You are not imagining it.
What was working in 2019, 2020, 2021 to fill your caseload with life first fee clients or to fill your caseload at all, that doesn't work anymore.
If you felt like your marketing suddenly stopped working, you are not imagining it, you're not making it up.
You're not just being lazy or not working hard enough or not smart enough or not strategic enough.
I'm talking to therapists all the time who are like, I'm on insurance panels, Tiffany, and I still can't fail my practice.
How could I possibly Have a caseload.
What, what, what world are you living in that you can imagine I can see 15 clients a week and make $150,000 because I'm charging my life first fee all while taking 6 weeks vacation.
I can't even fill my practice with insurance clients.
I can't even feel my, my practice charging $125.
I'm about to tell you why.
I'm gonna tell you exactly what has changed in the, in the marketplace.
, in our industry, I'm going to tell you why when your peers are talking about just do this to fill up your practice, what they were doing in 2020, why it doesn't work.
If you're new as a therapist, if you've been onto the scene in the last year or two, and you're feeling like, this is not what I thought it was gonna be, I don't wanna be working 30 hours and earning an insurance co-pay.
By the way, an insurance co-pay that is getting cut, rates that are getting lowered.
, this is not a, a you problem.
There is a shift in the industry and you have to shift with it or your practice is not going to survive.
And not only is your practice not gonna survive, our industry.
Our expertise as licensed mental health therapists, it's no longer going to be valued if we don't start making massive changes in how we're thinking about our work and valuing our time.
By the way, my name is Tiffany McLean.
I'm the founder of Lean In Make Bank where we help therapists earn more while working less so you can have more spaciousness, ease, presence.
You can do better clinical work.
You can actually show up.
At the end of the day and look at your kiddo in the eye.
In fact, you're picking him up from school because you have all the time in the world and you're there to be present and easeful.
You're actually taking vacation.
You're sitting across from your clients after a rested and relaxing four-day weekend because that's just the norm.
That's just what you do.
What does it take to get there?
I'm gonna tell you, and we've helped thousands of therapists get there.
We're gonna help you too.
So let me talk to you about what has changed in the landscape.
What, what, what was happening in 2018, 2019, 2021, 2022.
It doesn't work anymore.
Back then, you could do SEO, social media, get on Psychology Today directories.
that's how you've built your practice.
You could be kind of broad in your niche.
You could have someone do your website, have someone do your SEO, make a really, you know, compelling Psychology Today profile, and you could do fine, especially if you're on insurance panels.
But even if you had cash pay practice, you would, you would be fine.
That's not the situation anymore.
Therapists are now competing in a marketing environment that you did not consent to, you did not anticipate, and you are not, frankly keeping up with.
The ground under our feet has shifted.
No one is telling you about it, although you are feeling it every day.
Your colleagues are talking to you about it, you're feeling it in your guts, your phone is not ringing, so you know that it's true, and you're scrambling around wondering what's, what's happening.
You're trying to enlist marketing strategies or more likely you're not doing anything because you're so overwhelmed and it feels like nothing you're even doing is working, so you're kinda just sitting.
, watching your, your practice dwindle, lowering your fees, hopefully that's gonna be the solution.
staying on insurance panels when your hope was to actually be earning much more per, per, per session and seeing way too many clients because you're afraid of making a move.
Here's what happened.
During the pandemic, 2020.
, The industry was cracked wide open.
Demand exploded.
People wanted therapy, people needed therapy, people were desperate for help and connection in a way they never were before, at least not publicly.
, therapy went fully online, so suddenly more people had access to therapy without having to like get out, leave the middle of their workday, go to the therapist's office.
They can now have therapy online.
, mental health became a mainstream conversation, whereas in the olden days and still sometimes now, it used to be like, you know, we kinda whispered about getting therapy or maybe only the elites kinda talked about getting therapy.
Now in 2020, it became, just a national pastime, going to therapy, and we know it's true because there was the BetterHelp.
Every podcast you listen to had BetterHelp talking about get online, get your BetterHelp therapist.
Why?
Because big tech noticed the demand.
We therapists have always understood the importance of therapy, although we did not value it monetarily, and that is our failing, right?
We're, we're helpers. : We wanna give back for all of the reasons that I've talked about in all of these podcasts before.
our family of origin, we're the helpers.
You know, we, our, our role is defined and our family of origin as being the one who helps, who puts our feelings aside to make sure other people are taken care of.
If you're listening to my podcast, you're likely a woman or a person from a marginalized community, meaning societally, systemically.
We are the people who give and give and give.
That's the expectation without, with very little recognition of the help we're giving like it's just expected and very little monetary compensation or actual value, even though we're holding up the whole country, there's very little monetary value put on it.
And then we come into our industry as therapists.
And we're just, we're just, it's a concentration of people who are martyring ourselves, giving, giving, giving, asking for very little or nothing in return.
So then when we go out as professionals, unfortunately, we take that with us.
We devalue our time, we devalue our money, we have more education than so many white-collar professionals, and yet we don't charge accordingly.
I think the average, salary for licensed mental health clinicians in the United States is around 50,000.
Licensed mental health therapist, meaning you are a master's degree or a doctorate-level degree and you're still making 50,000 on average, it's tragic.
It's a, it's a travesty.
And yet that's what many of us expect.
Guess who noticed the demand and also understood the value?
Big tech.
They understand how to turn a profit.
They understand when something is of value and it can be monetized.
They saw scale.
They saw desperation and you know what else they saw?
An underpriced workforce.
What allows a technology to scale is when there's huge demand, when people are willing to pay for something, and when there are service providers who are willing to work at a very devalued price.
That's what happened in 2020.
2020, 2021, 2022.
It took a little time for it to take over, so initially therapists were like, this is great.
Our practices are full.
And then we started going over to big tech platforms, who were saying, hey, we'll, we'll take the finding clients off your, your plate.
We'll make it easy.
You just do your clinical work, we'll give you the clients, and we'll pay you jack shit.
And you know what therapist said, Great.
Are we bad for this?
No.
was this misguided?
Yeah.
is this gonna change? : It better.
I'll talk to you about that in a moment.
So here's what happened.
Over the past two years.
Here's what happens when we let tech define therapy.
therapy has been reduced to speed, volume, and one size fits all solutions.
algorithms are now defining what therapy is versus actually the professionals who do the work, that's us, and we're even buying in, not me, but so many therapists we're buying into, oh, I wanna work for big tech.
I'm gonna fill out this paperwork.
I'm gonna do the step by step model you're telling me I need to.
Do instead of the people who are clinicians determining what it means to provide mental health service and to allow for human transformation, we're letting big tech and algorithms define this, right?
clinicians we're now being pushed into low-paid, high output McDonald line workers, basically, right?
This is not just bad for therapists.
It's bad for depth, it's bad for dignity, it's bad for clinical integrity, and it's bad for actually allowing true transformation.
When profit defines care.
Everybody loses.
Our entire industry loses.
So this is not just about you and your practice anymore.
This is, this is no longer personal.
You can feel bad for charging life first fees.
That's the fee you actually need to do your work, which is, you know, $200 300 dollars per hour so you can see 12 to 15 clients a week and truly show up, right?
You might feel like, hey, that's not fair.
Hey, I wanna give back and not, and not hurt people.
Hey, I, mental health care should be cheap.
Well, guess what?
Here's the, here's the outcome of that kind of thinking.
We're no longer valued as professionals.
, you're burnt out, you're overwhelmed, and you're going to work for AI companies who are making fucking bank, insurance companies who are making fucking bank off of your hard work.
And not only your hard work, but you paid a lot of money to become a clinician.
And you're not getting that money back as long as you're going to work for big tech, as long as you're going to work for insurance, right?
That's a problem, that's a problem for you.
Absolutely.
But I'm also to the point where I'm fed up with this on an individual level because this is also having an impact on our industry.
When we say our work is worth a $25 co-pay, when we say we're willing to do, do this work and see 30 clients a week and make $70,000 60,000 dollars, $50,000 a year, we're saying the work we do is not valuable.
It's not as valuable as a lawyer, it's not as valuable as a doctor, it's not as valuable as the, you name it, who also has a master's degree or a doctoral degree or maybe not even that, the, the CEO of Big tech.
What we do is not worth it.
I'm not willing to say that.
And as long as you're willing to take a, a $20 co-pay, that's the message you're spreading.
We can't do that anymore, folks.
If you are not charging your life first fee, you are literally putting our industry on the line.
You are saying what we do is not worth it and guess what?
Guess what is happening and is going to continue happening as long as you're ceding your clinical authority to big tech.
You are going to be replaced by AI.
Because you are saying, hey, one size fits all.
I'm gonna check these boxes.
123.
Guess what happens next?
AI comes in. : I'm in San Francisco.
We already have the billboards up there saying get your AI therapist.
You can complain about big tech all day, but as long as you're undervaluing the work you do and falling into the big tech model, like you're allowing yourself to do that, you're choosing that option, you are devaluing it for the rest of us.
That hurts our profession, that hurts our industry, and guess who else it hurts?
Your clients.
Because big tech cannot replace, AI cannot replace the work you do if you are actually doing the work of therapy.
Many of you are not.
We're gonna have an episode coming out in Q1 about workbook therapists or worksheet therapists.
You're gonna definitely want to tune into that.
If you are a worksheet therapist, you're not doing, in my view, therapy.
You're following a 1231 size fits all model.
If you wanna actually understand what therapy is, you need to come, come work with me in my community.
You're gonna understand therapy at a whole another level.
Therapy is of value.
Your nervous system has to be regulated.
You need to show up in a, in a full, grounded, honest way if you're going to call yourself a licensed mental health clinician.
In private practice doing the work and that costs money.
That costs money.
You cannot lead an industry you're undercharging to survive in.
So this is the moment to choose.
As we go into 2026, we are going to either rise to the top and survive or we're gonna be in a race to the bottom.
You can stay invisible and interchangeable and let AI come in and do your good work, or you can step into authority and shape the future, not only shape the future of mental health, but actually step into being a thought leader, a cultural leader, because that's our job.
Our job as licensed mental health clinicians, as therapists, is we have our finger on the pulse.
Of the country's nervous system.
We always have been the people who can spot reality.
Before other people can see it.
We have our finger on the emotional pulse of the family, of the city, of the coffee shop, of our classroom when you're in grad school, right?
You step into a space and you can instantly feel what's happening on a deep level.
That's of value and nobody is gonna hold that value but you.
You can remember growing up in your family, you're likely the identified patient in so many ways.
Something is not working and you speak to it.
You don't stay quiet, you speak to it.
When you stop speaking to it, which many of us do, you get sick.
Right? : So you can either go out there and say, speak up for what you see.
In our society, people want the binary.
They want concrete ideas.
It's this or that, it's Republican or Democrat, it's, you know, and you know who, you know what that gets us?
You can see our president, you can see what's happening in our political system.
When we don't speak up for complexity.
For nuance, for thought, for the people who are willing to hold the tension and the gray long enough to come into a connected truth versus splitting, right?
That's what we do.
We hold the tension long enough to understand the complex and nuanced dynamics that is human relating, that is the human mind.
AI cannot do that.
It is our job if we're going to survive as clinicians, as an industry, if we're going to actually have an impact in the larger political, cultural sphere, we need to actually show up.
We need to step up we, and we need to own our authority as the go to when it comes to having strong mental health, presence of mind, nuance and authority, relationships that work, strong attachments, connectedness.
Over divisiveness, that's our job.
That is our job.
So as we step into 2026, we are making a call for authority and impact.
You must step into your authority as a clinician, as a therapist, as a thought leader, as someone who has your finger on the pulse, and when you do that, you're speaking up for impact, the impact of human connection.
The impact of human relatedness.
We are on the edge, folks.
We're gonna go one of two ways, not only as an industry, but as a society.
And if we're going to go in a way that's going to allow for connection, presence of mind, thoughtfulness, and human connection.
Then you need to own your authority.
You need to take up space.
You need to actually say what you see even when it's not gonna be the popular opinion, and you need to fight for the impact you are making as a human being sitting across from another human being in a body, sitting across from another human being with a body.
That is your job. : We are gonna do this or we are not.
We are going to rise or we're gonna become obsolete.
So this is your opportunity.
The future of therapy is literally going to be shaped by those willing to claim it.
And that costs money.
You need to claim it and you need to get paid for it.
If you are ready to shape our industry, shape our culture, step up and be seen and have an impact and get paid for it, it starts with your life first fee.
You need to understand what you need to be charging in order to show up and truly do this work, to have a mind, spaciousness, ease, and stop letting big tech, the algorithm AI define.
What we do.
Scroll down to the show notes, download our fun with fee calculator, get on board because in 2026 we're fucking going and you're either with us or you're not gonna make it, right?
You're either with valuing your time, your energy, what we do as licensed mental health clinicians, our role in society, or you're gonna become obsolete.
That's your choice.
It starts with your life first fee.
Download that, get on our newsletter and be fucking ready.
OK? : I'll see you on the other side.
2026 is going to be phenomenal for those who are ready to step the fuck up.
And get on this ride.