100. The Cost of Care: Why Therapists Are Struggling to Stay Afloat with Miranda Palmer


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Feb 27 2025 44 mins  

In this milestone 100th episode of The Colleague Down The Hall Podcast, Jeanene Wolfe welcomes Miranda Palmer, LMFT, a passionate therapist advocate, to discuss the financial and systemic challenges facing therapists today. Miranda shares insights from a recent discussion on the biggest problems therapists encounter. She highlights unsustainable insurance reimbursement rates, financial instability, and the increasing number of therapists leaving the profession. They dive into the complexities of insurance contracts, clawbacks, and the impact of venture capital-backed companies entering the therapy space. Miranda encourages therapists to take control of their careers by understanding their worth, setting sustainable rates, and advocating for legislative change. She emphasizes the importance of standing out rather than competing and creating a fulfilling, financially viable private practice. Listen in for an eye-opening conversation on making therapy work for therapists while still serving clients effectively.

“If we all said no to insurance contracts that were not sustainable for us, that literally are not good for clients, you have to see twice as many clients, you're falling asleep in session, you can't even get your clients in on the regular amount of treatment that they're needing. All of the different things that we know happen in this scenario, if we just said no to those things. I'm a client of that insurance company, and there's nobody who's a trauma therapist in my area who has space, that insurance company still has to connect me with a trauma therapist, and they have to find that person for me.” - Miranda Palmer

In this episode, let’s discuss:

***Financial Struggles of Therapists

The episode highlights the unsustainable reimbursement rates from insurance companies, the financial instability of therapists, and the growing number of professionals leaving the field due to inadequate compensation.

***Challenges with Insurance Companies

The discussion covers the exploitative practices of insurance companies, including delayed payments, clawbacks, and regionally inconsistent reimbursement rates that make financial planning difficult for therapists.

***The Business Side of Therapy Many therapists struggle to see themselves as business owners, leading to poor financial decisions. Miranda emphasizes the importance of calculating sustainable rates and making informed choices about contracts.

***Impact of Venture Capital in the Therapy Space

The rise of VC-backed therapy companies is discussed, with concerns about their profit-driven models further reducing therapist compensation and creating new challenges for independent practitioners.

***Advocacy and Solutions for Therapists

The conversation encourages therapists to take action, whether by advocating for legislative changes, shifting to private pay models, or making informed decisions about which insurance contracts to accept.



About Miranda Palmer:

Miranda Palmer is an LMFT and a therapist advocate who has been helping prelicensed and licensed therapists find joy and financial sustainability in their work.

Connect with Miranda:

Website: zynnyme.com
Instagram: @zynnyme



Get updates about future Fictionalized Clinical Consultation Groups: www.CollabOasis.com/FCC_live

Connect with Jeanene:

*Get your free Four Keys to Private Practice Peace of Mind workbook: https://collaboasis.com/4keysworkbook

*Learn more about clinical consultation groups: https://collaboasis.com/

*Join my free therapist Facebook group: https://www.facebook.com/groups/oasispcgt

*Connect on LinkedIn: www.linkedin.com/in/jeanene-wolfe-lcsw-64042220a/