How do older adults find a therapist?
Older adults find a therapist through Medicare, aging services and video care, and national survey data show lower mental health care use at older ages.
Oct 15, 2026 Matthew Sexton, LCSW
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Filtered field notes — private-practice.
Tag · private-practice
All private-practice posts.
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Oklahoma just joined. Which states can I see clients in under the Counseling Compact?
Ten states are live in the Counseling Compact after Oklahoma joined October 1, 2026. Where licensed counselors can see clients, and when a license is needed.
Oct 12, 2026 Matthew Sexton, LCSW
2027 ACA Premiums: What Should Therapists Tell Clients Now?
Tell Marketplace clients the dates: 2027 enrollment opens Nov. 1, Dec. 15 is the cutoff for Jan. 1 coverage, and federal enrollment ends Jan. 15.
Oct 05, 2026 Matthew Sexton, LCSW
Counseling Compact: Can I See a Client Who Moved States?
Yes, with a compact privilege in the client's new state. As of Oct. 1, 2026, 10 states issue them. Who qualifies, what it costs, and how to apply.
Oct 04, 2026 Matthew Sexton, LCSW
EHR Downtime Plan for a Small Therapy Practice
An EHR downtime plan gives a small therapy practice a one-page routine for the first hour, temporary notes, client contact, recovery, and testing.
Sep 01, 2026 Matthew Sexton, LCSW
Close the Month With a Practice Decision Log
A therapy practice monthly review works best when it ends in writing, not conversation. Set aside about an hour, look at four operating areas, and turn what…
Aug 30, 2026 Matthew Sexton, LCSW
Build a Coverage Plan Before You Need Time Off
A therapy practice coverage plan is a short written document that says who handles your clients, your messages, and any urgent situations when you're…
Aug 29, 2026 Matthew Sexton, LCSW
Know the Cost of a New Service Before You Announce It
Before you post about a new group, workshop, or specialty service, work out the full therapy practice new service cost: one-time setup, recurring monthly…
Aug 28, 2026 Matthew Sexton, LCSW
Turn Repeated Admin Questions Into a Practice Playbook
For one week, write down every administrative question that comes up more than once, in the words people actually use. Sort them into a handful of buckets,…
Aug 27, 2026 Matthew Sexton, LCSW
Run the Practice in One Weekly Owner Hour
Block one uninterrupted hour every week for therapy practice weekly operations, and use it for nothing else. Spend the first 10 minutes scanning what…
Aug 26, 2026 Matthew Sexton, LCSW
Your Practice Needs a Stop-Doing List Before It Needs Another App
Find duplicate work, unclear approvals, and unused reports before buying another app for a therapy-practice workflow that needs simplification.
Aug 25, 2026 Matthew Sexton, LCSW
Build the Referral Handoff Before You Add Another Referral Source
Map a reliable therapy-practice referral handoff before adding another directory, ad, or referral partner to an unclear intake process.
Aug 24, 2026 Matthew Sexton, LCSW
Check Capacity Before You Create More Demand
A practical capacity check for therapy-practice owners who want marketing to match their real openings, administrative time, and response path.
Aug 23, 2026 Matthew Sexton, LCSW
The Friday Landing Note for a Small Therapy Practice
A five-field Friday planning routine for therapists who want to leave Monday a clear administrative starting point without rebuilding the week.
Aug 21, 2026 Matthew Sexton, LCSW
AI Capacity Planning for Therapists: Model a Sustainable Caseload Before You Fill It
A practical, human-reviewed way for therapists to model caseload, cancellations, payer mix, overhead, taxes, and time off with de-identified assumptions.
Aug 08, 2026 Matthew Sexton, LCSW
Use AI to Build a Therapist Referral Network Without Automating the Relationship
AI can map public referral opportunities and keep follow-up from disappearing. Trust still has to be earned by a clinician.
Aug 07, 2026 Matthew Sexton, LCSW
How to Build a Private-Practice Business Plan With AI Without Letting AI Make the Decisions
AI can organize market research and test business scenarios, but a therapist still has to choose the practice model, capacity, risk, and boundaries.
Aug 07, 2026 Matthew Sexton, LCSW
AI Therapy Laws by State: The Burden Lands on Your License
AI therapy laws by state: 43 states filed health-AI bills in 2026, but only six Counseling Compact states issue privileges. The rules attach to your license.
Jul 24, 2026 Matthew Sexton, LCSW
What to Charge Per Session in NY/NJ/CT (and Why You're Probably Underpricing)
New York's average private-pay session runs about $176 — but after tax and overhead you keep only 55-65 cents on the dollar. The real ranges for NY/NJ/CT, the insurance-vs-private-pay math, and how to set (and raise) a rate without guilt.
Jul 23, 2026 Matthew Sexton, LCSW
Home, Suite, or Screen? A Therapist's Office Decision by Caseload Stage
Your office decision is a math problem disguised as an identity problem. Hourly sublease vs. monthly suite vs. home vs. fully virtual — the break-even math, the homeowner's-insurance trap nobody warns you about, and the cross-state licensing wall.
Jul 23, 2026 Matthew Sexton, LCSW
How to Build a Therapy Website With AI (2026 Compliance Guide)
AI builders put a professional therapy website within an afternoon's reach. The honest, tool-by-tool how-to, plus the HIPAA, Good Faith Estimate, and ADA layer affiliate listicles skip.
Jul 22, 2026 Matthew Sexton, LCSW
How I Use AI to Run My Therapy Practice's Back Office
58% of small businesses used generative AI in 2025, up from 40% a year earlier. Here is how a solo therapist runs the whole business side, website to video, with AI.
Jul 18, 2026 Matthew Sexton, LCSW
How to Start a Private Practice in New York (2026 Guide)
$260 in state fees for a solo PLLC, a mail-only form, and a 60-day law vs. a 6-month reality: the verified 2026 steps to start a private practice in New York.
Jul 17, 2026 Matthew Sexton, LCSW
How to Set Your Private-Practice Therapy Fee in 2026
Therapy sessions average $139 nationally and $176 in New York. Set your 2026 private-practice fee with real market data, no-show math, and the fee-raise payoff.
Jul 17, 2026 Matthew Sexton, LCSW
How Therapists Actually Get Their First Clients in 2026
53% of psychologists have no openings and the average one gets 8.8 seeker contacts a month. Where therapy clients actually come from in 2026, channel by channel.
Jul 17, 2026 Matthew Sexton, LCSW
What Is VibeCheck.luxury? The Between-Session Companion, Explained
The VibeCheck.luxury EMR is currently in beta. Email for more information.
Jul 12, 2026 Matthew Sexton, LCSW
Private Practice AI Stack for Therapists in 2026
AI monthly use among therapists nearly tripled to 29% in one year (APA, 2025). What the 29% use, what it costs, the compliance gaps, and what the 71% wait for.
Jul 09, 2026 Matthew Sexton, LCSW
Insurance Credentialing: The 90-to-120-Day Limbo
A licensed therapist can wait 90 to 120 days before an insurer lets them bill, per the AMA. That wait thins networks and breeds the ghost networks patients hit.
Jul 06, 2026 Matthew Sexton, LCSW
Too Many Clicks: The Tax Your EMR Charges Every Session
An ER doctor clicks 4,000 times a shift; outpatient clinicians spend 16+ minutes in the EHR per encounter. The click tax is a design choice, not a clinician failure.
Jun 10, 2026 Matthew Sexton, LCSW
EHR Documentation Burnout Made You an Unpaid Transcriptionist
Clinicians average 13.5 hours a week on documentation — the top driver of therapist burnout. The fix isn't a chatbot. It's software that signs under your name.
Jun 09, 2026 Matthew Sexton, LCSW
VibeCheck.luxury: The Between-Session Companion for Therapists
The VibeCheck.luxury EMR is currently in beta. Email [email protected] for more information.
Dec 20, 2024 Matthew Sexton, LCSW
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