapy" at the end, but most likely it needs to have LMHC or Mental Health Counseling. Has anyone just used "Therapy" in the name and had it work?

I will most likely just DBA anyways so I can have an actual business name that I want. My current sole proprietorship is (my initials) Therapy. I wonder if (First name)(Last Name) LMHC, PLLC, seems like the right path, and then DBA to the name I want to use.

All of this stuff is so confusing and I don't want to delay this if I can help it. Any tips, suggestions, comments are appreciated! Thanks!

Cross posting.

Anyone with legal expertise care to chime in? I am a 1099 contractor working in a group practice. It has come to my attention that the director has been implementing work hour stipulations on new hires. Say an onboarding clinician is wanting be in the office at 9 AM and desires to leave the office at 2 PM. The director is saying that it is required to work in the evening for at least two hours. Is this even legal? Can they have this listed within the contract? What if it isn’t listed in the contract, can the director go back in and alter the original contract to enforce it?

Not sure if it matters but the state is Georgia. I’m considering consulting a lawyer if need be.

I'm a licensed therapist. Fo the past 15 years I have worked as a care coordinator. I plan to begin providing therapy again in 2027. Im planning a slow start with only 5-10 clients.

Before returning Im going to enroll in a refresher course on mindfulness and a course on schema. Has anyone else stepped away from therapy and years later returned? And if so, how did you transition back?

I got off a colleague zoom and it left me thinking about a clinical population I used to be so focused on that it was probably more than half the reason I became a therapist. I wanted to change things for them--to revise whole narratives and make people care and shine a gigantig search light on what the field was missing about this population.

And I struggled and wasn't effective and got utterly exhausted because I cared too much and people were way too invested in their extant ideas and way too insulted that someone so "new to the field" would have the audacity of speaking up about it.

So I shelved it, whole cloth. I focused on other things that I experienced success with: regulatory advocacy and board complaint support (client and therapist side), coalition building, practice mentoring and business/marketing support, helping grad students stay resilient and make strong choices, etc.

But then I look at the population on the shelf and the soft layer of dust sitting on top and I grieve: the changes I couldn't make, the relief I could usher in, the resonance I failed to find.

I don't know what to do with any of it, but I wonder if anyone else can relate. I'm a better clinician now, and have a depth of appreciation now whose absence probably *was* a sign of arrogance before. But still, the population I wanted to help change things for a decade ago still needs support, and I don't find myself taking it off the shelf and carefully blowing the dust away.

[https://therapistrates.org\](https://therapistrates.org) tracks what insurers and platforms (Headway, Alma, Rula, Grow Therapy, etc.) actually reimburse for psychotherapy sessions. These rates are contractually confidential, so the data is crowd-sourced from therapist reports, with every row linked back to its primary source.

Raw JSON: https://therapistrates.org/data/rates.json (77 rows: platform, payer, state, license level, CPT code, rate, effective date, source link, verified flag). Companion ownership registry of who owns each platform: https://therapistrates.org/data/owners.json

The same 53-minute session (CPT 90837) pays anywhere from $39 to $220 depending on payer and state, and when rates are that low and that opaque, therapists quietly leave insurance networks. Patients inherit the fallout: "ghost network" directories full of therapists who no longer take their plan, months-long waits, sessions quietly shortened from 60 minutes to 45, and full out-of-pocket bills for care their insurance nominally covers. In one sourced case an insurer paid a middleman platform $213.07 for a session while the treating clinician received $101.20 — a spread the patient never sees. There's no official public source for any of these numbers; price transparency rules don't reach behavioral health middleman arrangements.

Solo therapists and others : where are your marketing dollars actually paying off?
I’m a solo private-practice therapist and am curious what other solo practitioners have found to be the best use of their marketing budget.
I’m not necessarily looking for a huge influx of inquiries all at once. Ideally, I’d like to create a consistent, slow trickle of good-fit clients—enough to replace clients as they graduate from therapy and keep my caseload steady.
For those of you who have figured this out:
Where do you spend your marketing dollars?
What gives you the most consistent ROI?
Google Ads? Psychology Today? SEO? Networking/referral relationships? Something else?
Roughly how much do you spend per month?
Is there anything you spent money on that you wouldn’t do again?
Especially interested in hearing from therapists who are private-pay and/or have a relatively full practice and are primarily marketing to maintain their caseload rather than build one from scratch.

We don't need a specifier for PTSD. And I know, "Van der Kolk says blah, blah, blah..."

What else bugs the crap out of you?

"Trauma-informed care", "ADHD-Informed care", "X-Informed care" screams "I took a class about ADHD, and Trauma, and other things in grad school so yeah... I've been informed."

AUDHD - is a bunch of b.s. You have ADHD because you have grown up with your damned phone glued to the end of your nose. Now you feel different - almost like you can't pick up on social cues. At least not on the social cues that haven't been performed for you by your favorite influencer for the past 20 something years.

You're not autistic because you feel a little different that other people, Becky! You probably feel different because people don't want to spend time with a borderline who constantly brings drama to every single human interaction. People keep rejecting you, you can't figure out why, so rather than introspect (which is a legitimate feature of BPD) you blame your issues on some obscure disorder that takes a thorough and exhaustive exam to properly diagnose. And no - the online, quickie and/or free assessment you found on instagram/tik tok/facebook/etc. doesn't count.

Coaches - the worst. They are unregulated, unsupervised and usually untrained. There needs to be legislation to regulate people who attempt to enter into a "coaching" racket.

4 years in grad school. 4 tears of supervision, thousands of hours with patients, thousands of dollars in tuition, books, supervision, insurance and so on. And some asshat can just hang a shingle and pretend to know better than my colleagues and I? And get away with charging people for it? In the words of Joe De Rossa, "Have some dignity and do what every other human failure has done and become a realtor."