Pricing When Your Heart Says Access and Your Bank Account Says Survival
You got into this work because you believe in healing. You see the systemic barriers keeping people from mental health care. You know the communities that need support most are often the ones who can least afford it. Somewhere along the way, you developed a deep commitment to making your services accessible.
That commitment is real. It matters.
But so does your rent. So do your student loans. So does the reality that you can't sustain a practice if your pricing model is built on self-sacrifice.
This is the tension keeping social justice-oriented providers up at night: How do you price services in a way that honors both your values and your survival?
The Self-Sacrifice Trap
The mental health field has long romanticized the self-sacrificing helper. The narrative says good providers care more about clients than income. Real healers would work for free if they could. If you worry about money, you're not in it for the right reasons.
This narrative is damaging.
It keeps talented providers stuck in agency jobs that burn them out. It keeps practice owners chronically undercharging. And it perpetuates the false idea that care and compensation are mutually exclusive.
Research published in The Professional Counselor on compassion fatigue shows that providers lacking financial stability are more likely to leave the field entirely. When we lose committed, social justice-oriented providers to burnout, the communities they serve lose access to culturally responsive, trauma-informed care. The martyrdom model doesn't create more access—it creates provider turnover and worse outcomes.
Here's the truth: you can't pour from an empty cup. And you can't build a sustainable practice on guilt.
What Accessibility Actually Means
When providers say they want to be "accessible," they often mean charging low rates so anyone can afford services. But accessibility is more complex than pricing alone.
True accessibility includes:
Geographic accessibility – Can clients reach you? Do you offer telehealth?
Cultural accessibility – Do clients see themselves reflected in your approach?
Scheduling accessibility – Can clients get appointments during non-business hours?
Communication accessibility – Do you accommodate different communication needs?
Financial accessibility – Can clients afford your services?
Financial accessibility is one piece of a larger puzzle. And it's the piece providers tend to sacrifice first, often to their own detriment. What if, instead of making your entire practice financially accessible to everyone, you got strategic about how and when you offer reduced rates?
Three Models That Honor Values and Viability
Model 1: The Sliding Scale Reserve. Instead of offering sliding scale to everyone, designate specific spots. If you see 20 clients weekly, reserve 3-5 spots for clients who genuinely can't afford your full rate. This allows you to serve clients with financial barriers without underpricing your entire practice. The majority pay your full rate, keeping you sustainable.
Model 2: The Scholarship Model. Build community partnerships or create scholarship funds specifically for clients from underserved communities. Partner with organizations, apply for grants, or set aside income percentage to fund reduced-rate spots. This separates business sustainability from social justice work. You price services sustainably, then use income portion to fund accessibility initiatives.
Model 3: The Hybrid Practice. Spend part of your time in private practice charging sustainable rates, part in community settings serving underserved populations at reduced or no cost. Many providers find this reduces burnout because work is diversified. Your private practice income supports you financially. Your community work supports your values.
The Hard Conversation About Who You Serve
Here's a question worth sitting with: Who are you trying to make your services accessible to?
If the answer is "everyone," you're setting yourself up for financial strain. Not because caring about everyone is wrong, but because it's not a viable business model.
If your answer is specific—"LGBTQ+ youth," "immigrant families," "people recovering from intimate partner violence"—then you can build a pricing strategy that works. Charge full rate to clients who can afford it, reserve sliding scale spots for your committed population, and create partnerships with organizations serving those communities.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), targeted community partnerships are more effective at increasing mental health access than individual provider discount models alone. Providers who burn out try to be everything to everyone. Providers who thrive get clear about their mission and build a financial model supporting it.
When Guilt Shows Up
If you come from a marginalized community or experienced financial insecurity, pricing feels complicated. There's guilt around charging rates you once couldn't afford. Fear of "selling out."
This guilt deserves compassion. But it doesn't deserve to dictate pricing.
Charging sustainable rates doesn't mean abandoning values. It means building a practice that will be here long-term, support you and your family, and allow you to continue this work for years instead of burning out in two. You're also modeling that healing work has value. That expertise deserves compensation. That providers from marginalized communities don't have to accept less to serve their communities.
Your Action Plan
Calculate what you need to earn to sustain life and practice. Be honest. Include student loans, healthcare, retirement, and buffer for rest. Decide how many client hours you can realistically see weekly without burning out. Divide needed income by those hours. That's your baseline rate.
Now decide how many reduced-rate spots you can afford without undermining sustainability. Start with 2-3, not 10. Get clear on who those spots are for. Create criteria. Communicate them clearly on your website.
This isn't perfect. But it's a model honoring both your need to survive and commitment to serve.
What pricing model would allow you to do this work for 20 years instead of burning out in five?
If you're ready to build a practice honoring both values and viability, schedule a strategy session to explore a pricing model that works.
Reni Weixler, CPC, LPC
Therapist | Executive Coach | Co-Founder, Inspire Wellness Collective