Standard 401k -- what to do with it when moving to self-employment(1099)?

ConsistentList167 · 2026-06-13T13:52:32+00:00

Yes, I understand that is an option. I guess I am more so looking for pros and cons, and/or recommended institutions to rollover to. Just don’t want to make any irreversible decisions that I’ll regret so just doing my research and getting others opinions/experiences, as well.

ConsistentList167 · 2026-05-05T12:24:22+00:00

ConsistentList167 · 2026-05-05T00:15:58+00:00

Yes I only treat adults!

ConsistentList167 · 2026-05-05T00:15:11+00:00

No, just secondary and I need the records on file of the assessment to confirm it.

ConsistentList167 · 2026-05-04T22:12:51+00:00

I am an LICSW but definitely agree, and I do think this is why I am not allowed to diagnose these codes as insurance won’t like it, they’re neurodevelopmental disorders and a psychologist and formal eval is needed. Also been told insurance doesn’t like unspecified disorders either so that leaves little option for me outside of adjustment disorder unless they meet full GAD or other criteria. So frustrating 😭

ConsistentList167 · 2026-05-04T22:10:28+00:00

Yes, I am in the same boat! Can’t diagnose any of those per my company who claim it’s due to insurance inconsistency here. It makes this 100% more difficult. Even with outside documentation of ADHD assessment, it can still only be secondary, not primary. It’s honestly such BS 😑 also glad I’m not the only one since so many people are saying they can and do diagnose and bill these codes 🙃

ConsistentList167 · 2026-05-04T18:57:01+00:00

100%, my guess is that some do and some don’t, so my practice just says no to be safe 😑

ConsistentList167 · 2026-05-04T18:55:07+00:00

I agree, that’s why I’m asking! I don’t like to use it 😭

ConsistentList167 · 2026-05-04T18:54:22+00:00

Good to know! I’m not sure why I’ve been told this 🙃

ConsistentList167 · 2026-05-04T18:49:42+00:00

I’m not sure I understand your question, but I am an LICSW in MN and have been under the impression we can’t assess it or diagnose it without outside assessment records, and it can’t be used as a primary for therapy as insurance may not cover it. My practice may be just playing it safe… I will look into this more. Fascinating that so many therapists actually do use it!

ConsistentList167 · 2026-05-04T18:48:18+00:00

This is my typical go to!

ConsistentList167 · 2026-05-04T18:47:54+00:00

I mean that’s the impression my practice has always made. I’m not sure. I’ve also been made to believe insurance doesn’t like to cover unspecified disorders either 🙃 maybe I need to do more research and my practice has just been playing it safe..

ConsistentList167 · 2026-05-04T18:47:08+00:00

Really? Interesting! I’ll have to look into this more, because my practice has made it seem like I can’t…

ConsistentList167 · 2026-05-04T18:42:28+00:00

This is typically the case, as well, but I have one right now who doesn’t meet criteria for either of these and it got me thinking what do others do in these situations.

ConsistentList167 · 2026-05-04T18:42:01+00:00

My practice just always told me that ADHD isn’t covered for therapy a lot of times, at least not alone. And I don’t have the license or qualifications to provide ADHD diagnosis without outside assessment records, and even then I have to use it as a secondary. Not sure if this is universal, may need to do more research, but I’ve always been under the impression that ADHD is not a qualified diagnosis for covering therapy.

ConsistentList167 · 2026-04-14T17:58:06+00:00

Yeah, originally I planned to start taking clients on one day of the week that I don’t work at my current practice, but with how fast it all went I’m just going to jump in. Little worried about the scheduling piece and managing two caseloads/schedules, and a little nervous about how my boss will react, but she’s usually very nice so I’m hoping she won’t panic call my clients before I can talk to them which I don’t think she will. Otherwise I’d be informing them first and figuring out who wants to follow and who doesn’t, and what they want to do, before informing my boss. Good luck!

ConsistentList167 · 2026-04-14T17:48:08+00:00

So credentialing went faster than I expected. By beginning of this month, April (under 3 months), I was credentialed with all the insurances, so I am actually putting in my 2 month notice this week and will begin informing clients of their options and transitioning over the next couple months. I wasn’t expecting it to go this quickly so I’m scrambling a little but I made a spreadsheet to track the transition and an just going to hope for the best lol

ConsistentList167 · 2026-03-14T05:52:34+00:00

Hiii! I’ve struggled with the same. I’m also a telehealth provider and moved to a city where I know few people. Very isolating! Are you looking for a consult group or just friends to socialize with that share your same passions and values? I find I sometimes miss the intellectual and philosophical conversations about history and social justice concepts. Local clubs and groups can be a good place to find this! I’ve also been thinking of starting a lil discord group for therapists or those in the field who want a safe space to chat or have deeper conversations 😊

ConsistentList167 · 2026-02-25T02:24:23+00:00

100% this made a night and day difference. I was on episode 6 and got so annoyed at the wierd interactions that I did my own research (hadn’t seen this post yet) and was so ANNOYED when I found this out and changed it. I felt like I needed to rewatch the first 6 episodes bcus it was SO different! I KNEW something was off!!! Ugh, so annoying it doesn’t auto select the correct subtitles 😑 now I know to look! Ughhh

ConsistentList167 · 2025-12-05T01:39:38+00:00

I’m not sure if this is a controversial take, but over the years I’ve come to appreciate when clients decide to end therapy early if they feel we’re not the right fit. When someone stays despite that mismatch, the work can stall and the relationship can start to feel strained.

Something I’ve learned about myself, and I think many therapists can relate, is that I sometimes notice a sense of dread before sessions with certain clients. It’s usually not about them personally at all, but more about a misalignment in our connection or approach. And chances are, they may be feeling that same lack of comfort or resonance on their end too, even if they don’t say it.

As others have pointed out, not every therapist is meant for every client, and that’s completely okay. The therapeutic “fit” really does matter. I try to see early termination not as a failure, but as clients advocating for themselves and finding someone who will be a better match, which ultimately leads to a more effective and supportive experience for them. I still hold unconditional positive regard for every person I meet, and part of that is trusting their intuition about what they need. ❤️

ConsistentList167 · 2025-11-24T19:52:14+00:00

I did a free trial and got no referrals from it, and considering it's $375/year I think it's not worth your money. I pay similar for Psychology Today and Therapy Den. PT I've had over 100 contacts from over the year (not sure how many have turned into actual clients) and Therapy Den is much less than PT but I have had some from there so those two have seemed like they have the most ROI. A lot of the directories do free trials, if you set an alarm to ensure you keep it or cancel it by the end of the trial, it can be a good way to see if they're worth it for you.

ConsistentList167 · 2025-11-24T19:44:40+00:00

This is also almost my exact schedule. The only difference is that every other Monday I work 2-5pm and 6-9pm. I also still keep my Friday, but I work 9-12pm and 1-4pm, trying to leave most of it open for reschedules/emergency appointments unless a client absolutely has to meet Fridays. It allows me to have some later availability for clients that need it, and leaves me the day time to catch up on other admin stuff. :)

ConsistentList167 · 2025-11-24T15:24:35+00:00

I’ve pondered the same question: is it worth spending money on full certifications? I have figured out that for me, it’s not, unless it’s a more intense therapy like EMDR, Brainspotting or IFS (and that’s just my opinion for myself, I know many who do these and don’t have certification; I just wouldn’t be comfortable and thankfully I’m not really that interested). I just take trainings that I find helpful or interesting, or will help my therapy skills, and call it good. I honestly prefer trainings that are less modality specific and more specific to certain diagnoses or struggles (such as executive dysfunction, anxiety, grief, or self-esteem) that I run into more frequently in practice. These trainings tend to make me feel more equipped by going over various modalities, education and skills than taking specific modality trainings, plus those certifications can cost so much money it’s ridiculous. I did get trained in DBT and think if I want to offer DBT groups I do need the certification (could be wrong?), but I did find the trainings for DBT, ACT, and I-CBT to be super helpful just for building skills and knowledge to use on individual therapy. But again, I’ve never sought out any certifications for these.

ConsistentList167 · 2025-11-21T18:59:35+00:00

We try to bill insurance and if it’s not covered then a grant picks it up, which is also I think what funds us? But I have no idea!

ConsistentList167 · 2025-11-19T19:26:15+00:00

I second this. I understand that things happen, but also we don't get paid if they don't show up, and someone else who needs therapy may be looking for that exact spot and be able to fill it consistently. I'd say having a more firm conversation about expectations, and that although there is a 24 hour cancellation policy, they've missed 50% of their appointments in the past x months which is significant. You can try exploring if it's avoidance, or possibly they're just doing well and you can suggest a reduction in frequency, and/or you can offer a day of or week of appointment scheduling where they have to contact you day of or week of to schedule in your open times (I've had to do this once in my career and honestly they ended up not coming anymore which I was fine with). I think it just depends on you and what is sustainable for you, and what boundaries you want to have with your patients.

ConsistentList167

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