1 00:00:01,000 --> 00:00:05,000 I already know what I have to say to you today is going to ruffle some feathers. 2 00:00:05,000 --> 00:00:07,000 it's gonna shake you up. 3 00:00:07,000 --> 00:00:09,000 It's going to piss some of you off. 4 00:00:09,000 --> 00:00:13,000 And if you listen through to the end, you're going to see that I am not wrong. 5 00:00:13,000 --> 00:00:15,000 What I'm saying is the truth. 6 00:00:15,000 --> 00:00:17,000 There's no way you can challenge it. 7 00:00:17,000 --> 00:00:27,000 There's no way you can deny it because it's all laid out in front of us so clearly once we actually look at all the pieces of this puzzle. 8 00:00:27,000 --> 00:00:29,000 So prepare to get mad. 9 00:00:29,000 --> 00:00:32,000 Prepare to potentially experience relief. 10 00:00:32,000 --> 00:00:42,000 Prepared to experience some anxiety as I put forth the argument that only rich therapists should offer low fee therapy. 11 00:00:42,000 --> 00:00:49,000 If you are not rich, if you are not wealthy from other means, you should not be offering lowfi therapy. 12 00:00:49,000 --> 00:00:52,000 You can, you can, but it's not on you. 13 00:00:52,000 --> 00:00:59,000 It's not actually your responsibility to offer low fi sliding scale therapy beyond insurance panels. 14 00:00:59,000 --> 00:01:01,000 By the way, my name is Tiffany McLean. 15 00:01:01,000 --> 00:01:05,000 , I'm the creator of this podcast, The Money Sessions. 16 00:01:05,000 --> 00:01:20,000 I have a program called the Lean In Make Big Academy where we help therapists actually understand how to design practices where they're making 150 185 $200,000 a year while seeing 12 to 15 clients a week. 17 00:01:20,000 --> 00:01:28,000 So let's talk about this idea that only rich therapists should offer low fee therapy, only rich therapists should be paneled with insurance. 18 00:01:28,000 --> 00:01:34,000 We're gonna actually go way back to thinking about the work of therapy, the work you are doing as a clinician. 19 00:01:34,000 --> 00:01:41,000 The fact of the matter is, paradigm shifts come at a cost. 20 00:01:41,000 --> 00:01:43,000 Behavior change requires a paradigm shift. 21 00:01:43,000 --> 00:01:49,000 So let's talk about the reality of what it takes to implement behavior change. 22 00:01:49,000 --> 00:01:52,000 We actually can even just use examples from our personal lives. 23 00:01:52,000 --> 00:01:59,000 You, me, every single person who's listening to this podcast, we have all been part of a system. 24 00:01:59,000 --> 00:02:28,000 Where one element of that system shifts and the entire system falls into chaos in an attempt to bring itself back to the center systems want to maintain themselves, so if you're attempting to change something in yourself, in your behavior, if you're attempting to help a client change something in themselves in their behavior, it's gonna mean that there is going to be a system that is pushing against them and pushing against you. 25 00:02:28,000 --> 00:02:31,000 To return to the status quo. 26 00:02:31,000 --> 00:02:32,000 I'm gonna give you an example. 27 00:02:32,000 --> 00:02:35,000 I'm gonna share something from my own life. 28 00:02:35,000 --> 00:02:40,000 There was a time in my life when drinking socially was the norm, late 20s, early 30s. 29 00:02:40,000 --> 00:02:43,000 I was part of a group of friends who would just drink. 30 00:02:43,000 --> 00:02:44,000 That's what we did for fun. 31 00:02:44,000 --> 00:02:52,000 We would do other things too, we, we play board games, go to puzzle rooms, but really it wasn't. 32 00:02:52,000 --> 00:02:59,000 Occasion to come together and drink and everything else with a kind of a partner to that drinking, right? 33 00:02:59,000 --> 00:03:06,000 So over the course of an evening I could have up to 3 or 4 drinks right over the course of a Saturday we'll play board games, we'd have conversations about this drink. 34 00:03:06,000 --> 00:03:07,000 oh what's in this drink? 35 00:03:07,000 --> 00:03:08,000 Oh, that's interesting. 36 00:03:08,000 --> 00:03:10,000 Look at we have this new book on. 37 00:03:10,000 --> 00:03:11,000 The drinks. 38 00:03:11,000 --> 00:03:12,000 Let's, let's try it out. 39 00:03:12,000 --> 00:03:13,000 Oh, it was classy. 40 00:03:13,000 --> 00:03:14,000 It was fun. 41 00:03:14,000 --> 00:03:16,000 It was interesting, right? 42 00:03:16,000 --> 00:03:22,000 Everyone was on the same page in terms of like we're not, we're we're, we're not here to be sober, right? 43 00:03:22,000 --> 00:03:30,000 We're here to drink, have fun, let loose, put our guard down in the way that only alcohol can allow for. 44 00:03:30,000 --> 00:03:34,000 So at some point in my life, my adulthood as I grow up. 45 00:03:34,000 --> 00:03:37,000 I decided that I wanted to drink less or sometimes drink not even at all, right? 46 00:03:37,000 --> 00:03:43,000 I wanted to, I wanted to be at social gatherings and feel what it felt like to be sober. 47 00:03:43,000 --> 00:03:44,000 Who could I be? 48 00:03:44,000 --> 00:03:46,000 Who would I be if I wasn't drinking? 49 00:03:46,000 --> 00:03:51,000 The system went into overdrive to right itself, right? 50 00:03:51,000 --> 00:03:58,000 This system did not want a member who was either drinking less or not drinking at all. 51 00:03:58,000 --> 00:04:08,000 So this this looked like external attempts to get the system back in order, which meant Tiffany drinking, and this could be subtle or not so subtle. 52 00:04:08,000 --> 00:04:15,000 , attempts to pressure me into drinking like just try this one, or jokes or passive aggressive comments, right? 53 00:04:15,000 --> 00:04:16,000 We need to get this system back. 54 00:04:16,000 --> 00:04:22,000 We want everyone on the same page just like it has always been and the dynamic that's at play when we're all drinking, we want that dynamic. 55 00:04:22,000 --> 00:04:32,000 Again, it's not like any individual is doing it consciously, it's simply what the system does and the individuals are shored up in efforts to return the system back to. 56 00:04:32,000 --> 00:04:37,000 , the baseline external attempts. 57 00:04:37,000 --> 00:04:43,000 There are also internal attempts on the part of the members to restore the status quo. 58 00:04:43,000 --> 00:04:52,000 This looks like, maybe them sharing or even thinking about stories of times they refrain from drinking like, oh I did that, yeah, yeah, you know, dry January. 59 00:04:52,000 --> 00:05:00,000 The, the, I think it's dry January, the message there being, yes, this is a temporary thing and then we'll return, right? 60 00:05:00,000 --> 00:05:17,000 Dry January, we did that once, or you know, it could be like, oh yeah, I did stop drinking for a while, but how boring that was or you know, it's just temporary, even if they're not saying it out loud internally, they're trying to make sense of a system that is no longer doing what the system is supposed to do. 61 00:05:17,000 --> 00:05:22,000 In so doing, they're dismissing the idea of non-drinking socially as even being an option. 62 00:05:22,000 --> 00:05:26,000 Because of non-drinking as an option, then this system is not gonna work anymore, right? 63 00:05:26,000 --> 00:05:30,000 So external and internal attempts. 64 00:05:30,000 --> 00:05:31,000 To get the system back in place. 65 00:05:31,000 --> 00:05:39,000 Now, this is one example, we can see this all over the place with your family, in your workplace, in our larger society, right? 66 00:05:39,000 --> 00:05:55,000 There is a lot of energy that went toward writing that system, getting it back to baseline, getting it back in order, be that getting the non-drinker to drink in this situation or making up stories in their minds, undoing the reality of the decision of the non-drinker. 67 00:05:55,000 --> 00:06:00,000 All of it to get us back to the status quo of, hey, we all drink to engage. 68 00:06:00,000 --> 00:06:03,000 that's how we engage with each other. 69 00:06:03,000 --> 00:06:15,000 There is a lot of emotional and psychic tension in every single member of that system when a change is taking place, and it is felt in everyone's body and everybody's mind. 70 00:06:15,000 --> 00:06:21,000 Me as the person who's choosing not to drink, feels the tension and the pressure from the group, even as we're doing other things. 71 00:06:21,000 --> 00:06:36,000 The every member of the group is aware, hey, this one member is not going with the flow and again whether it's conscious or unconscious, whether it's the topic of a conversation or not, it is a present tension, an elephant in the room that is energy. 72 00:06:36,000 --> 00:06:39,000 Why am I sharing this? 73 00:06:39,000 --> 00:06:54,000 Because when you are a therapist, my friend, my love, you are in the business of being an implementer and therefore a container for all of the energy. 74 00:06:54,000 --> 00:07:10,000 Your client brings in that comes with behavior change and not only that you are the container, the lightning rod, the digester, the processor for all of the energy. 75 00:07:10,000 --> 00:07:23,000 Of every system your client is coming into contact with that is putting conscious or unconscious pressure on your client to revert back to their old ways. 76 00:07:23,000 --> 00:07:26,000 Guess what? 77 00:07:26,000 --> 00:07:34,000 This systemic pressure doesn't stop with your client or their spouse or their family or their job. 78 00:07:34,000 --> 00:07:46,000 We are talking about generational systems that have been maintained on the back of your client continuing to do exactly what they have always done. 79 00:07:46,000 --> 00:08:05,000 Your work as a licensed mental health professional, a therapist in private practice, your work is an attempt to change a system that has been around for generations, through your client, through a couple, through the family work you're doing. 80 00:08:05,000 --> 00:08:17,000 You are attempting to change not just this individual who is trying to do something different, but every system that is working to get them back to the status quo. 81 00:08:17,000 --> 00:08:19,000 And here's the thing. 82 00:08:19,000 --> 00:08:28,000 When we, when we put it like that, when we put it like that, it's obvious that containing the energy of systemic change. 83 00:08:28,000 --> 00:08:33,000 Through working with an individual, through working with a couple, through doing family systems work. 84 00:08:33,000 --> 00:08:36,000 This work containing that energy. 85 00:08:36,000 --> 00:08:39,000 Comes at a cost. 86 00:08:39,000 --> 00:08:43,000 You feel it in your body, you feel it in your mind. 87 00:08:43,000 --> 00:08:45,000 You feel it in your emotional state. 88 00:08:45,000 --> 00:08:46,000 You know this is true. 89 00:08:46,000 --> 00:08:49,000 Of course, this is true. 90 00:08:49,000 --> 00:08:53,000 It takes money and it takes time to do that work. 91 00:08:53,000 --> 00:08:54,000 It's just a fact. 92 00:08:54,000 --> 00:09:05,000 It takes resources to push up against a system that is trying to maintain the status quo, long enough for The new behavior to be implemented. 93 00:09:05,000 --> 00:09:14,000 Either the system breaks down and that individual no longer is a part of it, or the system eventually somehow adjusts to this new behavior of the individual. 94 00:09:14,000 --> 00:09:17,000 That takes some fucking work. 95 00:09:17,000 --> 00:09:20,000 And that work takes resources. 96 00:09:20,000 --> 00:09:28,000 The resources we peddle in as therapists are time and money. 97 00:09:28,000 --> 00:09:33,000 When you are doing this work, you need time for digesting these stories that are coming into you. 98 00:09:33,000 --> 00:09:41,000 Truly understanding the dynamics at play when you're attempting to change a system, when you're attempting to change a paradigm. 99 00:09:41,000 --> 00:09:47,000 You need time for recalibrating your body after holding this tension. 100 00:09:47,000 --> 00:09:52,000 You need time for educating yourself about further about this client, right? 101 00:09:52,000 --> 00:09:57,000 The history, the systems they're part of. 102 00:09:57,000 --> 00:10:02,000 You need time simply to decompress from the feelings of doing this work. 103 00:10:02,000 --> 00:10:10,000 You need physical replenishment, you need to be able to eat, nourishing food, you need to be able to walk, you need to have body work, you need to exercise. 104 00:10:10,000 --> 00:10:13,000 You need relational replenishment. 105 00:10:13,000 --> 00:10:25,000 This takes time, friends, family, children, your own therapy, you need space to be held and contained yourself by those in your life. 106 00:10:25,000 --> 00:10:27,000 You need time for all of those things and more. 107 00:10:27,000 --> 00:10:33,000 You also need money because money buys you time and these other resources. 108 00:10:33,000 --> 00:10:40,000 More money means you need to have fewer clinical sessions, which gives you more time for all of the things above we talked about. 109 00:10:40,000 --> 00:10:42,000 You need money to buy your nourishing food. 110 00:10:42,000 --> 00:10:45,000 You need money to pay for a high quality clinical consultation. 111 00:10:45,000 --> 00:10:52,000 If you are not getting weekly consultation, paying for it with somebody who is a seasoned professional who has been doing this work for many years longer than you. 112 00:10:52,000 --> 00:10:58,000 Or has a stance or an understanding that you don't have, you are in contempt of court. 113 00:10:58,000 --> 00:11:01,000 That was what came to my mind, but really I, I'm going to put forth your, you're missing out. 114 00:11:01,000 --> 00:11:04,000 You're not doing quality work. 115 00:11:04,000 --> 00:11:08,000 You need money for professional coaching to maintain your business. 116 00:11:08,000 --> 00:11:12,000 If your business is not where you want it to be, you need to pay to understand and get those skills. 117 00:11:12,000 --> 00:11:14,000 You need money to go on vacation. 118 00:11:14,000 --> 00:11:17,000 You need money to pay for your own therapy. 119 00:11:17,000 --> 00:11:19,000 See my note above about clinical consultation. 120 00:11:19,000 --> 00:11:22,000 If you're not in your own therapy. 121 00:11:22,000 --> 00:11:27,000 Whoof. : Turn this podcast off now because already we're not gonna, we're not gonna jive. 122 00:11:27,000 --> 00:11:28,000 You need money for body work. 123 00:11:28,000 --> 00:11:30,000 You need money to have people being taken care of. 124 00:11:30,000 --> 00:11:38,000 You need money to have people take care of your physical body that is being used up as you do this work. 125 00:11:38,000 --> 00:11:49,000 You need all of these things in place to show up effectively to change a paradigm, a system that has been in place for generations. 126 00:11:49,000 --> 00:11:55,000 This is why I assert loudly and firmly and controversially. 127 00:11:55,000 --> 00:12:05,000 This is why only therapists who are already rich and resourced can afford to provide low fee therapy. 128 00:12:05,000 --> 00:12:15,000 Through their spouses or their family wealth they are able to have the time and money to subsidize their clients' low fees shoot, maybe they have wealth from a previous job, right? 129 00:12:15,000 --> 00:12:27,000 It, it might not even come from family or a spouse, maybe they were in a corporate job before, maybe they were entrepreneurs and sold their business, whatever the case is, they have preexisting resources. 130 00:12:27,000 --> 00:12:35,000 That subsidize the low fees of their clients because therapy comes at a cost, and somebody is paying it. 131 00:12:35,000 --> 00:12:38,000 Either you're paying it or your clients are paying it, or someone else is paying it. 132 00:12:38,000 --> 00:12:41,000 It's not free, it's not cheap. 133 00:12:41,000 --> 00:12:42,000 Right? 134 00:12:42,000 --> 00:13:11,000 If you do not have a very resourced spouse, if you do not come from familiar wealth, familial wealth, if you have not had a business in the past and you're an independently wealthy millionaire from from what you've done before, then you are subsidizing the low fees and if you do not have the resources to subsidize the low fees, you are sacrificing yourself because you, you literally don't have the energetic resources to help your clients deeply change the paradigm. 135 00:13:11,000 --> 00:13:14,000 In fact, I I'll even assert you can't do the work. 136 00:13:14,000 --> 00:13:21,000 You can't actually do the real work of changing a paradigm within your your client and then the rest of their lives. 137 00:13:21,000 --> 00:13:26,000 You don't have the resources to do it unless you have wealth coming from another source. 138 00:13:26,000 --> 00:13:32,000 If you're only charging low fees, you might be doing some surface level work with your clients, right? 139 00:13:32,000 --> 00:13:53,000 You might be helping them take one problematic behavior that they don't like and sublimating it into another temporarily less disruptive behavior, but you are essentially working with them to sit down and shut up and find a way to tolerate a broken system because because neither you nor they have the energetic capacity or bandwidth to change the system. 140 00:13:53,000 --> 00:13:54,000 It costs money. 141 00:13:54,000 --> 00:14:00,000 If they're not giving you that money and you don't already have that money, then you, you don't have enough money to change a system. 142 00:14:00,000 --> 00:14:09,000 You have just enough energy, you have just enough space to help them get along and stay quiet and maintain a system that's not actually working for them. 143 00:14:09,000 --> 00:14:10,000 Fight me on it, OK? 144 00:14:10,000 --> 00:14:11,000 Here's the truth. 145 00:14:11,000 --> 00:14:27,000 When you see therapists doing low fee work, this is insurance or sliding scale that do not support a fully realized day to day life, and you know, you know what it feels like when you're fully supported in your day to day life. 146 00:14:27,000 --> 00:14:33,000 Expansive, free, present, patient, generous, right? 147 00:14:33,000 --> 00:14:44,000 If you do not have the resources to support that life in your day to day more often than not, If you see a therapists who are doing low fee work, there's something else going on. 148 00:14:44,000 --> 00:14:46,000 Here are the three options. 149 00:14:46,000 --> 00:14:51,000 Either this therapist has financial support that you do not see, see above what we were talking about earlier. 150 00:14:51,000 --> 00:14:59,000 They have resources that you're not getting access to that allow them to have all the resources they need to do to do this low fee work and subsidize their clients. 151 00:14:59,000 --> 00:15:06,000 12, the therapists are new to the field and have not yet gotten to the end of their resources. 152 00:15:06,000 --> 00:15:07,000 But it's inevitable. 153 00:15:07,000 --> 00:15:09,000 They are gonna get there, right? 154 00:15:09,000 --> 00:15:11,000 They're coming, they have a lot of energy. 155 00:15:11,000 --> 00:15:14,000 They're excited. : That's getting them through the day to day right now. 156 00:15:14,000 --> 00:15:16,000 That shit is gonna run out. 157 00:15:16,000 --> 00:15:18,000 Or 3. 158 00:15:18,000 --> 00:15:27,000 That therapist doing low fee work, if they don't have financial support, if they're not at the beginning of their career and being buoyed by artificial energy. 159 00:15:27,000 --> 00:15:35,000 Then they are hanging on by a thread, and it is showing up in other symptoms like boredom and sessions, exhaustion. 160 00:15:35,000 --> 00:15:54,000 Distraction, doom scrolling, back pain, snapping at their kids, snapping at their spouse, putting off important life responsibilities like building a 401k, paying attention to their finances, eating healthy meals, supporting their family and eating healthy meals, exercise, right? 161 00:15:54,000 --> 00:16:04,000 They are hanging on by a thread and they're avoiding important parts of adulthood that they need to be paying attention to in order to live a well resourced life. 162 00:16:04,000 --> 00:16:14,000 I have been hearing the stories behind the scenes stories of therapists for over 8 years that I've been doing this work, helping therapists with designing practices that actually work for them. 163 00:16:14,000 --> 00:16:24,000 I promise you, regardless of what you are seeing on the surface, if a therapist is doing low fee work, they are either struggling in silence or. 164 00:16:24,000 --> 00:16:27,000 Or they're getting their practice funded by another source. 165 00:16:27,000 --> 00:16:31,000 The practice is more like a hobby, and I don't say that dismissively, right? 166 00:16:31,000 --> 00:16:33,000 It's not paying for their life. 167 00:16:33,000 --> 00:16:35,000 The the practice is not a business that's paying for their life. 168 00:16:35,000 --> 00:16:43,000 They have the resources to be showing up and creatively engaged and seeing a couple of clients a week and charging low fees because they're being taken care of financially by someone else. 169 00:16:43,000 --> 00:16:44,000 It's not a business. 170 00:16:44,000 --> 00:16:49,000 The purpose of a business is to Support you financially, that is the purpose of a business. 171 00:16:49,000 --> 00:16:54,000 To take care of you financially, more than take care of all of your life needs. 172 00:16:54,000 --> 00:16:59,000 If that's not happening, then there's something else going on. 173 00:16:59,000 --> 00:17:09,000 Like I said This might make you mad, defensive, yeah, that means we're on the cusp of a paradigm shift. 174 00:17:09,000 --> 00:17:24,000 You might feel some relief, recognition of something you've always known to be true or you have felt in your body, but nobody's verifying it or acknowledging it, so it feels like it can't quite be true relief because you're hearing something that you know in your gut is true. 175 00:17:24,000 --> 00:17:32,000 Or fear, fear, good, good, because that means once again we're bumping up against a paradigm change. 176 00:17:32,000 --> 00:17:48,000 If you're experiencing fear at the thought of acknowledging the truth of this or even feeling relief at the truth of this and then fear at the idea of actually implementing change to be more in line with reality, good, because you're part of a system that doesn't want you to change. 177 00:17:48,000 --> 00:18:01,000 You're part of a system that wants you to keep doing exactly what you're doing so that it can maintain itself and also, by the way, maintain the people at the top who are making a lot of money from you being on insurance panels. 178 00:18:01,000 --> 00:18:13,000 Or even if you have low fees and your folks are not on insurance, there's still a system that's benefiting from you, taking care of people, on your back so that that system doesn't have to step up and do its job. 179 00:18:13,000 --> 00:18:15,000 Hello, America. 180 00:18:15,000 --> 00:18:27,000 If you are ready to let go of the myth that it is your duty to provide low fee insurance-based therapy while seeing 30 clients a week, that is a myth that that is your responsibility. 181 00:18:27,000 --> 00:18:38,000 If you are ready to let go of the myth that it's even possible to do deeply effective therapy when you have to see 30 clients a week and are still struggling financially. 182 00:18:38,000 --> 00:18:46,000 Then send me an email, Tiffany at leanin makebank.com and I will show you how to step out of this broken system. 183 00:18:46,000 --> 00:18:54,000 And we will serve as your support in creating a new paradigm and stepping into a new paradigm because believe you me, the system is going to be against you. 184 00:18:54,000 --> 00:18:57,000 I'm gonna begin some comments about this podcast episode. 185 00:18:57,000 --> 00:19:02,000 I know because I've gotten comments historically when I've put this idea out there. 186 00:19:02,000 --> 00:19:08,000 The idea that truly only rich therapists. 187 00:19:08,000 --> 00:19:16,000 should be seeing clients at low fees because they have the existing resources to take on the true costs of this work. 188 00:19:16,000 --> 00:19:19,000 If you are not independently wealthy for whatever reason. 189 00:19:19,000 --> 00:19:23,000 Then it's not your duty to take on low fee insurance clients. 190 00:19:23,000 --> 00:19:37,000 In fact, for most of us, unless you live in an extremely low cost of living area and you can see 12 people a week on insurance and have more than enough to pay for all those things I described above, if you're in that case, this is not for you. 191 00:19:37,000 --> 00:19:40,000 I have people who are calling me from rural Virginia. 192 00:19:40,000 --> 00:19:45,000 I have people calling me from places in Ohio where the median income is 25,000. 193 00:19:45,000 --> 00:20:14,000 If they are seeing 30 clients a week on insurance and still struggling, burn out, overwhelmed, stressed, snapping at their kids, doom scrolling, not having spaciousness or ease or presence, so I know that this problem is existing, and I know that you are struggling because you have been operating under a system, a paradigm which is false that says not only is it your duty to see 30 clients a week and barely make ends meet, to give back, but also you should just be able to do it. 194 00:20:14,000 --> 00:20:18,000 The people who are successfully doing it have money from other sources. 195 00:20:18,000 --> 00:20:20,000 If that is not you. 196 00:20:20,000 --> 00:20:23,000 Then we need to change the fucking game. 197 00:20:23,000 --> 00:20:24,000 Send me an email, Tiffany at lean and make bank. 198 00:20:24,000 --> 00:20:26,000 If you're mad, send me an email, tell me about it. 199 00:20:26,000 --> 00:20:30,000 If you're defensive, not me, Tiffany, send me an email. 200 00:20:30,000 --> 00:20:31,000 Let's talk about it. 201 00:20:31,000 --> 00:20:39,000 If you're scared, maybe a little relieved, a little scared about what this means for the journey ahead of you. 202 00:20:39,000 --> 00:20:41,000 I want to hear from you too. 203 00:20:41,000 --> 00:20:45,000 I look forward to hearing what all of you have to say. 204 00:20:45,000 --> 00:20:48,000 Go fucking share this, go share this episode. 205 00:20:48,000 --> 00:20:53,000 Start some conversation in your professional groups, in your professional circles. 206 00:20:53,000 --> 00:20:54,000 Let's talk.