I'm a good therapist and my books are a disaster. How normal is that?
It is extremely normal. Most of the practice owners who reach out to me open with some version of that exact sentence, and almost all of them apologize while they say it. You do not owe me an apology, and you do not owe yourself one either.
Think about the training. Years of graduate coursework, supervised hours, diagnosis, treatment planning, ethics, licensure exams. Somewhere in all of that, nobody sat you down and taught you how to build a chart of accounts or reconcile a merchant deposit. Then you open a practice and get handed a business bank account, a payment processor, an EHR, a software subscription with a hundred settings, and a stack of receipts. That gap is a training gap. It has nothing to do with how good you are in the room with a client.
There is a practical reason it slips too. Clinical work takes everything you have. After a full day of sessions, notes get written because a real person depends on them. The books have nobody sitting across from them waiting, so they wait, and then a few months pass and it starts to feel too big to open.
When someone tells me their books are a disaster, it usually looks like one of a few familiar things. Personal and practice spending mixed in one account. QuickBooks connected in a burst of motivation and never categorized after that. A spreadsheet that stopped in March. Deposits landing in the bank with no record of what they were for. None of that is unusual, and all of it can be sorted out.
I spent more than 15 years as a licensed nurse in mental health, so I know firsthand how consuming the clinical side is. Bookkeeping for mental health professionals is what I do now, on purpose, so clinicians do not have to carry it themselves.
The important part is that getting current is a project with a start and a finish. Catch-up bookkeeping means gathering your statements and access, working through the missing months in order, reconciling every account, and handing you back books you can actually read. From there, steady monthly bookkeeping keeps you from ever repeating the climb, and your records stay ready for whoever prepares your tax return.
If you are behind and tired of thinking about it, book a consultation with me and we will look at what exists and lay out the way forward.
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.
More Questions
What is a healthy overhead percentage for a practice?
Common guidance puts overhead under roughly 32 percent of revenue for a lean solo practice, with group practices running higher. Treat that as a starting reference to verify, since the number that actually helps you is your own, tracked month after month.
Read answerIs my practice actually profitable, or does it just feel busy?
Busy and profitable are two different facts, and only your books can tell them apart. Compare the revenue that actually reached your bank account against your true monthly overhead, then divide what is left by the clinical hours you worked. Full weeks with thin margins usually trace back to fees, no-show leakage, or subscription creep.
Read answerHow many sessions a week does my practice actually need?
Add your real overhead, the pay you want to take home, and the tax reserve your tax preparer sets, then divide by what you actually collect per session. Common benchmarks put a sustainable full caseload somewhere around 18 to 22 sessions a week. Clean books give you honest numbers to put into that math.
Read answerWhat does working together month to month actually look like?
After a short setup, most months are quiet on your end. I categorize your transactions, reconcile your accounts, send you a small list of questions, and deliver reports with notes written in plain language.
Read answerHow do I know if my session fee is too low?
Private-pay fees commonly run around $100 to $200, with specialty work higher, but that range is only context. Your real answer comes from what your practice costs, what you need to take home, and how many sessions you can sustain. Clean books make that arithmetic honest.
Read answerWhat's the difference between catch-up and clean-up bookkeeping?
Catch-up is for books that were never done, meaning months or years with nothing recorded. Clean-up is for books that exist but cannot be trusted because things are miscategorized, unreconciled, or duplicated. Both end the same way, with accurate current books and a monthly rhythm going forward.
Read answer
