The State of Therapy: Surviving, Thriving, and (Un)Learning the Rules

Welcome to "Starting a Counseling Practice Success Stories"! In this State of the Union episode, hosts Kelly Higdon and Miranda Palmer tackle the latest shifts in mental health care and how they affect private practice owners. From the push toward value-based care and what that means for therapist pay and accountability, to the personal impact of working in an increasingly profit-driven system, Kelly and Miranda get real about insurance, outcomes, and the emotional cost of navigating broken structures.

You’ll get insights on tracking client improvement, negotiating with insurance, and building a sustainable practice that supports your clients—and yourself. Tune in for honest discussion, practical tips, and encouragement for therapists striving to create positive change in a challenging environment.

00:00 "Understanding Value-Based Care Concepts"

03:19 Therapist Payment Issues and Challenges

09:02 UHC: Profitable Yet Problematic Partnerships

13:10 Therapists' Fear-Induced Behavioral Shift

17:23 "Burnout vs. Mental Health Diagnosis"

20:27 Decolonizing Practice for Healing

25:03 Holistic Support Over Self-Care

26:58 Balancing Business and Community Support

29:59 Navigating Private Practice Challenges

33:43 Evaluating Therapy Success Metrics

39:30 "Orlando's Top Trauma Therapists"

42:03 Therapists' Anxiety and Outcome Improvement

43:56 "Recognizing Progress Beyond Trauma"

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