You Don’t Have to Choose Between Making a Difference and Making a Living
Growing up, I learned it was best to focus on the wants and needs of others. This was the way to stay safe, get praise, and feel self-worth. And I developed this into a superpower.
Many years (and lots of therapy) later, I’ve come to view this as a mixed blessing.
Being able to read other people and consider their needs is part of what makes me a great therapist. But I’ve also seen firsthand the hazards of this “others-focused” approach when it excludes tending to my own needs. Too often, it’s a recipe for burnout, resentment, and unhappiness.
Thankfully, I’m learning that small changes can make a big difference in shifting this pattern. For example, checking in with myself more regularly has been very powerful, whether that means taking breaks and drinking more water or making professional decisions that create a practice I can sustain for the long term.
Making these changes isn’t just about boundaries. It’s about releasing the false belief that I had to choose between making a difference and making a living.
The “self-sacrifice” trap
I can trace that belief back to early in my career, when self-sacrifice was baked into the culture. I’d hear colleagues say things like:
“I’ll just stay late. It’s the only time the client can make it. I can do my notes on the weekend.”
“Another pro bono client is fine. They really need me.”
I said versions of these myself. It felt generous and even noble, but over time, I saw what it led to in my colleagues and in me: messy boundaries, self-righteousness, and resentment. (We all know the sting of bending over backwards for a client who then no-shows.)
The hard truth is that this way of working isn’t sustainable. And when it isn’t sustainable, the people we’re trying to help eventually lose a clinician who could have been rested, present, and still in the field.
The belief underneath it
Underneath all of this was that same belief, one I rarely questioned: that you have to choose. You can be a therapist who cares deeply about people, or you can be someone who cares about money. Not both.
I heard it often in community mental health: “Yeah, but we didn’t get into this for the money.”
It sounds harmless, but it quietly teaches us that wanting to be paid fairly is a sign we care less. So we undercharge, say yes to everything, and feel guilty when we think about our own financial needs.
But the choice itself is false. Caring about our clients and caring about our livelihood aren’t in competition. Often, one is what makes the other possible.
What I learned from therapists who do it differently
The clinicians who helped me shift this pattern were ones who embrace making a difference and making a living.
They value their own time. They check in with their preferences and set clear boundaries. They treat their clients with dignity and respect, honoring their resiliency.
They also build financial stability for themselves and their families. Many see a mix of full-fee and pro bono clients. They aren’t afraid or ashamed to make money. They take vacations. They make decisions that create careers they can sustain for the long term.
Watching them changed how I thought about all of it. Financial stability wasn’t the opposite of meaningful work. It was what made meaningful work possible.
What stability makes possible
When you’re financially stable, you have more room to do the things that matter most. For example, you can:
Offer reduced-fee or pro bono work without resentment, because it’s a choice you can afford to make, not a sacrifice you’re making at your own expense
Invest in training so you can expand your offers and your impact
Take time off and come back with real energy for your clients
Stay in the profession for the long haul, instead of burning out and leaving
Seen this way, “making a living” isn’t taking something away from your clients. It’s what lets you show up for them, year after year.
We don’t have to pick one or the other
That belief, that we have to choose, is the one I’d most like us to let go of.
What I’ve learned from these clinicians is that we can care about our clients and also care about our own wants and needs.
Tending to ourselves is the key ingredient that brings energy to our work, reduces burnout, and makes everything more meaningful and fun.
None of this means giving up on service. It means building a practice that lets you serve well for a long time.
What this looks like in my practice
For me, immigration evaluations have been one of the ways I’ve been able to live this out. Clients who need these evaluations come from all walks of life, so many therapists find that a mix of full-fee and pro bono work can create a practice that’s both sustainable and deeply meaningful. And referral relationships with lawyers can bring ongoing, steady work.
It’s not the only path, and it isn’t right for everyone. But if you’re curious whether it might be a fit for your practice, I’d love for you to watch my free introductory webinar. It’s a clear, no-pressure look at what this work involves so you can decide for yourself.
