Cash Flow for Therapists: Profit on Paper, Empty Bank Account

Emily Bowie: One, it’s intimidating. Two, it’s a foreign language.

LMB: So team, I talk all the time to therapists in private practice, brilliant, hardworking therapists who believe with all their heart and soul that the answer to their money stress is to earn more money, right? More clients, more hours, bigger caseload, more revenue.

LMB: And here’s the thing that shocked me as a business owner in private practice is that earning more money is not the same thing as having more money, keeping more money. There’s all kinds of things that can actually get in the way of that.

Emily Bowie: That’s where my business partner Andrea and I, we were like, look, we need to help these therapists because they’re helping everybody else. They need this help, and they don’t know what they don’t know, and how would they?

LMB: And so that is why today we are talking to a very special guest. Her name is Emily Bowie. She is a CPA and cash flow strategist who works specifically with service-based professionals just like us who are on paper, maybe like top line revenue doing great, but don’t have any money left at the end of the day. And we’re gonna find out why today with Emily.

Emily Bowie: It’s gonna make you a better therapist when you’re not worried about your finances.

LMB: Welcome. Oh my goodness.

Emily Bowie: Thanks for having me. This is definitely something I love talking about because I think it’s a struggle for most business owners, and there’s not a lot of spaces where you can ask questions without having to pay for that.

LMB: Yeah. And, and pay you do.

Emily Bowie: Yeah. And even if you pay for it, you might not even feel comfortable enough to ask the question, because I hear that a lot too with CPAs. People feel silly asking questions, and I’m like, “No, no, no. We are the ones you want to ask questions to. Please let me answer them.”

LMB: Yeah. Well, and you do need to ask questions, and honestly, you know, I just have a long history of doing things the hardest way possible typically, and then, like, making a huge mess and being like, “Oh, no.” And then that’s when I learn, and I’m just so happy for all of our friends who are here with us who might be learning from this before making all the mistakes.

LMB: But I mean, just, just to share, maybe this is where we start. Um, I’m sure you’ve seen this story before, but for me personally, I was a therapist, a psychologist. I went forth in private practice and started as a solopreneur, and then because I’m ambitious and insane, I was like, “Let’s do a group practice. It’s gonna be great.” And then, you know, fast-forward several years later and had 65 therapists running around here. The high-water mark, I think we made like $4 million in annual revenue just from billables. But I never learned how to read a financial statement. I was like, “Okay, money coming in. There’s money in the bank to pay for stuff. We’re all right.” Not all right. It was only when I started getting serious about finances, a CPA, and honestly a very brilliant business coach who was like, “What are you doing?” That

Emily Bowie: Well, have we looked at these?

LMB: “Right?” And then I was like, “Oh. Oh, this is why I don’t have any money left over,” ’cause, you know, it’s like, where’s the money at the end of the day?

Emily Bowie: Well, and I think that it’s very common for new business owners, but even seasoned business owners, a lot of times people know to ask for their income statement or their profit and loss statement, but they don’t know that that net income doesn’t actually equate to what’s in their bank account. And often they don’t have that background because they got into business, or in this case, they got into creating a group practice because they were really good at that, and they were really good at being a leader in that industry.

Emily Bowie: But now all of a sudden they have to wear 15 different hats that they didn’t have to wear before when they were not a business owner. So it’s actually very understandable that, one, it’s intimidating, two, it’s a foreign language once you do hear about it. And I think it’s probably more common than we realize that business owners, they just are hoping and praying they have the money they’re supposed to have to make payroll or do the next thing.

LMB: Well, and honestly, I mean, I didn’t realize how important it was. I thought the goal was to make money, like revenue. That we’re good. And I did not realize that there are all these other metrics that need to be paid attention to, and I also didn’t realize, maybe you could speak to this part, because when I started working with, like, serious financial professionals, I was like, whoa, that even when I was getting financial statements prepared for me by a bookkeeper, the chart of accounts was not set up in a way that generated any useful information at all.

LMB: And I remember asking about it at one time, and they were like, “Ah, well, you know, I mean, at the end of the day, it’s all just an expense as far as the IRS is concerned, so it doesn’t even matter,” versus being able to see, like, where am I spending my money? Could you speak a little bit about that? ‘Cause I was like, “Oh —”

Emily Bowie: I think, well, I’m very passionate about this because as a cash flow strategist, I come from that fractional CFO world. If your information is not useful, we can’t do anything with it. And I think one thing most business owners struggle with is understanding whose role is what. So a bookkeeper is typically just categorizing for you.

Emily Bowie: They’re not necessarily strategically thinking about the information you need to get from your financials. So oftentimes they are just doing what they know how to do, which is, “Hey, you said this was an office expense, it’s going in there. You said it was this revenue stream, it’s going in there.” And that is your one financial professional.

Emily Bowie: The next I would say would be that fractional CFO cash flow strategist. I like to say cash flow because I think it’s the most important part that a fractional CFO does, but that person is looking at your financial statements to gain knowledge so then you can actually perform strategy. So I think often in the online space specifically, they’ll encourage you to hire a business coach or a business strategist, but then they don’t have the fundamental background to do the analysis that’s needed to actually say that strategy’s gonna work or not.

Emily Bowie: That’s kind of where a fractional CFO or a cash flow strategist comes into play. And then we have the tax preparer, which is what most business owners know and are familiar with. It’s the person who files your taxes every

LMB: we have to do that. We know

Emily Bowie: have to do that, and they just plug and play. They take your reactive financial decisions, and they plug it into a worksheet, and they make sure you pay the government what you’re supposed to pay. They don’t think about it. They’re not looking at ways to save you money. That’s when you get to a tax strategist. That’s somebody who’s looking at how you’ve been doing things and shares with you other opportunities for you to potentially engage in, and then runs numbers for you and says, “If you do this, it looks like that. If you do this, it looks like that.”

Emily Bowie: And so the most powerful combination I have found is that cash flow strategist with the tax strategist, because you don’t have to translate to this tax strategist the things the cash flow strategist tells you and vice versa. Instead, they work in tandem to make sure you not only generate as much cash as possible, but then you get to keep it or you invest it in ways that build wealth today and tomorrow.

Emily Bowie: And that is kind of what we do at Thorne, and it is something that you don’t get it everywhere, and usually you have to pay five different people to kind of get that holistic nature, and it can leave you in a deficit having you conducting the train and you’re like, “I don’t even have a license to do this.” And it can be really rough. So it makes sense that, not only not having that fundamental knowledge, but then if you don’t know what professional you’re actually working with, your expectations of them could be totally unrealistic.

LMB: Absolutely. I’ve done that too. I’ve done that too, you know, and, uh, because… And I think this is so basic. This is like so starter pack. But the reality, again, as a therapist, why should we know any of this, right? And even that there are different types of financial professionals that have different roles in this whole landscape, and that they’re not the same thing as each other, right? It was news to me, honestly, at the beginning. So let’s talk about this a little bit more, because, you know, as our therapist friends have gathered around this campfire listening to this conversation, I can already imagine some of them are already dissociated, like, with just what you were starting to talk about with tax planning.

LMB: So let’s bring them back. So let’s talk about this. When it comes to therapists, I’m actually curious to hear your story. So you’re a CPA. How did you come to have a special heart for the helping professionals? Is there a story there?

Emily Bowie: Oh, for sure. There’s the personal story that I’ve invested in therapy my whole life because to me, in order to grow and scale and have a really healthy relationship with your business as well as your family and your home life and all of that, you gotta talk about some things. You gotta sort through some things.

Emily Bowie: So I love a therapist both personally, but professionally speaking, we had one client that we were working with and paying $300,000 in taxes. Not an exaggeration.

LMB: But yay for her, she musta had a, or him, musta had a great business, right?

Emily Bowie: Paying $300,000 in taxes because 30 years ago, somebody told them that, “You know, you don’t need to become an S corp. There’s no advantage to it.” And they just never revisited it again because they were in solo practice. They had grown and scaled in different ways, working at universities and different things like that. And so they were never really with other professionals, even in their industry, to ask those types of questions. And that’s where my business partner Andrea and I, we were like, “Look, we need to help these therapists because they’re helping everybody else. They need this help, and they don’t know what they don’t know, and how would they?”

LMB: Right. Yeah. And so you saw this person kind of wandering around paying so much more money it sounds like than they really needed to because they didn’t have the guidance that we’re talking about right now. So let’s get into this. I mean, you know, why, for a therapist who believes that the answer to the problem is making more money, why is that not always a direct, you know, one-to-one outcome from your perspective?

Emily Bowie: From my perspective, especially being in the cash flow side of things, they could be priced really bad. And that is typically what I see being the biggest issue is that they’re not accounting for what it costs to turn the lights on every day. Because one, they probably don’t have great books. Why? Because they haven’t outsourced them yet ’cause it’s just them or it’s just a few of them or whatever the case may be. And then two, once they got those financial statements, they didn’t know what it meant, and they just priced based on what everybody else does, and they’re not factoring in that, hey, about 30% of the money they will make go to expenses off the bat, regardless of if they make that money or not.

Emily Bowie: So they need to be putting that into perspective when they’re pricing. So what I like to do is I like to sit down with them and say, “Hey, what do you price at? How much does it cost you to deliver?” So like, what’s your hourly rate? So if you’re paying somebody to do it, what’s their hourly rate? Do they need to rent a space? Whatever the case may be. That is your gross margin. And then you get this sweet percentage that happens on your financial statements, and it’s all those below the line expenses, and you take that number in comparison to what you’ve earned, and you get a percentage. That percentage is applied, and then all of a sudden you realize every time you have a session at that price, you’ve lost money. And it can be devastating.

LMB: I would like to just say from personal experience that that is true, but we need to like slow down because this is gold right here, and I wanna make sure that people understand really deeply what you’re talking about, because I didn’t. I honestly like worked with a business coach for a year, and he was excellent with finance, and he was like, “Okay, so we need to talk about a few things. One is called cost of goods sold, and here’s this equation.” And I was like, “Wha- uh, what? Okay.” And, like, operating expenses, gross profit margin. And so take us more deeply into this. I’d love just a little starter pack explainer.

Emily Bowie: I love this.

LMB: Yeah. What do those things even mean?

Emily Bowie: Okay, so I will do the accounting 101 of an income statement because that is the one everybody looks at. That’s the one everybody talks about. Your income statement, when you’re working with typically a business strategist or a coach, they are encouraging you to get that top line revenue. So that is the money you

LMB: billable hours.

Emily Bowie: as a therapist. Yes, billable hours.

LMB: A session, let’s say. Round number. Okay.

Emily Bowie: So that’s that $100 a session. Then we roll into the cost of goods sold. On that line, basically those are expenses that you incur to generate that $100. It is a direct correlation. So it would be your hourly rate or cost, or if you’re in a group practice, it would be the cost of having that therapist do that session. And it can be also the rental, you know, like whatever additional costs that are directly related to making that session happen.

LMB: And, can I just share something that, this is when it clicked for me when my business coach was like, “If this number goes up because of the more clients you see, that would be a direct delivery”

Emily Bowie: Yes. Yes.

LMB: And I was like, “Okay.”

Emily Bowie: Way to explain it, is that you would, every time you earn dollars, you expect the cost of goods sold to match it, right? Because you would not have that cost if you did not earn that dollar.

LMB: Mm-hmm.

Emily Bowie: It’s one of those things. And then you get to gross margin, which is just the difference between the two. So it’s that revenue, if it was $100 and your cost of goods sold was $50, that gross margin would be $50.

LMB: Yeah. And that is actually the money that you have to work with, right? Especially if you’re an employer and you have to pay somebody else $50 to do whatever the thing is, then basically, like, the $50 left over, yeah, that’s where you’re starting.

Emily Bowie: Yeah, and so when we’re at that $50, then we have expenses such as your Zoom. Well, you have probably a more fancy way of meeting with clients, but whatever your practice software is or if it’s your rent or any of like the tools within your business to be able to turn the lights on every day that you’re gonna pay regardless if you make money or not, that’s your overhead, that’s your operating expenses that you were talking about.

Emily Bowie: And they are a percentage of how much money you earn on a regular basis. So for sake of simple numbers, let’s say that bottom line when you compare it to your income is 10%. And so you paid $100 — or they paid $100 for a session. You paid 50 to somebody else. You got 50 remaining. Then you take that 10% times the 100, which gets you 10 more dollars that you pay out in just what it costs to run the business, and you only end up with 40. But if you just recognize life as the revenue you generate, you were thinking you were working with $100, but you’re only actually working with 40. And typically, that operating expense piece is more like 30%, 40%. So if it’s 40% and you only have $50 after you pay somebody, you’re only ending all of that every time that session runs with $10.

LMB: Yeah, that sounds about right.

Emily Bowie: Yeah, and it makes it really tough to operate in that and have predictable margins if you don’t know your numbers, truly.

LMB: I am so glad that we’re talking about this. I mean, this is so, uh, let’s just name it, horrifying, discouraging, right? Like, all the things. But it is also the reality, and I think that is what we need to… You know, ’cause I think therapists view private practice as like this oasis in the desert, right? I’m gonna get out of an agency where I’m not earning enough money, right, or salary. Go into private practice, I will make $150 an hour. But not realizing that by the time you pay for all the stuff, it is so much less than that. And you know what else I started to think about as you were sharing?

LMB: Like, if you are billing insurance, what you need to pay someone else if you have help to submit that insurance claim and then have it denied, and then sit on the phone for 45 minutes on hold, and go back and forth. Like, if their rate is 20, 25, $30 an hour, and it is taking them how long to get the fricking claim paid, or if that’s something that you’re doing with your own time, that is

Emily Bowie: to be factored in. Well, it’s expensive, and then the other side of it too is the delay in cash that comes back in. And so again, we’re now chasing money that we anticipated to come in because we already had the session. But then we’re not getting it for 30, 60, 90 days, depending on what’s happening, or in a week or whatever it is. And so then there’s that difference between that net income you’re supposed to have in the bank and then what’s actually in the bank.

LMB: Oh my gosh.

Emily Bowie: And it’s — So I think from my perspective, it’s like you should be like, “Oh, it’s okay.” Like, it is hard. That is why it feels so hard. It is hard. But it doesn’t have to be hard because you don’t have to do it alone. Mm-hmm. And there’s that piece, you know?

LMB: Are some of the things that you have seen or coached therapists to think about or maybe do differently that can begin to help them, I don’t know, actually support themselves and earn a living and have something left at the end of the day. Let’s talk about that.

Emily Bowie: So one easy practical is doing expense audits. I recommend this at least quarterly. I would hope everybody did it quarterly, but realistically every six months or so. And just going through and making sure you need all the things you’re paying for. It helps so much with saving on that overhead expense, truly, and it gives you an awareness, and anytime you bring awareness into your finances, you just do better. It’s a very simple, practical thing you can do.

LMB: Oh my gosh. Can I just validate what you’re saying? My bookkeeper was like, “You are so extra. What are you doing?” I was like, “No, I need a spreadsheet with all of the things.” Because you know what I found? There’s all these damn subscriptions that you’re paying for. Like, you know, things that you sign up for and it’s like 9.99 a month, you don’t even notice it, but then you have like 12 of them, right? I mean, just stuff like that. Or sometimes there’s less expensive ways to get the same result, right? And so such a good idea. I love that.

Emily Bowie: So I think there’s one common category I feel like most people need to audit right away is their software subscriptions,

LMB: Yes. Oh my

Emily Bowie: there are so many tools that do the exact same thing, and you’re paying for all three of them. Like,

LMB: Yeah, I know. Yeah.

Emily Bowie: and so, you know, it’s like one of those things. The other thing to look at is just return on investment of things. So say you’ve been in a coaching program, and you just continue to reinvest, reinvest. Are you using it? Have you thought about or implemented the information? You keep getting new information. Have you done anything with it? So, like, that’s another kind of filter you can run it through, and I think this is helpful because it’s that quick win, and we all know, like, in order to continue to do hard things, we have to have wins in the process.

Emily Bowie: And I feel like an expense audit is one of those things that helps you be able to be like, “Hey, I really don’t need this,” or, “Hey, I’ve been paying for this monthly. If I pay for it annually, I save, like, $400 a”

LMB: Totally.

Emily Bowie: “I should do that.”

LMB: Yeah.

Emily Bowie: But there is the flip side of it too, is like you might want to pay it monthly so that your cash flow is free to reinvest in something else or to do tax strategy or whatever. So it goes back to, there’s not a one size fits all, but we all should be looking and bring awareness to, like, where the money is going out, you know?

LMB: Such good advice. And I’m hoping you could talk a little bit more about something else you said that I thought was so powerful. And again, this is the stuff that you live and breathe, and it’s so obvious to you. But I’m telling you, mental health professionals are just not wired this way. And so what you were talking about is what is the return on your investment? And we have to bring something else into the room right now, Emily. There’s also, I think, a very real and powerful socialization that happens with therapists and other helping professionals around money and the meaning that we make of, like, our self-image. What kind of person looks at what we do, saving lives, helping people in the most powerful ways, and then thinks return on investment? Like, I think there’s this capitalist corporate raider, like I need to push this away. And so I think that this is probably a separate thing that we need to talk about is, like, how do you start to reclaim this, like it’s like a values alignment thing.

Emily Bowie: Yeah. So I have so much to say about that. And even this comes into play when we’re talking about increasing pricing too, because when you would do it for free, you think how can I raise the price?

LMB: And that’s the truth,

Emily Bowie: but if you can’t turn the lights on next week, you gotta raise the price. And you’re not selfish, you’re not greedy, you’re not taking advantage of anything, but you do have to look at it from the lens of impact. If you are not generating enough income to live, if you’re not generating enough income to grow and scale, that diminishes the amount of impact you can have. And when you kind of make that shift in understanding around your pricing, it’s a lot easier to get behind it. The other thing with pricing too is you don’t have to change existing patients.

Emily Bowie: You could say, “Hey, my new patient rate is this.” So then you establish from the get that that is how much it costs to work with you. And so then you don’t have to raise it for the existing. But if you do need to, like say you’re losing every time that session happens, you can do it in $5 increments, $10 increments, and you can work your way up. Because sometimes those patients, the lifetime value that they provide, you wanna honor it with like a slow increase. And you can be as transparent as you need to be, you know?

LMB: Yeah. Oh, so many good ideas. Like, if you are not able to take care of yourself, and this is not a sustainable profession for you, you’re not doing anybody any favors, first of all, right? And so you have a right to live.

LMB: Emily, I’m like having so… I mean, this is so powerful, so important. We might actually have to have a part two because I think there’s so much here. I wanna plant a flag in this one thing about return on investment, and at some point get you to talk about how do we even start to measure that. But let’s go here first. So what I’m hearing you say is that an important thing to consider is raising rates.

LMB: And on behalf of our friends here with us, you know, probably eight out of 10 of them are paneled with insurance companies who control their hourly rates, which is often quite low. And the other thing, and I’ve seen this as a private practice owner, on the one hand, to therapists and also affordability of services has never been lower. We now have big, you know, heavily funded corporate machines in this space who are able to scale and can have all kinds of therapists that they’re able to connect with clients, clients are able to use insurance, or they’re able to subsidize client acquisition to the point that it can be very difficult for an independent therapist to compete.

LMB: Like, you know, why should a client say, “Well, I could work with you for $200 an hour, or I could work with this therapist who sounds like does exactly the same thing that you do for nothing because I can use my insurance.” Why, you know? Can we talk about that part?

Emily Bowie: And I think that’s very real, right? And I think just like any other business owner, you should identify who your ideal patient is and what they’re experiencing and how you can serve them well, because also that will help you with the socioeconomic side of it. Like, can they afford to work with you? And if you want to work with, um, you can always do scholarships for people. You can do passive income things where you can share the knowledge that you have that you feel like a certain group of individuals would benefit from, and then that can be an additional income stream so that you can still work at those lower rates if that is what your heart’s telling you you need to do.

Emily Bowie: And then there’s just options of saying, “Hey, that doesn’t work for me,” and maybe you consider maybe not working on your own. Maybe there is an opportunity to join a group practice where you can charge lower and not have the full cost impact on yourself. I think sometimes when we make a decision one day and then we decide and evaluate that decision doesn’t make sense anymore, sometimes we judge ourselves. And I think there’s no need to do that because seasons change, and I’m sure you walk patients through this on a regular basis where life serves up different circumstances and things might change, but there’s so many options. You just need to have the eyes to see and be like available for what different ways you can go about getting the same amount, if that makes sense.

LMB: Right. Oh my gosh, this is all so good. And again, just to validate what you’re saying, that was absolutely my experience. I think when I did get more visibility into finances and how much it was actually costing me to try to like make all this magic happen, it was not worth it. And I was like, “I don’t… This is stupid. I don’t wanna do this anymore.” But that’s where I think it comes back to what we had stuck that little pin in, was how do we actually measure the return on investment and start to get our heads around how much this is worth really at the end of the day? How do you get a handle on that?

Emily Bowie: Yeah. So I think return on investment, when you hear it, you’re like, “What does that mean?” One. But two, it really can be different for anybody, right? It could be quantifiable where it’s say, “Hey, I have spent $1,000, and because I now have this skill, I can charge $100 more an hour,” or whatever the case may be. So you can then do the calculation and say, “Hey, for every 10 patients, this makes sense for me to invest in this course or certification or whatever.” But there’s also a qualitative factor, I think, that we kind of skip over once we start understanding the financial side. Sometimes we’re like, “The numbers are telling me no.”

Emily Bowie: But qualitatively speaking, it is important to also say, “Hey, I just really wanna learn this skill.” And so it might not make sense numbers-wise, but for me, in order for me to stay excited and in the business, I need to go out and just go do that thing. And that’s okay too, and I think that’s where the professional you’re working with, having them like know you both on a professional and a personal level is super helpful because my job is to show you the numbers, help you understand them, and say, “Hey, have you considered doing X, Y, and Z?” But for me to give you good solutions X, Y, or Z, I need to know like your personality and what you need as a business owner too, because sometimes the qualitative overrides whatever the number’s actually saying, you know?

LMB: Yeah. Ah, thank you. I love this, that it needs to be values aligned. And you know what? At the end of the day, it’s not always about just the math, right? Because having a good time, enjoying yourself also maybe needs to be part of the story, right? And for you to do something because you want to and feel excited about it, like that is a different kind of valuable. There’s more things than just money that are valuable.

Emily Bowie: So, and I talk about this a lot with business owners. I really encourage them to have their vision, mission, and core values. And I say, “This is your measuring stick of yes and no’s in your business,” right? Raising your prices, does it fit and align with my values? Does it further my mission? Or is it if more or less if I keep them at the rate that I’m at, can I actually go do the impact the vision statement I wrote says? Maybe not. And so using that as that measuring stick is helpful, but it can even be working with a patient. Like, you might meet a patient and you’re like, “Hey, I really need to have another session for this month to be profitable.” But on the other side of it, it’s taking away from your capacity, and you may not actually be better on the other end of it, and then you can’t see more patients.

LMB: Right.

Emily Bowie: That’s a very real thing in what you’re doing as a mental health professional, is like you have to be really clear on that value system and where you’re trying to go, where you’ve been, all of that, in order to say, “Hey, this number makes sense or it doesn’t.”

LMB: Absolutely. Well, and I’ll just chime in here. You know, as a clinical supervisor as well, I think that there’s also a risk for therapists who are in a private practice who are in a precarious place financially to make clinical decisions based on what they need financially, and sometimes at the expense of a client. So, you know, do you need to see that client four times a month? Would that client actually benefit more from having a little more space in between those sessions? I’ve also seen that many times, and I gotta say this out loud, people probably get mad at me for doing it, but, you know, does this client still really need to be in a relationship with you, right?

LMB: Like, there can be this catch and hold thing where, like, I’ve been in therapy for 10 years, I’m thinking, “What?” Because there’s this thing and, like, it turns into a paid friend situation that can create a lot of dependency. That is actually in opposition with our ethical code. And so I would argue that financial strength is actually part of ethical practice because when you’re in an okay place, you could be like, “I think our work here is done. Bye.” Right? Come back if something else comes up, obviously. But that needs to be part of what we do.

Emily Bowie: No, I totally think that is a very relevant conversation, right? Because I think we can, once we understand the importance of numbers, rely on them too heavily. And sometimes you need to kind of go back to that measuring stick that you outlined, the reason you’re doing the thing you’re doing, and saying, “Hey, does this make sense?” on both ends of it. Because I do think financial responsibility allows you to say no when no makes sense.

LMB: Yes. And to have boundaries. Ugh, so good. Wow. So I’d also be curious, you know, to hear your thoughts for I think that in this profession and just the nature of the industry itself, especially with the way it’s changed a lot over, I would say, the last even five years or so, and this is accelerating, right, with the rise of AI-based therapy, right, to put that loosely.

LMB: I think that more and more therapists are not just feeling a squeeze, but honestly feeling trapped. I think one potential exit door that isn’t right for everybody, but, you know, a significant part of my practice shifted when I understood that so much of what therapists are asked to do day to day is really not clinical mental health treatment. It is development and outcome attainment. You know, what am I doing with my career? I want to improve my relationship. It isn’t clinical, it’s not necessarily medically necessary treatment, right? It’s not behavioral healthcare. And so my practice changed a lot when I started exploring coaching psychology and actually diversified my skill set into coaching to have a different way of helping those people who are non-clinical, I think, honestly, more effectively than trying to apply treatment modalities to these outcome results.

LMB: So that changed a lot of things for my business. And so I think that some therapists, I mean, there are advantages. Coaches, unfortunately, typically can command higher rates because it’s a more specialized service, and it isn’t covered by insurance, so that is an area of it’s like an island of safety in all of this. But tell us more about some of the things that you’ve seen work for therapists who really wanna get out of this, the, you know, this

Emily Bowie: Grind. Yeah.

LMB: Yeah. Thank you. That’s the word. That’s the word.

Emily Bowie: Um, coaching is a perfect example of providing a service you’re very qualified to provide, but you’re confined to not really be able to provide in the traditional therapy setting. Or to your point, maybe somebody needs to graduate from the traditional therapy setting, and you then can have another offer in which you actually are a coach.

LMB: I have to say something out loud. Oh my gosh. Wait, wait, I’m so sorry. So I’m a clinical supervisor, and I’m also a coaching educator for therapists. So I do a board-certified coach training program. And so some of the things that we need to talk about are ethics related to coaching because therapists in this space, even though coaching is unregulated, therapists are still regulated, and we have to be really careful about how we thread some of these needles.

LMB: And what you just described is actually prohibited. You didn’t know that. You didn’t know that. That’s okay. But I just wanted to say that in case anybody’s listening to this and be like, “Oh, okay.”

Emily Bowie: Oh, I should clarify. I didn’t mean graduate that patient into your coaching practice, but knowing that it’s out there and available for them because that’s really what they need and not your actual traditional modality of therapy. So I should clarify that. So I’m glad you made that distinction because I do know there are so many more regulations. It’s the same thing in the financial world too.

LMB: It is.

Emily Bowie: It’s kind of the safety of working with somebody who has a CPA versus nothing or something different, if that makes sense. And

LMB: coach.

Emily Bowie: yeah, financial coach. And that’s not to say they can’t be legitimate. I just have to be legitimate, if that makes sense.

LMB: We are in the same boat. I get it. Yeah.

Emily Bowie: Similarly… So thank you for interrupting that because that is not what I meant, but I could see how it

LMB: And I’ve talked to so many therapists who they don’t know what the regulations are. They don’t even know that it’s problematic, and so they do it. And so that’s why I’m like, ah. Anyway, okay. We’re back.

Emily Bowie: yeah, because there’s this gap there where people are staying in therapy, but they really could benefit from a different unique approach to coaching, and you can offer that. And you also can take all that knowledge that you have that doesn’t just go away from you when you get into that coaching space and support them.

Emily Bowie: But then also there’s a market out there for just tools for people that you are working with patients on a regular basis or clients on a regular basis, and you can make them into PDF guides and sell them for five bucks. And it gives them a tool that they can utilize that’s outside of that. You could create programs where you walk people through specific things they’re going through from a coaching standpoint and provide it as a course. It could be a group coaching opportunity. And these are all opportunities where you can make a little bit more on doing what you do best, which is to share your expertise in an area. And the beautiful thing too, along that same line, is that this gives you opportunity to stay at those lower rates in therapy because you have another revenue stream coming in.

LMB: A good point.

Emily Bowie: And it gives you just this opportunity to be able to kind of level set and live within your values and also still be not potentially resentful having to get charged lower than you should be getting, you know?

LMB: Yeah. So that diversification and having different types of income that you could charge differently. Now, what, you know, ’cause I also talk to therapists sometimes, and they’ve invested so much into being highly skilled clinical mental health professionals, right? And so I think what we’re talking about just now appeals to a subset. But there are other people who’s like, “I don’t wanna do that. I really wanna do clinical work.” What have you seen work in a private practice setting?

Emily Bowie: I would say I have seen people that operate within private practice then work at university level

LMB: Okay.

Emily Bowie: and helping other clinical professionals without having the responsibility of maintaining them on a day-to-day basis, but can share some of that expertise. That’s another really great, very lucrative way where you can go and go a couple weeks and go do something of that nature and then go back to your clinical work. But I think also in the private practice piece, if you really wanna live there and thrive there, you really should consider looking at your prices and potentially raising them to support you better. Because it’s gonna make you a better therapist when you’re not worried about your finances, right? And the work you do, the impact you have is not just limited to the person in front of you. It’s that person and everyone they interact with, and you deserve to make not only a livable wage, but also be able to thrive too so that they can thrive and so on and so forth, because there’s such a ripple effect, you know?

LMB: Yeah. And team, there are ways to do this. You know, to raising your prices, maybe fewer clients, but clients that pay you more. On the other side of that equation though, there can be a marketing problem to solve, and I would refer you back to other episodes in my feed where we’ve tackled that as its own thing.

LMB: Emily, this has been a phenomenal conversation. I’m just so grateful to you on behalf of our listeners today, but also, you know, what you’re doing day in and day out. And just as we’re talking, reflecting on how vitally important it is to have somebody like you in our corner, like it was for me. And so if somebody’s hearing this and is like, “I need to talk to Emily,” what’s the first step? How would they track you down?

Emily Bowie: So if you go to thorneadvisors.com, Thorne with an E at the end, advisors.com. My business partner Andrea Mason and I, we operate that. If you hop on a call with us, we just walk through where you’re at, where you wanna go, and how, what’s working for you, what’s not, and we figure out if we’re a good fit to move forward and assess what it is you actually need. And then if you just wanna hear just nuggets of information that you can run and go apply, Andrea and I have a podcast called “Prosper and Get Paid Playbook.” And we do 10, 15 minute episodes just to run you through one thing so you can digest it and go off and go do something about it, you know?

LMB: That’s incredible. Oh my gosh, I love that so much. Okay, and so your practice is Thorne with an E. That’s the name of the website, Thorne. Okay, excellent. And I’ll… Oh, go, say that again.

Emily Bowie: Yes. Thorne Advisors. Yes, thorneadvisors.com.

LMB: thorneadvisors.com. And of course, you guys, a link to this will be in the show notes. But Emily, thank you so much for your time today. This was wonderful.

Emily Bowie: Thank you for having me.