Clinical Social Workers
Bookkeeping for LCSWs in private practice. Modest fees and generous sliding scales make clean books matter more, and Aretha keeps the numbers clear so the practice stays sustainable.
Coming Out of Agency Work
Most of the clinical social workers I work with came out of agency life. County behavioral health, a hospital, a school district, a community nonprofit living on grant cycles. Somebody else handled payroll and rent and whatever accounting software was running in the back office. Your job was the caseload in front of you, and that was already more than enough to carry. Then you opened your own practice, and now you are the clinician, the scheduler, and the person responsible for the books.
Nothing in an MSW program covers this part. You studied assessment, ethics, systems, advocacy, and the real lives of the people you serve. Nobody handed out a chart of accounts. So a lot of LCSWs are building business records for the very first time, usually late at night after the last session of the day, which is exactly when small mistakes get made and then repeated. That is the part I take off your plate.
Who I Work With
Who I Work With
LCSWs in solo private practice and small practices with one to ten people, anywhere in the country. Clinicians still holding an agency job part time while a caseload grows. Private pay practices, panel-based practices, and clinicians who also carry contracts with schools, agencies, or community programs.
The Part Nobody Taught You
The Part Nobody Taught You
Keeping practice money separate from household money. Knowing which expenses belong to the business and which do not. Keeping records steady enough that tax time is uneventful. These are learnable skills, and how comfortable you feel with them says nothing about how good you are at the clinical work.
The Fundamentals, Done Right
The first thing I ask about is banking. A dedicated business checking account and one card used only for the practice. It sounds like a small housekeeping item, and it is the change that makes everything after it easier. When practice money and grocery money share one account, every month becomes a memory test about which charge was which, and the answers get fuzzier the longer you wait.
From there the monthly work is steady and unglamorous, which is how it should be. Deposits from your practice management system and your payment processor get matched against what actually landed in the bank. Reduced-fee sessions, late cancellations, and outstanding balances get recorded honestly. Practice expenses get categorized the same way every single month, from office rent or a shared suite to your EHR subscription, liability insurance, license renewal, CEUs, consultation group, and professional dues. That work is my Full-Service Bookkeeping service, and it runs on a monthly rhythm so you are not thinking about it in between. I want to be clear about one boundary. I do not handle claims, coding, credentialing, or insurance billing. My work begins with the money that arrives and makes sure the record of it is accurate and complete.
A Monthly Picture You Can Actually Read
A Monthly Picture You Can Actually Read
Short reports you can absorb between sessions. What came in, what went out, what the practice earned. Your books stay ready for whoever prepares your return, since I do not prepare tax returns myself and your preparer deserves clean numbers instead of a folder of receipts. Anything you want explained, you ask me and I explain it in plain words.
QuickBooks Built for a Practice
QuickBooks Built for a Practice
If you are starting from scratch or restarting after a rough first attempt, my QuickBooks Online Setup and Training gets the foundation right. A chart of accounts fitted to a private mental health practice rather than a generic small business template, accounts connected, settings correct, and hands-on training so you can use it with confidence. I am a QuickBooks ProAdvisor, certified at Level 2 with the Gold Badge.
Modest Fees and Generous Sliding Scales
Clinical social work carries a value system about access, and it shows up in the fee schedule. Many of the LCSWs I talk with keep their standard fee below what their market would bear and hold slots open for people who could never pay full rate. I have no interest in talking you out of that. What I will tell you is that the more of your week sits under your full fee, the more precisely you need to know your numbers. A practice built on generosity still has rent to cover, and it still has to pay you a real living.
Current books show you the average you actually collect per session over a month, which is usually a different figure from the one posted on your website. They show how much of the month went to reduced-fee work, what your fixed costs truly run, and how many sessions a week it takes to cover everything with something left over for you. Once you can see that clearly, decisions about caseload and fees get calmer. You can carry as many low-fee slots as the practice can genuinely support, and you know where that line sits instead of hoping you are somewhere near it.
What a Session Actually Brings In
What a Session Actually Brings In
Posted fees, sliding scale fees, adjusted payments, no-shows, and unpaid balances all pull the real number in different directions. Reconciled books give you one honest average per session and per clinical week, tracked month over month so you can see when it starts to drift and catch it early.
Decisions With Something Behind Them
Decisions With Something Behind Them
Whether to take one more client, adjust your standard rate, let a low-paying contract go, keep a reduced-fee slot open for another year, or take a week off without a knot in your stomach. Same decisions you are already making, made with numbers in front of you instead of a guess.
What Changes
The month closes and you get a short report you can read between clients. You know what came in, what went out, and what the practice earned. Your records stay ready for whoever prepares your taxes, so January becomes a simple handoff instead of a scramble through email receipts. If something in the numbers puzzles you, you write to me and hear back from me, because I am the one doing your books. There is no rotating team here and no account manager in the middle.
I spent more than 15 years as a licensed nurse working in mental health before I opened AD Keeps The Books. Bookkeeping is a different craft, and it comes from the same place, which is taking care of the people who spend their days taking care of everybody else. You will not have to explain what an LCSW does, what a consultation group is, what your EHR is for, or why your Thursdays look the way they do. I already know, and I have a lot of respect for the work.
No Judgment About Where You Are Starting
No Judgment About Where You Are Starting
Some practices come to me with a year of transactions nobody has touched. Some come with a QuickBooks file that got away from them somewhere around month three. Neither one is a situation I have not seen before, and neither one gets a lecture from me. We find out what exists, get it current, and then keep it current so it does not happen again.
Let's Talk
Let's Talk
Book a consultation with me and tell me about your practice, what you have for records right now, and what you would like to stop carrying in your head. We will sort out whether a QuickBooks setup, some catch-up work, or straight monthly bookkeeping is the right place to begin. It is a real conversation, not a sales pitch.
Helping the People Who Help Others
Let's Start With
a Short Conversation
Tell me where your books stand right now, even if the honest answer is that nobody has looked at them in a year. I'll ask a few questions and give you a clear idea of how I can help.
