A therapist’s income shouldn’t be the impetus for shame and judgement. And yet, it often is.
Unfortunately, I don’t think it’s much of a secret at all that therapists have a way of shaming each other around all things money.
We have a way of thinking that if somebody is trying to charge more than we are then we can shame them for being greedy. Then, we take it a step further, and call into question if that person genuinely cares about client care.
It definitely goes both ways. Sometimes, therapists may look at colleagues who charge less than they do and shame them for not advocating for adequate pay for therapists.
And of course, anything in between. We can be so unkind to each other, especially when it comes to money.
But I’d like to wave my hands in the air and say: “TIME OUT!! Can we please call a truce??”
Call me overly optimistic or naive. Of course, there is the occasional bad apple. But, I genuinely believe that most of us are just making the best decisions we know how to. And just because the path someone else is on isn’t the path you want to be on, you don’t need to bash where they’re at.
We get plenty of stigma around money from the rest of the world. So we don’t need to add to the noise by flinging insults at each other.
If you’d rather watch than read, check out the video version of the article below:
Judging a specific income number
I know I won’t be able to unpack this whole issue in a single article. But, there’s one tendency, that I see in my comments, that I’d like to zoom in on.
That’s the tendency for folks to reference a therapist’s income point, such as $100k per year, and have very different reactions to that amount.
Some folks might say that $100k is really decent pay. Lucrative, perhaps. And others will describe that as an absolute minimum for therapist pay, or not enough to even meet basic necessities.
Here’s the thing: the folks watching and listening to Private Practice Skills come from a very diverse range of financial situations. I love that!
But I think what happens is that we can take a salary number, like $100k and zoom in to a place, like where I live (San Diego, CA), and realize that $100k is not even enough to cover the mortgage payment of a condo. Let alone the cost of food and any other bills you need to pay.
In a different part of the country $100k might be enough to purchase a single family home and live comfortably.
It’s not just geographical differences that influence cash flow. There are so many variables in addition to that!
Let’s say you were fortunate enough to be able to buy a single family home 15 years ago. Then, you’re probably locked in at a mortgage rate that’s much cheaper than if you were to be trying to buy a house now.
Income vs. cash flow
So, we have to use this filter in our minds when we hear an income level of $100k. Even when we’re talking to someone who lives in the same zip code as us. Each person’s cost of living can be vastly different. Having an income of $100k might mean a different cash flow for each of you.
I think it’s important to focus on things like cash flow rather than overall income numbers. Because, one person in one city/situation earning $100k annually may have zero cash flow. This means they have nothing left over after paying for basic necessities and their bills.
But, somebody living in a much different situation making $100k a year might have a very comfortable cash flow. Meaning, they have a fair amount of money left at the end of the month after they’ve paid for their most basic necessities.
Variables
There are so many other variables that make cash flow look so different for each individual.
Maybe someone carries a really heavy load of student debt whereas somebody else may have little or no student debt. Or maybe someone has a partner that they share finances with, which is a different financial situation than someone who is trying to raise two kids on a single income.
Others may have had parental help to afford a downpayment on a home, whereas someone else may have no parental help at all.
There is such a huge variation in situations that influence cost of living. Therefore, I don’t think it’s helpful to assume we know whether someone is greedy or not.
And believe you me, there will always be greedy people out there. But, more than likely, they may actually be in a financially tighter position than you realize and they’re just trying to find a path forward.
The goal: stop shaming
So for today, I thought it might be helpful to pull out the calculator. Quite literally! I want to show the math of how cash flow can vary WIDELY from one person’s situation to the next.
This feels valuable to hopefully diminish the money shaming we do to each other. I also want to help you feel empowered to know that it’s okay to tailor your career choices based on what fits best for you, your finances and your values.
Let’s look at the numbers
We are going to take a look at the financial situations of two different people. One person living in a high cost of living neighborhood, and one person living in a much more affordable cost of living area.
We’re going to take a look at how different it would be to earn $100k annually in each of those contexts.
Example 1: living in San Diego
Let’s imagine that you’re a therapist living in the same neighborhood where my therapist office is currently located. My office is in a neighborhood called University City in the city of San Diego. This zip code has one of the highest jobs per capita of any zip code in San Diego county. So, it is a particularly expensive neighborhood.
How much does it cost to live in University City? According to Redfin, the median sales price for a house in University City was $937,500 in July 2025. Keep in mind that University City is densely populated, so most of these sales are for homes with shared walls.
So, if you want to look at a single family home, that median price jumps up to $1.6 million.
Let’s say you wanted to buy a 1.6 million dollar single family home in the neighborhood my office is located in, and you managed to save 20% down. (Which, by the way, is $320,000. That’s the cost of an entire single family home in some parts of the country.)
Then, your remaining mortgage loan would be 1.28 million dollars. A 30 year long mortgage at a 5.98% interest rate and a .73% property tax rate would leave you with a monthly payment of $8,831.13, or just shy of $106k per year.
Other expenses
On top of housing costs, there are, of course, many other life expenses. Like childcare. Last year, our household spent $48,000 on daycare for our two preschool age children.
So now just to have a roof over your head and the option to generate income by paying for childcare, you’re already well past $150k per year for the household. And that doesn’t factor in putting food on the table and any of the other expenses of life.
Even if you’re in a dual-income household, you would each likely need to generate $100k per year post-tax just to cover the cost of a roof over your head and childcare if you have kids. And that doesn’t even address the matter of how you managed to cough up a $320k down payment.
The rental market isn’t exactly cheap either. In the same neighborhood, a single family home would run you a minimum of $4500 per month. A 600 square foot apartment would run you a minimum of $2400 a month here.
San Diego therapist’s income
Meanwhile, according to ziprecruiter, the average annual salary of a therapist in San Diego, as of September 2025, is $80,000 per year.
Remember, the monthly payments for the average single family home came out to about $106k per year. Your income wouldn’t even come close to putting a roof over your head.
In other words, even a dual income household at that income level, after taxes, might not be able to afford purchasing even a condo in the area. And they may potentially be priced out of the rental market over time.
Example 2: living in Memphis
Let’s say instead you live in Memphis, Tennessee. This city is well known for having a far more affordable housing market relative to other areas of the United States.
Here, notably, the median home price was $185 in July 2025. Single family homes were $190K. That’s only a little over half of the down payment necessary to purchase a single family home in my local neighborhood of San Diego.
So, assuming you had $38,000 sitting in the bank, then you’d have a solid 20% down payment on a single family home in Memphis. Let’s say you took out a $152k mortgage loan with a 5.98% interest rate for 30 years. And then you had a property tax of $1610 per year. Then, your monthly expenses to have a roof over your head would come out to just under $1250 per month. That’s just shy of $15,000 per year.
And if that’s a little steep for your budget, it’s possible to find a one bedroom apartment to rent in the area for closer to $800 per month.
Memphis therapist’s income
Meanwhile, according to Ziprecruiter, the average annual therapist income in Memphis is $73,000 per year. That’s lower than San Diego. But the magnitude of difference doesn’t even come close to reflecting the difference in cost of living.
So if you’re a therapist living in Memphis you might judge me when you hear me advocating that therapists should be making a minimum of $100k per year. In your area, especially if you have a dual income household, you can live quite comfortably on the average therapist salary of $73,000.
No matter how you slice it, having $100k in San Diego is very different than having $100k in Memphis.
What I’m advocating for
I wanted to paint the picture, using numbers, to show how vastly different your financial situation can be depending on multiple factors.
Here’s what I’m advocating for: I don’t think it’s helpful to make blanket statements about what every therapist should charge or what the average therapist salary should be nationwide. Rather, I think it’s a lot more beneficial to take an open and personalized approach.
For instance, we should factor in geography. Personally, I think all therapists in San Diego should be earning a minimum of $100k annually. Meanwhile, it’s possible that for a therapist, in a city like Memphis, to feel like earning $70k a year is reasonable.
If you take nothing else away, I’d like to encourage you to think twice before you judge another therapist’s income. Before you light your keyboard on fire with a spicy comment about how others approach their finances, channel your inner capacity for empathy.
And if you’ve been able to make it work on a lower salary than you see your colleagues advocating for, amazing! Count it as an opportunity to be grateful.
Want a 100k income?
Personally, I have worked hard to be able to work part-time and make 100k. Maybe you have questions about how that’s possible. If so, I made a video diving into how I’m able to generate six figures as a private practice therapist.
If you are interested in learning more about how you can increase your salary to 100k, I have an article with 3 ways to make 100k as a therapist.
And until next time, from one therapist to another: I wish you well!
-Marie
Photo by Vitaly Gariev on Unsplash
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