Think you have to work harder or longer to make more money in private practice? Fortunately, that isn’t the case. Your calendar does not need to become a hostage to your good intentions.

Instead, it may be helpful to look at how your practice could be quietly leaking money.

First: Waiving missed session fees

I’ve written before about one common way therapists lose money: by not charging missed-session fees. And I get it– this is hard. Your policy may be clear. But when the moment comes to actually charge the fee, that neat little cancellation policy can suddenly feel less like a reasonable written agreement and more like a test of your distress tolerance.

And this challenge appears to be growing. A Private Practice Survey by Zynnyme found that the problem has worsened by 27% in recent years, while the no-show fees therapists charged dropped by 8%.

For many of us, missed-session fees are a big income leak. If collecting these fees is an issue for you, please read my article “Missed Sessions: Being Nice Can Cost You Thousands.”

Another way our generosity can be a problem

But today, I want to look at a related form of “therapists-being-just-too-darn-nice.” It’s our tendency to run overtime in session, and the often-invisible costs of those “just a few more minutes” moments.

How many of us run overtime?

One statistic from the Zynnyme survey especially caught my attention: 76% of therapists said they run overtime in sessions. That’s 3 out of 4 of us. Even more striking, that number was 36% higher than in a few years earlier, which means this little habit is not exactly on its way out.

On average, therapists reported going seven minutes over per session. Seven minutes. Doesn’t sound like much, does it. And that is exactly what makes it so easy to miss. You didn’t begin with the grand business strategy called “Let Me Work for Free.” It began with compassion, urgency, discomfort, or the very human wish not to interrupt someone mid-sentence — or mid-sniffle.

Zynnyme’s analysis put it well: “It’s small decisions, made kindly, in a hurry, one at a time.” But over time, this extra time became a pattern, for you and for your client, and quietly became the expected norm.

A look at the numbers

Seven minutes may not sound like much. But a few minutes here and there can become a surprisingly expensive habit.

If you provide 60-minute sessions and routinely go seven minutes over, you are giving away about 12% of each session.

The Zynnyme team points out that using the survey averages of 18 clients a week and 47 working weeks a year, those extra minutes add up to about 99 unpaid hours annually. That is more than three full 32-hour workweeks of labor you are giving away for free, out of tiny moments of compassion and politeness.

So depending on your fee, routinely going overtime that can easily mean more than $10,000 a year in unpaid therapy time. Before you know it, “just a few more minutes” has cost you the equivalent of a European vacation (or OK, maybe paying down your student debt).

And that does not even include missed-session fees you may also be waiving out of kindness, which can easily add up to more than $10,000 annually.

The mental health costs

But the mental health argument may be even more compelling than the financial one. Many of us stack 60-minute sessions back-to-back, then wonder why we feel completely wrung out by the end of the day.  We don’t allow time for documentation, and are too exhausted at the end of the day, so we fall behind, leading to a new source of stress.  With the combination of this stress and exhaustion, you may find you are losing the joy you once had for the profession.

Those few minutes between clients are not a luxury; they are necessary.  They give you a chance to do your session notes, return a quick call or email, eat something that is not found at the bottom of your bag, or simply breathe and reset your nervous system before welcoming the next client.

Private practice already includes lots of unpaid work: documentation, billing, bookkeeping, taxes, consultation, treatment planning, phone calls, emails, and the occasional staring into space while you process something your client said.  Because so much of that work is uncompensated, it becomes even more important to protect the time and income that you can control.

Tips For Ending Sessions on Time 

1. Name the frame from the start. Tell new clients how long sessions are, that you make a point of ending on time, and that you leave the last 10 minutes for wrap up and scheduling. As the Zynnyme team notes, “most clients settle more easily into a container once it has been clearly named.”  Then comes the harder part: actually following through with this.
2. Resolve not to give away unpaid time. If you bill 90837 but do 60-minute sessions, remember that the code can be billed starting at 53 minutes. Try ending at 53 minutes and giving yourself those seven minutes back after each session.
3. Invite clients into the change. If you have been letting sessions run long, simply say, “I’ve noticed I’ve been letting us go over time, and I’m working on ending more consistently. I’d appreciate your help with that.”
4. Hold the boundary warmly. When a client raises something important near the end of the session, you might say, “That sounds important, and I want to give it the time it deserves. Let’s write it down so we can begin there next time.”
5. Treat the boundary as part of the work. We ask clients to set limits, protect their energy, and respect their own time. Ending on time lets us model the same thing. It is not cold; it is clear, consistent, and clinically useful.
6. Believe you deserve the space between sessions. Acknowledge them as key to providing quality care and preventing burnout.

The Takeaway

If you want to earn more in private practice, the answer is not always to work longer hours, push harder, or raise your fee. Start by looking for the places where money may be quietly slipping out the side door: waived missed-session fees, sessions that regularly run over, and all those small moments of generosity that begin to add up.  If running overtime has become part of your routine, try ending on time for a few weeks.  You may find that you are not only reclaiming income, but also protecting the breathing room that helps you reset, stay present, and offer better care to the next client. And you may even find you are getting your notes done!