I know, I know, we aren’t in this for the money. But until my bill collectors start accepting the warm feeling I get from helping my clients in lieu of payment, I need to generate income. (Did I ever tell you about the supervisor who told me I should be grateful to get paid at all because if I really believed in the “mission” I would work for free? And then told me I had too many Medicaid clients on my caseload and wasn’t generating enough revenue?)
Insurance companies reimburse at unsustainable rates, and the hoops we have to jump through with billing are an administrative nightmare. Coverage changes constantly too, and it feels impossible to keep up. On the other hand, so many of the clients who need our services simply cannot afford to pay out-of-pocket. (By the way, the ACFB Fund is working on bridging the gap between affordable mental health care and living wages for therapists in New Zealand, with plans to launch in other countries soon!)
So, by popular demand, here is the big list of revenue streams I rely on as a therapist. As always, your mileage may vary, try at your own risk, vet any companies you work with to make sure they meet your ethical and moral criteria, et cetera.
In creating this list, I stuck to ideas that fit under my expertise as a psychologist and therapist. I took out those student loans, and I am getting my money’s worth, darn it!
Here are my top 8 revenue streams for therapists!
Employee Assistance Programs (EAPs)
An EAP is a program where your employer covers the cost of a certain number of therapy sessions so that your out-of-pocket cost is $0. I used to refuse to accept EAPs because the reimbursement was awful (sometimes as low as $30 for a session billed at $160), took forever (I once got a payment 18 months after the session date), and unreasonably time limited (some programs made the client stop seeing me after three sessions).
In recent years, many companies have contracted with EAP providers like Spring Health and Lyra, offering a sustainable reimbursement rate, more reasonable number of sessions, and much simpler billing. I’ve also had opportunities to facilitate wellness conversations and develop mental health educational materials through these companies.
Although EAPs simplify the billing process and tend to pay better than many insurances, you are still providing therapy services, so if you’re looking to develop income streams without increasing your caseload, this might not be the best fit.
Adjuncting (And Other University Work)
In the spring semester of 2021, my graduate university held classes online, so I had the opportunity to teach Family Therapy over Zoom. I must have done an okay job because they have had me back in 2022 and 2023 even though the rest of the courses were in-person. In addition to adjuncting this course, I have helped out with the admissions process, reviewing applications for prospective students and answering questions about my experience in the program.
The reimbursement is not fantastic compared to my other revenue streams, but teaching can be rewarding and enjoyable, and I like knowing that I am helping the next generation of psychologists be good at their job.
Have I mentioned my Teachers Pay Teachers store lately? How about the A Change for Better store? Basically, when I need a worksheet, educational tool, or other resource that I can’t find in my existing library, I put one together. Then, I list it in an online store so that other therapists can access it for a few dollars.
I do not make a huge amount of revenue from these downloads, but what I make is passive income, so that’s nice.
I love writing (can you tell?). I submit articles to many different online publications on various mental health topics, which helps the general public better understand my line of work and their own mental health. Plus, I can use time when clients cancel at the last minute or miss their appointment to write, so I can be more flexible with my cancelation policy without sacrificing my income.
Plus, I get quite a few referrals for both clinical work and consultations from people who read my articles and found them helpful.
Taking writing a step further, if you have an idea for a book, this can be another great way to get information out there and make income through royalties. We live at a time when self-publishing is incredibly accessible, or you can pitch your idea to a traditional publisher for help with editing and marketing your book. (Just beware of vanity publishers – a reputable publisher will never charge authors. Their job is to pay you, not take your money.)
Therapists can write books to help other therapists be better at our jobs, or write books for the general public about mental health.
If you are considering pitching a book to a traditional publisher, by the way, my post today on Patreon shares a sample proposal with tips for writing your own.
When the State of Emergency ended and I knew some of my clients might lose their Medicaid or Medicare coverage, I increased my professional consultation rate. That allowed me to offer more pro bono and sliding scale spots in my practice without sacrificing my passion for eating and paying bills on time.
Just make sure you are clear about your rate and get in writing that they understand that they have to pay you. No free interviews. T-Mobile offered me a “consultation role” but said I had to interview first, and the interview was a consultation. They used the information I gave them to make their company more profitable but weaseled out of compensating me for my time.
Now, I make them sign a contract up front before I will provide my expertise, and it has become a solid source of income.
Every licensed mental health professional is required to take continuing education every year to make sure we are up-to-date on the treatments we offer our clients and are doing our jobs to the best of our ability. Those courses need to be taught by someone qualified. Why not you?
I have taught continuing education with a few different companies. Some pay a higher speaking rate up front just for the course, and others record the course, sell it, and pay me a royalty. Hooray for passive income!
If you have the resources, you can apply to be a sponsor and create your own continuing education content that you fully own and can distribute independently. However, this comes with startup costs and takes a lot of unpaid time and labor to get it going. Figure out what is realistic for your business.
Other Speaking Opportunities
Conferences, organizations, and groups are often looking for experts to share our knowledge. As with consultations, make sure you are up front about your speaking fee, and get a commitment in writing. Some organizations will want you to speak for free, but your time and labor has value.
I recently hosted an Ask Me Anything about neurodivergent parenting that helped a lot of people and allowed me to talk about a topic I care deeply about.
So there you have it – my eight favorite supplemental income streams. Another day, I will speak to how you can decide which stream is a good fit for your interests and business goals.
What other revenue streams have you developed in your practice?