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With demand for counselors surging since the COVID-19 pandemic, the counseling industry is growing, according to the 2024 ACA Counseling Workforce Survey Report. Counselors are experiencing great satisfaction in doing meaningful work. Wages, however, have not kept pace, and student loan debt is overwhelmingly high for many. This causes undue stress and, in some cases, is driving already busy counselors to take on second jobs. What can counselors facing these challenges do?

Student Loan Debt

ACA commissioned the workforce survey to gain a better understanding of the current needs of counselors. The results showed that more than half of survey respondents have student loan debt, with the total average debt of $79,434 exceeding the average annual salary of $70,956. This can saddle counselors with a financial burden for years to come, but there are steps counseling training programs and employers can take to help offset these costs.

ACA President Christine Suniti Bhat, PhD, LPC, LSC, professor of counselor education in the Patton College of Education at Ohio University in Athens, Ohio, says it is possible for training programs to obtain government grants to support students during practicum and internship. Grants allow students to take on less debt during these typically unpaid work experiences.

“Counseling students need to at least sustain themselves because if you’re doing 20 hours of internship a week or more on top of coursework, that doesn’t leave much time for another job,” Bhat says. “Paid internships in our field should be the norm rather than the exception.” 

Nadia Joseph, LPC-S, accumulated more than $90,000 in student loan debt while obtaining her education. The owner of a private practice, New Orleans-based Beyond Your Brick Wall LLC, Joseph has worked multiple jobs throughout her career to help pay down that debt. “I am continuing to pay with hopes of at least some repayment forgiveness based on populations I have serviced,” she says.

Joseph currently works as a utilization manager at an insurance company, where she reviews various behavioral health levels of care authorization requests to determine medical necessity. She has decided, however, to transition back to private practice due to the lack of resources within her community to address mental health needs.

“Services that could possibly prevent hospitalization or provide proper after-care are limited,” she says, “resulting in individuals either becoming rapid readmits or suffering in silence while going untreated.” Private practice, she adds, also allows for more self-care and work-life balance, which she says is extremely important to her.

A couple of solutions to address student loan debt, Joseph believes, would be better student loan repayment options or forgiveness programs that identify counseling professionals as health care providers, like nurses and first responders.

“Comparative wages across occupations within the profession would also be beneficial,” Joseph says. Loan repayment programs are available through the National Health Service Corps (NHSC) for licensed professional counselors. Bhat notes that in her area, graduates who work at approved NHSC sites have benefited from loan repayment programs. But she acknowledges that it would be good to have more such programs.

Building on her previous role as a veterinary technician, Catherine Eaton, LCPC, executive director of the Maryland Counseling Association, worked as a professional pet sitter during graduate school. She continues this gig work today. The pet-sitting job, she says, helped her pay her quarterly taxes before the pandemic and allows her a lot of freedom. However, she believes second jobs generally lead to burnout.

While there are different ways of making more money as a counselor, Eaton is still figuring out how to leverage her experience in counseling to do so. In addition to her association role, she maintains a small private practice, Upcounty Pastoral Counseling Services, in Gaithersburg, Maryland, which qualifies her for student loan forgiveness through the Public Service Loan Forgiveness program.

She remembers in 2011 working in Baltimore as a community-based clinician shortly after getting her counseling degree. While she was excited to have a job in her field, the pay meant she continued to qualify for Medicaid, just like her clients, and drove an older beat-up car with a bumper held together with duct tape.

“My clients initially assumed I was wealthy because I was white and a counselor and owned a car, but when I pulled out my red and white Medicaid card, we started connecting over economic things like what was on sale at CVS for school supplies and the fact that Walmart had a price match,” she says. “It gave us more common ground.” 

Insurance Reimbursement

When Eaton opened her private practice, Medicaid was the only insurance that would credential her right away to see clients, whereas the other insurance companies took 90 days. “I thought to myself, ‘What am I supposed to eat for 90 days?'"

Eventually, she was credentialed by major insurance companies and expected she would get annual increases without asking. But that wasn’t the case. “I didn’t know you could petition insurance panels and ask for an increase,” she says. “But in speaking with some of my colleagues, I found out they had better reimbursement rates than I did.”

According to the 2024 ACA Counseling Workforce Survey Report, the majority of counselor revenue comes from private and government insurance. Since the pandemic, however, there has been a high level of interest in telehealth and private practice, according to the workforce survey, and billing both government and private insurance companies can be a challenge for those taking this route. One anonymous workforce survey respondent said, “I have absolutely no training in how insurance works, and I feel like the choices are either completely fumbling in private practice or losing up to 40% of my income to credentialing/billing services.” 

Last November, Eaton decided to stop accepting insurance altogether, despite worrying that this would make her less accessible to those in need, which was not her intention. What she discovered, however, was that her full-paying clients supported her sliding scale and pro bono clients. “It’s a nice balance,” she says, adding that her pet-sitting business was a test run on how to run a business. 

It would be helpful, she says, if business classes had been offered as part of her master’s degree. She suggests counselors going into private practice seek out resources on running a business, such as grant opportunities through the Small Business Administration, and meet with a financial planner.

Higher-Paying Jobs

There are a variety of counseling jobs that come with higher salaries that counselors and counseling students may not be aware of. (See “Path to Discovery,” Counseling Today, May 2024.)

For example, working for government agencies in a variety of settings can bring home larger paychecks. “I have a colleague who has been working as a government contract worker on military bases abroad,” Joseph says. “The opportunities present great financial benefits and also the chance to travel.”

Bhat says as counselors are in the field longer, they can also usually earn higher salaries by taking on leadership roles with additional administrative or supervision duties in agencies or clinics. “Counselors can also think about ways in which they can leverage their knowledge and experience to work in other fields, even part time, using the skills and knowledge that they have learned as counselors,” Bhat says.

Lisa Henderson, LPC-MHSP, has done just that. She spends most of her workday as chief brand officer of Synchronous Health in Nashville, Tennessee, a company she co-founded that partners with health systems to provide behavioral health to primary care and other specialty practices in hospitals. They have 150 employees; 120 of them are clinicians. Henderson still sees some clients, supports the team with supervision and consultation, spends time supporting initiatives of professional associations, and presents at conferences in the broader health care industry.

As more counselors go into private practice, many counselors believe counseling programs should offer courses in building and managing a small business. Keith Dempsey, PhD, LPC, owner of Keith Dempsey Counseling & Consulting, says it’s “absolutely ridiculous” to train counselors to be on their own without talking about the business aspect of running a private practice.

“The skill set that folks are learning as counselors is transferable to so many other types of business and can be used in so many places,” he says. “But we need to support counseling students in understanding how to apply this.”

ACA offers tools and resources related to private practice and will host a virtual conference on the business of running a private practice in 2025.

Mindset Shift

Dempsey started his career working at a nonprofit, then earned his PhD. For 15 years, he taught counseling as a professor at George Fox University in Newberg, Oregon, moving up through the ranks to associate dean of the School of Counseling. He also maintained a small private practice — something that was expected of all professors.

As his practice grew, Dempsey decided to leave teaching in 2020 and concentrate on his business. As a Black man, he says he realized that the further he climbed the ranks in the university, the further he would be getting from his community, which especially needs Black male counselors. “I made the decision to retire from academia and go with my community,” he says. “And I haven’t looked back.” 

Dempsey, who says he is earning more now than he did when working in academia, is glad ACA decided to take a look at the workforce issues counselors face. “It’s almost impossible for underrepresented people to find counselors who look like them,” he says, “and more people need to know that it’s possible to make a good living as a counselor if you shift your mindset.”

Although he resisted having a social media presence or a website for some time, when a friend convinced Dempsey to invest some time and money in marketing, things took off. He started getting calls to conduct workshops for large corporations and give keynote speeches on a wide range of topics, from psychological safety and communication in the workplace to multicultural counseling and diversity, equity and inclusion. His consulting work supports his counseling practice.

“It’s so hard to get people out of the mindset that they can only do one thing,” he says. “It’s a big risk. But our skill set as counselors is so strong, and it really is possible to use it to make a very good living.”

DISCLAIMER

Opinions expressed and statements made in this magazine by the article authors or those quoted within articles do not necessarily represent the opinions of the editors or policies of the American Counseling Association.