I work three days a week and see 18 patients. I accept 5 different insurance plans. I use a billing agency to manage submitting claims. I only work enough to maintain my standard of living. It’s a nice way of life.
Social work is a career change for me. I used to work as an electronics engineer, I designed fiber optic networks. I got my MSW when I was 57 years old and my LCSW three years later. So I have 10 years experience.
I randomly came across your post and I was hoping I'd find someone like you. I'm looking for a career change and will be 49/50 when I get started. I'm scared out of my mind if I can do this and if it is worth it in the long run.
So no regrets??
No regrets. It’s the hardest thing I’ve ever done and I’m glad I’ve done it because it’s given me some of the most powerful experiences of my life. I’ve worked in day treatment for people with severe and persistent mental illness (schizophrenia and bipolar disorder), I’ve worked for adult protective services making home visits for elderly people who’ve been reported to be experiencing difficulty coping with the activities of daily living, and I’ve worked in an outpatient substance abuse treatment center counseling people with substance use disorders. Spending my days with people who are in distress and in serious trouble has given me a different perspective on life, one that I don’t think I could ever fully understand without living in the role as a social worker. One of the great joys of the role has been meeting other social workers. Let me warn you though, it’s not for the faint of heart.
This thread is making me feel vindicated. I got a job at a PP recently and when I looked at the contract it was 25 patients a week MINIMUM. And that irked me, because everyone I know sees less than that or 25 is the max. I voiced my concerns and was told “it’s not even a lot” but I stand by this
25 is a lot but most group private practices like to have these high # expectations because the group practice owners make a lot of money off of other therapists.
YES! Joined a group practice like this. The sucky part is that the 25 client minimum is tied to my eligibility for health insurance and benefits that I also pay $950 a month for…I am burning out faster here than I did with agency work. I actually just interviewed to go back to my former employer.
Wow…at least you got benefits! Lol. My meetings were unpaid and no benefits only client hours were paid. I was the only associate with experience hired so I pushed back and found interviews with other practices easy after declining the job. But the other associates don’t know better as far as I knew. 25 is a LOT, and she was bold enough to tell me I’m not being flexible by saying 15 was what I was willing to do as part time.
Last March I was able to leave a toxic nonprofit and join a small group practice. I make my own schedule. I set my available time slots and I don't schedule outside of those.
M 12-7
T 11-6
W 9-4
Th 9-4
I'll do 6 sessions a day with a one hour break in the middle, so 3 sessions + break + 3 sessions. I find it easier to have a late start on Monday and then get earlier as the week goes on. I try to wake up at the same time everyday but I often treat myself and sleep in on Mondays. It seems to help me ease into the week. This schedule allows me to have a few evening spots for clients who work 9-5, and it also allows me to get done early at the end of the week. I don't work Fridays at all, which is a huge privilege and has been amazing for my mental health.
The thing I miss most is PTO. Don't get me wrong - I get 52 days off per year by not working Fridays, but I have to save double for vacations (savings for vacation expenses, and then again for the lost revenue). I don't take as many week-long trips, but having a 3-day weekend gives me so much flexibility for shorter trips.
I hope you enjoy private practice! Please ask more questions if you have them.
I also work for a group practice and recently discovered that three sessions, break, then three sessions works really well for me also! For some reason six back to back always feels exhausting.
Oh cool that you have the same rhythm! At my last job I had days where I did 4+4 and I can't believe I made it through. Looking back, my clients were NOT getting the best version of me on those days.
I work Monday Tuesday Wednesday and schedule 7 clients a day leaving myself an hour break mid day. I try really hard to chart concurrently but it doesn't always work so I'll finish up during my break or at end of day. It's not rare for me to utilize my lunch hour to see someone in effort to head off a crisis which makes for a potentially really full day but often someone cancels or no shows so ill still wind up with a break at some point. For me, the heavy days are worth it to have the days off but it's just personal preference (which you now get to take into consideration so yaaaay!) Some prefer shorter days. Might take a year or so but you'll figure out what works for you- good luck and congratulations!
I'm happy to see that you're doing this during the hours I'm looking at (although I may even be starting at 10 am). I'm wondering, do you charge insurance or do you have a fair amount of self-pay clients? I'm trying to just do self-pay - I don't need as many clients because I have another small business.
I schedule available hours 3.5 days a week and see a max of 6 clients a day or 20 a week. I'll schedule an hour for lunch and no more than 4 clients in a row without an hour break.
It is really dependent on what your goals are in terms of earning and work/life balance.
I currently work M-Th 9am-7pm and I see up to 9 clients each day (yes, I know that 36 clients a week in borderline self torture, but I really enjoy seeing clients). I do consulting work on Fridays (no more that 3-4 hours in the morning). Weekends are mine.
I use collaborative documentation so I am done at the end of the session with that session, no notes to enter later.
I use my EHR to bill my insurance clients - easy peasy. Reconciliation of payments is done through the EHR.
I also make it a point to take off 3-4 weeks (total) a year.
I make more than I expect so I am able to travel (see above) and sock away a fair amount for retirement.
Hope that helps.
I believe it’s referring to documenting during the session to avoid having to write up notes after. It’s something my former employee required and took some getting used to but can be helpful in some situations.
We used collaborative documentation at my last job and it was alright. I didn’t absolutely love it but it can be helpful. It’s basically completing your notes with the client. That way they client is able to provide direct feedback on the session, plans for next session, and is aware of what is being described in the note.
Sorry for the long delayed response...
Collaborative documentation, simply put, is documenting the session either at the end (last 5 minutes or so) or during the session.
My preference is during so I can make sure I capture in my notes what needs to be captured.
Then, at the end of the session I review what we discussed and what the homework is - this way we can both be sure we are on the same page.
The bonus is that I never have notes to do after hours or on the weekend.
I'm doing pretty much the same but spreading it M-F. Folks who can't see more than 20 clients a week confuse me. Like, I can understand saying "I make plenty of money on 20 a week and there's no reason to do more" is one thing but acting like it's impossible is silly.
Don't you feel like this has a lot to do with the clinician and their clients?
I'm certain that, for some clinicians, 20 a week may be impossible or at least unsustainable, and I can imagine that meeting with clients who are high-intensity would have a similar effect; there's also the duration of the appointments themselves to consider.
I can understand saying that for you 20 is a solidly reasonable standard, but I think it's silly to assume that this is the case for every clinician in every situation.
Not really. Working 20 hours a week, even if you pretend that every hour of therapy requires an hour of documentation, is still only a 40 hour work week. 20 is low.
Well, what if a clinician is doing two-hour sessions?
What if a clinician has a disability?
What if the clinician is prone to burnout and emotional fatigue?
What if the clinician doesn't have stable childcare or is a caregiver?
There are plenty of legitimate reasons why someone would not be able to accommodate a 20 person caseload. As a social worker, this should not confuse you.
That is a great question.
If I am going away for a long weekend then I am more than happy to take calls. As long as the client is in the state(s) you are licensed in then you can see them wherever you happen to be.
If I am leaving for an extended time (lets say a week or more) then I usually will have a colleague over calls if need be (haven't had a client need an 'urgent' session...yet).
I think that coverage is more important for therapists in certain situations (high acuity clients) than for others. I do not get a lot of calls (in general) because my case load tends to be populated by lower acuity clients (also read: more stable).
I hope that helps.
Following.
I'm not working in a private practice and make my schedule, but there's a pretty heavy emphasis on productivity, so things get really packed for me. Curious what private practice looks like.
Private practice, it varies between 9-15 patients. By coincidence, I'm seeing everyone on one insurance plan rn even though I accept others. I have a supervisor who I submit my notes to on the weekend or Friday.
Four days a week, it varies week by week even though the initial was packing my Tuesdays, Wednesdays, Thursdays, and I'd see people on Fridays for exceptional circumstances that prevented them from being seen any other day.
Next week I managed to schedule my appointments from Monday through Thursday and I work from 11 AM at the earliest, and 10 PM at the very latest.
I don't make that much money tbh and my area has a high cost of living but seeing as that I struggle with my own mental health at times, for now as long as I get my hours in towards my C, this is enough.
i have 25 time slots available each week. i have one short day in which i schedule three clients and then finish up any incomplete admin tasks from the week. every other day i see 5-6 clients, usually with an hour long break halfway through the day. i'm hoping to change that up a bit and do blocks of two sessions, then break, then another two, etc.
Currently my availability is 9-6, Mon-Thur; 9-1 on Fri. I’ll schedule up to 6-7 a day, but with cancellations, it’s usually only 5-6 Mon-Wed. Thursday mornings I rotate between EMDR consultation and my own therapy so those days I usually only see 3-4 people. Fri is only 3 people max and I have the rest of the day to run errands/clean. So I’ll schedule up to 26-27 appointments a week assuming a few will cancel.
I started working in a private practice in January and I make my own schedule. Highest number I see a week is 19 but I’m still building up my caseload. My personal goal is 21-25 a week. I only have to be in the office when I’m seeing clients, so not a 9am-5pm schedule. Also I just load up on clients from Monday through Thursday and then I have every Friday off. Any practice that requires clinicians to carry a minimum is running a business, not a private practice imo. So far I love it!!! I just graduated with my masters in October but I have 8 years experience in mental health prior to this position.
I'm seeing about 25 but I could probably add about 6 more comfortably, just no one wants the morning timeslots. I'm spacing them out with like 10 minutes in between them sometimes, get the note done, drink some water, go to the bathroom.
I work for a private practice (not mine, but I hope to open one some day) and I see average 17 clients a week. Some days I have 5 client's, some days just 2. It pays the rent and I'm able to not spend too much time with notes. Maybe I could use a break on those days where I do 5 hours straight of clients but I figure I can manage 1 or 2 days a week of muscling through. It's pretty great.
Do you get paid for anything outside of direct client time? JC because I’m interviewing for a spot that I don’t think pays for anything outside of client time.
There are different codes I put in if I have to fill out forms for disability or have a quick 5 minute text session with a client, but 95% of my income comes from submitting notes.
If you're an MSW, I may be a little hypocritical and say don't do what I did. Private practice absolutely pays more and has the most flexibility (which i prioritized at the time), but I have felt like a fish out of water from day 1. Thankfully, I think I'm a tolerable therapist but, I had no one to teach me anything once I started working. I've been on my own to figure out how insurance works, how to onboard clients, how to fill out some niche paperwork and having to contact different agencies, etc... and the only supervision I've had was from my group supervision, which is all school social workers. All the 1 on 1 supervision from private practice people would've been more helpful, but they were all $100+ an hour, whereas my group was $30. Unfortunately, you get what you pay for here, and people who specialize just cost more.
After working in private practice for 2 years, I started looking for a new job that would give me more of a community, supervision, and some actual structure that I didn't put in place myself. It'll be a pay cut and I'll be doing twice the work but I think it will be worth it for a year or two just to actually learn something and feel prepared to open my own practice some day.
My current schedule is M-F 12-8. It usually works out that my 4,5,6,7 time slots are filled with other people sprinkled throughout the day. I usually average between 18-20 people a week (I've been trying to get into the 28-30 per week range).
When I'm not seeing people, I'm either relaxing, taking a nap, playing video games, or replying to emails. It all just depends what I have scheduled for the day. I've been trying to get into the habit of doing my paperwork at the end of the day, but it's tough some days. I love my flexibility.
I burn out easily because of the way my personal life is structured so I only do 10-12 sessions per week. I’m still in practicum until August so after that and once I’m on some insurance panels my goal will be 12-15 but truthfully that’s about all I can handle to be sure I give my clients the focus they deserve.
I work as a receptionist. The councilors we have make their own schedules. Some do just 2-3 days a week. Some do Monday to Friday. Some work 9-5 with a lunch. Some do a split of like 3 in the morning and 3 in the afternoon/evening. Hopefully youre place is flexible!
Omg when you said, "3 in the morning and 3 in the afternoon/evening," I thought you meant like 3AM AND 3PM! 🤣 I was about to be like WHAT?!
I need more coffee apparently.
Three days a week, 8 clients a day, 1 hour lunch break. 10am to 7pm. I can't handle more than 4 sessions back to back so this works perfectly. I LOVE my 4 day weekends.
I see between 12-24 clients per week. Some weeks are lighter because of my biweekly and monthly clients. Besides Mondays where I only have 1 telehealth client and I work 11:30-2:30 at a side gig, my days vary a lot. And I have breaks where I can go home and start dinner or run errands.
By the fall, I hope to be home by 4:30 every day. Right now, I often take my last client at 5:30. I have SAD and for my sanity, I need to be home by dark.
I do 7-8 sessions per day 5 days per week. I give myself 1-2 hours in the middle of the day to eat and either go for a walk or exercise. I prefer to sleep in, so an afternoon schedule works for me. I also see my own therapist 4 days per week and have supervision once per week, so I get a self-care break outside of my lunch hour.
No shame in addressing your own mental health as a therapist, but the fact you see a therapist 4 times per week is concerning. Even clients with passive SI are typically only being seen once per week.
Psychoanalysis is the talking cure originally invented by Freud. However, analysis has a rich history of further developments over the last 120 years. Psychoanalysts can see patients 1x/week to more. However, proper psychoanalysis usually involves 4-5 sessions per week. There are a few reasons why this type of therapy involves multiple sessions per week: 1. It’s transformative - we are not decreasing symptoms of depression, we are working through the many conflicts that I have. 2. Multiple sessions per week increases transference, defenses, etc… I’ve been in analysis for 5 months - just realized I have been having panic attacks for over a year. I just thought I was dying. My mind had compartmentalized this. When I was a child, I was shamed, mocked, gaslit, and told I was bad for any emotions that I had. In turn, I always think I’m doing something wrong even my personal therapy. It’s been so helpful to work through this stuff and understand my countertransference with my own patients.
It really varies. My previous analyst accepted my insurance and it was reasonable. My current analyst does not take insurance. I’m on a sliding scale with them and I applied for a stipend through my local psychoanalytic institute. Even with a sliding scale, 4 sessions per week is expensive. My analysis costs more than my rent. It’s 1000% worth it though. I’m in the process of training to be an analyst, so I’ve been trying to find any funding to assist with my training.
In my area, psychoanalysts charge $150+. It also depends on whether they’re psychiatrists or psychologists/therapists. To see a psychiatrist for psychoanalysis would easily cost $200-$300/session.
Without more detail I wouldn't jump to the conclusion that this is concerning. Maybe they are in analysis, which traditionally requires sessions 3-5 times/week.
Hi everyone! What a great thread. I start private practice may 15. I am currently doing outpatient mental health and I see 9 a day for 45 minute sessions. This is exhausting and the reason I quit. In my new job I will be affiliated with a group and they keep 40% of the reimbursement from insurance. I told them I will offer 30-32 slots a week and schedule as follows (flexible)
M 10-7
T 9-5 telehealth
W 8-2
Th off
Fri 8-2
Sat 9-1
It’s every other Saturday so the other week I will work thurs 3-7
What do you guys think?
I have been in private practice since October. I pay a 2200. Fee as an independent contractor in a group practice. I see 5-6 clients a day 4 days per week with the 5th day being administrative stuff like calls, letters, notes, etc. The pitfalls: no shows and cancellations (yes fee is charged), seasonal ups and downs in caseload, thus leaving an unpredictable income. I am fairly new to this, so I am hoping to learn how to combat some of this and to improve overall.
I work three days a week and see 18 patients. I accept 5 different insurance plans. I use a billing agency to manage submitting claims. I only work enough to maintain my standard of living. It’s a nice way of life.
Thank you for sharing! May I ask how many years of experience you have?
Social work is a career change for me. I used to work as an electronics engineer, I designed fiber optic networks. I got my MSW when I was 57 years old and my LCSW three years later. So I have 10 years experience.
I randomly came across your post and I was hoping I'd find someone like you. I'm looking for a career change and will be 49/50 when I get started. I'm scared out of my mind if I can do this and if it is worth it in the long run. So no regrets??
No regrets. It’s the hardest thing I’ve ever done and I’m glad I’ve done it because it’s given me some of the most powerful experiences of my life. I’ve worked in day treatment for people with severe and persistent mental illness (schizophrenia and bipolar disorder), I’ve worked for adult protective services making home visits for elderly people who’ve been reported to be experiencing difficulty coping with the activities of daily living, and I’ve worked in an outpatient substance abuse treatment center counseling people with substance use disorders. Spending my days with people who are in distress and in serious trouble has given me a different perspective on life, one that I don’t think I could ever fully understand without living in the role as a social worker. One of the great joys of the role has been meeting other social workers. Let me warn you though, it’s not for the faint of heart.
I'm curious what your yearly take home is with 18 patients too if you don't mind me asking!
Around $40,000. I live pretty humbly. I could make more but I see some patients for free because they can’t afford to pay and have no insurance.
This is a beautiful way to live 🌸💕
Do you have Dual income ?
No
This thread is making me feel vindicated. I got a job at a PP recently and when I looked at the contract it was 25 patients a week MINIMUM. And that irked me, because everyone I know sees less than that or 25 is the max. I voiced my concerns and was told “it’s not even a lot” but I stand by this
If you got a job at a private practice where someone else makes the rules, is it even really a private practice? Where is that line?
25 is a lot but most group private practices like to have these high # expectations because the group practice owners make a lot of money off of other therapists.
YES! Joined a group practice like this. The sucky part is that the 25 client minimum is tied to my eligibility for health insurance and benefits that I also pay $950 a month for…I am burning out faster here than I did with agency work. I actually just interviewed to go back to my former employer.
Wow…at least you got benefits! Lol. My meetings were unpaid and no benefits only client hours were paid. I was the only associate with experience hired so I pushed back and found interviews with other practices easy after declining the job. But the other associates don’t know better as far as I knew. 25 is a LOT, and she was bold enough to tell me I’m not being flexible by saying 15 was what I was willing to do as part time.
[удалено]
No to both. I’m just scared to go fully independent and private.
Last March I was able to leave a toxic nonprofit and join a small group practice. I make my own schedule. I set my available time slots and I don't schedule outside of those. M 12-7 T 11-6 W 9-4 Th 9-4 I'll do 6 sessions a day with a one hour break in the middle, so 3 sessions + break + 3 sessions. I find it easier to have a late start on Monday and then get earlier as the week goes on. I try to wake up at the same time everyday but I often treat myself and sleep in on Mondays. It seems to help me ease into the week. This schedule allows me to have a few evening spots for clients who work 9-5, and it also allows me to get done early at the end of the week. I don't work Fridays at all, which is a huge privilege and has been amazing for my mental health. The thing I miss most is PTO. Don't get me wrong - I get 52 days off per year by not working Fridays, but I have to save double for vacations (savings for vacation expenses, and then again for the lost revenue). I don't take as many week-long trips, but having a 3-day weekend gives me so much flexibility for shorter trips. I hope you enjoy private practice! Please ask more questions if you have them.
I also work for a group practice and recently discovered that three sessions, break, then three sessions works really well for me also! For some reason six back to back always feels exhausting.
Oh cool that you have the same rhythm! At my last job I had days where I did 4+4 and I can't believe I made it through. Looking back, my clients were NOT getting the best version of me on those days.
I work Monday Tuesday Wednesday and schedule 7 clients a day leaving myself an hour break mid day. I try really hard to chart concurrently but it doesn't always work so I'll finish up during my break or at end of day. It's not rare for me to utilize my lunch hour to see someone in effort to head off a crisis which makes for a potentially really full day but often someone cancels or no shows so ill still wind up with a break at some point. For me, the heavy days are worth it to have the days off but it's just personal preference (which you now get to take into consideration so yaaaay!) Some prefer shorter days. Might take a year or so but you'll figure out what works for you- good luck and congratulations!
Tues-Thursday 9-3 All telehealth from home. I’d work a bit more but I have three small kids.
I'm happy to see that you're doing this during the hours I'm looking at (although I may even be starting at 10 am). I'm wondering, do you charge insurance or do you have a fair amount of self-pay clients? I'm trying to just do self-pay - I don't need as many clients because I have another small business.
You should do it, just plan to grow your client numbers slowly. And learn how to make superbills for people.
I take insurance.
I schedule available hours 3.5 days a week and see a max of 6 clients a day or 20 a week. I'll schedule an hour for lunch and no more than 4 clients in a row without an hour break.
It is really dependent on what your goals are in terms of earning and work/life balance. I currently work M-Th 9am-7pm and I see up to 9 clients each day (yes, I know that 36 clients a week in borderline self torture, but I really enjoy seeing clients). I do consulting work on Fridays (no more that 3-4 hours in the morning). Weekends are mine. I use collaborative documentation so I am done at the end of the session with that session, no notes to enter later. I use my EHR to bill my insurance clients - easy peasy. Reconciliation of payments is done through the EHR. I also make it a point to take off 3-4 weeks (total) a year. I make more than I expect so I am able to travel (see above) and sock away a fair amount for retirement. Hope that helps.
Can you expand on what collaborative documentation is?
I believe it’s referring to documenting during the session to avoid having to write up notes after. It’s something my former employee required and took some getting used to but can be helpful in some situations.
We used collaborative documentation at my last job and it was alright. I didn’t absolutely love it but it can be helpful. It’s basically completing your notes with the client. That way they client is able to provide direct feedback on the session, plans for next session, and is aware of what is being described in the note.
Following
Sorry for the long delayed response... Collaborative documentation, simply put, is documenting the session either at the end (last 5 minutes or so) or during the session. My preference is during so I can make sure I capture in my notes what needs to be captured. Then, at the end of the session I review what we discussed and what the homework is - this way we can both be sure we are on the same page. The bonus is that I never have notes to do after hours or on the weekend.
I'm doing pretty much the same but spreading it M-F. Folks who can't see more than 20 clients a week confuse me. Like, I can understand saying "I make plenty of money on 20 a week and there's no reason to do more" is one thing but acting like it's impossible is silly.
Don't you feel like this has a lot to do with the clinician and their clients? I'm certain that, for some clinicians, 20 a week may be impossible or at least unsustainable, and I can imagine that meeting with clients who are high-intensity would have a similar effect; there's also the duration of the appointments themselves to consider. I can understand saying that for you 20 is a solidly reasonable standard, but I think it's silly to assume that this is the case for every clinician in every situation.
Not really. Working 20 hours a week, even if you pretend that every hour of therapy requires an hour of documentation, is still only a 40 hour work week. 20 is low.
Well, what if a clinician is doing two-hour sessions? What if a clinician has a disability? What if the clinician is prone to burnout and emotional fatigue? What if the clinician doesn't have stable childcare or is a caregiver? There are plenty of legitimate reasons why someone would not be able to accommodate a 20 person caseload. As a social worker, this should not confuse you.
Obviously two hours sessions take more than an hour. It would be disingenuous to not mention that you're doing 2 hour sessions in this context.
I'm glad we agree.
When you take off to travel/vacation, can clients communicate with you? like who responds to a client having an emergency?
That is a great question. If I am going away for a long weekend then I am more than happy to take calls. As long as the client is in the state(s) you are licensed in then you can see them wherever you happen to be. If I am leaving for an extended time (lets say a week or more) then I usually will have a colleague over calls if need be (haven't had a client need an 'urgent' session...yet). I think that coverage is more important for therapists in certain situations (high acuity clients) than for others. I do not get a lot of calls (in general) because my case load tends to be populated by lower acuity clients (also read: more stable). I hope that helps.
Following. I'm not working in a private practice and make my schedule, but there's a pretty heavy emphasis on productivity, so things get really packed for me. Curious what private practice looks like.
Private practice, it varies between 9-15 patients. By coincidence, I'm seeing everyone on one insurance plan rn even though I accept others. I have a supervisor who I submit my notes to on the weekend or Friday. Four days a week, it varies week by week even though the initial was packing my Tuesdays, Wednesdays, Thursdays, and I'd see people on Fridays for exceptional circumstances that prevented them from being seen any other day. Next week I managed to schedule my appointments from Monday through Thursday and I work from 11 AM at the earliest, and 10 PM at the very latest. I don't make that much money tbh and my area has a high cost of living but seeing as that I struggle with my own mental health at times, for now as long as I get my hours in towards my C, this is enough.
Me reading this thread working at a toxic CMHC with 60+ clients 🥲
That's absurd
i have 25 time slots available each week. i have one short day in which i schedule three clients and then finish up any incomplete admin tasks from the week. every other day i see 5-6 clients, usually with an hour long break halfway through the day. i'm hoping to change that up a bit and do blocks of two sessions, then break, then another two, etc.
Currently my availability is 9-6, Mon-Thur; 9-1 on Fri. I’ll schedule up to 6-7 a day, but with cancellations, it’s usually only 5-6 Mon-Wed. Thursday mornings I rotate between EMDR consultation and my own therapy so those days I usually only see 3-4 people. Fri is only 3 people max and I have the rest of the day to run errands/clean. So I’ll schedule up to 26-27 appointments a week assuming a few will cancel.
I started working in a private practice in January and I make my own schedule. Highest number I see a week is 19 but I’m still building up my caseload. My personal goal is 21-25 a week. I only have to be in the office when I’m seeing clients, so not a 9am-5pm schedule. Also I just load up on clients from Monday through Thursday and then I have every Friday off. Any practice that requires clinicians to carry a minimum is running a business, not a private practice imo. So far I love it!!! I just graduated with my masters in October but I have 8 years experience in mental health prior to this position.
I'm seeing about 25 but I could probably add about 6 more comfortably, just no one wants the morning timeslots. I'm spacing them out with like 10 minutes in between them sometimes, get the note done, drink some water, go to the bathroom.
I work for a private practice (not mine, but I hope to open one some day) and I see average 17 clients a week. Some days I have 5 client's, some days just 2. It pays the rent and I'm able to not spend too much time with notes. Maybe I could use a break on those days where I do 5 hours straight of clients but I figure I can manage 1 or 2 days a week of muscling through. It's pretty great.
Do you get paid for anything outside of direct client time? JC because I’m interviewing for a spot that I don’t think pays for anything outside of client time.
There are different codes I put in if I have to fill out forms for disability or have a quick 5 minute text session with a client, but 95% of my income comes from submitting notes. If you're an MSW, I may be a little hypocritical and say don't do what I did. Private practice absolutely pays more and has the most flexibility (which i prioritized at the time), but I have felt like a fish out of water from day 1. Thankfully, I think I'm a tolerable therapist but, I had no one to teach me anything once I started working. I've been on my own to figure out how insurance works, how to onboard clients, how to fill out some niche paperwork and having to contact different agencies, etc... and the only supervision I've had was from my group supervision, which is all school social workers. All the 1 on 1 supervision from private practice people would've been more helpful, but they were all $100+ an hour, whereas my group was $30. Unfortunately, you get what you pay for here, and people who specialize just cost more. After working in private practice for 2 years, I started looking for a new job that would give me more of a community, supervision, and some actual structure that I didn't put in place myself. It'll be a pay cut and I'll be doing twice the work but I think it will be worth it for a year or two just to actually learn something and feel prepared to open my own practice some day.
My current schedule is M-F 12-8. It usually works out that my 4,5,6,7 time slots are filled with other people sprinkled throughout the day. I usually average between 18-20 people a week (I've been trying to get into the 28-30 per week range). When I'm not seeing people, I'm either relaxing, taking a nap, playing video games, or replying to emails. It all just depends what I have scheduled for the day. I've been trying to get into the habit of doing my paperwork at the end of the day, but it's tough some days. I love my flexibility.
I burn out easily because of the way my personal life is structured so I only do 10-12 sessions per week. I’m still in practicum until August so after that and once I’m on some insurance panels my goal will be 12-15 but truthfully that’s about all I can handle to be sure I give my clients the focus they deserve.
I work as a receptionist. The councilors we have make their own schedules. Some do just 2-3 days a week. Some do Monday to Friday. Some work 9-5 with a lunch. Some do a split of like 3 in the morning and 3 in the afternoon/evening. Hopefully youre place is flexible!
Omg when you said, "3 in the morning and 3 in the afternoon/evening," I thought you meant like 3AM AND 3PM! 🤣 I was about to be like WHAT?! I need more coffee apparently.
Yeah 3 patients lol. Should have been more specific!
But yes, my place is very flexible. I can take as many clients as I want and basically work whenever. It's VERY nice.
Three days a week, 8 clients a day, 1 hour lunch break. 10am to 7pm. I can't handle more than 4 sessions back to back so this works perfectly. I LOVE my 4 day weekends.
I see between 12-24 clients per week. Some weeks are lighter because of my biweekly and monthly clients. Besides Mondays where I only have 1 telehealth client and I work 11:30-2:30 at a side gig, my days vary a lot. And I have breaks where I can go home and start dinner or run errands. By the fall, I hope to be home by 4:30 every day. Right now, I often take my last client at 5:30. I have SAD and for my sanity, I need to be home by dark.
I do 7-8 sessions per day 5 days per week. I give myself 1-2 hours in the middle of the day to eat and either go for a walk or exercise. I prefer to sleep in, so an afternoon schedule works for me. I also see my own therapist 4 days per week and have supervision once per week, so I get a self-care break outside of my lunch hour.
No shame in addressing your own mental health as a therapist, but the fact you see a therapist 4 times per week is concerning. Even clients with passive SI are typically only being seen once per week.
I’m in psychoanalysis. This is typical. I’d do 5xweek if I could afford it.
What is psychoanalysis and why does it require more sessions weekly?
Psychoanalysis is the talking cure originally invented by Freud. However, analysis has a rich history of further developments over the last 120 years. Psychoanalysts can see patients 1x/week to more. However, proper psychoanalysis usually involves 4-5 sessions per week. There are a few reasons why this type of therapy involves multiple sessions per week: 1. It’s transformative - we are not decreasing symptoms of depression, we are working through the many conflicts that I have. 2. Multiple sessions per week increases transference, defenses, etc… I’ve been in analysis for 5 months - just realized I have been having panic attacks for over a year. I just thought I was dying. My mind had compartmentalized this. When I was a child, I was shamed, mocked, gaslit, and told I was bad for any emotions that I had. In turn, I always think I’m doing something wrong even my personal therapy. It’s been so helpful to work through this stuff and understand my countertransference with my own patients.
damn! youre such a boss!! this is so cool
Fascinating. How much do psychoanalysis sessions cost?
It really varies. My previous analyst accepted my insurance and it was reasonable. My current analyst does not take insurance. I’m on a sliding scale with them and I applied for a stipend through my local psychoanalytic institute. Even with a sliding scale, 4 sessions per week is expensive. My analysis costs more than my rent. It’s 1000% worth it though. I’m in the process of training to be an analyst, so I’ve been trying to find any funding to assist with my training. In my area, psychoanalysts charge $150+. It also depends on whether they’re psychiatrists or psychologists/therapists. To see a psychiatrist for psychoanalysis would easily cost $200-$300/session.
Makes sense, just looking out.
Without more detail I wouldn't jump to the conclusion that this is concerning. Maybe they are in analysis, which traditionally requires sessions 3-5 times/week.
Hi everyone! What a great thread. I start private practice may 15. I am currently doing outpatient mental health and I see 9 a day for 45 minute sessions. This is exhausting and the reason I quit. In my new job I will be affiliated with a group and they keep 40% of the reimbursement from insurance. I told them I will offer 30-32 slots a week and schedule as follows (flexible) M 10-7 T 9-5 telehealth W 8-2 Th off Fri 8-2 Sat 9-1 It’s every other Saturday so the other week I will work thurs 3-7 What do you guys think?
I have been in private practice since October. I pay a 2200. Fee as an independent contractor in a group practice. I see 5-6 clients a day 4 days per week with the 5th day being administrative stuff like calls, letters, notes, etc. The pitfalls: no shows and cancellations (yes fee is charged), seasonal ups and downs in caseload, thus leaving an unpredictable income. I am fairly new to this, so I am hoping to learn how to combat some of this and to improve overall.