Maximizing income for your mental health practice with group sessions

After long hours spent in individual counseling, you may wonder if it’s possible to consolidate these stretches without forfeiting their profits. Solo sessions afford therapists and clients the chance to form an intimate connection — however, this reward requires a significant length of time and effort. I’ve worked with some clients who’ve become transparent and trusting of me only after months or years of therapy.

If you’re interested in offering a new and efficient intervention to your lineup, consider group therapy. This add-on will help you to capitalize on important business elements: time, money, and service. By organizing individual clients into therapy groups, you can work less direct contact hours. 

Depending on your group rates and number of participants, you can collect more income than you would from a single client. Ultimately, though, your choice to offer group sessions can help your clients to achieve their treatment goals at an efficient pace while in the company of like-minded peers.   

Groupwork can serve as a respite to therapists who are feeling the toll from constant solo sessions. While facilitating group therapy at a hospital, I noticed that my input was infrequently needed; the patients took it upon themselves to verbalize their needs and offer feedback to one another. I’d be there to ensure that our meetings started and ended on time, introduce relevant subjects for discussion, and make interjections when needed.

The small crowd which constitutes a therapy group can help reduce any weariness you may be experiencing from one-to-one appointments. During group sessions, you’re not the only listening ear or alert pair of eyes in the room — other people are present who can fill in the silences and ask pertinent questions. It’s possible that your time spent in group therapy appointments can recharge you emotionally and mentally, so much so that you’re better equipped to continue building up your business.

Some therapists prefer group sessions rather than individual ones due to the simpler documentation involved. Therapy groups tend to be well-structured with a clear purpose and outline. 

Though conversation among members can stray from the intended target, it’s the therapist’s responsibility to bring the group back to its main point. The organization needed for successful groupwork helps to streamline your documentation.

When composing group notes, you simply document the topic addressed in that session and the response of the member. A routine I developed while providing groupwork was to keep a legal pad close for notetaking. 

I’d start every group with an icebreaker, during which each member had to give their name and response to a fun question. As members shared, I’d write their name and answer in a circle design on my notepad which correlated to where they sat in the group. I found I needed less time to finish progress notes since I could glance at my visual illustration and notes afterwards to remember clearly what each member had said or displayed.

A clear benefit of adding group therapy sessions is your ability to meet more clients within a shorter timeframe. Currently, you may work with 6 clients daily over the course of 5 workdays. By the week’s end, you’ll have amassed 30 direct client contact hours. 

Such a quantity can bring in significant income — while simultaneously depleting your energy and motivation to continue client work at this pace. If you incorporate groupwork, you can shrink your contact hours while still meeting the same number of clients.

Depending on the size and frequency of your groups, this intervention can be remunerative. Clients tend to view group therapy as attractive due to the large cost difference involved. Some would rather share their counseling experience with others if it means paying just a quarter or half of what’s owed for individual sessions. 

If you’re strategic with numbers, your group services can yield more dollars than what you’d receive for the same amount of time with a single client. Envision a group of 6 members who pay $30 for each one-hour session. By the hour’s end, you’ll have brought in $180 from their collective payments.  

Making updates to your service list is enlivening, so it’s tempting to rush the incorporation of group sessions. In order to make your groups successful, you’ll need to evaluate several factors prior to advertising this new offer. Use the following notes to be detailed in your planning.

Think first about the identities of your ideal participants: 

Simultaneously, understand before advertising your group who would not be a good fit for it. Such individuals include those with high-risk behaviors (i.e., self-harm, suicidal thoughts and attempts), hallucinations and delusions, and proneness to verbal or physical aggression. Develop a plan for how you can screen interested callers for red flags so you don’t naively admit them into your group.

Decide beforehand if you’ll accept insurance payments for group sessions. Keep in mind that if you do so, you’ll need to complete an intake evaluation for each member, assign them a diagnosis, and submit their claims. 

Insurance acceptance can draw potential members to your group — but cause you headaches when it comes to billing. For example, if your group is composed of 6 members with assorted insurance plans (2 Aetna, 2 BCBS, 1 Medicaid, and 1 Tricare), you’ll need to be extra vigilant as you monitor for claim approvals and fulfilled payments. 

If you opt for the self-pay route, clarify upfront with group members about the total rate due and when payment should be made. You can facilitate open groups (new members can join at any time) and collect fees at the start of each session. Alternatively, you can keep your groups closed (members must join by a specified date) and request that the entire sum be paid upon registration.

After managing a multitude of groups for clients across the life span, I’ve found that the following size ranges lead to the most productive groups: 

My experiences in groupwork have taught me that when I exceed these ranges, it’s difficult to keep all members focused — talkative individuals assume monologues and side conversations start up. When I don’t have enough members to match my minimum, it takes more effort for me to draw out feedback and keep the conversation flowing. 

Note that falling short of your minimum can result in lost revenue as you charge members less than you do individual therapy clients. 

A group of 3 participants who pay $30 each for your hourly group sessions may quickly become cohesive, but their financial profit is capped at $90. Assuming that you average over $100 from each of your individual appointments, your continued groupwork with this trio would cause your business to lose money.

Your therapy office may offer sufficient room for one-to-one meetings but fail to provide the relaxed environment needed for group sessions. Children and adolescents tend to be gracious in this area, but adults who are paying you directly expect a setting that’s spacious enough for all members. 

Ensure that the space you plan to use for groups won’t feel overcrowded once everyone is seated. If it’s unrealistic for the group to meet in your office, first consider using a conference or break room in the same building, so you don’t need to pay the rent for a separate location.

Your budget for therapy supplies may cover the needs of your regular caseload, but need an upgrade based on what resources you’ll include in groupwork. Some examples of items you may want to purchase are: 

Make a list of the potential expenses you’ll encounter with groupwork and generate their total cost to learn if this intervention will bring funds in or leak them out.    

As with any new service you add to your business, it pays (literally) to develop solid marketing strategies ahead of time. While outlining your initial group, reflect on the problem it’s designed to address and who would have a need to attend. 

If you plan to host co-parenting classes for recent divorcees, for instance, ensure that professionals in your community with legal connections are aware of these meetings. Such sources include your area’s Bar Association and the lawyers and judges who present in family court hearings. 

If you’re organizing groups for adolescents with depression, give all the registration details to fellow clinicians to share with their own clients and post flyers in their lobbies.

When advertising groupwork, highlight the unique features which will make your business stand out from others. All therapists received basic training in group therapy during their graduate programs, which means they’re able to provide such a service, but some do so better than others. 

A colleague from my previous worksite facilitated Lego® group therapy sessions for children throughout the year. Her promotion efforts were rewarding as kids viewed their group meetings as opportunities to play, while their parents enjoyed downtime for 1 hour each week in the office lobby. 

You might be the only Registered Play Therapist (RPT™) in your surrounding locale. If you design a group for children that uses not just Legos®, but other toys and art supplies as well, it’s likely that parents will choose your groups over others that are restricted to conversation and handouts.

Finally, be willing to waive fees and offer discounts as you start out with groupwork. Gyms and workout clubs are well-known for their “first-time free” policies, in which curious patrons can try out services before making a membership commitment. This approach has a high success rate and can be applied to your group therapy sessions. 

You may offer group members a discounted rate if they pay for all the sessions in a group series at once, or arrange for a free introductory group session, after which the attendees decide whether or not they’ll return for future ones at a cost.

Group therapy has a reputation for being more arduous than individual sessions due to the higher number of participants present. When thorough preparations and considerations are made, though, I’ve witnessed plenty of benefits in groupwork to maintain my interest in offering this service. If you invest the time needed to develop productive therapy groups, you’ll enjoy a financial increase, meet new clients, and address their needs in a simplified way.