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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 fears and limitations of the average therapist to determine what you believe is possible for your own practice.

Because you don't need to build the practice everyone else is building.

You need to build the practice that supports the life you actually want.

And if you're already years into your practice, don't write this episode off because you're not "starting from scratch."

The same decisions still matter.

Your fee can change.

Your positioning can change.

Your referral relationships can change.

And the people you're spending your time around can change.

You can decide to stop building from where you've been and start building toward where you're going.

If you're ready to do that, email Tiffany at tiffany@leaninmakebank.com with the words "I'm Ready."

Because you don't have to start over.

You just have to start making different decisions.

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.

• 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

• LIMB Academy

• LFF Calculator

• Jen Gallagher's Rage Style Quiz

• Jen's Website

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.com with the words "I'm Ready."

Because your marketing doesn't need more perfection.

It needs more of you.