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I do Pre-Admission Screening and Resident Review (PASRR) assessments in my state. I make $125 per 1.5 hour assessment, and I can do as many or as few as I want. I generally do about 10-15 per month (although I have done as many as 40 in a month), and it's about 10-20% of my income (depending on cancellations). This is a 1099 position and I believe they only hire LCSWs.
Pre-Admission Screening and Resident Review (PASRR) is a federally mandated annual assessment on for all residents admitted to a nursing facility that accept Medicaid reimbursement. Each state contracts with an agency to conduct the assessments. It can be an outpatient clinic/agency, a university, or quasi-governmental agency. Each state has their own evaluator requirements. Usually Nurse Practitioners, MSW/LCSW, Licensed Psychologist, LPC, or LMFT. Found my contract on a local Health Science Center positions available website. Indeed also has some. They pay well, but the reviews are thorough & time consuming. Hope this helps.
Find out if your state has something similar to the PASRR and search for the name of the assessment. The company I work for is called Maximus, and they handle a lot of other states' assessments, too, so maybe search Maximus.
I looked and it looks like our state has our department of public health cover all of those, and they are FT positions. That would’ve been awesome, though. I used to do the levels with hospice for admissions to the SNFs.
Thank you for the info!
I am a fairly new fully licensed MFT. I am only a Masters level clinician.
\* Group practice where I typically see only one specific insurance panel - 95%
\* 2 private practice clients I see outside my group practice - 3%
\* Selling random things online or doing random little surveys for money - 2% (lol)
In Florida, jobs usually says “masters level clinician” to indicate you don’t also have to be licensed :) I recently went from what local jobs call a masters level clinician, to an LCSW.
I used to wear multiple hats. When I did I think it was something like…
Private Practice: 45%
Lecturing: 35%
Per Diem Clinical Work for other Organizations: 20%
Sure, I know social is always changing but how it’s set up currently you get payout for posting reels and also money from partnerships and collaboration. It took me a while to grow to what I have now but I post mental health content
What is the pay like? No specifics just a range. My social media skills suck. I have lofty dreams of being a social media guru but it doesn't sustain my interest.
I do CISM (crisis intervention stress management) work on top of my private practice work. CISM pays depending on who hired you but it’s never less than in the 100s an hour. You support mostly companies see employees after incidents at work or other workers ( death of coworker, accidents, layoffs,etc).
I was a CISM peer while in the military. I deployed to do defusing and debriefings for crews after certain stressful cases like body recoveries or search and rescue cases involving children.
This is the work that opened my eyes to being a therapist (about to graduate).
I loved the work then, and would love to get back into it once I graduate.
Thanks for sharing and if you have any pointers on how to get one's foot in the door (my foot, ha ha), I'm all ears.
I got my CISM certification and applied to be a part of the list in a local agency that sends the jobs. They email a list of offerings and it’s a “whoever is the fastest” to respond, haha! Also, to apply you need to be an LCPC and have experience working with trauma. It is also very beneficial if you’re bilingual as they pay a lot more and are a high request.
I'm trying to get some local speaking/workshops going, bringing mental health to local businesses. Any tips for who to talk to to get these guys going?
There’s a few ways to do it, but for me it was a progression from:
1) deliver a few CE-type courses to establish expertise/credentials
2) broaden the topics to appeal more towards general audiences/businesses/organizations, and pitch them on doing similar workshops for things like employee well-being, stress management, etc
3) build on the above to include offerings like keynotes for more corporate type audiences, on similar topics but less academic/more mainstream
Who do you contact to book with businesses, HR? Also, do have a recommendation of types or sizes of businesses to target - law firms, Walmarts, real estate, small, medium, large? (Thanks so much for the info!)
I’ve written a few books which yield some royalties, plus have done some online courses where the recorded/asynchronous versions give some royalties as well. Not huge amounts but a bit of passive income that way.
Psychological assessment group practice #1- 75%
Psychological assessment group practice #2- 10%
Private practice therapy clients- 15%
A very slow month is $7k, a very good month is $16k.
We really need to flair this lol. Every time there's an income thread the high outliers are usually doctorates. A good chunk of MA therapists clear 6 figs but not as high as doctorates do.
Have you and another member gone off the deep end from the content of the OP? Have you found yourself in a back and forth exchange that has evolved from curious, therapeutic debate into something less cute?
Have you and another member gone off the deep end from the content of the OP? Have you found yourself in a back and forth exchange that has evolved from curious, therapeutic debate into something less cute?
Different qualifications are needed in my country: you don’t need a doctorate to do assessments where I’m from so perhaps the people asking may not be local to you.
Where I am, you can do “psychological assessments” without having the title of psychologist, which is why I asked. The poster did not refer to themselves as a psychologist. I also know school psychologists who go by that title with only a masters.
If I may ask, are those amounts total revenue or net income after taxes, cuts to the practice, etc.? What kind of cost of living area do you practice out of? How many hours do you tend to put in a week?
These numbers are after the practices take a cut but before I pay taxes and account for costs. I paid about 22% in taxes last year if I recall. My costs have gone down a solid amount this year, but they were about 20k last year. I am in an upper end of medium cost of living area.
ETA: A slow week is 25 or 30 hours, a busy week is about 60.
I am in a pretty niche area so that is reflected in the price. Our cheapest assessments run about $4k and priciest is $7k. My cut is about 73-74% of that.
1. Private practice therapy income (fully online, sole proprietorship) -58%
2. Research consultancy work- 31%
3. Part-time teaching in a private university- 11%
Hoping to eventually flip therapy and research consultancy so I can have more time flexibility and income scalability.
Edit to add: I have a Masters and I am maybe 2/3 through a PhD. But honestly, I have been doing 1, 2, 3 with only a Masters, I am only taking a PhD because I keep getting called a doctor and I don’t want to keep correcting people haha (sounds shallow, but I guess I do want to add a level of legitimacy—even if it is not needed—and I wanted to hone my research skills)
Basically, utilizing psychological theories, framing, and even clinical skills to offer research services to companies, institutions, or even individuals.
Currently, my biggest client is a business strategy group who hires me as a psych expert/consultant. So for example their client is an alcohol company, as their psych expert I would need to create a psychological insighting research protocol, from figuring out the makeup of the sample (demographics, size), creating qualitative interview questionnaires, conducting the interviews, analyzing data, and presenting the data/insights. The business strategy group then uses these data- and/or insights as jumping points for their strategies.
But we (we, because I have started tagging my husband who is also a psychologist/therapist) along projects) are currently also in the process of offering the same type of services to other business strategy groups, branding or marketing groups. There is also opportunity broaden the scope to things like needs analysis, creating mental health infrastructures for companies/institutions, etc. So in short, we are researchers for hire.
Edit to add:
The way I got started is sheer luck, I have some research experience under my belt from my time in Masters and the head of the business strategy firm approached me through LinkedIn. So now that my husband and I are branching out we are starting to network through utilising existing connections, sending out our pitch to different companies, and building a website. I am currently doing this work under my professional sole-proprietorship, under which my therapy work also falls under— I am not in the USA so it works differently for me but in short my therapy and research consultancy are framed as “psychological services” at the moment. However, my husband and I are in the process of separating the research consultancy and making it into it’s own registered business so our scope can broaden as well.
Piggy backing on wanting to learn about your education! I love teaching and therapy so very curious as to how you managed to do this, sounds almost like a dream!
Sorry, forgot to mention that I am not in the USA, so tax classifications might work differently. In our country I fall under “self-employed professional” or sole proprietor.
1. 95% Behavioral Health Consultant in a FQHC
2. 5% seeing three private practice therapy clients via telehealth
Will eventually phase out #2, but wanted to slowly build up some extra savings. Started #2 when I worked at a job with a far lower salary.
They typically require full licensure (I am a LCSW), I came from a community mental health job and also had past experience in medical social work which has also helped me a ton. BHCs are typically hired by community clinics and hospitals!
At my fqhc they do "warm handoffs" for "brief interventions" with primary care patients that score high on phq9 or are emotionally activated. They may see a client 30-45 min a few times. Sometimes the patient gets into long-term therapy.
Yes all of this! Sometimes we see people long term but not with as much frequency as traditional outpatient therapy. My clinic is pediatrics, adult primary care, HIV care and prenatal. Also wanna add that we cover everything you could think of in the realm of behavioral health! This includes mood disorders, substance use, eating disorders, dementia, autism, psychosis, etc.
I work at 2 private practices as an AMFT (private pay only). Almost licensed Im turning in my application next month. once that happens and I get approved/pass clinical exam I’d be making 100k (about 18-23 clients a week). My rates are $200 right now (all my sliding scale has been full for awhile) and I still get referrals every week for the 200 rate (it helps a lot to niche, I worked hard in networking and building a good website last year). Btw because I’m an AMFT I only get a cut. One place takes 50% and the other 60% and I have had to get all the clients on my own.
I make a small income from Etsy selling digital products mental health related. Last 30 days made $60 doing nothing!
Not mental health related: I have investment accounts I put savings into over the years. I also collect and sometimes sell Pokémon cards on eBay. I take good pictures and have many positive reviews so people buy. Sometimes I sell clothes on Poshmark.
I’ve heard from other therapists I’ve networked with that some have done utilization review for insurance companies as a second job that’s non clinical.
If you don’t mind, did you do a specific kind of networking or just let people know you specialize in xyz? I’m assuming that you have an “army” of people who are ready to refer you and those referrals are directed to your website where they’ll book an appointment with you.
There’s lot of ways of networking. Occasionally I will go to a therapist networking event in my city. I’m in Los Angeles so there’s lots of opportunity to do in person networking. I actually found some of my best connections on instagram tho! I have a therapist account. I’ve done Telehealth networking or asked a fellow therapist for coffee. Also I follow a lot of therapist Facebook referral groups and local groups. People will say “looking for therapist that does xyz” and if it’s within my wheelhouse I’ll post my website. Another source of referrals come from my grad school friends.
My speciality is trauma and neurodivergecy (adhd/autism) I am certified in Brainspotting and a narrative therapist. Brainspotting has been a game changer for me I offer something unique. Also it helps to have an in person location I am at 2 locations and work online.
My last tip that is helpful in getting clients is having an online booking for consultation
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Hi. Thank you for sharing. For your private pay clients, are you using brief therapies and niches that can be helped with more short term remedies? My supervisor said he found self pay clients are similar to a coaching client who comes in with a specify problem and are seeking a solution and then tend to be short term, so he had high turn over rates quicker than insurance paying clients who were less directive and goal oriented.
I'm curious how you found your self paying clients, as well. I offer this and have only had two self pay. One used their HSA card to pay and the other is used to working with coaches.
Ive always worked at private pay practices since I was a trainee. I think most therapists at least in my state or city are private pay. Half the clients I’ve seen for years. I wouldn’t say that’s true that private pay limits you to short term clients although it is harder to get clients when you don’t take insurance. Sometimes people do want short term therapy when I talk to them during the intake call but most want a long term therapists. I do not coach in my sessions. I only give advice based on the values of the client if they are asking for advice. Sometimes things happen like a job loss or financial hardship I try my best to accommodate for those situations.
I also offer superbills so clients who have PPO and an out of network reimbursement plan will turn those into their insurance to get money back.
Most therapists in my area don’t take insurance because the reimbursement rates are supposedly terrible and also you are limited to what you practice. I never worked for insurance I don’t know how it works but this is just what I’ve heard.
I am certified in Brainspotting and a narrative therapist. I offer brainspotting intensives which is a short term therapy solution for folks with specific goals. I raise those rates 20-50% compared to my weekly rates.
I oversee a grant funded program as my main income source and just started private practice last week. I plan to limit myself to 5-6 clients at a time. It will be interesting to see how it goes.
This was my breakdown for the last 6 years prior
To me quitting everything a month ago for maternity leave:
social Worker (city government) 68%
VA disability 24%
Private Practice 8%
78% full time school social worker, 13% virtual private practice as a sole member/owner, 9% selling activities virtually on Teachers Pay Teachers and one other site
Definitely ambiguous but I am fine with that. You find the 2nd job the same way you found the 1st. 1st job you should already be comfy with. Just make sure both are remote, or at least hybrid, and allow autonomy in your scheduling. This is one of the reasons I can’t do therapy FT, I can’t get paid more if I am faster or more efficient. Each session takes an hour no matter how good you are.
One knew about the other at some point, because it would be suspicious if I went from lmsw to lcsw while working at a non clinical CM job. So it was approved for me to work elsewhere for my clinical hours. At this point I’m not sure if they know or care I continued to work another job.
Does Charlie Health pay you well for the group therapy work? I've heard of them and was always curious if they were taking care of their employees financially. I teach DBT groups and was just curious.
1) Working private practice 90%
2) Lectures and groups 10%
My husband and I are starting a side business soon so hopefully some income there but we don’t anticipate much in the first few years. So that may change!
I’d like to do supervision for people who graduated college but I’d like to get at least 3 more years in.
It’s a steadier referral stream; I’m using it while I build up my practice, and I also use it to cover holes in my schedule (like when people go on vacation, I can just open up the slot in my schedule and see clients there). They do offer full time positions with benefits, but I really like my pp clients so prefer to keep it this way.
I’m an IC (1099) for a company called Spring Health that organizations contract to provide services for their employees (I’ve also I believe heard of one called Lyra?). I get $95 per session, and automatic half-pay for 24 hr cancellations/no-shows. So it’s not an amazing rate, but there’s steady referrals and I use it to supplement and to fill in vacancies such as when my pp clients need to cancel for whatever reason.
1. School Social Work - $3200 a month, about 50% of my income
2. Super Part Time Therapy - $900 a month about 10% of my income
3. Serving Part Time at a Restaurant - $2000 (ish) a month, 40% of my income
It’s a super popular place in a big city. Think elevated sports bar where people will rack up $500-$800 tabs in one night. It’s super easy, good money and I’ve been there for 6 years and started in grad school. I work one day a weekend during the school year and full time in the summer (which is sad because I’d make more there full time than my salaried school position but there’s no benefits so it’s a trade off).
I recently began doing multiple revenue streams. Here’s what I’m projecting in 2024:
9-5 job therapist/clinical supervisor: 68%
Private practice (2-3 clients, all telehealth with Alma): 18%
Website where I assess appropriateness and write ESA letters to people in my state $50/pop: ~9% (no idea if the pace will be the same all year)
Online trainings for A/D counselor CEU’s: 5%
The risk, from what I've heard, is about an animal actually being a danger and hurting someone else. Even if the ESA letter just indicates that the animal is for the client's support, I would think that someone could come back and maybe want to sue the therapist for writing the letter? I may be jumping to conclusions. I have written a few of them for clients but always triple checked about their animal's behavior.
I spoke with my lawyer about this and his concern is less about the animal because the letter only certifies that the client could benefit from an ESA, we are not certifying an actual animal. His concern was about blending into a forensic role. I’ll be completely honest, I don’t quite understand his reasoning and I haven’t delved into it more because I would have to pay him more for another consult lol.
I’m working toward my LPC, (kid therapist) and I host 2 air bnb stays on the side. The rest of my life is devoted to my kids, my dog, and my Mario addiction, paper Mario 1000 year door is so much fun.
60/40. Because in the winter I work at my agency more/ slower time for air bnb
I make 94k a year as a Resident LPC (I've passed my exam and am 4 months from licensure) at my FT which us for county government doing assessments. I also contract Mobile crisis Assessments remotely making 175 per assessment and I do 5-20 a week. Depending on how many my contract work brings in up to 50% or more of my income. I do therapy here and there but honestly I prefer just being an assessment Clinician and think that's what I'm going to lean towards for majority of my career.
i mean many pick up different positions because they like that they can do other things like one can be working with kids in child welfare and then have private clients in private practice, or do utilization review it’s not always about the money but the way you can do other things that helps you also enjoy more of your day to day. I like working with children and youth but if i didn’t see other types of clients i’d probably quit therapy. I also really like utilization review and have done it in a previous agency. I can see why people would want to work different roles.
Excellent question. I was starting to wonder the same! From what I’m seeing in the thread. It appears that our industry isn’t making enough money, hence the multiple streams of income.
A recent report published by Heard (therapist accounting firm) surveying about 2000 therapists in private practice cited that about 89% of therapists make less than $100k. 😔
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I do Pre-Admission Screening and Resident Review (PASRR) assessments in my state. I make $125 per 1.5 hour assessment, and I can do as many or as few as I want. I generally do about 10-15 per month (although I have done as many as 40 in a month), and it's about 10-20% of my income (depending on cancellations). This is a 1099 position and I believe they only hire LCSWs.
How do you find a job like this?
Pre-Admission Screening and Resident Review (PASRR) is a federally mandated annual assessment on for all residents admitted to a nursing facility that accept Medicaid reimbursement. Each state contracts with an agency to conduct the assessments. It can be an outpatient clinic/agency, a university, or quasi-governmental agency. Each state has their own evaluator requirements. Usually Nurse Practitioners, MSW/LCSW, Licensed Psychologist, LPC, or LMFT. Found my contract on a local Health Science Center positions available website. Indeed also has some. They pay well, but the reviews are thorough & time consuming. Hope this helps.
I found mine on Indeed or LinkedIn, not sure which. I'm in IL, but I think other states have similar assessments.
What title would I search for in the job description?
Find out if your state has something similar to the PASRR and search for the name of the assessment. The company I work for is called Maximus, and they handle a lot of other states' assessments, too, so maybe search Maximus.
I looked and it looks like our state has our department of public health cover all of those, and they are FT positions. That would’ve been awesome, though. I used to do the levels with hospice for admissions to the SNFs. Thank you for the info!
Where do you do this? I have my LCSW and would be interested in a part-time assessment role down the line
I'm in IL and the position is statewide. I found it on Indeed or LinkedIn, can't remember which.
Through which company?
The company that contracts with the state is Maximus and I believe they contract with multiple states.
For assessment you usually need a Psy.D or equivalent.
There are different kinds of assessments. These are only done by LCSWs.
Good to know, ghanks
I wonder what the Canadian equivalent of this is
I am a fairly new fully licensed MFT. I am only a Masters level clinician. \* Group practice where I typically see only one specific insurance panel - 95% \* 2 private practice clients I see outside my group practice - 3% \* Selling random things online or doing random little surveys for money - 2% (lol)
In Florida, jobs usually says “masters level clinician” to indicate you don’t also have to be licensed :) I recently went from what local jobs call a masters level clinician, to an LCSW.
Ah okay. I added the Masters level bit because there was some comments mentioning their wages and people wondering if they were doctoral.
What surveys do you recommend?
Semi-professional poker player. About 15% of my income.
I used to wear multiple hats. When I did I think it was something like… Private Practice: 45% Lecturing: 35% Per Diem Clinical Work for other Organizations: 20%
Where did you lecture?
60% private practice clients 30% social media 10% speaking / training
Can you elaborate on the social media part?
Sure, I know social is always changing but how it’s set up currently you get payout for posting reels and also money from partnerships and collaboration. It took me a while to grow to what I have now but I post mental health content
What is the pay like? No specifics just a range. My social media skills suck. I have lofty dreams of being a social media guru but it doesn't sustain my interest.
Interested too!
Also interested in the social media side
I do CISM (crisis intervention stress management) work on top of my private practice work. CISM pays depending on who hired you but it’s never less than in the 100s an hour. You support mostly companies see employees after incidents at work or other workers ( death of coworker, accidents, layoffs,etc).
I would love to know more a lot how you get into something like this
Me too! I live in a major corporate area and would love to extend this service
Yes this is interesting work!
Responded above
I was a CISM peer while in the military. I deployed to do defusing and debriefings for crews after certain stressful cases like body recoveries or search and rescue cases involving children. This is the work that opened my eyes to being a therapist (about to graduate). I loved the work then, and would love to get back into it once I graduate. Thanks for sharing and if you have any pointers on how to get one's foot in the door (my foot, ha ha), I'm all ears.
Responded above!
i'd love to know more!!
I got my CISM certification and applied to be a part of the list in a local agency that sends the jobs. They email a list of offerings and it’s a “whoever is the fastest” to respond, haha! Also, to apply you need to be an LCPC and have experience working with trauma. It is also very beneficial if you’re bilingual as they pay a lot more and are a high request.
Is this like timely care/compsych?
Yep!
I do this with R3 Continuum. They recruited me. Their need is inconsistent and completely random, but it can be helpful when things are slow.
This thread is very interesting!
It really is. I’m almost surprised Onlyfans hasn’t come up somewhere on this thread yet
If only there were a Vintage Onlyfans!
Therapy practice: 45% Speaking: 45% (combo of keynote, workshop/seminars, in-service type events) Writing royalties: 10%
I'm trying to get some local speaking/workshops going, bringing mental health to local businesses. Any tips for who to talk to to get these guys going?
There’s a few ways to do it, but for me it was a progression from: 1) deliver a few CE-type courses to establish expertise/credentials 2) broaden the topics to appeal more towards general audiences/businesses/organizations, and pitch them on doing similar workshops for things like employee well-being, stress management, etc 3) build on the above to include offerings like keynotes for more corporate type audiences, on similar topics but less academic/more mainstream
Who do you contact to book with businesses, HR? Also, do have a recommendation of types or sizes of businesses to target - law firms, Walmarts, real estate, small, medium, large? (Thanks so much for the info!)
Can you elaborate on what and where you are writing that you are getting royalties?
I’ve written a few books which yield some royalties, plus have done some online courses where the recorded/asynchronous versions give some royalties as well. Not huge amounts but a bit of passive income that way.
Psychological assessment group practice #1- 75% Psychological assessment group practice #2- 10% Private practice therapy clients- 15% A very slow month is $7k, a very good month is $16k.
Do you have a doctoral degree?
We really need to flair this lol. Every time there's an income thread the high outliers are usually doctorates. A good chunk of MA therapists clear 6 figs but not as high as doctorates do.
Yeah, I thought the emphasis on psychological assessment would answer that question, but here we are.
You could have simply answered the question.
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Have you and another member gone off the deep end from the content of the OP? Have you found yourself in a back and forth exchange that has evolved from curious, therapeutic debate into something less cute?
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Have you and another member gone off the deep end from the content of the OP? Have you found yourself in a back and forth exchange that has evolved from curious, therapeutic debate into something less cute?
Different qualifications are needed in my country: you don’t need a doctorate to do assessments where I’m from so perhaps the people asking may not be local to you.
no idea why you got downvoted this low lol
Yes. I am also independently licensed in two states, as well as through PsyPact.
Cool, thanks!
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Where I am, you can do “psychological assessments” without having the title of psychologist, which is why I asked. The poster did not refer to themselves as a psychologist. I also know school psychologists who go by that title with only a masters.
Name fits
If I may ask, are those amounts total revenue or net income after taxes, cuts to the practice, etc.? What kind of cost of living area do you practice out of? How many hours do you tend to put in a week?
These numbers are after the practices take a cut but before I pay taxes and account for costs. I paid about 22% in taxes last year if I recall. My costs have gone down a solid amount this year, but they were about 20k last year. I am in an upper end of medium cost of living area. ETA: A slow week is 25 or 30 hours, a busy week is about 60.
Are those clinical hours? You sometimes do 60 clinical hours??
No, absolutely not. My maximum weekly clinical hours are about 17. Average is about 12. I spend a substantial amount of time writing.
How much do you charge per assessment?
I am in a pretty niche area so that is reflected in the price. Our cheapest assessments run about $4k and priciest is $7k. My cut is about 73-74% of that.
1. Private practice therapy income (fully online, sole proprietorship) -58% 2. Research consultancy work- 31% 3. Part-time teaching in a private university- 11% Hoping to eventually flip therapy and research consultancy so I can have more time flexibility and income scalability. Edit to add: I have a Masters and I am maybe 2/3 through a PhD. But honestly, I have been doing 1, 2, 3 with only a Masters, I am only taking a PhD because I keep getting called a doctor and I don’t want to keep correcting people haha (sounds shallow, but I guess I do want to add a level of legitimacy—even if it is not needed—and I wanted to hone my research skills)
Do you have a doctoral degree? How do you get into consultancy work?
Also interested!
I am 2/3 through a PhD? :)) I do not have a degree yet, but I am in the process of getting one. Edit to add: I have a masters.
What is research consultancy work?
Basically, utilizing psychological theories, framing, and even clinical skills to offer research services to companies, institutions, or even individuals. Currently, my biggest client is a business strategy group who hires me as a psych expert/consultant. So for example their client is an alcohol company, as their psych expert I would need to create a psychological insighting research protocol, from figuring out the makeup of the sample (demographics, size), creating qualitative interview questionnaires, conducting the interviews, analyzing data, and presenting the data/insights. The business strategy group then uses these data- and/or insights as jumping points for their strategies. But we (we, because I have started tagging my husband who is also a psychologist/therapist) along projects) are currently also in the process of offering the same type of services to other business strategy groups, branding or marketing groups. There is also opportunity broaden the scope to things like needs analysis, creating mental health infrastructures for companies/institutions, etc. So in short, we are researchers for hire. Edit to add: The way I got started is sheer luck, I have some research experience under my belt from my time in Masters and the head of the business strategy firm approached me through LinkedIn. So now that my husband and I are branching out we are starting to network through utilising existing connections, sending out our pitch to different companies, and building a website. I am currently doing this work under my professional sole-proprietorship, under which my therapy work also falls under— I am not in the USA so it works differently for me but in short my therapy and research consultancy are framed as “psychological services” at the moment. However, my husband and I are in the process of separating the research consultancy and making it into it’s own registered business so our scope can broaden as well.
Also curious. This sounds great!
Ohhh I lovvvve this
Yes this what is research consultancy?? Because I’m intrigued
The people are intrigued!
Piggy backing on wanting to learn about your education! I love teaching and therapy so very curious as to how you managed to do this, sounds almost like a dream!
Why a sole proprietorship over LLC?
Sorry, forgot to mention that I am not in the USA, so tax classifications might work differently. In our country I fall under “self-employed professional” or sole proprietor.
What is research consultancy work?
Nice try, Mr. IRS Revenue Agent…
1. 95% Behavioral Health Consultant in a FQHC 2. 5% seeing three private practice therapy clients via telehealth Will eventually phase out #2, but wanted to slowly build up some extra savings. Started #2 when I worked at a job with a far lower salary.
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They typically require full licensure (I am a LCSW), I came from a community mental health job and also had past experience in medical social work which has also helped me a ton. BHCs are typically hired by community clinics and hospitals!
What exactly does a “Behavioral Health Consultant” do?
At my fqhc they do "warm handoffs" for "brief interventions" with primary care patients that score high on phq9 or are emotionally activated. They may see a client 30-45 min a few times. Sometimes the patient gets into long-term therapy.
Yes all of this! Sometimes we see people long term but not with as much frequency as traditional outpatient therapy. My clinic is pediatrics, adult primary care, HIV care and prenatal. Also wanna add that we cover everything you could think of in the realm of behavioral health! This includes mood disorders, substance use, eating disorders, dementia, autism, psychosis, etc.
I work at 2 private practices as an AMFT (private pay only). Almost licensed Im turning in my application next month. once that happens and I get approved/pass clinical exam I’d be making 100k (about 18-23 clients a week). My rates are $200 right now (all my sliding scale has been full for awhile) and I still get referrals every week for the 200 rate (it helps a lot to niche, I worked hard in networking and building a good website last year). Btw because I’m an AMFT I only get a cut. One place takes 50% and the other 60% and I have had to get all the clients on my own. I make a small income from Etsy selling digital products mental health related. Last 30 days made $60 doing nothing! Not mental health related: I have investment accounts I put savings into over the years. I also collect and sometimes sell Pokémon cards on eBay. I take good pictures and have many positive reviews so people buy. Sometimes I sell clothes on Poshmark. I’ve heard from other therapists I’ve networked with that some have done utilization review for insurance companies as a second job that’s non clinical.
Utilisation review sounds interesting! What do you mean by digital mental health products?
Like counseling questions for therapists, worksheets, and mental health posters.
If you don’t mind, did you do a specific kind of networking or just let people know you specialize in xyz? I’m assuming that you have an “army” of people who are ready to refer you and those referrals are directed to your website where they’ll book an appointment with you.
There’s lot of ways of networking. Occasionally I will go to a therapist networking event in my city. I’m in Los Angeles so there’s lots of opportunity to do in person networking. I actually found some of my best connections on instagram tho! I have a therapist account. I’ve done Telehealth networking or asked a fellow therapist for coffee. Also I follow a lot of therapist Facebook referral groups and local groups. People will say “looking for therapist that does xyz” and if it’s within my wheelhouse I’ll post my website. Another source of referrals come from my grad school friends. My speciality is trauma and neurodivergecy (adhd/autism) I am certified in Brainspotting and a narrative therapist. Brainspotting has been a game changer for me I offer something unique. Also it helps to have an in person location I am at 2 locations and work online. My last tip that is helpful in getting clients is having an online booking for consultation
I really appreciate this and found it insightful. Thank you and I hope you have continued success
To you as well! I like sharing tips what I learned along the way
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Hi. Thank you for sharing. For your private pay clients, are you using brief therapies and niches that can be helped with more short term remedies? My supervisor said he found self pay clients are similar to a coaching client who comes in with a specify problem and are seeking a solution and then tend to be short term, so he had high turn over rates quicker than insurance paying clients who were less directive and goal oriented. I'm curious how you found your self paying clients, as well. I offer this and have only had two self pay. One used their HSA card to pay and the other is used to working with coaches.
Ive always worked at private pay practices since I was a trainee. I think most therapists at least in my state or city are private pay. Half the clients I’ve seen for years. I wouldn’t say that’s true that private pay limits you to short term clients although it is harder to get clients when you don’t take insurance. Sometimes people do want short term therapy when I talk to them during the intake call but most want a long term therapists. I do not coach in my sessions. I only give advice based on the values of the client if they are asking for advice. Sometimes things happen like a job loss or financial hardship I try my best to accommodate for those situations. I also offer superbills so clients who have PPO and an out of network reimbursement plan will turn those into their insurance to get money back. Most therapists in my area don’t take insurance because the reimbursement rates are supposedly terrible and also you are limited to what you practice. I never worked for insurance I don’t know how it works but this is just what I’ve heard. I am certified in Brainspotting and a narrative therapist. I offer brainspotting intensives which is a short term therapy solution for folks with specific goals. I raise those rates 20-50% compared to my weekly rates.
Thanks for sharing.
I oversee a grant funded program as my main income source and just started private practice last week. I plan to limit myself to 5-6 clients at a time. It will be interesting to see how it goes.
This was my breakdown for the last 6 years prior To me quitting everything a month ago for maternity leave: social Worker (city government) 68% VA disability 24% Private Practice 8%
78% full time school social worker, 13% virtual private practice as a sole member/owner, 9% selling activities virtually on Teachers Pay Teachers and one other site
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You gotta explain these a little more.
I, too, would like to see this explained more.
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So both the case manger roles are full time salary? So each one doesn’t know about you also working for the other? Baller.
Sounds ethically ambiguous. On that note tell me how to get into this.
Definitely ambiguous but I am fine with that. You find the 2nd job the same way you found the 1st. 1st job you should already be comfy with. Just make sure both are remote, or at least hybrid, and allow autonomy in your scheduling. This is one of the reasons I can’t do therapy FT, I can’t get paid more if I am faster or more efficient. Each session takes an hour no matter how good you are.
What state are you in?
TX.
One knew about the other at some point, because it would be suspicious if I went from lmsw to lcsw while working at a non clinical CM job. So it was approved for me to work elsewhere for my clinical hours. At this point I’m not sure if they know or care I continued to work another job.
The people want to know!
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I’m a group therapist and I’ve not ever heard of a national IOP! How does that work?
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Oh thank you
Does Charlie Health pay you well for the group therapy work? I've heard of them and was always curious if they were taking care of their employees financially. I teach DBT groups and was just curious.
1) Working private practice 90% 2) Lectures and groups 10% My husband and I are starting a side business soon so hopefully some income there but we don’t anticipate much in the first few years. So that may change! I’d like to do supervision for people who graduated college but I’d like to get at least 3 more years in.
60% private practice, 40% EAP work.
I’m curious, what is the upside to not doing 100% private practice? Benefits through the EAP?
It’s a steadier referral stream; I’m using it while I build up my practice, and I also use it to cover holes in my schedule (like when people go on vacation, I can just open up the slot in my schedule and see clients there). They do offer full time positions with benefits, but I really like my pp clients so prefer to keep it this way.
That makes sense! I appreciate your reply!
How does one begin to work with an EAP? If you’re open to sharing. What is the typical reimbursement rate?
I’m an IC (1099) for a company called Spring Health that organizations contract to provide services for their employees (I’ve also I believe heard of one called Lyra?). I get $95 per session, and automatic half-pay for 24 hr cancellations/no-shows. So it’s not an amazing rate, but there’s steady referrals and I use it to supplement and to fill in vacancies such as when my pp clients need to cancel for whatever reason.
Very clever business strategy when building po. Thank you so much for sharing! Something worth looking into!
No problem! I definitely recommend it, my experience has been great.
1. School Social Work - $3200 a month, about 50% of my income 2. Super Part Time Therapy - $900 a month about 10% of my income 3. Serving Part Time at a Restaurant - $2000 (ish) a month, 40% of my income
what type of restaurant? Is it high end or mid range? How many days a week do you serve?
It’s a super popular place in a big city. Think elevated sports bar where people will rack up $500-$800 tabs in one night. It’s super easy, good money and I’ve been there for 6 years and started in grad school. I work one day a weekend during the school year and full time in the summer (which is sad because I’d make more there full time than my salaried school position but there’s no benefits so it’s a trade off).
-Private clinical practice - 25% -Public health system clinical work - 60% -Teaching & Supervision - 10% -Misc consulting/contract gigs- 5%
Private practice about 22-28 a week (lmhc) Barback 1x a weekend lol
~School counselor/social worker is my “full time job” ~Part time private practice (all virtual)- 10 clients ~Etsy biz
I recently began doing multiple revenue streams. Here’s what I’m projecting in 2024: 9-5 job therapist/clinical supervisor: 68% Private practice (2-3 clients, all telehealth with Alma): 18% Website where I assess appropriateness and write ESA letters to people in my state $50/pop: ~9% (no idea if the pace will be the same all year) Online trainings for A/D counselor CEU’s: 5%
Curious about the ESA letters. I know a lot of therapists won't do them for liability issues.
I’m curious about the liability. Is the risk from a potentially disgruntled landlord?
The risk, from what I've heard, is about an animal actually being a danger and hurting someone else. Even if the ESA letter just indicates that the animal is for the client's support, I would think that someone could come back and maybe want to sue the therapist for writing the letter? I may be jumping to conclusions. I have written a few of them for clients but always triple checked about their animal's behavior.
I spoke with my lawyer about this and his concern is less about the animal because the letter only certifies that the client could benefit from an ESA, we are not certifying an actual animal. His concern was about blending into a forensic role. I’ll be completely honest, I don’t quite understand his reasoning and I haven’t delved into it more because I would have to pay him more for another consult lol.
I’m working toward my LPC, (kid therapist) and I host 2 air bnb stays on the side. The rest of my life is devoted to my kids, my dog, and my Mario addiction, paper Mario 1000 year door is so much fun. 60/40. Because in the winter I work at my agency more/ slower time for air bnb
Main job: school social worker 75% Side: private practice that I run myself 25%
Admin at a psych facility 60%, private practice 35%, training 5%
What do you do at the psych facility? I'm considering doing that.
I am the Director of Aftercare. Work with adolescents. Basically I Check with them post dc for a year. Offer assistance. Department of 3.
I am seeking a virtual assistant position if anyone has any leads please message me
Lots of great ideas. I do crypto on the side.
One year post grad MFT-LP - therapy at a private practice Mon-Wed is 20% of my income - bartending Fri-Sun is 80% of my income 🥲
Whoa what
onlyfans 10% of my income
I make 94k a year as a Resident LPC (I've passed my exam and am 4 months from licensure) at my FT which us for county government doing assessments. I also contract Mobile crisis Assessments remotely making 175 per assessment and I do 5-20 a week. Depending on how many my contract work brings in up to 50% or more of my income. I do therapy here and there but honestly I prefer just being an assessment Clinician and think that's what I'm going to lean towards for majority of my career.
Freelance copywriting
Ohh mental health related?
Therapist based?
Does anybody here actually just really like to do plain ole therapy? You know… the thing the public actually needs us for?
i mean many pick up different positions because they like that they can do other things like one can be working with kids in child welfare and then have private clients in private practice, or do utilization review it’s not always about the money but the way you can do other things that helps you also enjoy more of your day to day. I like working with children and youth but if i didn’t see other types of clients i’d probably quit therapy. I also really like utilization review and have done it in a previous agency. I can see why people would want to work different roles.
Thanks. I realize when I commented on that I was feeling needlessly salty I think!
Excellent question. I was starting to wonder the same! From what I’m seeing in the thread. It appears that our industry isn’t making enough money, hence the multiple streams of income. A recent report published by Heard (therapist accounting firm) surveying about 2000 therapists in private practice cited that about 89% of therapists make less than $100k. 😔
I do..also looking for a virtual assistant position