Private pay isn't a dream. It's a decision. And this podcast is for the therapists who are making it.
Each week I sit down with private pay practitioners and industry experts who are actually doing the work -- building sustainable practices, ditching insurance, and creating businesses that don't require their burnout to survive. Real conversations. Practical strategies. Let's get to work.
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S2E45 | You Don’t Know What’s Happening in Your Nervous System Until You Stop | Vickery Rendall, LICSW
Vickery Rendall was going to die in the ER. That was the plan. Then she ran out of PTO.
She spent over a decade in emergency rooms and medical units across four Washington hospitals. Code blues. Sexual assault exams. Mental health evaluations at the most acute moments of people’s lives. She did not know what it was doing to her nervous system until she stopped.
Now she is building Coastal Trauma in Bellingham, Washington, a private pay practice for the people who have been living that world their whole careers and have never had a therapist who actually understood what they were walking into every day.
We talked about what those years in the ER actually looked like and what the body was holding that the mind had learned to ignore. The 16-month Regents depaneling trap that a mental health lawyer could not find a way around. Why her clients worry their stories will be too much for the therapist. Why adding more trainings is sometimes about legitimizing the fee rather than trusting what she already knows. What her EMDR and IFS intensives are starting to make possible. And what it means to finally open a physical office after building entirely in telehealth.
She also mentioned something about retreats on boats. I love that idea.
If this episode got you thinking about what you are sitting on and whether you are trusting it, let’s talk. Book a 90-minute strategy session at privatepaypractitioners.com (https://privatepaypractitioners.com).
Vickery Rendall: coastaltrauma.com (https://coastaltrauma.com)
12 Oct 2026
Bonus Episode - Member Spotlight - Tiffany Green
Tiffany Green has been in the Founders Circle for almost two years. Private pay in Chicago for five. In that time she raised her rates, started offering 90-minute sessions because her clients kept asking, and stopped doing Saturday morning consults she never wanted to do in the first place.
My favorite part of our conversation: she told me about waking up early for a Saturday consult that no-showed, and I just asked her, do you even want to be up on a Saturday morning? She said no. So she stopped. That's the whole thing. Permission to build the practice around your actual life.
In her words: "if you wanted to hire a coach, it is better to hire somebody who has done exactly the thing you want to do." And on the cost compared to other programs: "it was like a no brainer."
Tiffany's practice is Charism Counseling Center. (https://www.charismcounseling.com/) Go follow her work.
If you want in on these conversations, the premium community is where they happen. Bonus episodes, monthly gatherings, and direct access to me. https://www.patreon.com/privatepay (https://www.patreon.com/privatepay)
Come sit with us.
7 Oct 2026
S2E44 | I Can't Fight the System While Being in the System | Private Pay, EMDR Intensives & Getting Free | Anna Parker, LICSW
Anna Parker opened her practice last year and was full within two to three months. On insurance.
She is a licensed independent clinical social worker based in Spokane, Washington, and the founder of Changing Tides PNW. She spent eight years in community mental health before going solo. She works with trauma, LGBTQIA folks, and late-diagnosed high-masking autistic and ADHD adults. She is also late-diagnosed AuDHD herself, and that shapes everything about how she practices.
She cannot sustainably see 24 people a week. She is trying to find her way out.
We talked about why the writing is on the wall for insurance practices right now. What happened with CAQH and the data systems that are making practitioners rightfully nervous. What her EMDR and IFS intensives actually look like and why the investment changes how clients show up. Why she keeps signing up for trainings she does not need when she already has three streams of income running. And the niche clarity question she is still working through.
She also said the thing I think a lot of people have been feeling but not saying out loud.
I can't fight the system while being in the system.
If this episode resonated with where you are right now, let's talk. Book a 90-minute strategy session at privatepaypractitioners.com (https://privatepaypractitioners.com).
Anna Parker: changingtidespnw.org (https://changingtidespnw.org)
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