A 1099 therapist in Washington pays the full 15.3 percent self-employment tax, both halves of Social Security and Medicare, where a W-2 employee pays 7.65 percent and the employer pays the other 7.65. On top of that, a 1099 clinician buys their own malpractice coverage, has no workers' compensation coverage through the practice, cannot draw unemployment from that engagement, and receives no employer contribution toward Washington's Paid Family and Medical Leave premium. A 1099 arrangement has...

Relational hours are direct client contact hours accrued with couples or families rather than individuals. Washington requires at least 500 of the 1,000 direct hours for LMFT licensure to be spent diagnosing and treating couples and families. Most placement sites carry mostly individual caseloads, so students accrue individual hours quickly and relational hours slowly.

Washington requires at least 200 supervision hours for LMFT licensure, and at least 100 of them one on one. At the $100 to $200 hourly rates Washington supervisors publish, those individual hours alone run $10,000 to $20,000. A small number of group practices employ approved supervisors and provide that supervision to their own associates at no cost.