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The Money Sessions: Daily Summaries Delivered
by Tiffany McLain
Deep, thoughtful, raw conversations with real therapists who are in the midst of leaning into raising fees and making bank – all while working with the clients they are passionate about serving.
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- 5 days ago31 min
The Dark History of the DSM & How it Led to AI Therapy
Ready to set your fee? You choose the dream, we'll do the math.🎁 Download our FREE Life First Fees Private Practice Calculator 👉🏽 https://www.leaninmakebank.com/free Ready to charge Life First Fees? Click here to fill out an application What if AI therapy isn't the threat we think it is? What if the real problem started decades before the technology ever existed? Because in 2025, an AI therapy chatbot showed results comparable to those of traditional cognitive behavioral therapy in a clinical trial. And that raises an uncomfortable question: If AI can pass the test we've designed to measure therapy, what exactly have we been measuring? To understand how we got here, Tiffany takes us back to the 1970s, when a group of researchers began pushing psychiatry toward standardized diagnostic criteria—and away from the messier, more complicated understanding of human psychology. The goal made sense. Researchers wanted reliability. Funders wanted measurable outcomes. Psychiatry wanted legitimacy. Insurance companies wanted to know what they were paying for. But all those reasonable decisions began pointing in the same direction: Put the human experience into a box. And once we turned complex human suffering into diagnoses, checklists, treatment manuals, symptom scores, and billable minutes, we created a system that technology could eventually replicate. The DSM didn't create AI therapy. But the shift toward standardizing and measuring therapy helped create the conditions that made AI therapy possible. In this episode, Tiffany explores the history behind that shift, what got lost along the way, and why therapists need to reclaim the definition of what psychotherapy actually is. Because the question isn't simply whether AI can reduce symptoms. It's whether symptom reduction is enough to define therapy. In this episode, Tiffany explores: How American psychiatry moved from psychoanalytic thinking toward standardized diagnostic checklists The controversial research and questions about diagnostic reliability that helped fuel the push for a more systematic approach Why the DSM-III, published in 1980, represented a major shift in how mental health conditions were classified How diagnoses, ICD codes, CPT codes, and insurance reimbursement became intertwined What happens when a person's grief, trauma, unconscious patterns, and relationships have to be translated into codes and billable minutes Why the way we measure therapeutic outcomes can influence which treatments are studied, funded, and labeled "evidence-based" What research on psychodynamic psychotherapy and the therapeutic relationship suggests about the limits of measuring change through symptom checklists alone How AI therapy chatbots are able to perform well within a system built around defined diagnoses, manualized treatments, and measurable symptom reduction Why AI passing a clinical trial does not automatically mean it can replicate the full complexity of psychotherapy Why protecting professional licensure isn't enough if we fail to define what therapy actually is What therapists, researchers, and the profession need to reconsider about outcome measures, psychological change, and the therapeutic relationship Because here's the danger: When we define therapy by how it's billed instead of how it works, we make it easier to turn therapy into a product. A diagnosis becomes a category. A treatmen
- 1 weeks ago48 min
An $85 Fee Raise with Existing Clients: Dr. Emily W. is BACK
Ready to set your fee? You choose the dream, we'll do the math.🎁 Download our FREE Fun with Fees Calculator 👉🏽 https://www.leaninmakebank.com/free Ready to charge Life First Fees? Click here to fill out an application Dr. Emily Williams is BACK—and this time, we're talking about what happens after you've already built the practice you dreamed of. Emily went from being paneled with 9–11 insurance companies, seeing 25+ clients a week, and bringing in around $150K a year to building a private-pay practice with fewer clients and significantly more revenue. But then life happened. After a major health scare forced her to drastically reduce her caseload, Emily realized something profound: her Life First Fee couldn't just support the life she was living today. It had to support her through aging, illness, family changes, and the unexpected seasons of life. Now, she's raising her fee from $265 to $350/session—an $85 increase—even though she already has more demand than she can handle. This conversation is about the messy middle of success, what happens when your practice becomes too full, and why getting to your Life First Fee isn't the finish line—it's the beginning of continually redesigning your practice around your life. IN THIS EPISODE WE COVER Why Emily originally stayed on 9–11 insurance panels—and what that was really costing her How she went from making around $150K while seeing 25–27 clients a week to making $200K+ with a significantly smaller caseload The warning signs that your current way of working is no longer sustainable What a major health scare taught Emily about building a practice that can actually take care of you Why your Life First Fee needs to account for aging, illness, family responsibilities, and the unexpected The surprising reality of raising your fee by $85 with existing clients What happens when raising your fee doesn't reduce demand because people still desperately want to work with you The anxiety, grief, and even shame that can come with being more in demand than you have capacity for Why there is no "finish line" in building a Life First practice How Emily learned to embrace the fact that she is naturally driven, curious, and built to keep growing The difference between being grateful for what you have and staying stuck because you're afraid to want more Why "What if it works?" can be just as powerful a question as "What if it doesn't?" Emily's reminder that the answer to every question you don't ask is no What it really looks like to keep redesigning your practice as your life changes RESOURCES MENTIONED LIMB Academy LFF Calculator Emily's Website Emily's email: ewilliams@silvermaplepsychology.com
- 2 weeks ago17 min
The 4 Things I Would Do Differently If Starting My Practice From Scratch in 2026
Ready to set your fee? You choose the dream, we'll do the math.🎁 Download our FREE Life First Fees Private Practice Calculator 👉🏽 https://www.leaninmakebank.com/free Ready to charge Life First Fees? Click here to fill out an application If I were starting my private practice from scratch in 2026, I would do things very differently. Not because private practice is dead. Not because AI has made therapists irrelevant. And not because you need another 47 certifications before you're allowed to charge what you're worth. Quite the opposite. I would get much more intentional from the very beginning. Because the practice you build is going to be shaped by the decisions you make before you ever have a full caseload. What you train in. What you charge. Who you position yourself for. And who you spend your time around. After 10 years of helping therapists build premium cash-pay practices, Tiffany breaks down the four things she would do differently if she were starting over today. And some of them are probably not what you'd expect. Because if you want to build a practice that is genuinely differentiated in an increasingly crowded and AI-driven marketplace, being another therapist who does another modality isn't enough. You need depth. You need a Life First Fee. You need a niche that creates demand. And you need to be extremely intentional about whose advice you're listening to. In this episode, Tiffany explores: Why she would invest in a year-long psychoanalytic training program if she were starting her practice today Why depth-oriented clinical training may become even more valuable as AI takes over formulaic, standardized approaches to mental health Why she would determine her Life First Fee BEFORE looking at insurance reimbursement rates or asking other therapists what they charge How to stop setting your fee based on fear and start setting it based on the life you're actually trying to create Why your modality, certification, or specialty isn't necessarily your niche What R³ — Resourced, Ready, Recognized — means when you're building a premium cash-pay practice Why "I work with anxiety, depression, trauma, and EMDR" doesn't necessarily give a potential client a compelling reason to choose you The difference between someone who has a problem and someone who is ready to solve it Why your ideal client needs to recognize themselves in your language and positioning Why Tiffany would stop spending time networking with the average therapist if she were building her practice from scratch The rare exception to that rule — and the kind of therapist she WOULD want to build relationships with Where your time and attention need to go if you're trying to build a practice around $300, $400, or $500+ Life First Fees Because here's what changes when you stop asking, "How do I get more clients?" and start asking, "What kind of practice am I actually building?" You're no longer trying to fit yourself into the existing mental health marketplace. You're making deliberate decisions about your expertise. Your fee. Your positioning. Your relationships. And the people you want to serve. And maybe most importantly, you're no longer allowing the
- 3 weeks ago50 min
Owning Midlife Rage & Claiming her $350 Fee with Jen Gallagher
Ready to set your fee? You choose the dream, we'll do the math.🎁 Download our FREE Fun with Fees Calculator 👉🏽 https://www.leaninmakebank.com/free Ready to charge Life First Fees? Click here to fill out an application What if the rage you've been taught to suppress is actually the very thing trying to show you where you're ready to take up more space? In this episode of The Money Sessions, Tiffany sits down with therapist Jen Gallagher to talk about midlife rage, visibility, money, and what it took for Jen to step out of her husband's group practice and build her own private-pay practice. After more than 20 years as a therapist, Jen is now specializing in working with women in midlife who are experiencing rage, burnout, and the urge to blow up their lives. Jen shares the messy middle of going from an average session reimbursement of around $125 to charging $250 for 50 minutes and $350 for 80 minutes—and the internal work required to believe that this reality was actually possible for her. This conversation is about so much more than raising your fee. It's about visibility, self-trust, taking ownership of your finances, and learning to recognize that the number on your fee schedule is often just the tip of a much bigger iceberg. IN THIS EPISODE WE COVER Why Jen's journey to a $250/$350 fee required much more than simply choosing a number The difference between saying your fee and actually fully committing to it How being invisible can become a survival strategy—and why building a visible private practice requires challenging that pattern The fear and doubt that show up in the liminal space between choosing a higher fee and having a full caseload at that fee Why having only two clients at $250 and $350 doesn't mean the strategy isn't working—it can be the first visible evidence of a much bigger shift How Jen learned to separate what her fears were telling her from what was actually true The connection between suppressed rage, boundaries, self-advocacy, and money Why rage isn't necessarily something to get rid of—it can be information that tells you something needs to change How years of putting everyone else first can eventually show up as burnout, illness, resentment, and financial depletion What Jen learned from interviewing more than 20 women about rage in midlife Why women who have spent their lives being "good," generous, and accommodating eventually reach a point where their system says enough How imagining a different reality—and seeing other therapists actually living it—helped Jenn believe that a different financial reality was possible for her too The deeper transformation underneath Jenn's $350 fee—and why the money is ultimately just the byproduct of the work underneath the surface RESOURCES MENTIONED LIMB Academy LFF Calculator Jen Gallagher's Rage Style Quiz Jen's Website
- Oct 5, 202614 min
The Danger of Being Seen & It's Impact on Your Marketing
Ready to set your fee? You choose the dream, we'll do the math.🎁 Download our FREE Life First Fees Private Practice Calculator 👉🏽 https://www.leaninmakebank.com/free Ready to charge Life First Fees? Click here to fill out an application You say you want more clients. More visibility. More referrals. Higher fees. A practice that actually supports your life. But there's a question you may not be asking: What if you're terrified of being seen? Because marketing requires something therapists aren't always comfortable with: Being visible. Letting people know who you are. What you do. Who you help. Why your work matters. And that can bring up a lot more than a marketing problem. It can bring up shame. Fear. Judgment. The possibility of being misunderstood. The possibility of being criticized. And suddenly, "I don't know how to market myself" becomes a very convenient way of avoiding something much deeper: "I don't know if I'm willing to let people see me." In this episode, Tiffany explores the psychological cost of hiding behind perfect websites, endless preparation, vague messaging, and "professionalism" when what your practice actually needs is for you to step forward and be known. Because you can learn SEO. You can learn Google Ads. You can improve your copywriting. You can build the perfect marketing funnel. But none of those strategies can compensate for a therapist who is fundamentally afraid of being seen. In this episode, Tiffany explores: Why marketing can trigger much deeper fears than therapists expect The connection between visibility, vulnerability, and self-protection Why "I need to figure out my marketing" can sometimes be a disguised form of avoidance How fear of judgment can keep you vague, quiet, and invisible Why therapists often hide behind credentials, modalities, and clinical language instead of allowing their actual perspective to come through The difference between being professionally appropriate and making yourself invisible Why being seen by the right people is essential to building demand for a premium practice How your relationship with visibility impacts your ability to charge Life First Fees Why marketing strategy is only one piece of the puzzle What becomes possible when you stop trying to make sure nobody can misunderstand you Because here's the uncomfortable truth: You cannot be deeply trusted by people who cannot find you. And you cannot build demand for work that you refuse to clearly talk about. Being seen doesn't mean turning yourself into an influencer. It doesn't mean sharing every detail of your personal life. It doesn't mean performing online. It means becoming willing to let the people who need your particular expertise recognize themselves in what you're saying. That requires specificity. It requires courage. And sometimes, it requires tolerating the discomfort of knowing that not everyone is going to like you. Because the goal isn't to be liked by everyone. The goal is to be unmistakable to the people who are looking for exactly what you do. If you're ready to stop hiding behind "I need better marketing" and start building a practice where the right clients can actually find you, email Tiffany at tiffany@leaninmakebank
- Sep 28, 202644 min
$350/Sessions: Spilling the LIMB Tea with Jorshua Stewart
Ready to set your fee? You choose the dream, we'll do the math.🎁 Download our FREE Fun with Fees Calculator 👉🏽 https://www.leaninmakebank.com/free Ready to charge Life First Fees? Click here to fill out an application What actually happens behind the scenes inside Lean In. MAKE BANK.? In this episode, Tiffany sits down with Jorshua Stewart, LIMB's Student Success Manager, for an honest, behind-the-scenes conversation about what it really takes for therapists to create sustainable, Life First practices—and what happens when they hit the messy middle. Jorshua shares what she sees every day as she supports therapists through the program: the patterns that help people build momentum, the places where they get stuck, and why asking for help can be the difference between staying stuck and finally moving forward. This conversation is a deep dive into the messy middle, taking action while scared, using community, and trusting that the process doesn't have to be perfect to work. IN THIS EPISODE WE COVER What Jorshua does as LIMB's Student Success Manager and how she supports therapists throughout their journey Why Jorshua left a highly structured corporate environment without another job lined up—and what she learned about doing it scared How caring for her younger brother after losing her mom shaped the way she listens to and supports others What Jorshua notices about therapists who come into LIMB ready to make a change Why the most successful therapists aren't necessarily the ones who have everything figured out—they're the ones who keep going The reality of the messy middle and why getting stuck doesn't mean the process isn't working The patterns Jorshua sees when therapists stop taking action or avoid the scary parts of their journey How LIMB's data tracker, accountability systems, live calls, and community help students stay on track Why therapists can miss the very thing that's keeping them stuck when they try to do everything alone The importance of showing your work, asking questions, and letting other people see what you're doing Why reaching out for help doesn't mean you're behind or doing something wrong What Jorshua has learned about flexibility, adaptability, and pivoting from working inside a growing business Why business doesn't come with a perfect set of rules—and why your practice has to be built around your actual life What the LIMB community is really like and the kind of life its therapists are working toward The bigger ripple effect of therapists choosing to stop sacrificing themselves and build practices that support their lives If this episode gives you even one insight that makes you think differently about what's possible for your practice, share it with another therapist who needs to hear it. And if you're ready to stop waiting until you feel completely confident and start building the practice you actually want, email tiffany@leaninmakebank.com with the word "Ready." RESOURCES MENTIONED LIMB Academy LFF Calculator
- Sep 21, 202614 min
Escaping the Time Massa': Fees and the Legacy of Slavery
Ready to set your fee? You choose the dream, we'll do the math.🎁 Download our FREE Life First Fees Private Practice Calculator 👉🏽 https://www.leaninmakebank.com/free Ready to charge Life First Fees? Click here to fill out an application What if your relationship with money isn't just about money? What if your relationship with time, work, rest, safety, and your right to take up space has been shaped by something much older and deeper? In this deeply personal episode, Tiffany explores a realization that stopped her in her tracks: the feeling of an internal "time master"—a constant ticking clock that says you can rest later. When you're financially secure. When your children are safe. When you've worked enough. When you've earned it. But what happens when the clock never actually stops? For Tiffany, this question led directly into the legacy of slavery, intergenerational trauma, labor, and the ways that the value of Black bodies has historically been tied to their capacity to work. And then the question gets even more uncomfortable: What if financial freedom alone isn't enough to make us feel free? Because you can earn more. You can build the business. You can create time freedom. And still have an internal voice telling you that you haven't done enough to deserve rest. This episode is about that voice. And about what might finally quiet it. In this episode, Tiffany explores: The "time master" and the internal pressure to constantly produce Why financial safety can become psychologically intertwined with permission to rest The historical relationship between labor, worth, and the bodies of Black people and women How intergenerational and relational trauma can shape our experience of money and safety Why making more money doesn't automatically create an internal experience of freedom The connection between financial security and attachment, safety, and belonging Why community can create a sense of safety and expansiveness even before financial security arrives How being seen and believed in by other people can help us see possibilities we cannot yet hold for ourselves Why your clinical work can only expand as far as you're willing to explore inside yourself The importance of having a container where difficult thoughts, fears, grief, and desires can actually come forward What happens when self-protection becomes the very thing limiting your professional and personal growth Why creating a Life First Practice is about much more than increasing your income Tiffany also shares the story of a therapist in the Lean In. MAKE BANK. Academy who once questioned whether she could really charge premium fees in her rural community—and then watched that possibility become real. She booked $450 intake sessions. Clients said yes to $300 weekly sessions. The money was important. But what made the transformation possible was something deeper: Community. Connection. Mattering. Someone else seeing the possibility in you before you're fully able to see it yourself. And maybe that's the real work. Not simply getting paid more. But learning that you are allowed to exist, take up space, breathe, rest, and be present before the money arrives. Because the ultimate goal of a Life F
- Sep 14, 202646 min
From $110 & Paneled to $300/Session & FREE with Adina Babad
Ready to set your fee? You choose the dream, we'll do the math.🎁 Download our FREE Fun with Fees Calculator 👉🏽 https://www.leaninmakebank.com/free Ready to charge Life First Fees? Click here to fill out an application When Adina Babad first found Lean In. MAKE BANK., they were charging around $110/session, fully paneled with insurance, overwhelmed, and wondering how much longer they could keep doing it. Today, they charge $300/session, have left insurance panels behind, are seeing fewer clients, earning $10K+ months, and have built a practice that actually feels sustainable. But this episode isn't about marketing hacks or overnight success. It's about the uncomfortable work of trusting yourself, challenging deeply held beliefs about money, and learning that the biggest obstacle to premium fees often isn't strategy—it's the mindset underneath it all. If you've ever thought, "Other therapists can do it, but not me," this episode is for you. IN THIS EPISODE WE COVER How Adina went from earning about $110/session on insurance panels to $300/session in private pay. Why leaving insurance wasn't just a business decision—it was a trust-in-yourself decision. The fear of "betting on yourself" and what finally helped them move forward anyway. Why borrowing someone else's belief in you can be enough until you develop your own. The mindset work therapists try to skip—and why strategy alone won't get you premium fees. How childhood, family history, gender, culture, and money beliefs quietly shaped Adina's relationship with earning more. What happened after they stopped trying to stay small and started showing up in the world. Why networking isn't about being loud—it's about being genuinely yourself. How confidence is built by collecting evidence, not waiting to feel ready. What therapists who think "everyone else is special except me" need to hear. RESOURCES MENTIONED LIMB Academy LFF Calculator Adina's Website Adina´s Instagram
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