Fourth Edition

The Financial State of Private Practice

Insights from nearly 2,000 mental health and wellness professionals on what they earn, what they keep, and what it really costs to run a practice.

Heard
joinheard.com
Scroll

Therapists are earning, growing, and building something real. But the money side is where they feel the most alone.

"The caseload building process took so much more time than I expected it to. It became like every client was attached to like a dollar amount for myself. So having to do a lot of math around how many clients do I need to see to make sure that I can, like, pay rent this month"
Nia Henderson, LMFT
"My expenses for operating my business are going up and I did raise my fees for new clients but I haven't raised them for existing clients — at what point is this sustainable for me? Because I don't want to work more and I don't think it is feasible to work more and have it be sustainable and healthy"
Sophia
"Looking at the numbers can be scary when you're a business owner. We finally looked at the numbers. The numbers didn't make sense. Looking at the numbers justified what the next move needed to be"
Anim Aweh

Quotes represent themes from therapist interviews.

About This Report

Making the money part a little less lonely

Most therapists and wellness practitioners are not taught the money part. Not in graduate school, not in supervision, and not in any of the clinical hours required to get licensed. And because no one teaches it, no one really talks about it either. So they end up figuring out the financial side of private practice alone.

This report exists to change that. For the fourth consecutive year, Heard surveyed therapists and wellness practitioners about the financial realities of private practice, and this year nearly 2,000 individuals across all 50 states and D.C. responded. They shared what they're earning, spending, charging, worrying about, and how they're running their practices day to day.

The findings reflect their experiences, not of everyone in private practice, but with a sample this broad, the trends tell a meaningful story. Two-thirds of respondents earned more this year than last. But earning more doesn't always mean the financial side feels easier. This report is about what's really going on behind the numbers.

A Note on the Data

All findings are based on 2025 survey responses and reflect historical, self-reported data. This report is shared for educational purposes to help you understand broad industry trends. It is not guidance for setting your own rates, which should always be based on your individual practice, market, and costs.

Survey Snapshot
1,950
total respondents
50
All 50 states + D.C.
86%
Solo run practices
58%
In first five years of practice
Top Five States

California, Texas, New York, Colorado, Florida

Fourth Edition

The Financial State of Private Practice

Insights from nearly 2,000 mental health and wellness professionals on what they earn, what they keep, and what it really costs to run a practice.

Heard
joinheard.com
Scroll

Therapists are earning, growing, and building something real. But the money side is where they feel the most alone.

"The caseload building process took so much more time than I expected it to. It became like every client was attached to like a dollar amount for myself. So having to do a lot of math around how many clients do I need to see to make sure that I can, like, pay rent this month"
Nia Henderson, LMFT
"My expenses for operating my business are going up and I did raise my fees for new clients but I haven't raised them for existing clients — at what point is this sustainable for me? Because I don't want to work more and I don't think it is feasible to work more and have it be sustainable and healthy"
Sophia
"Looking at the numbers can be scary when you're a business owner. We finally looked at the numbers. The numbers didn't make sense. Looking at the numbers justified what the next move needed to be"
Anim Aweh

Quotes represent themes from therapist interviews.

About This Report

Making the money part a little less lonely

Most therapists and wellness practitioners are not taught the money part. Not in graduate school, not in supervision, and not in any of the clinical hours required to get licensed. And because no one teaches it, no one really talks about it either. So they end up figuring out the financial side of private practice alone.

This report exists to change that. For the fourth consecutive year, Heard surveyed therapists and wellness practitioners about the financial realities of private practice, and this year nearly 2,000 individuals across all 50 states and D.C. responded. They shared what they're earning, spending, charging, worrying about, and how they're running their practices day to day.

The findings reflect their experiences, not of everyone in private practice, but with a sample this broad, the trends tell a meaningful story. Two-thirds of respondents earned more this year than last. But earning more doesn't always mean the financial side feels easier. This report is about what's really going on behind the numbers.

A Note on the Data

All findings are based on 2025 survey responses and reflect historical, self-reported data. This report is shared for educational purposes to help you understand broad industry trends. It is not guidance for setting your own rates, which should always be based on your individual practice, market, and costs.

Survey Snapshot
1,950
total respondents
50
All 50 states + D.C.
86%
Solo run practices
58%
In first five years of practice
Top Five States

California, Texas, New York, Colorado, Florida

Survey Demographics

Profession breakdown

Social Worker (LCSW)
31.2%
Professional Counselor (LPC)
23.1%
Marriage/Family (LMFT)
15.6%
Mental Health (LMHC)
13.4%
Psychologist (PhD/PsyD)
9.5%
Other health & wellness professionals (NPs, SLPs, etc)
7.2%

Reference

Key definitions

Understanding the financial terms used throughout this report will help you interpret the data and apply insights to your own practice.

Financial Terms
Revenue
The total amount of money your practice brings in before any expenses are deducted. This includes all payments from clients, insurance reimbursements, and other income sources related to your practice.
Income
Often used interchangeably with revenue in this report, income refers to the money earned from providing therapy services. Net income specifically refers to what remains after all expenses.
Profit
The money remaining after subtracting all business expenses from your revenue. This is what you actually "take home" and can pay yourself or reinvest in your practice.
Profit Margin
The percentage of revenue that becomes profit. Calculated as (Profit ÷ Revenue) × 100. For example, if you earn $100,000 in revenue and have $30,000 in expenses, your profit margin is 70%.
Tax Liability
The amount you owe to the IRS after filing your return. Tax liability comes out of your profit, not your revenue, and it is not a deductible business expense even though it reduces what you take home. For self-employed therapists, tax liability includes both income tax and self-employment tax (the 15.3% that covers Social Security and Medicare).
Statistical Terms
Median
The middle value when all responses are arranged in order. Unlike the average (mean), the median isn't skewed by extremely high or low values, making it more representative of the "typical" therapist's experience.
Average (Mean)
The sum of all values divided by the number of responses. Averages can be pulled up or down by outliers, which is why we often report median values alongside averages.
Expense Ratio
The percentage of your revenue that goes to business expenses. Calculated as (Total Expenses ÷ Revenue) × 100. For example, if you earn $80,000 in revenue and spend $18,000 on expenses, your expense ratio is 22.5%. A lower expense ratio means you keep more of what you earn.

Geography

Geographic distribution

Nearly 2,000 therapists across all 50 states and Washington D.C. responded, making this the most geographically representative report to date.

Highest Density (100+)
California, Texas, New York
105–362
High Density (50–99)
Colorado, Florida, Washington, North Carolina, Virginia, Massachusetts, Georgia, Illinois, Pennsylvania, Michigan
51–96
Moderate Density (20–49)
Oregon, Maryland, Arizona, New Jersey, Tennessee, Connecticut, Ohio, Minnesota, Wisconsin
22–46
Lower Density (10–19)
Indiana, Missouri, Arkansas, Utah, Nevada, South Carolina, Alabama, Iowa, Kentucky, Hawaii, Kansas, Washington D.C., Louisiana, Nebraska, Delaware
10–21
Represented (fewer than 10)
New Mexico, Montana, Alaska, Mississippi, Maine, Vermont, New Hampshire, West Virginia, Oklahoma, Idaho, North Dakota, Rhode Island, South Dakota, Wyoming
1–9