Episode #782: See Fewer Clients Without Making Less Money

Summary

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Episode Overview

Abundant Practice Podcast – Episode #782: See Fewer Clients Without Making Less Money
Host: Allison Puryear
Guest: Rebecca Smith, Limitless Practice Graduate & Team Abundance Member
Air Date: August 8, 2026

This episode dives into a relatable dilemma for therapists in private practice: how to reduce client load without sacrificing income. With humor and honesty, Allison and Rebecca dissect a listener’s question about burnout, finances, and the path to a sustainable caseload—offering actionable strategies for making more by working less.

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Key Discussion Points & Insights

1. Listener’s Dilemma: Burnout vs. Financial Needs

Timestamps: 01:45 – 02:20

• Listener’s Question:
  The episode centers on a therapist seeing 32 clients per week and feeling dangerously exhausted, worried about providing less than their best in sessions, but unable to envision reducing their caseload due to financial obligations.
• Quote — Rebecca (01:45):

  “I am currently seeing 32 clients a week. Oh, my God. I was there. I could feel it. Oh.”

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2. The Realities of High Caseload and Burnout

Timestamps: 02:20 – 04:44

• Rebecca recalls her similar experience, seeing 32–35 clients weekly before joining Limitless Practice.
• She initially thought the answer was finding another side income, but Allison’s frank coaching redirected her to reform her existing practice.
• Quote — Rebecca (03:58):

  “I was like… I need your help figuring out something else I can do while I see 35 clients a week… And you very sweetly were like, that's so dumb.”

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3. The Only Sustainable Solution: Raising Rates and Going Private Pay

Timestamps: 04:00 – 05:58

• Both hosts agree the only meaningful change is to reduce reliance on insurance panels and raise session rates.
• They discuss the “developmental stage” therapists reach when ready to combine wellbeing with financial security.
• Stagnation leads to burnout, which then affects clinical quality and referrals.
• Quote — Allison (04:44):

  “The bottom line and wellbeing cannot be two separate things...they’re going to influence each other in both directions.”

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4. Negotiating with Insurance—Slim Hope, Gradual Rewards

Timestamps: 05:11 – 05:58

• Therapists sometimes gain small increases from insurance panels, but this seldom allows for a radically reduced caseload.
• Allison’s suggestion: Try asking for increases, emphasizing specialization, but don’t expect dramatic changes.

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5. Facing the Fear: Calculating Your Necessary Rate

Timestamps: 06:05 – 10:35

• Rebecca describes her own experience transitioning off insurance and raising rates by $75 per session for private-pay clients—surprisingly, she didn’t lose any clients, and some congratulated her.
• For many, the fear of losing clients is overblown; a financial cushion helps, but attrition is often less than imagined.
• Quote — Rebecca (07:25):

  “I got off insurance and I raised my rate by $75… I did not lose any current private pay patients. And… at least two or three, like, congratulate me and then pay my higher rate.”

Quick Math Breakdown

• They calculate that to maintain a $3200 weekly income, dropping from 32 to 20 clients means charging $160/session—still a reasonable, not “premium,” rate in many markets.

• Mindset shift: The number needed may be lower than therapists fear.

• Quote — Allison (09:30):

  “For a lot of people, if a third of their caseload stays with them, they’re fine. They’re making the same money and… working a third of the amount.”

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6. The Impact on Personal and Professional Life

Timestamps: 07:52 – 10:35

• Chronic overwork means therapy quality and home life both suffer.

• Burnout isn’t just a professional hazard—it erodes family and personal wellbeing.

• Quote — Rebecca (08:06):

  “You’re probably emotionally burnt out, you’re very tired. You’re not being able to give to your family or friends or personal life in an appropriate way. And it’s seeping into your work life.”

• Quote — Allison (09:02):

  “This is a developmental stage you have graduated to.”

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7. Tools and Resources Offered

Timestamps: 10:35 – End

• Free worksheet: “Top 10 Things You Can Do to Regain Balance”—not just focused on raising fees, but a range of interventions.
• Listeners encouraged to access this via the show notes or social channels for actionable steps.

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Notable Quotes & Moments

• The Blunt Truth about Overworking:

  “Shut up, Rebecca. You’re an idiot. No, she was very nice about it.” (Rebecca, laughing over Allison’s honest but kind pushback, 04:00)

• On Client Retention and Raising Rates:

  “I did not lose any… had at least two or three… congratulate me and then pay my higher rate.” (Rebecca, 07:25)

• Balancing Wellbeing and Income:

  “The fact is your wellbeing is impacted by your income. And you need to be well to be able to provide good care.” (Rebecca, 10:22)

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Episode Timeline & Key Timestamps

• 01:45: Listener’s question about burnout and caseload
• 03:20: Rebecca’s pre-Limitless Practice story
• 04:44: Raising rates as the real solution
• 05:11: Insurance increases—possibility and pitfalls
• 06:42: Addressing the fear and practical steps
• 07:52: Emotional and life impact of overworking
• 09:30: Salary math: what’s really needed?
• 10:35: Announcing the free worksheet resource

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Conclusion

This episode delivers tough love and tactical advice for therapists stretched too thin. Allison and Rebecca emphasize that the only sustainable route is to value your time, raise rates, and carefully transition toward a manageable private-pay caseload. For therapists fearing the jump, real-world experiences and concrete math offer reassurance—and the free worksheet provides a place to start. The tone is warm, supportive, and gently humorous: “Your wellbeing and your bottom line can’t be two separate things.”

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Transcript

[A]

Foreign.

[B]

Welcome to Ask Abundance. Y' all ask the questions about having a fun and thriving practice. We answer them. We have a worksheet for you today so you can bring this answer into your life. If you want support in your practice, we have you covered with on demand or one on one support. Links for the worksheet and support are in the show notes. Can't get enough. Ask Abundance. Check out our YouTube channel for the entire library. Therapists whose practices are full. Is this actually the practice you want? If you're secretly stuck, you're cramming in evening sessions, glued to insurance panels, unable to raise rates. Limitless practice is your way out. Over 12 weeks, you'll make the changes you've been thinking about making for months so that you can work fewer hours while making more money. You'll design a schedule that actually fits your life and you'll say yes to only the clients you love. Together, we'll release you from your golden handcuffs. We're capping the cohort at 10 people because I'm personally running every individual call, every group call, and every accountability check in. People on the waitlist will get first dibs on those spots and then the opportunity to sign up will go out to the rest of my audience. So join the waitlist now. Going to put the link in the show notes and I look forward to helping you get your practice exactly where you want it.

[A]

Hey.

[B]

Hey. Welcome back to Ask Abundance. Today we have Rebecca Smith with us. Rebecca is a limitless practice grad who came aboard Team Abundance. She has a premium fee private pay practice in New Orleans and she is great at helping Abundance therapists imagine what's possible for them. So here is today's question. She's going to give it to you. Okay.

[A]

Thanks, Allison. This one says, I am currently seeing 32 clients a week. Oh, my God. I was there. I could feel it. Oh. I'm currently seeing 32 clients a week and I'm exhausted in a way that's starting to scare me a little. I can feel myself becoming less present in session, and that's not okay with me. I know I need to see fewer people, but I genuinely cannot figure out how to reduce my caseload without taking a significant financial hit. And I have real expenses that depend on my current income. Where do you even start when you feel stuck between your well being and your bottom line?

[B]

Yeah, it's really hard. We're going to get to it. I first would like to thank TherapyNotes for sponsoring Ask Abundance. I've talked about them for years, know their features by heart. But what really sets them apart is that they genuinely care about your experience. It's not just about troubleshooting. They actively implement user suggested features like clinical outcome tracking, their AI notes feature, therapy fuel and secure messaging. Everyone at TherapyNotes believes in the product and they you to love it too. Plus, they're independently owned, which means no venture capital and no pressure to prioritize investors over customers. This independence allows them to keep their prices fair, to focus on innovation and prioritize customer experience. With over 100,000 therapists already on board, they've proven that you don't have to compromise success for quality. If you're ready to see for yourself, you can try Therapy notes free for two months with the code [e-mail] so, I mean, you were here a few years ago. Do you want to start us off?

[A]

Yeah, Yeah, I was right there. I was seeing between 32 and 35 a week when Allison started Limitless Practice. And then I did Limitless Practice and my life is better. But I think that the thing that was. It was crazy. I remember being on the call with you, Alison, to like, see if I wanted to do Limitless. And I was like, allison, I am going to, like, make money in another way. I need your help figuring out something else I can do While I see 35 clients a week to try to make more money. And you very sweetly were like, that's so dumb.

[B]

Please don't do that.

[A]

Shut up, Rebecca. You're an idiot. No, she was very nice about it. But you're like, you. You have something valuable. You have a practice that seeing 35 clients is seeing 32 clients, whatever it is, and. And make that practice into what you need it to be for your life. And so what I had to do is I had to get off insurance and I had to raise my rates to a livable place. And Now I'm at 20 a week. And it is really nice. A lot more than I was seeing 35. And I think that that's. That is the answer. Because the bottom line and wellbeing cannot be two separate things. Right? Like, it's going to. They're going to influence each other in both directions.

[B]

Right. Like you said, you're not feeling present or not you. But this person said they're not feeling present. That's going to start to impact word of mouth referrals. You know, when we get burned out and we don't act on it, then it starts to spiral. So I wish that there was some magic wand thing I could do besides you need to raise your rate and you need to be private pay. But this is the developmental stage you're in now.

[A]

Yeah.

[B]

Like, this is really the only way you can try to get. You can ask insurance companies if they will give you a raise. That's absolutely something some people get. So, you know, you can send in something. You usually need to work with a specific niche. You need to show that you are more competent than the average therapist in that niche and say that you would like increased reimbursement. Ask for more than they're going to give you because it's always. They'll be like, we're not going to give you $20 more. We may give you $3 more. But I know some therapists who have effectively done that year over year. And now they're making significantly more than the newbies coming on the panel. But I don't usually see them giving a huge chunk per session in such a way that you could reduce your caseload significantly.

[A]

Right. Because the thing that this person is saying is like they, their number cannot decrease.

[B]

Right.

[A]

Take home cannot decrease.

[B]

Right.

[A]

And if you want to decrease sessions by like one session, let's say you're getting paid 150 bucks from the insurance. I don't realistic in most places, but

[B]

I love your optimism.

[A]

Let's say you're getting paid $100. You need those other 31 patients to like equal $100. Right. Like.

[B]

Right.

[A]

It's just. It's just not going unless you do something relatively, I won't say drastic, but unless you really commit to real change.

[B]

And that's scary if you're basically barely making ends meet. You and I have talked in the past about you need to have a financial cushion if you're going into private practice. What's interesting is depending on your caseload, more people than you think are likely to stay in your practice when you go private pay. Mm. Especially if you've got a great relationship with them. Rebecca had a lot of clients who could not follow her. So she had a bigger drop off than I wanted her to have. Than you wanted you to have.

[A]

But I was also only on one panel and everybody was on that panel.

[B]

Right.

[A]

So like for a lot of people, they're on multiple panels and you don't have to explode your whole practice like I did.

[B]

Yeah.

[A]

I will also say I got off insurance and I raised my rate by $75 for current private pay patients and I did not lose any current private pay patients. And that even though I significantly raised their rate, I had at least two or three, like congratulate me and then pay my higher rate. Love it.

[B]

Yes.

[A]

That was great. And so I think the other thing too is this person is clearly saying that taking so many clients is impacting their work. What the heck is it doing to your life?

[B]

Right.

[A]

Like, if it's already impacted, like, you're, you're probably emotionally burnt out, you're very tired. You're not being able to give to your family or friends or personal life in an appropriate way. And it's. And it's seeping into your work life.

[B]

Right, Right. Because I can only imagine after that many clients, and it's impacting the clients. When you come home, you're not coming energized and ready for the next thing. You're coming home probably like, please just don't talk to me.

[A]

Like, if one person tells me about their day.

[B]

Uhhuh. Yeah. Yeah.

[A]

And you're, I mean, like, hi, honey. And you're like, ah,

[B]

most of us probably have been there, so no judgment because I know Rebecca's been there. I know I've been there. But this is the path off.

[A]

Yeah.

[B]

And I'm sorry that it is hard and it is scary and it takes a lot of self trust.

[A]

Yeah.

[B]

But this is a developmental stage you have graduated to.

[A]

Yeah.

[B]

And of those 32 people, probably a good chunk of them will stay with you. And sometimes math helps of looking at like, okay, how much money are you bringing in per week right now? How many clients at a premium rate do you need to see to make the same exact money each week? And for a lot of people, if a third of their caseload stays with them, they're fine. They're making the same money and I'm working a third of the amount, so.

[A]

Okay, so let's, let's pretend they're seeing they're getting reimbursed $100.

[B]

Okay.

[A]

Then they're making $3200 a week.

[B]

Okay.

[A]

Right. And they would rather see what, 20 clients. Then they need to charge 160.

[B]

I mean, that's not a premium rate.

[A]

No, that is a very low rate to be able to keep your bottom line and reduce your caseload by. I was going to say a percentage, but I have a PhD in Feelings and not math, so we're going to seeing 12 fewer clients a week.

[B]

Yeah, yeah, yeah.

[A]

That's not a ridiculous number.

[B]

No, it's really not. And it's a good entry number if premium rates scare the bejesus out of you.

[A]

It's true. But the fact is your well being is impacted by your income.

[B]

Yes.

[A]

And you need to be well to be able to provide good care.

[B]

100%. And on that note, we do have a free worksheet for you today. It is top 10 things you can do to regain balance are some different things you can do that aren't all just, you know, increase your fee. But that's going to be the most impactful. If you're listening to the pod, you can get this in the show notes. If you're watching on social, you can just say the word. The word worksheet.

[A]

That's that word. That's the word.

[B]

The word worksheet. And it'll. I'll send it to you. So that's how that one works. All right. Thanks, Rebecca. Have a good day.

[A]

Thanks, Allison.

[B]

If you're ready for a much easier practice, Therapy Notes is the way to go. Go to therapynotes.com and use the promo code abundant for two months free. I hope that helped. Please get in touch with any of your questions for askabundance. If you're listening, you probably need some support building your practice. If you're a super newbie, grab our free checklist using the link in the show. Not I'd love for you to follow rate and review, but I really want you to share this episode with a therapist friend. Let's help all our colleagues build what they want.