Building a Six-Figure Counseling Practice

How Much Money Can A Master’s Level Counselor in Private Practice Make?

According to, the average Licensed Professional Counselor working in Cambridge, Massachusetts makes $84,164 a year. That’s beyond bleak. For a city where a 900 square foot apartment can run over $400,000, it’s dismal.

Is this our fate? Financially speaking, are counselors better off getting jobs at Wal-mart?

I don’t think so.

With good practice planning, counselors can do better. For many, earning over $100,000 profit in year two of private practice is an obtainable goal. In this article, we’re going to look at the financial aspects of running a private counseling practice.

Note: the following numbers are rough estimates for a single practitioner in private practice. For your purposes, you may need to adjust expenses, client fees, and volume based on your own personal practice goals, and on the costs of living in your area.

Read Counseling Article

6 Counseling Rumors about Accepting Health Insurance

From recent graduates to seasoned clinicians, today it seems that everyone in part- or full-time private practice is asking the same question: “Should I accept health insurance?”

It’s a complicated question. The decision whether to accept third party payments will have a big impact on your counseling practice. The question is made even more difficult as there isn’t just a lot of information to consider—there is also a lot of misinformation about working with insurance companies.

Below are a few semi-misguided statements I’ve heard from counselors worried about accepting insurance. I’ve tried to provide a helpful response to each statement:

1) “I’ve heard I should stay away from accepting insurance.”

Read Counseling Article

Mental Health Billing: Medical Billing Tips for Therapists

A new video we put together reviews three important questions to ask your mental health billing team (or medical billing company), to determine if your practice is up to standard!

Counseling Medical Billing: 17 Reasons why Your Claims are Denied

Medical billing is a frustrating process for counselors who are often juggling too many business tasks, as well as trying to provide excellent clinical care. In fact, many counseling practices collect less than 85% of the monies that they’re rightly owed from insurance companies. However, with good planning, and a smart billing staff (in house or otherwise), your practice can reasonably expect to collect between 96-99% of claims.

Look out for these pitfalls! There are many reasons that claims can go unpaid, including:

1) You Waited too Long to File the Claim

The vast majority of insurance companies allow 90 days from the time of service to file a claim. However, some insurance companies allow only 30 days to file (and a very few, such as Medicare, allow a year—wow). When claims are filed too long after the date of service, they are rejected.

Read the rest of this article here: Counselor Medical Billing Article

How to Ethically Improve Client Retention

As professional counselors, we help others. It’s in our DNA, our learned behaviors, and our personalities.

This is usually a good thing. However, it has its dark side too. Over the last 10 years, I have noticed an alarming reluctance among counselors to run their practices so that they benefit both their clients AND their selves.

It’s as if counselors have the motto: “If it’s good for me, it’s probably bad for my clients—and it’s also probably unethical.”

The follow article—which is pretty long, so it’s broken into two parts—gives step-by-step strategies for improving counseling client retention. We’re really excited to have you read this article, so be sure to leave us some feedback!

7 Strategies for Ethically Improving Client Retention

7 Strategies for Ethically Improving Client Retention (Part 2)

The Online Therapy Myth: What Online Counseling Won’t do for your Private Practice

Being a spokesperson for the online therapy field, I have, every week for the past several years, received calls from counselors who have recently listed their name and practice information on an online counseling website (such as, or who are having someone build them an online counseling website of their own. I usually meet these calls with a certain level of excitement: “Great! Super! Excellent! Congratulations! Welcome to the club!” I will say. But I have recently grown to be a bit hesitant with my cheers, “Wait a second,” I might say, “What are you expecting to happen when you start your online therapy practice?”

Too often, the counselor’s response sounds something like this. “Well, I’m getting fewer new clients at my face-to-face practice, so I was thinking that, with online counseling, I would have a much larger pool of potential clients.” Then the counselor will ask me, “How long do you think it will take for me to have a full caseload?”

“Well, that’s the thing,” I’ll say, “Caseloads, especially caseloads of online clients, don’t just happen; they are BUILT with a lot of effort. Being on the Internet is a great start, in some ways it even puts you miles ahead, but it isn’t the solution to all your private practice woes.”

And then, I will tell them what I’m about to tell you.

Online Counseling Is a Smaller Pond

In the example above, the counselor is operating under an understandable misconception—the syllogism is as follows:

Major Premise: Big Nets Catch Fish

Minor Premise: With Online Counseling I Have a Big Net

Conclusion: With Online Counseling I Will Catch Fish

Brings you back to undergraduate philosophy, doesn’t it? In less philosophical terms, the reasoning sounds like this: “As an online counselor, my reach is a million times longer than it is offline. Therefore, even if I don’t put a lot of effort into promoting my practice, I should still get more than enough clients!”

And here’s the flaw. One’s net may be huge, but how big is the pond?

According to Google, in January of 2009 there were 1,220,000 web searches for the keyword “Counselor.” In the same month, there were 6,600 searches for the keyword “Online Counselor.” Note the magnitude of the difference: 1,213,400 more searches for “counselors”, compared to “online counselors”. Hence, while an online counselor’s net may be huge, the pond is (for now) relatively small.

Other Nets in the Pond

When it comes to online counseling, there is increasing competition every day. While it is true that most counselors in the USA have no Internet presence what-so-ever, there are still thousands of therapists providing online services. In addition, the growing field of life coaching creates competition for counselors, and life coaches customarily provide services via telephone, or online.

Make no mistake, competition for online and telephone clients is strong, and any new online counselor is entering a competitive arena.

Immediate Benefits for Online Counselors

This column is not meant to discourage. All hope is not lost for the therapists considering online counseling! There are some immediate benefits to having online counseling training, and having an infrastructure for efficiently and ethically providing online or telephone counseling. Such will allow you to:

1.       Retain clients who relocate (a common problem in college areas like my hometown, Boston, MA)

2.       Help clients who can’t make it to all of their appointments (stuck at work, stuck in traffic, traveling, etc.)

3.       Attract a small number of new clients (your net will catch some fish)

The Competitive Online Counselor

Build a Business

Going online is not an alternative to the arduous task of building a counseling business. Therapists need to develop a solid strategic plan. Develop a company structure. Measure growth. One needs advertising and PR. One needs a marketing plan that takes into account the online audience. I recommend every online therapist create content and publish it on the web in order to begin becoming an active part of the online community where they are hanging their virtual shingle.

Find a Niche

Client X needs counseling. What makes you the best choice?

One way to attract online clients is to specialize. Focus your efforts on a specific type of client: clients with liver cancer, clients with pregnant teens, clients who have lost a child, office spouses, desperate housewives, Americans living in Japan, Japanese living in the Americas…you get the picture.


Online counseling is not your niche! It is a method of delivering service. It is added value to your in-person clients. Build your practice. Find a target audience and help them. Don’t just be online—be so valuable that people across the country are calling and emailing you to ask: Do you take online clients?”

Getting On Insurance Panels is a Process!

Hi Readers, we’re working on some new articles for you this week. But for now, check out a great article just published at Thriveworks! It’s no secret that therapists loath the process of getting paneled with insurance, so much so that some counselors decide against it (we don’t recommend this).

If you’re in this position, maybe you’ll find the new article encouraging:

Thriveworks helping counselors build successful practices

Thriveworks Counseling is helping private practice owners build their counseling practices via a series of unique services. Services include:

  • Scheduling support
  • Website creation and maintenance
  • Marketing assistance
  • A premium model of counseling services

For more information on starting a Thriveworks practice, visit

Marketing a Counseling Practice: Don’t Censor Your Fans!

Hi Readers!

I’m really excited to write this article, which is going to talk briefly about what not to do after you have done the hard work of creating a “raving fan” of your counseling practice.

First, Remember. Getting Raving Fans is the Goal!

In a previous post we talked about how you need to make a great impression on a client to turn him or her into a raving fan. You need to go above and beyond their expectations, provide outstanding service and care, and make for them a “remarkable” experience that they can’t help but to tell their friends about.

Once you accomplish this, and you have clients who are talking about you, writing about you, singing about you, etc., there is something very important you need to do. Ready? This is what you need to do: Stay Out of Their Way! It took a lot of fuel to get that car moving… don’t hit the brakes!

In fact, the only reason you should intervene, is to help (or incentivize) your fans to continue talking about (and promoting) your counseling service.

Isn’t This Common Sense? Don’t Quiet your Cheerleaders?

This seems like common sense, right? Maybe not—companies are making mistakes left and right when it comes to trying to manage their fans. They don’t know when to let go and let their customers spread the word about them, and generate business for them.

It can be difficult for companies to give up that control! And it can feel scary to have persons talking about your business. For sure, your customers won’t market your counseling practice the way you market your counseling practice. They will do it their way.

Your client might post about you in chat rooms. She might blog about her counseling sessions. She might mention that you wore an ugly sweater on Wednesday (my clients have told their friends that I wear brightly colored socks. Not exactly what my marketing message is, but I’ll take it! Obviously, I made an impression, and it’s true! My dress socks are yellow, green, red, light blue, and even pink!).

If your customer (or client / patient) is speaking about his or her experience with your brand / service – don’t censor this! Learn to get comfortable being reviewed (even if it’s mixed. Even if it’s a negative review). And learn to love your clients’ creative and unorthodox methods of spreading the word about your product (which is an exceptional counseling practice, right?).

A Real-Life Example of What Not to Do

I have an example of a company that just this week (Black Friday Week, even!) contacted me to ask me to remove a blog post I wrote that promoted their company. Guys, again. Don’t ever do this!

Here’s the email:


Hi Anthony! I hope this email finds you well. I was doing some

searching on the internet and noticed you posted up our entire Black

Friday email on your wordpress blog

This was a special offer sent out only to our previous customers, and

not intended to be posted up for the public to see. I would appreciate

it if you removed the coupon code and email entirely.  Thanks so much

and please let me know if you have any other questions.

[Name Removed]



[Company Name Removed]


This is a polite email, for sure… but still, it’s the opposite message you want to send to your fans. I had been promoting “Company X” in my writing, speaking, and consulting for some time. Recently, I took an email they sent me about a sale, and posted it so that my readers (you!) could know about it–helping my readers get a deal, and “Company X” get more sales! Sounds good right? Not to the marketing department at “Company X” … how unfortunate! How backwards!

More Articles on Marketing a Counseling Practice

I’m going to be writing on this topic more, for sure. However, there are a few books available that talk about viral marketing, and creating Raving Fans, that I would recommend.

  1. What Would Google Do? by Jeff Jarvis
  2. Raving Fans by Ken Blanchard
  3. The Gift Economy by Gary Vaynerchuk
  4. The Referral Generator by John Jantsch

Thanks for reading. If you’re looking for help building a counseling practice, check out our innovative practice building service at, and be well! – Dr. Anthony Centore

Building a Counseling Practice Office —

Looking for Wall Tatoos? check out — A colleague of mine recently bought beautiful wall tattoos from them, and notes that the specific colors of their decals are labeled for easy matching with the color codes of leading paint companies. This apparently was a huge help when designing the color palate for his new apartment.

Read our article about how smart Social Marketing Techniques: Stop Censoring Your Fans!


Dr. Anthony Centore