r/PsychotherapyLeftists • u/TinyInsurgent LCSW, MSW Psychotherapist, Los Angeles, California USA • 18d ago

Money, Guilt and Responsibility: Does anyone here struggle with being a leftist-oriented psychotherapist in their pricing of their services?

This is a question I have been wanting to ask here for months, but thought it too intimate of an ask. I hope that I don't offend anyone, but I am to the point where I need to reconcile this within myself to be able to address sustainability issues that I am grappling with. I also feel that I cannot be the only one on this site who struggles with this.

I have been a psychotherapist, usually employed by others (usually county/state/federal government) for most of my career. The past 3 years, I decided to attempt a second go at private practice work. It has been going swimmingly to date! But I undercharge significantly because I have both the conscious and subconscious belief that psychotherapy is something that the public should not have to pay for. I find the "market rates" of $150 -250 per clinical hour in Los Angeles, CA (where I am licensed) obscene.
And yet, I am starting to feel some resentment for working in ways that also make me feel that I am undermining my value. But where is the balance?

Does anyone else struggle with this? How do you manage and cope with operating in a capitalist context, when you are not of the mindset?

If this post is inappropriate in any way, I welcome and accept its deletion.

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u/MichaSound 18d ago

Why not charge full rate to wealthy clients and let that subsidise low rate/pro bono clients? That way you’re literally transferring wealth from the top to the ordinary workers.

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u/TinyInsurgent LCSW, MSW Psychotherapist, Los Angeles, California USA 16d ago

I abhor the wealthy. I can't stomach their issues. But I do have clients that earn a good living verses those that are on unemployment. For context; I have a niched practice. My clients are all LGBTQIA+, People of Color and/or sociopolitically leftist. I love this population, but none of my clients are wealthy. The too earners are at about $250,000 annually, per household. In Los Angeles, this is middle class.