1 00:00:00,000 --> 00:00:02,000 You are not imagining it. 2 00:00:02,000 --> 00:00:12,000 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. 3 00:00:12,000 --> 00:00:17,000 If you felt like your marketing suddenly stopped working, you are not imagining it, you're not making it up. 4 00:00:17,000 --> 00:00:23,000 You're not just being lazy or not working hard enough or not smart enough or not strategic enough. 5 00:00:23,000 --> 00:00:29,000 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. 6 00:00:29,000 --> 00:00:32,000 How could I possibly Have a caseload. 7 00:00:32,000 --> 00:00:41,000 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. 8 00:00:41,000 --> 00:00:44,000 I can't even fill my practice with insurance clients. 9 00:00:44,000 --> 00:00:47,000 I can't even feel my, my practice charging $125. 10 00:00:47,000 --> 00:00:49,000 I'm about to tell you why. 11 00:00:49,000 --> 00:00:52,000 I'm gonna tell you exactly what has changed in the, in the marketplace. 12 00:00:52,000 --> 00:01:00,000 , 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. 13 00:01:00,000 --> 00:01:11,000 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. 14 00:01:11,000 --> 00:01:16,000 By the way, an insurance co-pay that is getting cut, rates that are getting lowered. 15 00:01:16,000 --> 00:01:19,000 , this is not a, a you problem. 16 00:01:19,000 --> 00:01:24,000 There is a shift in the industry and you have to shift with it or your practice is not going to survive. 17 00:01:24,000 --> 00:01:28,000 And not only is your practice not gonna survive, our industry. 18 00:01:28,000 --> 00:01:41,000 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. 19 00:01:41,000 --> 00:01:43,000 By the way, my name is Tiffany McLean. 20 00:01:43,000 --> 00:01:52,000 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. 21 00:01:52,000 --> 00:01:54,000 You can do better clinical work. 22 00:01:54,000 --> 00:01:56,000 You can actually show up. 23 00:01:56,000 --> 00:01:58,000 At the end of the day and look at your kiddo in the eye. 24 00:01:58,000 --> 00:02:02,000 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. 25 00:02:02,000 --> 00:02:05,000 You're actually taking vacation. 26 00:02:05,000 --> 00:02:11,000 You're sitting across from your clients after a rested and relaxing four-day weekend because that's just the norm. 27 00:02:11,000 --> 00:02:12,000 That's just what you do. 28 00:02:12,000 --> 00:02:13,000 What does it take to get there? 29 00:02:13,000 --> 00:02:16,000 I'm gonna tell you, and we've helped thousands of therapists get there. 30 00:02:16,000 --> 00:02:18,000 We're gonna help you too. 31 00:02:18,000 --> 00:02:20,000 So let me talk to you about what has changed in the landscape. 32 00:02:20,000 --> 00:02:24,000 What, what, what was happening in 2018, 2019, 2021, 2022. 33 00:02:24,000 --> 00:02:26,000 It doesn't work anymore. 34 00:02:26,000 --> 00:02:33,000 Back then, you could do SEO, social media, get on Psychology Today directories. 35 00:02:33,000 --> 00:02:35,000 that's how you've built your practice. 36 00:02:35,000 --> 00:02:37,000 You could be kind of broad in your niche. 37 00:02:37,000 --> 00:02:46,000 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. 38 00:02:46,000 --> 00:02:51,000 But even if you had cash pay practice, you would, you would be fine. 39 00:02:51,000 --> 00:02:53,000 That's not the situation anymore. 40 00:02:53,000 --> 00:03:03,000 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. 41 00:03:03,000 --> 00:03:05,000 The ground under our feet has shifted. 42 00:03:05,000 --> 00:03:08,000 No one is telling you about it, although you are feeling it every day. 43 00:03:08,000 --> 00:03:17,000 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. 44 00:03:17,000 --> 00:03:25,000 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. 45 00:03:25,000 --> 00:03:31,000 , watching your, your practice dwindle, lowering your fees, hopefully that's gonna be the solution. 46 00:03:31,000 --> 00:03:39,000 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. 47 00:03:39,000 --> 00:03:41,000 Here's what happened. 48 00:03:41,000 --> 00:03:42,000 During the pandemic, 2020. 49 00:03:42,000 --> 00:03:48,000 , The industry was cracked wide open. 50 00:03:48,000 --> 00:03:49,000 Demand exploded. 51 00:03:49,000 --> 00:03:58,000 People wanted therapy, people needed therapy, people were desperate for help and connection in a way they never were before, at least not publicly. 52 00:03:58,000 --> 00:04:09,000 , 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. 53 00:04:09,000 --> 00:04:10,000 They can now have therapy online. 54 00:04:10,000 --> 00:04:21,000 , 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. 55 00:04:21,000 --> 00:04:28,000 Now in 2020, it became, just a national pastime, going to therapy, and we know it's true because there was the BetterHelp. 56 00:04:28,000 --> 00:04:33,000 Every podcast you listen to had BetterHelp talking about get online, get your BetterHelp therapist. 57 00:04:33,000 --> 00:04:34,000 Why? 58 00:04:34,000 --> 00:04:37,000 Because big tech noticed the demand. 59 00:04:37,000 --> 00:04:46,000 We therapists have always understood the importance of therapy, although we did not value it monetarily, and that is our failing, right? 60 00:04:46,000 --> 00:04:51,000 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. 61 00:04:51,000 --> 00:04:53,000 our family of origin, we're the helpers. 62 00:04:53,000 --> 00:05:01,000 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. 63 00:05:01,000 --> 00:05:07,000 If you're listening to my podcast, you're likely a woman or a person from a marginalized community, meaning societally, systemically. 64 00:05:07,000 --> 00:05:09,000 We are the people who give and give and give. 65 00:05:09,000 --> 00:05:24,000 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. 66 00:05:24,000 --> 00:05:27,000 And then we come into our industry as therapists. 67 00:05:27,000 --> 00:05:36,000 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. 68 00:05:36,000 --> 00:05:40,000 So then when we go out as professionals, unfortunately, we take that with us. 69 00:05:40,000 --> 00:05:48,000 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. 70 00:05:48,000 --> 00:05:54,000 I think the average, salary for licensed mental health clinicians in the United States is around 50,000. 71 00:05:54,000 --> 00:06:03,000 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. 72 00:06:03,000 --> 00:06:05,000 It's a, it's a travesty. 73 00:06:05,000 --> 00:06:07,000 And yet that's what many of us expect. 74 00:06:07,000 --> 00:06:09,000 Guess who noticed the demand and also understood the value? 75 00:06:09,000 --> 00:06:10,000 Big tech. 76 00:06:10,000 --> 00:06:13,000 They understand how to turn a profit. 77 00:06:13,000 --> 00:06:17,000 They understand when something is of value and it can be monetized. 78 00:06:17,000 --> 00:06:19,000 They saw scale. 79 00:06:19,000 --> 00:06:22,000 They saw desperation and you know what else they saw? 80 00:06:22,000 --> 00:06:25,000 An underpriced workforce. 81 00:06:25,000 --> 00:06:41,000 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. 82 00:06:41,000 --> 00:06:43,000 That's what happened in 2020. 83 00:06:43,000 --> 00:06:46,000 2020, 2021, 2022. 84 00:06:46,000 --> 00:06:49,000 It took a little time for it to take over, so initially therapists were like, this is great. 85 00:06:49,000 --> 00:06:51,000 Our practices are full. 86 00:06:51,000 --> 00:07:02,000 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. 87 00:07:02,000 --> 00:07:03,000 We'll make it easy. 88 00:07:03,000 --> 00:07:08,000 You just do your clinical work, we'll give you the clients, and we'll pay you jack shit. 89 00:07:08,000 --> 00:07:10,000 And you know what therapist said, Great. 90 00:07:10,000 --> 00:07:11,000 Are we bad for this? 91 00:07:11,000 --> 00:07:12,000 No. 92 00:07:12,000 --> 00:07:13,000 was this misguided? 93 00:07:13,000 --> 00:07:15,000 Yeah. 94 00:07:15,000 --> 00:07:16,000 is this gonna change? : It better. 95 00:07:16,000 --> 00:07:18,000 I'll talk to you about that in a moment. 96 00:07:18,000 --> 00:07:20,000 So here's what happened. 97 00:07:20,000 --> 00:07:22,000 Over the past two years. 98 00:07:22,000 --> 00:07:25,000 Here's what happens when we let tech define therapy. 99 00:07:25,000 --> 00:07:31,000 therapy has been reduced to speed, volume, and one size fits all solutions. 100 00:07:31,000 --> 00:07:44,000 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. 101 00:07:44,000 --> 00:07:45,000 I'm gonna fill out this paperwork. 102 00:07:45,000 --> 00:07:47,000 I'm gonna do the step by step model you're telling me I need to. 103 00:07:47,000 --> 00:07:57,000 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? 104 00:07:57,000 --> 00:08:05,000 clinicians we're now being pushed into low-paid, high output McDonald line workers, basically, right? 105 00:08:05,000 --> 00:08:07,000 This is not just bad for therapists. 106 00:08:07,000 --> 00:08:17,000 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. 107 00:08:17,000 --> 00:08:20,000 When profit defines care. 108 00:08:20,000 --> 00:08:22,000 Everybody loses. 109 00:08:22,000 --> 00:08:24,000 Our entire industry loses. 110 00:08:24,000 --> 00:08:26,000 So this is not just about you and your practice anymore. 111 00:08:26,000 --> 00:08:28,000 This is, this is no longer personal. 112 00:08:28,000 --> 00:08:31,000 You can feel bad for charging life first fees. 113 00:08:31,000 --> 00:08:38,000 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? 114 00:08:38,000 --> 00:08:40,000 You might feel like, hey, that's not fair. 115 00:08:40,000 --> 00:08:44,000 Hey, I wanna give back and not, and not hurt people. 116 00:08:44,000 --> 00:08:46,000 Hey, I, mental health care should be cheap. 117 00:08:46,000 --> 00:08:47,000 Well, guess what? 118 00:08:47,000 --> 00:08:49,000 Here's the, here's the outcome of that kind of thinking. 119 00:08:49,000 --> 00:08:51,000 We're no longer valued as professionals. 120 00:08:51,000 --> 00:09:01,000 , 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. 121 00:09:01,000 --> 00:09:05,000 And not only your hard work, but you paid a lot of money to become a clinician. 122 00:09:05,000 --> 00:09:10,000 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? 123 00:09:10,000 --> 00:09:12,000 That's a problem, that's a problem for you. 124 00:09:12,000 --> 00:09:13,000 Absolutely. 125 00:09:13,000 --> 00:09:21,000 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. 126 00:09:21,000 --> 00:09:36,000 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. 127 00:09:36,000 --> 00:09:48,000 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. 128 00:09:48,000 --> 00:09:50,000 What we do is not worth it. 129 00:09:50,000 --> 00:09:51,000 I'm not willing to say that. 130 00:09:51,000 --> 00:09:56,000 And as long as you're willing to take a, a $20 co-pay, that's the message you're spreading. 131 00:09:56,000 --> 00:09:58,000 We can't do that anymore, folks. 132 00:09:58,000 --> 00:10:04,000 If you are not charging your life first fee, you are literally putting our industry on the line. 133 00:10:04,000 --> 00:10:07,000 You are saying what we do is not worth it and guess what? 134 00:10:07,000 --> 00:10:15,000 Guess what is happening and is going to continue happening as long as you're ceding your clinical authority to big tech. 135 00:10:15,000 --> 00:10:17,000 You are going to be replaced by AI. 136 00:10:17,000 --> 00:10:19,000 Because you are saying, hey, one size fits all. 137 00:10:19,000 --> 00:10:20,000 I'm gonna check these boxes. 138 00:10:20,000 --> 00:10:21,000 123. 139 00:10:21,000 --> 00:10:23,000 Guess what happens next? 140 00:10:23,000 --> 00:10:24,000 AI comes in. : I'm in San Francisco. 141 00:10:24,000 --> 00:10:29,000 We already have the billboards up there saying get your AI therapist. 142 00:10:29,000 --> 00:10:40,000 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. 143 00:10:40,000 --> 00:10:43,000 That hurts our profession, that hurts our industry, and guess who else it hurts? 144 00:10:43,000 --> 00:10:45,000 Your clients. 145 00:10:45,000 --> 00:10:52,000 Because big tech cannot replace, AI cannot replace the work you do if you are actually doing the work of therapy. 146 00:10:52,000 --> 00:10:53,000 Many of you are not. 147 00:10:53,000 --> 00:10:57,000 We're gonna have an episode coming out in Q1 about workbook therapists or worksheet therapists. 148 00:10:57,000 --> 00:10:59,000 You're gonna definitely want to tune into that. 149 00:10:59,000 --> 00:11:02,000 If you are a worksheet therapist, you're not doing, in my view, therapy. 150 00:11:02,000 --> 00:11:05,000 You're following a 1231 size fits all model. 151 00:11:05,000 --> 00:11:09,000 If you wanna actually understand what therapy is, you need to come, come work with me in my community. 152 00:11:09,000 --> 00:11:12,000 You're gonna understand therapy at a whole another level. 153 00:11:12,000 --> 00:11:15,000 Therapy is of value. 154 00:11:15,000 --> 00:11:17,000 Your nervous system has to be regulated. 155 00:11:17,000 --> 00:11:25,000 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. 156 00:11:25,000 --> 00:11:29,000 In private practice doing the work and that costs money. 157 00:11:29,000 --> 00:11:30,000 That costs money. 158 00:11:30,000 --> 00:11:36,000 You cannot lead an industry you're undercharging to survive in. 159 00:11:36,000 --> 00:11:38,000 So this is the moment to choose. 160 00:11:38,000 --> 00:11:44,000 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. 161 00:11:44,000 --> 00:12:01,000 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. 162 00:12:01,000 --> 00:12:06,000 Our job as licensed mental health clinicians, as therapists, is we have our finger on the pulse. 163 00:12:06,000 --> 00:12:09,000 Of the country's nervous system. 164 00:12:09,000 --> 00:12:13,000 We always have been the people who can spot reality. 165 00:12:13,000 --> 00:12:14,000 Before other people can see it. 166 00:12:14,000 --> 00:12:23,000 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? 167 00:12:23,000 --> 00:12:29,000 You step into a space and you can instantly feel what's happening on a deep level. 168 00:12:29,000 --> 00:12:32,000 That's of value and nobody is gonna hold that value but you. 169 00:12:32,000 --> 00:12:36,000 You can remember growing up in your family, you're likely the identified patient in so many ways. 170 00:12:36,000 --> 00:12:38,000 Something is not working and you speak to it. 171 00:12:38,000 --> 00:12:42,000 You don't stay quiet, you speak to it. 172 00:12:42,000 --> 00:12:46,000 When you stop speaking to it, which many of us do, you get sick. 173 00:12:46,000 --> 00:12:51,000 Right? : So you can either go out there and say, speak up for what you see. 174 00:12:51,000 --> 00:12:54,000 In our society, people want the binary. 175 00:12:54,000 --> 00:12:55,000 They want concrete ideas. 176 00:12:55,000 --> 00:13:00,000 It's this or that, it's Republican or Democrat, it's, you know, and you know who, you know what that gets us? 177 00:13:00,000 --> 00:13:04,000 You can see our president, you can see what's happening in our political system. 178 00:13:04,000 --> 00:13:07,000 When we don't speak up for complexity. 179 00:13:07,000 --> 00:13:18,000 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? 180 00:13:18,000 --> 00:13:19,000 That's what we do. 181 00:13:19,000 --> 00:13:28,000 We hold the tension long enough to understand the complex and nuanced dynamics that is human relating, that is the human mind. 182 00:13:28,000 --> 00:13:30,000 AI cannot do that. 183 00:13:30,000 --> 00:13:41,000 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. 184 00:13:41,000 --> 00:13:56,000 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. 185 00:13:56,000 --> 00:14:00,000 Over divisiveness, that's our job. 186 00:14:00,000 --> 00:14:01,000 That is our job. 187 00:14:01,000 --> 00:14:09,000 So as we step into 2026, we are making a call for authority and impact. 188 00:14:09,000 --> 00:14:23,000 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. 189 00:14:23,000 --> 00:14:26,000 The impact of human relatedness. 190 00:14:26,000 --> 00:14:27,000 We are on the edge, folks. 191 00:14:27,000 --> 00:14:33,000 We're gonna go one of two ways, not only as an industry, but as a society. 192 00:14:33,000 --> 00:14:40,000 And if we're going to go in a way that's going to allow for connection, presence of mind, thoughtfulness, and human connection. 193 00:14:40,000 --> 00:14:42,000 Then you need to own your authority. 194 00:14:42,000 --> 00:14:44,000 You need to take up space. 195 00:14:44,000 --> 00:15:00,000 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. 196 00:15:00,000 --> 00:15:03,000 That is your job. : We are gonna do this or we are not. 197 00:15:03,000 --> 00:15:05,000 We are going to rise or we're gonna become obsolete. 198 00:15:05,000 --> 00:15:08,000 So this is your opportunity. 199 00:15:08,000 --> 00:15:13,000 The future of therapy is literally going to be shaped by those willing to claim it. 200 00:15:13,000 --> 00:15:15,000 And that costs money. 201 00:15:15,000 --> 00:15:19,000 You need to claim it and you need to get paid for it. 202 00:15:19,000 --> 00:15:32,000 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. 203 00:15:32,000 --> 00:15:43,000 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. 204 00:15:43,000 --> 00:15:47,000 What we do. 205 00:15:47,000 --> 00:15:57,000 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? 206 00:15:57,000 --> 00:16:05,000 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. 207 00:16:05,000 --> 00:16:06,000 That's your choice. 208 00:16:06,000 --> 00:16:08,000 It starts with your life first fee. 209 00:16:08,000 --> 00:16:13,000 Download that, get on our newsletter and be fucking ready. 210 00:16:13,000 --> 00:16:14,000 OK? : I'll see you on the other side. 211 00:16:14,000 --> 00:16:22,000 2026 is going to be phenomenal for those who are ready to step the fuck up. 212 00:16:22,000 --> 00:16:23,000 And get on this ride.