Talking about money makes most therapists uncomfortable, especially when it comes to raising fees.

Tiffany McLain, Founder and CEO of Lean In. MAKE BANK., joins Michael Fulwiler to explore how therapists can build financially sustainable practices without sacrificing their values or clinical integrity.

Tiffany shares how her personal upbringing shaped her views on money, why sliding scales aren’t always ethical, and how therapists can rethink their business model to better support themselves and their clients. She also breaks down the unconscious patterns that often hold therapists back from charging what they need and how confronting those patterns can deepen the clinical work.

Listen to this conversation to help you think differently about what it means to be a successful therapist in private practice.

In the conversation, they discuss:

• The internalized beliefs that hold therapists back from raising fees, and how these often stem from family dynamics
• What therapists get wrong about sliding scale models and why setting fees based on assumptions about a client’s income can damage the therapeutic relationship
• The strategy Tiffany teaches to help therapists leave insurance panels and build premium-fee caseloads

Connect with the guest:

• Tiffany on Instagram: https://www.instagram.com/leaninmakebank/ 
• Tiffany on LinkedIn: https://www.linkedin.com/in/tiffanymclain/
• Visit the Lean In. MAKE BANK. website: https://leaninmakebank.com/ 

Connect with Michael and Heard:

• Michael’s LinkedIn: https://www.linkedin.com/in/michaelfulwiler/ 
• Newsletter: https://www.joinheard.com/newsletter 
• Book a free consult: joinheard.com/consult 

Jump into the conversation:

(00:00) Welcome to Heard Business School

(01:05) Meet Tiffany McLain

(02:21) Childhood Lessons that Shaped Tiffany’s Money Beliefs

(04:34) Hiding Financial Goals During Therapy School Interviews

(06:20) The Mindset Most Therapists Bring to Private Practice

(08:03) How Tiffany Challenged the Fee Status Quo

(10:12) Early Lessons on Raising Fees at Access

(12:24) Common Myths Therapists Believe about Setting Fees

(14:54) Why Therapists Assume Clients Can’t Afford Therapy

(16:32) Private Practice Isn’t Built to Serve Everyone

(19:40) Sliding Scale Often Masks Money Avoidance

(23:02) A Practical Method for Calculating Your Fee

(25:30) What to Say When Raising Your Rate

(30:18) Low Fees Can Harm the Therapeutic Relationship

(33:59) Can You Build a Practice on Insurance?

(40:31) Tiffany’s Four-Step Framework for Premium Practices

(46:39) Hiring Challenges and Growing a Values-Led Business

This episode is to be used for informational purposes only and does not constitute legal, business, or tax advice. Each person should consult their own attorney, business advisor, or tax advisor with respect to matters referenced in this episode.