How to Start a Private Practice
It’s so possible - let’s talk about how.
To every therapist out there - tell me you didn’t think, upon entering your first semester of graduate school - that this would all be worthwhile because some day, I will have my own private practice. The time going to class, studying, writing endless papers; working your full time job so you could afford school while having to also do your internship for free; and let’s not forget the money spent on your degree - all of that would be worthwhile when you finally get to work for yourself in private practice.
And to every therapist out there - tell me this is not a long road! By the time I got my independent licensure, it had been years in the making, and I felt no where near equipped to be in private practice. So then came the first couple of jobs where I was sure I had no idea what I was doing and certainly being underpaid. Still, I desperately wanted to start my private practice - but, how?
I’ll be honest, I was very lucky to have supervisors and mentors who paved the way and gave me the push I needed to start. Little by little, I started seeing clients in the evenings or on Saturdays and began carving out my own niche - the private practice dream started to become a reality. But it was a GRIND working my full time job and seeing my own clients in my “spare time” though I couldn’t see a way to step into private practice, both feet in, all the way. I know I’m far from alone in that experience.
I don’t claim to have inherent wisdom about taking the private practice leap, but being on the other end of it, I’d like to share some of the things that really helped me, and I hope can help you, too.
As Arnold Schwarzenegger puts it - “Ignore the naysayers.” You are likely to hear folks around you doubt the feasibility of a full time private practice. Ask yourself, if this is the case, are these reliable sources for advice on this particular topic? Most of the time - no. If you want to pursue full time private practice, you need to practice your CBT skills here.
Make a business plan. This doesn’t have to be perfect or polished, but you have to start with a rough outline at the very least. Look at your salary now, calculate what you will need to make per month to meet your financial needs, and be realistic about how many clients you would need on average per week to meet that number. This is not an exact science, but you need to start somewhere.
Define your niche. Decide where you want to focus as far as client population and therapeutic modality. Try to be specific instead of broad - having too many specialties is sometimes a detriment to building a caseload. You can always expand your client base as you grow your practice!
Start marketing your practice by setting up directory profiles and begin to build a modest caseload, if you can manage it, before you transition to full time private practice. You will feel a whole lot more confident if you push past the fear and see that you can indeed get clients!
Identify the business operation needs of your private practice and set up the administrative structure to support them. Considerations here include (but are not limited to) liability insurance, EHR platform, billing and payment processing, Telehealth needs and office space if you will be seeing clients in person.
Seek out professional and peer support. Lean on your existing network of therapists, join online groups and professional associations, enroll in con-ed, seek supervision, etc. Running your own private practice means working for yourself, often by yourself, and that can get lonely - so try not to go it alone!
There are, of course, other considerations and steps I’m sure I’ve missed and in no way is this an official or exhaustive guide to starting a private practice. I started my business, The Clinical Collective, because I wanted to build a platform for private practice therapists that I wish existed for myself. If you are looking to start your private practice or have a private practice and want extra support, reach out anytime! Our mission is to build a community of independent clinicians who support each other in private practice. So join us! Hope this helps you on your journey - you got this!