Please see the updated version of this article, now posted at Mindset Market Blog
Really though – how many clients does an average therapist have? Aspiring and experienced therapists alike ask this question – it’s useful for income planning, people are competitive, and it’s just interesting!
The goal of this article is to summarize some of the data out there, because there is no conclusive answer. There are several causes of confusion.
For that reason, we’ve chosen to provide a host of resources that have interesting contributions to this conversation. We will make one particular point, however; income does improve over time within the psychotherapy industry (not surprisingly), but that absolutely does not have to pair directly with a growth in the number of clients a therapist sees.
The range of salaries for therapists is also startling. From our standpoint, it suggests the value of therapist business coaches like Lynn Grodzki, LSCW, MCC and Casey Truffo, MS, LMFT (check these books out – very, very informative – one of Lynn’s bestsellers and one of Casey’s.
The variation in income, client load, and revenue stream diversity suggests there is an enormous amount of pure business information with which many therapists have perhaps not yet come into contact. After all, therapy is an extremely high-value service that transforms lives – we question whether too many therapists continue to undervalue their own practice’s contribution to the greater good.
Onto the conversation:
The number of clients I have tends to fluctuate. At the moment I have 27 clients, and they include couples, families and individuals. This is about as many clients as I can see in any given week. (If my practice is full, I compile a wait list. If the length of time a client must wait is more than one month, I keep a referral list of other therapists that I recommend to potential clients.) Anyway of this 27 clients about half are couples, with one or two families and the remainder are individuals.
Depending on which study you read, between 20 and 57 percent of therapy clients do not return after their initial session. Another 37 to 45 percent only attend therapy a total of two times. Although many factors contribute to premature client termination, the number one cited reason by clients is dissatisfaction with the therapist.
I used to work at a nationally recognized prestigious group practice. The psychologists there don’t take insurance, have published many books/articles in their field, and are board certified etc. They also advertise a ton on the web. Even with all this, it would take a psychologist 1 year to build her case load. Many of the psychologists saw only between 15-25 patients per week because of cancellations and did not have a full case load. WE never had a wait list for the year that i worked there and few of the psychologists were able to have a full case load. Also, they would then have to deduct 50% due to rent and office expenses and had no benefits or health insurance. I don’t know how much they made exactly, but i do know that they had to have another job on top of this one or had to leave due to the salary.
Each session is approximately one hour, and I definitely don’t work 15 hours per day. If any mental health professional sees 15 people per day, they’re in the nod and smile school of psychotherapy.
Karrion D. Lalor, LPC, CMS says in the comments section of an article on practice marketing (the entire comments section is very informative):
Yes this is absolutely realistic. I have a private practie for the past 4yrs and 6months ago I began doing it full time. My income has increased and I should be at the 100K by the end of next year if not sooner. The one thing I want to point out about the numbers are the amount of clients you have to see during a week. I am currently seeing 10/15 clients per week and I feel good about that. 30-40 clients per week can be very draining and for me, the trade off is not worth the money. I am incorpating a lot of group work/workshops so that I have variety of service and can more quickly get to the salary range I desire without being burnt out.
Many friends in private practice are struggling or have to have a regular paying job as a faculty member or something to get by. But don’t get me wrong, there are many psychologists in private practice who are thriving and earning beyond $150K in the US. They tend to be the ones that wear many hats, like teaching at a university, doing some consulting work, getting major NIH grants, and running their practices on the side. The wealthiest psychologists I know have developed some sort of training model that gets them invited to speaking engagements all over the world, have successful practices that provide therapy and assessment services, offer training workshops at their practices that others pay top dollar for, write successful books or training manuals for other practitioners, etc. But I must say that one of the defining characteristics is that they love their work and are committed to the field. That’s probably the most important contributing factor to a high earning salary.
Each of those sources include a whole host of additional commentary and insight. We will leave you, however, with an important thought about properly relating total client visits to job satisfaction.
Unfortunately, a challenging economy and a rapidly changing cultural environment for therapy services has made it difficult for many therapists to be as successful as they’d like. So while you may have inquired about the question “How many clients does a therapist have?” for either income benchmarking purposes, pure curiosity, or some other motivation, keep in mind that quality over quantity not only applies to the complete total of clients on your calendar, but also the types of experiences you have as a practitioner. Focusing on the business health of your practice means so much more than just getting more people through the door.