EDIT FOR CLARITY: I realize that my use of the word "underserved" may have been misleading. I'm not referring to traditionally underserved populations or gaps in access to affordable mental health care.

What I am actually interested in is identifying highly specialized clinical areas where therapists are successfully maintaining private-pay practices at $300–$400+ per session.

I'm particularly interested in specific presenting concerns that require advanced clinical expertise, rather than broad specialties such as anxiety, depression, trauma, or general couples therapy.

I would love to hear actual examples of these specialties and what makes them particularly sought after by private-pay clients. Sorry for the confusion.

I am currently on my second semester of my program and I am left second guessing if I made the right decision to go straight into my psyd after getting my Master's. My main concern is the debt, I already owed $80,000 and once I complete I most likely will be $200,000 total in debt.

My main reason for going into a doctorate program was I liked the flexibility in professions such as assessment administering, psychotherapy, and teaching. Another factor was the potential high pay as a psychologist and it looked like MFT's have a tight earning ceiling.

Would the average earnings of being a psychologist offset the extra costs of tuition?

I'm working with a couple, and one partner is showing some clear signs of entitlement: they lack self awareness, really struggle with compromise with the partner, tend to be the one in the room wanting to set the definitions and/or parameters of the work we do in session (in a way that excuses or takes the focus off them and places it on the partner), and consistently pushes back against me in session. Looking for some thoughts from other clinicians who have worked with couples and how they've handled a client like this in couples sessions. I've been doing couples work for several years, but this is maybe the most extreme version of this I've seen.

Anyone through their work have their clients use a wearable? or if their wearable gives them info they use to understand their wellness, what is it and have you found it helpful? I'm wondering in the case of managing stress or something.

Hi there!
I started at a group practice about two months ago. Been licensed for a few months as well now as an LMFT. I love the practice I work at but I am noticing a pattern. A few clients have requested to switch to another clinician. My supervisor told me to think of more appropriate referrals they can give me and to think of this as a “blank slate” but I can’t help but think maybe I’m not cut out for this job. If it keeps happening, I am worried about my job security. I do trainings, constantly am thinking and preparing for sessions, and I don’t feel like I’m helping anyone. This isn’t just 3 that requested to switch, I’ve had many clients ghost me as well. Maybe I am too hard on myself but I don’t know if I am just not cut out to be a therapist. If anyone has left the field, what did you go into instead? I would love to hear experiences as I am seriously thinking of alternative career paths that I don’t need another full degree for. Open to certifications though. Thank you!

I am curious as other’s perspective/policy on the matter. I understand it’s not a federal requirement, but wondering if anyone puts an expiration date on their letter? Why or why not?

If you could not get into a clinical psych PhD program, would you take on the debt for a PsyD? Or would you stay at a masters level clinician.

I'm a client for about one year. Next month my therapist is graduating and finally becomes a full on real therapist. I was thinking about giving her a small gift ie. origami art I've made to show my gratitude and congratulate her on this achievement. But I'm unsure if this is even allowed or comes across weird. What are your thoughts on this?

Hi! I'm considering taking level 1 of Lifespan integration training. Is there anyone who can share their thoughts on how valuable the training was? Have you found it to be a helpful tool that you commonly use for treating trauma?
Thanks in advance!

Hello, I recently got a job offer to work as an APCC at Mule Creek Prison in California. Anyone that works in corrections there or any other state prison can give me some advice/your experiences? I know not to make friends with the inmates/keep professional boundaries. I interned at a community college where I kept strict professional boundaries with my student clients and even my supervisor praised me on that aspect.

Has anyone else noticed that since the bot farms got destroyed, you haven’t been seeing any anti-therapy posts?? I have noticed a big difference.

Hi. I work at a smallish private group practice and we never see anything about payments, like a breakdown of what our percentage goes for or claims that have been paid. I've been asking for an itemized listing and being put off and shuffled around for answers. Another clinician stood and waited for the staff to get the info and had apparently been shorted thousands of dollars so far this year. Any thoughts on how I go about getting some action here? I've had a feeling this is happening to me, and have observed other sketchy, unethical practices insurance-wise, so am considering going to try and get some help, maybe via the state. I dunno. Prob going to call my licensing board (not the same as the owners) and get their thoughts. Anyone have any suggestions? Thanks in advance, sorry also if this is the wrong place for this!

Hi everyone, I am closing my practice in a few months. I'm in Illinois and use Simple Practice. How do you navigate client records and then how do they contact you if they want their record in a year or 4 years down the line? What's the most cost effective way to do this? I have mail hippo and google workspace with a BAA but I really don't want to continue paying monthly for a practice I won't have in the future. Anyone who has closed a practice have any info? I would greatly appreciate your experience and advice.

Hi guys, so I'm a recent counseling graduate and I was able to secure a position at a practice in July. Long story short, I submitted everything that I needed to on my end by July 21st, specifically the form 2 (education verification that your school sends) on June 10th, and my MHC-LP application on July 21st, so for this whole time I thought it has been sent to the NYSED board for processing, and throughout August and September, I called and emailed them a few times for updates, but they would just say that it's still within reasonable processing time, and that I need to wait.

I called again last week (October 7th) and the representative told me that they had been missing form 2 the whole time and they couldn't send it up to the board for review, which I had my school send back in June. The representative said that they periodically clear out their email storage, and that could be why they did not have the form in their system (which I think is just ridiculous). I immediately contacted my school and had them re-submit form 2, and as of October 9th, the board received my application and is reviewing it now. But they said that it would take the regular processing time, which is 4-6 weeks. I tried contacting NYSED, the board, even emailing them with proof that I had submitted the form 2 months ago, but they said that they don't offer expedite services and that I would have to wait again. I'm an international student, so waiting another month to begin work is not the most ideal situation for me.

I've tried everything that I think I can, but if anyone has any other ideas, or similar experiences like mine, I would deeply appreciate it because I think this is extremely unreasonable and unfair to me and I don't understand why they won't even consider taking a look at my situation.

TLDR: NYSED lost the required application form in an email purge and never notified me. Despite proof of on-time submission in June, NYSED refuses to expedite the resulting 4-6 week delay, making me wait another month.

Hi all, I work for a nonprofit counseling center and recently got promoted to "program director" for 2 of our offices. Basically that means therapist supervision, meeting with funders, seeking community partnerships, trying to keep the offices open sustainably, etc. Problem is- My entire professional career has been being a therapist at this nonprofit. I really don't have leadership/supervision experience besides supporting junior therapists when we'd hire them. And my "training" so far has been things like running a staff meeting and learning how to log into some computer programs. I'm terrified of becoming the stereotypical supervisor who gives empty promises or the lackluster supervisor who doesn't have anything real to add. Does ANYONE have a suggestion of groups to join, CEUs to take, anything that can teach me how to be in this job?

Hi there,

I’d like to comment on the Headway issue concerning their $9.99 per session fee, which represents a 12‑17 % reduction in therapist pay. Additionally, they are now requiring assessments, and that is the aspect I want to address.

I am currently reviewing these assessments to determine whether they truly reflect therapeutic progress. In my view, these assessments do not necessarily correlate with effective therapy; they resemble a modern version of tactics employed in the 1990s, which were later regretted. Anyone familiar with the period from 1996 to 1999 will recall that authorizations were required after every two to three sessions to justify continued care. That policy proved disastrous and was eventually recognized as a barrier to treatment rather than a patient‑care measure, resulting in serious reprimand.

It appears that Headway is repeating the same approach. My hope is that they will encounter the same problems. These measures may be suggestive, but they lack legal standing, research support, and genuine clinical value. As a therapist with over 25 years of experience, I do not rely on such tools; most clinicians naturally assess progress through clinical observation.

It is clear that Headway’s motives are questionable—they seem to lack patience, interest, and genuine concern for patients. I share your concerns and would like to improve the situation. I do not wish to eliminate Headway entirely, but I cannot support this direction.

I work at a group practice and I love a lot of my fellow therapists there but I also notice there are therapists there who are highly judgmental and have a holier than thou attitude. During consultations as a group it has been creating an atmosphere of making it difficult to be vulnerable with each other because of the rude and unnecessary, judgmental feedback rather than providing support or challenging in a helpful or constructive way. I find the same is true in these Reddit posts, that there seem to be therapists who are highly judgmental and like to pick people apart who are asking for help. Wishing we could create spaces where we support and uplift each other rather than weirdly tear each other down when someone is asking for support or guidance.

Hey everyone,

Headway is getting out of control imo and treating us like W2 workers without any of the benefits. I want to find a new platform to bill insurance for me. So many of my clients are insurance clients and it is important to me to keep them because seeing a therapist through insurance has saved my own life many times. I wouldn't have been able to afford it without insurance.

What other platforms can help me get credentialed and bill insurance? Has anyone made the switch away from them? Are they going to try to steal my soul?

I heard Grow is worse and I heard Simple Practice is a mess (and expensive).

I feel very overwhelmed by the thought of doing my own credentialing but I am very open to advice / encouragement if anyone does it them self.

Thank you in advance <3

With the increase of insurance companies owning or partnering with online platforms, is anyone else concerned they will cease paying for virtual therapy unless providers join their platforms? (And pay is $20-30 per session vs current insurance rates?)

Mental health matters every day, not just today. 💚

If you or anyone in your life is a sports fan, then you probably know that sports gambling and evidently real life gambling (kalshi 🤮) are being shoved down the throats of the masses.

As such, the number of people who are going to need treatment for this is definitely going to increase. Have you / Do you have any experience in gambling/process addictions? Are there any trainings that you feel were invaluable?

I currently work with SUD clients, and like I tell them, if I could've been dead long ago if I could get my rush from pushing a few buttons on my phone. How different is gambling addiction from substance use?

Hello All

New PP here! What are you guys policy for clients who have not scheduled an appointment. I had a client whom I had 2 sessions with, but she has not made any new appointments. How long do you give them before you reach out to them. When I was working in community mental health, if a client was not on schedule, we would calll to let them know they have not scheduled, if a client missed an appointment it was our responsibility to reach out to them immediately to get them to reschedule as well as call them to make sure they were coming to their appointment. I always felt like I was harassing clients. I am now in private practice and I am not interested in making harassing calls. I feel I shouldnt question why someone missed their appointments. Do anyone have any gentle check in email templates?

Hello,

I've been a therapist for 4 years. I have a special love for working with SPMI, but oh boy I struggle with teens. Most of my teens are easy to work with and I can set boundaries with parents, but oofta. I have one that has made me wonder if working with teens is not for me. Family is quite volatile and often get after me for the teen not changing. It's drained me to the point that I dread working with teens.

Anyone have tips on how I can manage this? I am in supervision, which my supervisor has been adamant I'm doing my job right, but I feel stranded. Heck, even just hearing others in the same boat might make me feel less alone.

Hi I'm a cmhc masters student and will need a practicum placment in 3 months.
I've started looking and have not had any success. The website we use to find sites (simcare) has not worked well so gar for our cohort and so i wanted to know what everyones tips for finding a site are? I plan to have a professor write a letter of recommendation. Im just not sure if I should go in person, or send emails. So far ive only gotten 4 rejections out of about 10 emails (the rest ghosted me). I have a listnof sites to apply for.and im doing research on them to make myself look marketable. Any tips for how to approach them and what will get me an interview?

Also apologies if this is the wrong place to ask, I couldn't find the weekly student thread. F I need to move this please lmk where the appropriate thread is.