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Starting a practice

What 3 therapists wish they knew before starting their own practice

To set yourself up for success, why not learn from people who have gone through the process before you?

December 21, 2023

6 min read

Starting your own private practice is a big deal. You’ll have the opportunity to set your own hours, create your therapy caseload, and make a name for yourself in the mental health field. That said: Venturing out on your own also requires some essential steps, and some of them are easy to neglect in the excitement of everything you’re dreaming about.

To set yourself up for success, why not learn from people who have gone through the process before you? Read on for five important truths therapists wish they’d known before they took the leap into private practice.

1. You’ll need boundaries.

As a therapist, you understand the importance of boundaries for well-being. As a private practice therapist, you’ll inevitably use this skill in some new ways — for example, as you set up your workweek and build your caseload.

With the excitement of your newfound freedom and income growth, you may be tempted to say “yes” to any client that comes your way as you build your business. But it’s important to think through on the front end how you want your practice to look and what you can realistically take on, says Bridget Mozina, LMFT, founder of Grow and Thrive Therapy. That may include limiting your caseload or starting slow to preserve your well-being and your ability to properly support your existing clients.

“There are a lot of unhealthy narratives therapists experience when working for a clinic or group practice, where we have the pressure to see 30-40 clients a week, and it was a big shift for me to unlearn that,” says Mozina. “I have a pretty good balance now, but I wish I had explored more of what I wanted my work week to look like and what my ideal caseload would be.”

2. It’s important to have a niche.

Similarly, when you’re creating your own caseload for the first time, you might feel compelled to help as many people as possible (and, let’s be honest, to start making money as soon as possible). One part of achieving balance as you grow your practice — and creating a sustainable business — is carving out a niche for yourself. 

Maybe you’re excited about working with young adults, or maybe you’re passionate about supporting people with depression. Either way, Mozine says figuring out early on what type of clients you’re best suited to treat can ensure you enjoy your work and can offer better support to people you do choose to work with. 

It may seem counterintuitive, but defining your ideal client can also help you grow your business. “You will actually get more clients by maintaining focus on your specialty or niche than you will trying to be the generalist who claims to do everything,” says private practice therapist Sam Marion.

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3. It’ll involve a learning curve.

Before you launch a private practice, you focus primarily on clinical work: building skills, gaining knowledge, and effectively supporting clients. As a private practice therapist, you’ll need to implement an entirely new skillset. “I quickly realized that my masters program and training did not prepare me to do payroll or know how to pay quarterly taxes, not to mention that now I needed marketing expertise too to advertise my business and set myself apart,” says therapist Stephanie Gilbert, founder of Stephanie Gilbert and Associates.

Gilbert recommends finding a mentor who also works in private practice so you can ask for guidance when needed. “The internet is also a great resource on learning basics like marketing and advertising online,” she says.

4. Investing in expert support is worth it.

With a private practice comes a new stream of income — and, with that, new expenses and financial responsibilities. All these extra components can add stress, which can take away valuable time from your client care. On the flipside, focusing too much on the therapeutic side can cause you to miss the mark financially.

To ensure you stay on top of these responsibilities and provide the best possible care to your clients, it can help to consult with professionals early on as you set up your business. For example, Mozina adds she wishes she would have linked up with a financial planner for advice about managing income and budgeting. And Marion says he wishes he’d known earlier how valuable it is to build a relationship with a good accountant. “Those are some of the best dollars I invest in my business on a regular basis,” he says.

5. You’ll need accountability.

Going into private practice, for most therapists, means working for yourself in isolation. You’re your own boss, which means you get to make many of the most important decisions about your practice. But you’ll also lack the accountability you’re used to. 

“Without a time to clock in and clock out or a supervisor checking our work, things can get put on the to do list only to get put off until tomorrow, and then tomorrow, and then tomorrow,” says Gilbert. “This can be even more challenging if you’re working virtually.” 

Before getting your practice started, Gilbert recommends thinking through what will help you be the most productive. Maybe you do well with a to-do list, or maybe you’re more motivated with outside support. If that’s the case, she recommends finding another private practice therapist to help keep you accountable in your work. “Keeping up to date on business tasks is a must, and you’ll thank yourself later if you set yourself up for success early on,” she says.

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This content is for general informational and educational purposes only and does not constitute clinical, legal, financial, or professional advice. All decisions should be made at the discretion of the individual or organization, in consultation with qualified clinical, legal, or other appropriate professionals.

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Starting a practice