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Getting Started- First Steps

Thinking about starting a private practice? Let’s do a gut check. Way before looking for office space or hiring a web designer, you need to be really clear about two things 1- that you really want to run a private practice, and 2- your vision for the practice you want to build.  

There are many ways to be a therapist, and while there are certainly many benefits to private practice, it is not for everyone, nor is it better than any other way of practicing. It is worth taking some time to sit down and be really honest with yourself about your interests, temperament, assets, and challenges and how these will fit with being self-employed. Consider the following-

  • Are you willing and able to have some unpredictability in your income?  
  • Do you have another source of income or sufficient savings to manage your expenses while you develop your referral base and grow a business reserve to weather downturns? 
  • Do you have sources of support and inspiration to buoy you, help you stay on track and accountable, and challenge you when necessary?  
  • Do you enjoy working on your own? 
  • Do you feel excited when imagining your future practice?   

You don’t have to be a business savvy entrepreneur to get started, but if you are going to be in private practice, you are going to be running a business. Most therapists, including myself, did not have a business background when they opened their practices. After all, that’s not why we went to graduate school. You don’t need to have the business skills to get started, but you do need to have a willingness to learn them over time- and there are plenty of ways to do so. 

Ready for the adventure?   

Now allow yourself a chunk of time to turn off the phone, take a deep breath, pull out a journal, pen and paper, poster board- whatever gets your creative juices flowing- and create, in as much detail as possible, the picture of the practice you’d really want to have.  Think big and have fun with it. Below are just a few categories to include-

Caseload. How many clients would you like to see? How many clients feels like too many?  With whom are you most excited and interested to work?  

Hours. What hours will you work? Do you have limitations on hours due to other obligations at home?  Do you want to work one or two evenings? Half-time? Would you ultimately like a full-time practice? Will you work weekends? 

Structure. Do you want to build an insurance-based practice, try to get on one or two panels, or build a fee-for-service practice?    

Core Values & Must Haves. What do you need to have in your practice to allow you to work from a place of integrity and authenticity?   

Considering these questions may reveal some conflicts. For example, say you love working with adolescents, yet are limited by your own children’s schedules and can’t work in the late afternoons or weekends. If that’s your passion, you may need to negotiate things at home so that you can have after-school office hours, or consider working for a school-based agency or organization and seeing adults in your practice, and it would be best to work some of this out before signing a lease on an office. Having a clear vision of what you are working towards will help you stay focused when making all sorts of other decisions along the way.  

Starting, growing, and maintaining a private practice takes a lot of work.  If you are going to put in the work-it should be not only for the benefit of others, but should nourish and sustain you as well.  And if you are going to be self-employed, be a great boss to yourself and give yourself props for all the hard work you’ve done so far!