Purpose and Profit: Scale Your Therapy Practice

18 | Why Therapists Leave Thousands on the Table (4P —Profit Pillar)


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How much money would you be making if you didn't have beliefs about what therapists are "supposed" to charge? This episode tackles the profit problem in our profession: why therapists with incredible expertise, advanced training, and transformational impact are charging as if they're fresh out of grad school—and leaving tens of thousands of dollars on the table every single year.

What You'll Learn:
  • Identify five core money beliefs - Recognize the limiting narratives keeping you stuck, including "therapists don't get rich," the guilt loop around profit, the martyr narrative, accessibility traps, and growth myths
  • Understand the roots of therapy's money issues - How patriarchy and the historical undervaluing of women's work created the belief that good helpers aren't motivated by money
  • Distinguish revenue from profit - Why six-figure income doesn't equal six-figure security and how to calculate healthy profit margins (goal: 30% or higher)
  • Navigate Canadian-specific considerations - Provincial regulations, tax implications, business structure decisions, and regional fee variations across Canada
  • Implement strategic pricing - How to structure fees that reflect your expertise, specialisation, training, and the transformational value you provide
  • Approach fee increases confidently - Annual review strategies, gradual implementation plans, and communication frameworks that announce rather than apologize
  • Create sustainable sliding scales - How to offer genuine accessibility by setting floors, limiting availability, using strategic scheduling, and giving yourself permission to say no

Key Topics Discussed:

This episode explores the inherited beliefs that create artificial income ceilings for therapists, including how the guilt loop equates fees with ethics and the martyr narrative connects to centuries of undervaluing women's work in a profession that's 90% female. We examine why financial security for therapists isn't selfish but sustainable, and how having associates complicates rather than fixes money mindset issues. The conversation covers the critical distinction between revenue and profit, with most therapy practices operating at 5-10% margins when the goal should be 30% or higher. Cecilia provides specific strategies for fee structuring, annual increases, and sliding scale implementation, plus guidance for group practice owners on pricing leadership value appropriately. We discuss sustainable profit metrics including calculating revenue per billable hour, tracking profit margins, building emergency funds, and creating long-term wealth beyond annual income.

Mentioned in This Episode:

This episode continues the Sustainable Practice Framework™ series with the Profit Pillar, exploring how ethical profit supports rather than compromises your purpose. We reference how the Purpose Pillar (Episode 1) connects to profit decisions, the importance of knowing your numbers for sustainable practice management, Canadian tax considerations including RRSPs and TFSAs for wealth building, and the upcoming People Pillar (Episode 3) on authentic leadership and values-aligned hiring. Key concepts include the difference between revenue and profit, healthy profit margin calculations, revenue per billable hour metrics, and strategic approaches to fee increases and sliding scales that maintain both accessibility and sustainability.

Next Episode Preview: Episode 3 explores the People Pillar—authentic leadership, values-aligned hiring, and how to scale your impact through others without losing your mind.

Take Action This Week:

  1. Research market rates for therapists with your credentials in your region
  2. Calculate your current earnings per billable hour
  3. Identify three money beliefs and notice which limits you most
  4. If below market rate, create a 12-month fee increase plan
  5. Find a business accountant if you don't have one

ABOUT YOUR HOST: Cecilia Mannella is a leadership coach for therapists and wellness practice owners with 25 years as a mental health practitioner and 17+ years building her group practice from solo therapist to seven-figure success. She's lived through every leadership identity phase herself and now helps Canadian therapists navigate their own leadership evolution to scale sustainably.

LOVED THIS EPISODE?

This is real talk about the messy parts of business ownership—share it with another practice owner who needs to hear they're not alone ⭐ Leave a review sharing which money belief resonated most with you ⭐ Hit follow so you don't miss Episode 3 on the People Pillar next week

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Purpose and Profit: Scale Your Therapy PracticeBy Cecilia Mannella