Is Your Counseling Practice Prepared for an Economic Downturn?

In a Facebook Therapist group, a person recently asked a question about how people had experienced their practice during past recessions. The answers varied as one would expect for a variety of therapists in a variety of places. As a person who practiced in the SF Bay Area during both recessions in 2001 and 2008, I wanted to add my feedback. The Bay Area was hit very hard by the recession in 2008. Many people lost their jobs. During that time I was seeing insurance clients and I did not struggle at all during the recession. One of my suitemates did not accept insurance and did struggle quite a bit. 

Therapists have their reasons for being on or not being on insurance panels. In some areas of the country (like the Bay Area) most therapists do not accept insurance. They can sustain their practices with private pay clients only. Because of the high incomes of many people that live there, that is a possibility. In many other areas of the country that is not a possibility. It is so dependent on economic situations. However, it is important to remember that economic circumstances can change. 

We have been hearing for several years that a recession is coming. We certainly know that high inflation has made many people reconsider how they are spending their money. Therapy can be considered a luxury item for many. Not just for those paying the full fee but for those with co-payments. 

How do you plan for or try and sustain a counseling practice if there is an economic downturn?

  1. Have a specialty that is recession-proof. What specialties will people pay for even if times are tough? Two easy ones are working with children and couples therapy. People will often find money to help their children or save their marriage. 
  2. Diversify your practice. What can you add? Groups, consultation, coaching, or teaching or creating an online course. Having a diversity of offerings can keep you going during tough times. Having any type of passive income is awesome. I have some online classes. They were a lot of work to develop but once they were done they have become a source of passive income. I don’t have to do anything but collect the fee (and of course check in every so often to make sure the content is up to date). 
  3. Expand your skill set. Learn a technique that is in high demand. During the pandemic, I used the time to become both certified in EMDR and a consultant. This has helped me both be a better therapist and diversify my income by adding consultation to my offerings. 
  4. Stay connected with other therapists. This is different now in these post-COVID times. Many of my therapist relationships have started online. I am in at least ten different therapist Facebook Groups. I have to target where I spend my time. I focus on EMDR groups to allow me to be seen as a knowledgeable resource for people. Most of my consultation groups have been recruited for on Facebook. I understand the real issues about social media and the good and the bad. To have a practice in 2022 and on and not be engaged in some social media is to restrict your marketing. People like to make referrals to therapists that they know and knowing someone on social media counts. 
  5. Start making videos and even better do them and post them on TikTok. Videos are an easy way to get your name out there. You can almost do video blog posts. Give your thoughts on things related to your practice. A YouTube channel helps your SEO and can build your brand. TikTok is the new wave of social media. People like quick bits of information. The attention span of the average person seems to have dropped, so short content is more effective. Make sure you share your content on social media and use a great picture in your post. This is a marketing tip, but it is even more essential to make yourself stand out during tough economic times. People want to feel like they are getting their money’s worth and working with the best person to help them. 


I would love to hear your feedback about how you have handled different economic circumstances in tough economic times. Feel free to post in the comments.