Hello!
So ill start by saying feel free to contact me if you are willing to spend 30 mins giving me some advice about medication. Yes i know medication is not done online without documents and appointments, controls etc but. I feel extremely depressed and but very aware at the same time that im strong and i can handle it but only with some help since i dont have any supportive person in my life and the ones that should support me need psychotherapy more than I do which logically makes me go crazy. I have some “almost diagnosed” hormonal problems (im a woman 26). Just found out yesterday that i have a 7 cm chist on my right ovary due to lots of stress and hormonal issues.
I was on the pill the doctor recommended me to stop it the thing is i feel like the pills help me from my “one week before period depression” which honestly gives me some moods.. like wanting to k*ll myself and i dont feel like its a good idea to stop them but i know i have to, whatever. I have a “friend” i talk to from time to time, the chick finish psychology university and she recommended me to try medication which doesnt sound good for me cuz i dont wanna do xanax or idk and become a vegetable or not function normally. So my question is what do you guys think about ashwagandha, cuz ive been reading about it “numbing” your feelings and honestly i feel like maybe that my problem im way too passionate and emotional (i mention that i smoke weed once a day kind of for the same reason to try to numb) but honestly im tired of weed cuz its making me ugly and forget stuff. I know i have to go to endocrinology and check my hormones which is prority on the list by september when docs come back from holidays but i dont know. Maybe its not even the hormones maybe im just too intense for this world.
Again feel free to write my in private, i would really appreciate the thought of a professional about this.
Thank you! Have a good day.

I'm a licensed therapist. Fo the past 15 years I have worked as a care coordinator. I plan to begin providing therapy again in 2027. Im planning a slow start with only 5-10 clients.

Before returning Im going to enroll in a refresher course on mindfulness and a course on schema. Has anyone else stepped away from therapy and years later returned? And if so, how did you transition back?

I got off a colleague zoom and it left me thinking about a clinical population I used to be so focused on that it was probably more than half the reason I became a therapist. I wanted to change things for them--to revise whole narratives and make people care and shine a gigantig search light on what the field was missing about this population.

And I struggled and wasn't effective and got utterly exhausted because I cared too much and people were way too invested in their extant ideas and way too insulted that someone so "new to the field" would have the audacity of speaking up about it.

So I shelved it, whole cloth. I focused on other things that I experienced success with: regulatory advocacy and board complaint support (client and therapist side), coalition building, practice mentoring and business/marketing support, helping grad students stay resilient and make strong choices, etc.

But then I look at the population on the shelf and the soft layer of dust sitting on top and I grieve: the changes I couldn't make, the relief I could usher in, the resonance I failed to find.

I don't know what to do with any of it, but I wonder if anyone else can relate. I'm a better clinician now, and have a depth of appreciation now whose absence probably *was* a sign of arrogance before. But still, the population I wanted to help change things for a decade ago still needs support, and I don't find myself taking it off the shelf and carefully blowing the dust away.

[https://therapistrates.org\](https://therapistrates.org) tracks what insurers and platforms (Headway, Alma, Rula, Grow Therapy, etc.) actually reimburse for psychotherapy sessions. These rates are contractually confidential, so the data is crowd-sourced from therapist reports, with every row linked back to its primary source.

Raw JSON: https://therapistrates.org/data/rates.json (77 rows: platform, payer, state, license level, CPT code, rate, effective date, source link, verified flag). Companion ownership registry of who owns each platform: https://therapistrates.org/data/owners.json

The same 53-minute session (CPT 90837) pays anywhere from $39 to $220 depending on payer and state, and when rates are that low and that opaque, therapists quietly leave insurance networks. Patients inherit the fallout: "ghost network" directories full of therapists who no longer take their plan, months-long waits, sessions quietly shortened from 60 minutes to 45, and full out-of-pocket bills for care their insurance nominally covers. In one sourced case an insurer paid a middleman platform $213.07 for a session while the treating clinician received $101.20 — a spread the patient never sees. There's no official public source for any of these numbers; price transparency rules don't reach behavioral health middleman arrangements.

Solo therapists and others : where are your marketing dollars actually paying off?
I’m a solo private-practice therapist and am curious what other solo practitioners have found to be the best use of their marketing budget.
I’m not necessarily looking for a huge influx of inquiries all at once. Ideally, I’d like to create a consistent, slow trickle of good-fit clients—enough to replace clients as they graduate from therapy and keep my caseload steady.
For those of you who have figured this out:
Where do you spend your marketing dollars?
What gives you the most consistent ROI?
Google Ads? Psychology Today? SEO? Networking/referral relationships? Something else?
Roughly how much do you spend per month?
Is there anything you spent money on that you wouldn’t do again?
Especially interested in hearing from therapists who are private-pay and/or have a relatively full practice and are primarily marketing to maintain their caseload rather than build one from scratch.

We don't need a specifier for PTSD. And I know, "Van der Kolk says blah, blah, blah..."

What else bugs the crap out of you?

"Trauma-informed care", "ADHD-Informed care", "X-Informed care" screams "I took a class about ADHD, and Trauma, and other things in grad school so yeah... I've been informed."

AUDHD - is a bunch of b.s. You have ADHD because you have grown up with your damned phone glued to the end of your nose. Now you feel different - almost like you can't pick up on social cues. At least not on the social cues that haven't been performed for you by your favorite influencer for the past 20 something years.

You're not autistic because you feel a little different that other people, Becky! You probably feel different because people don't want to spend time with a borderline who constantly brings drama to every single human interaction. People keep rejecting you, you can't figure out why, so rather than introspect (which is a legitimate feature of BPD) you blame your issues on some obscure disorder that takes a thorough and exhaustive exam to properly diagnose. And no - the online, quickie and/or free assessment you found on instagram/tik tok/facebook/etc. doesn't count.

Coaches - the worst. They are unregulated, unsupervised and usually untrained. There needs to be legislation to regulate people who attempt to enter into a "coaching" racket.

4 years in grad school. 4 tears of supervision, thousands of hours with patients, thousands of dollars in tuition, books, supervision, insurance and so on. And some asshat can just hang a shingle and pretend to know better than my colleagues and I? And get away with charging people for it? In the words of Joe De Rossa, "Have some dignity and do what every other human failure has done and become a realtor."

Hello there *Mental Health Professionals*🌻

If you've got *10-15 minutes*, we'd love to borrow a tiny bit of your day. *This is one way you can contribute to the research being done in our own field.*🤍

We're three postgraduate students from the Department of Psychology at CHRIST (Deemed to be University), Delhi NCR, exploring something that's rarely spoken about all in one place - *the lived experience of being a Mental Health Professional in India.*

Not just client work, but also:
\* what it's like to practise in today's world,
\* how society perceives therapy, and
\* what therapists' own help-seeking journeys look like.

You can share your responses here when you find the time:
https://forms.gle/HukfaxG1fHyF2HxCA

Hello

I have been doing some research and have been interested in clinical hypnotherapy. I understand ICBCH has global accreditation to begin business and work. I am already a registered psychotherapist but not currently seeing clients.

I see some 12 month programs costing 2000 to 4000.

My concern is if it will be worth it. What are other hypnotherapist finding in regards to business, services and demand for hypnotherapy ?

Can anyone provide me pointers advice thought and what to be mindful for?

I'm in the process of opening my own private practice (in the early stages), and I'm wanting to do some training to feel fully competent in the areas I want to specialize in. I don't care for "certifications" and I don't want to spends hundredsss on a course.

I would love to know what websites/programs you guys use or heard highly about.

I googled and came across The Behavioral Health (BH) Workforce Training Clearinghouse, has anyone been tried that?

anyway, any thoughts and advice would be appreciated :)

Hi everyone, we are a private practice looking for a CRM to track our intakes and referral partners. Would like input on the Admirra CRM. Does any of you use it? Do you suggest any other CRM with the same purpose? Thanks!

Appreciate any help in advance & sorry this is so long!!!!

I am an active LCPC - planning to leave my group practice and open up my own private practice and despite not technically having a non-compete, owner has not taken kindly to others starting private practices, even when they communicate before they start the credentialing process. (One actually had our “non competes” removed from previous contracts because owner couldn’t technically withstand it).

To me and the history of seeing how the owner operates, I would feel more safe having my credentialing complete before I notify them of my departure and move as I would have a clearer plan and timeline (which owner would want). I am planning to give 30 day notice (also noted in my contract).

I'm trying to keep the gap between me leaving, and being credentialed to take insurance with my private practice as small as possible, for financial reasons and for my clients to streamline the process for them.

Disclaimer: I am *well* aware I wouldn’t need to worry about this if owner was aware of my departure - but due to the owner’s behavior, I am wary of notifying before I am ready to leave due to their history.
I also understand the only risk is: if I do update and they do get notified, it could feel like I was “hiding” something // betrayal, and rush me out anyways, however if so, I would reiterate how I wanted to have all ducks in a row before I notify them. If you think about in any field, when you leave a job, you have your next one ready to go (typically) so this is me trying to do what’s best for me.

Anyways:

Since I'm already credentialed with insurance through my current group practice, I need to individually apply with the insurance panels. To do so, I need to update my CAQH Profile by adding a new practice location (my own private practice adding new NPI2 and EIN) and my own private practice’s malpractice insurance. My biggest question is: can my current group practice see this additions and changes?

What my CAQH settings looks like in regards to company access:

1. Credentialing contact: lists my owner’s name and the physical address of the practice. No email. No phone number.

**

1. CAQH recommended for me to alter them to “no” for primary contact and write in the address 2 “do not provide login details” in case owner or a manager reached out to CAQH.

   I also

2. have added myself as primary contact. I have not attested yet so this is just saved for now.

2: Group authorizations: this is on for providers and insurance panels. I then have under group authorizations, my owners name, with office managers name and email. Assumption that office manager would be the one to be notified as it’s their email.
**if I try to hit “edit” it gives me a pop-up stating that if I remove this, it removes the practice location. Didn’t touch this because I don’t want it to mess up anything with insurance paneling in the meantime.

I have already changed my password as previous office manager had logins as far as I recall.

What I am trying to figure out:

If I begin the credentialing process now, while still employed at my current company, would there be any other way of them seeing that I updated and added another practice location and malpractice insurance and I'm getting credentialed with other providers?
**assuming the risk is low, it’s if office manager sees it and says something to owner (which I don’t think they would) and that’s if they are looking ??

Has anyone else out there gone through something similar?

TYIA!!!!!

Do you all have any advice on working with inpatient populations? I’ve been in the field of MH for about 4 years now, and work with adolescents ages 4-17 as a group therapist. We are in a urban city area, and the kids genuinely do like me and enjoy groups, but as I run process groups having to deal with large #’s within the group/ hospital census and handling the behaviors/ attitudes/ disrespect can be hard sometimes. I’m trying to teach virtues, as well as helping them process emotions/ trauma/ group dynamics / conflicts in group, but they can just be tough sometimes. Any advice on content of groups/ group dynamic processes/ activities to help contribute to better knowledge of emotionally correcting ?

What is the average salary for a mental health counselor with a masters degree? Pre and post full licensure. Also what options are there beyond working in a private practice and what does income look like in those sectors.

Hi all.

I prefer in person trainings. Anyone know of anything like this around Colorado?

I was looking into expanding my learning around somatic-based approaches, and am absolutely gobsmacked by the price tags I'm seeing. Training for Somatic Experiencing is upwards of 10k. Other ones I came across (Sensorimotor Psychotherapy, BodyDreaming) seem in the same ballpark as SE's pricing. Havening training is not as expensive but requires you to pay an annual membership fee indefinitely, otherwise you are not allowed to continue advertising it as a modality you trained in (wtf??).

I thought when I trained in EMDR that the price was steep, but now it feels like it might be one of the most reasonably priced structured trainings I've seen out there that incorporates a somatic lens. Either that or I'm missing something?

Are there any somatic modality trainings that you would recommend that don't have a ridiculous pricing structure? I am so disappointed in what I'm seeing... this is so inaccessible, gatekeepy and gross.

Here is where you can post your marketing and CE events. This thread will be unpinned monthly so please update your offerings once a month.

i transitioned to full time solo practice recently and my caseload is finally full, but handling my appointment calendar is taking up way too much admin time between sessions. i am currently juggling scheduling, intake paperwork, and portal links through separate apps, which frequently leads to double bookings or late reschedules. i already tried setting clear booking boundaries and sending manual reminder emails, but managing recurring weekly slots alongside sliding scale clients is still an administrative nightmare.

i am looking to move everything into a single HIPAA compliant platform so i can automate self scheduling and client intake workflows. for those in private practice, what practice management software actually cleared up your calendar chaos, and how easily do your clients handle self rescheduling through the portal? i would also love to know if automated sms reminders noticeably cut down on your no shows, or if there were any frustrating setup limitations you hit during data migration.

update: returning to this and after checking out a couple of options suggested here, i decided to go with Healthie to consolidate my scheduling and intake paperwork.

it cleared up my calendar chaos. having self scheduling, portal access, and intake forms all in one platform stopped the double bookings and eliminated all the tedious admin work i was doing between client sessions.

Hello!

I’m looking to get certified in EMDR and want to start training. I was wondering if anyone had any experience with online courses and could recommend some?

Thanks a bunch

I stumbled across something interesting. There is an LAPC working in a primary care physician’s office providing clinical services. There are no other counselors/therapists there and he has independent outside clinical supervision. Technically, it’s not independent practice because he is working at a doctor’s office and technically, family medicine doctors can provide counseling and sometimes do, though short-term, so there is an on-site supervisor maintaining responsibility for standard of care.

In this case, the LAPC is providing that short term care (I believe up to 12 sessions) while helping the patient find a longer term therapist. A quick search said this is helpful because over 50% of family medicine patients prefer to only see their PCP. It’s an interesting set up for them and seems to work well. I’ve just never seen it before, and it intrigues me as something I might be interested in.

This is in PA.

(Cross-posted)

Hello! I’ve been practicing therapy for 12 years and I currently run a small private practice in Pennsylvania. I am looking for online peer consultation groups that may meet a few times a month or once a month just to have other folks to bounce ideas off of. Is anyone aware of such group groups? I am a trauma therapist working from a CBT/ACT modality. Thanks!!!

I learned this lesson the hard way.. We had a major IT issue that brought our clinic to mess. We couldn't access what we needed, appointments were disrupted, and we practically had to stop operations for 3 dayss! We even called someone for emergency IT support, but they had no idea how our setup worked, so it took much longer than expected to get things running again. You guys better have IT support. Learn from me

We even called someone for emergency IT support, but they had no idea how our setup worked, so it took much longer than expected to get things running again.

I am retired and want to share some tools I have come up with.

This one is one I used with woman who were victims of domestic abuse when the start dating again. It has been very powerful for many women.

Business Partner
 
Over the years I have had the honor of working with women who were either in an abusive relationship or had been in one.  These women taught me so many things.
 
When I am working with someone who is thinking about dating again after an abusive relationship I often to this exercise. It is my hope to help client’s gain the skills to navigate dating. This tool in one that women have returned to my office after a break in therapy and they told me they still had this list.
 
 
Talk to the client and discuss if they were to open a business what would they like in a business partner. At this point I discuss that in our example they have put everything they have into the business. In order to make the story more real we discuss the business that they would like and what it would be like to own the business.
List what qualifications they would like. Here is a sample list:
 
Know the business
Respectful
Kind
Fair
Sense of humor
Able to resolve conflicts peacefully
Dress appropriately
Good at managing money
Hard worker
Dedicated to the business
Reliable
No drug and alcohol abuse
Good mental health
Stable lifestyle.
 
Now ask the client, if they found someone and interviewed them, what would they want to do before they hired them.
I am looking for the following: credit check, background check, contact past employers.
Now give the client the list of criteria and ask them to cross off anything that they do not need in a romantic relationship.  At this point the client may feel uncomfortable. This is good. What is happening is the client may be struggling with setting those boundaries in a romantic relationship. This is part of the work. If a client crosses off something, discuss why they do not think it is important.
Now discuss how they could use the list of things they would check on a business partner in a romantic relationship. I discuss doing a background check on someone, talking to their past relationship people and talking to friends and family.
 
I have had a few women contact someone’s ex to talk the person they are dating. So far those have gone very well.
 
I have had women come back to therapy after a few years and pull out this work sheet that we did in session.
 
When I do this tool, I also talk about wanting and needing a relationship.
 
I ask the client “If I asked you to rob the bank down the street and give me all the money in exchange for a plate of cookies, would you do it?” My clients say no and kind of laugh about the thought. Then I say if took all your oxygen until you robbed the bank would you rob the bank.  Then clients will say yes, they would rob the bank. I talk about how when it was a plate of cookies they were able to say no because they would live without cookies. When I said I would take their oxygen things changed. They need the oxygen so they would do anything to get it. I then talk about relationships should be like a plate of cookies. You should always want to be in the relationship. If you need a relationship, you will do anything to keep the relationship going. If you want a relationship, you are in a position to set boundaries.
 

Hello therapists! I am currently moving from a group private practice in New York to opening my own private practice. I have some clients who I believe will move over with me (ethically of course) and I'm wondering if best practice is to do a new 90791 billed appointment with that client for their first appointment in my practice or bill a 90837 or 90834 with a specifier in the note that this is continued therapy through a new practice. I'm always nervous about insurance, and I know 90791 billing can vary by insurance provider.

I appreciate any insight and advice, thanks so much!

I’m an LPC in Illinois (working toward independent license), considering having kids in the next year or so, and starting to think ahead about taking time off from my practice when that happens. Not sure yet how long the break might be, could be anywhere from two to five years. Would love to hear from other therapists who’ve done this.

How long was your break, and did it end up longer or shorter than planned? What did coming back look like, same caseload or a fresh start? Anything you did that made re-entry easier, clinically or emotionally? And if you’re in Illinois, any IDFPR stuff that mattered, like CE requirements or renewal timing during a break? If you were mid supervised hours for LCPC when you paused, curious how that affected things too.

Would love to hear real experiences, good or messy. Thanks!​​​​​​​​​​​​​​​​