This transcript was machine-generated and may contain spelling errors or other inaccuracies.



Ashley Whiteside: Therapy can be expensive, and federal funding cuts and work requirements for Medicaid recipients could make it easier. Even harder for thousands of Philadelphians to pay for mental health care. But patients aren’t the only ones struggling with the cost of care. Mental health care workers are also feeling the weight. Block by Block reporter Lohen Parchment brings us this story about two mental health care workers who are trying to maintain compassion and caregiving.

In spite of new challenges,

Lohen Parchment: and Lucia are two Philly based therapists at different stages in their careers, but both came to the field later in life. Lucia has been working at a nonprofit advocacy organization in New York, but during the COVID-19 pandemic, she began thinking about a career change.

Lucia: So I remember talking to my therapist and being like, I’m thinking about becoming a therapist. Like, I don’t know. And I was really nervous because I thought she was going to be like, oh God, no, you’re too messed up for that. But, you know, a great therapist. And so I was also really supportive of my journey with that. And talking to other people and talking to my friends and family and close supporters, a lot of folks were like, That makes sense for you.

And so I started to see that too. It was a lot to kind of change, make that leap, but I knew that, as burnt out as I was, it did need to involve something that was like a really big value for me and involve working with people.

Lohen Parchment: Therapy is also a second career for Brian. He’s now co-owner of a group therapy practice called. PHL Therapy Collective. But up until 15 years ago, he was working in an industry that he says didn’t seem to have many career prospects.

Brian: So I was working in newspapers for about 10 years, and that was not going to go very far. And I was in an alternative relationship structure at the time. So it wasn’t just any kind of therapy that I was looking for. As far as where I might be interested in working, it was in working with relationships that are either married or unmarried or poly or open or whatever it happens to be.

PHL Therapy Collective has always been centered in the LGBTQ population, which is where I identify and where a lot of the clients come here are. It’s also Something that then attracts that kind of intern identities interested in that work.

Lohen Parchment: Both Brian and Lucia find their new careers rewarding, but there are also challenges. Lucia says one of those challenges is making a living wage when working with clients who may not be able to afford to pay very much for their care.

Lucia: One of the hard parts about therapy is that so much of it is dependent. Financially, on where the client is or where someone seeking services is. One thing I’ve been really struggling with is figuring out exactly how much I earn day to day. So much of what we make as therapists can be so dependent on a lot of different factors: if you have a session scheduled that day, if insurance is going to reimburse you.

If someone’s able to make it to your session, either be physically present or emotionally present in the session. If there are emergencies in your own life or anyone else’s life. So there’s a lot of factors that go into how much you’re going to make in a specific week or day or month.

Lohen Parchment: While therapists can charge anywhere from $50 to $300 per hour for a session, Lucia says it’s important to remember that therapists who are independent contractors or who own their own practices don’t get benefits like healthcare, pay time off, or retirement plans unless they pay for them out of their own pockets. And for therapists like her who are newer to the field and just looking to start their own practice, it can be difficult to make a living wage.

Lucia: This year I’m working on transitioning to going full time in my private practice and building that up. And so it is a low earning, hopefully, year, but I’m hoping to make like just under 50K. Reflective of the having a graduate degree and all the training that we put in, it’s definitely not enough. I think that’s one of the big barriers. I knew going into this profession that I wasn’t going to be making a ton of money.

And what I thought was it was gonna provide a little bit more security than it has.

Lohen Parchment: Another factor is the role that insurance companies play in the cost

Lucia: of care. Insurance companies have so much power in the rates that they set. What that does is a lot of therapists, as you might see, like go into cash pay. Going to private pay, which makes sense because insurance companies having that much power over your livelihood, over how you do therapy and all of that, it impacts so much. And so that puts the onus of paying on the client.

And so it really only means that you can only access therapy if you have the stability and the finances to pay for it. And then that creates an unjust system.

Lohen Parchment: At PHL Therapy Collective. Brian says all of the therapists are independent contractors who are dealing with these same pressures. He says therapists also face other challenges. The world of private practice can be very lonely. I could be in the office here all day and only see other therapists here for about 30 seconds when I go out to get a client and come back because we’re all just going into our rooms and disappearing for.

About an hour. So it can be pretty lonely work. One of the reasons why I’m thinking about doing the collective in the way that I am, so that there is cross-pollination with interns and people who have graduated already, but certainly connections to people that don’t just happen normally like they would at some office places where there’s a lunch hour that everyone’s mostly doing and they can do together.

It can be very lonely. Despite those challenges, Brian says he remains deeply connected to the work.

Brian: I’ve been doing this for about 15 years now. So I really get to work with the cases and the kind of clients that feed me. And so it’s really nice to have the privilege to make some of those choices. But working with people who are new to therapy. Working with people who have not really thought about themselves or their life in different ways, like I’m thinking about them systemically, makes for some really great conversations in the therapy room.

Lohen Parchment: And despite the financial challenges, Lucia also remains compassionate and dedicated to providing care for others.

Lucia: It’s so amazing to be able to give an hour into kind of like. Their day and their lives, and to really be there as a support. And that hour, that day looks completely different depending on what someone’s bringing in, how you’re sharing this space with someone. But there are some moments and times that are just, it makes it all worth it because you’re there to help.

Empower someone to get through the systems and being there while someone can feel seen and heard and supported. Yeah, that keeps you going through a lot.

Lohen Parchment: For Block by Block, I’m Lohan Parchment.

This story was broadcast as part of October 7, 2026 (Block by Block).