How I Built a Group Practice From Scratch

In this article I’ll explain the steps I took to grow my group practice from zero clients to three counselors each with full caseloads.
But first, let’s see where I started off, so you know you can do this.

Have you ever moved to a new city and wondered: How will my career survive this?

That’s exactly where I was four years ago.

Imagine driving on a busy interstate in a brand new city and getting honked at because you’re driving too slow.

My experience on the road felt like a metaphor for my career as a practitioner.

We don’t want you here.

You’re too slow.

You don’t fit in.

You’re not enough.

Get out of the way.

You’re not wanted.

My path to private practice

When I moved to Atlanta—a bigger city than I was used to—I found myself feeling lost, uncertain, scared, and overwhelmed.

I had no connections in the therapy world in my new home, and I wasn’t sure how to start making them. I moved to an area where there are plenty of talented therapists.

And, on top of that—from what I could tell—there wasn’t a large demand for a therapist from my minority ethnic background.

I wasn’t sure if people would want a therapist who didn’t fit exactly what their idea of a therapist should look or act like.

This uncertainty came from my own insecurities more than what anyone was telling me or how anyone was treating me. But still, I was scared. 

I had all the imposter syndrome thoughts many of us in this profession have.

I’m not ready to be a successful private practice therapist.

I’m not impressive enough.

I don’t have enough skills to do this.

By now, you’re probably catching the theme of shame running through all these thoughts. I had no proof to support these shame messages, yet there they still were.

And, as a therapist, I knew I needed to take action—despite what shame had to say about it. 

So I took the most important step: the first one.

Despite all the ways I’m not perfect, I grew my group practice from zero clients to three counselors each with full caseloads.

It was hard work, and there was a good amount of trial and error that happened as well as great levels of avoidance. 

How I started my group practice in a new city

I wish there was a perfect formula to this kind of growth that would work for everyone, but, alas, there is not a one-size-fits-all approach.

Along my journey, I’ve learned from other successful entrepreneurs who built their own successful group practices.

Some of the strategies I’ve learned helped, and some of them didn’t.

Consequently, the group practice growth strategy I’ll share here was effective for me, and I hope some if it will help you too.

Here’s are the group practice growth steps that worked for me:

1. I planned my finances carefully  

A lot of people say that it takes a year for a therapist in private practice to get a full caseload.

And, I realized I would have a lot of ground to with my marketing.

Before starting my practice, I realized I would need to rely on some money I had saved for the purpose of marketing my business. Additionally, I took on part-time work while I built my practice to becoming substantial enough to support me on its own. 

2. I pushed hard on marketing

First, I explored tips on how to market a group practice.

I started a website early. Additionally, I created an updated a blog on my website, and I worked hard to get people to actually visit my site. This meant I spent a lot of money in this area during my first year.

While I initially built my first website myself, I ended up hiring a professional to redesign and rebuild my site when I realized it wasn’t converting well.

For me, the investment in a professional website ended up being worth the money—but only after I had started generating consistent traffic to my site. 

3. I worked part-time on the side

I got myself a part-time role as a counselor at a university’s student counseling center.

The environment there was perfect for me, because the university did a great job at hiring a diverse population of people.

This meant I was surrounded by strong, amazing, and talented therapists of all different races, ethnicities, and sexual identities.

The university community helped shatter some of the fears I had surrounding my own racial identity, and how that would impact my experience in private practice.

In the end, however, I wound up hiring my first contractor at my practice before I even left the university job.

That was a personal decision based on my own business goals, one of which was not wanting to be the only counselor in my practice. 

4. I hired a consultant

I’ve always believed in the power of mentorship for practitioners.

Alas, I didn’t personally know anyone who was doing what I wanted to do and who would be a great mentor for me. 

I was new to the city, and I had no idea where to turn.

Then, I learned about a woman in the community who had built a large, reputable group practice and offered consultations for other therapists.

After asking her to be my mentor, I have been able to benefit from her knowledge, and I no longer need to figure out everything on my own. 

5. I invested in learning 

When I graduated with my degree, I didn’t have a ton of money to invest in continuing education and additional training.

At that time, I also didn’t have anyone encouraging me to do so.

After moving to the new city, I realized the caliber of the therapists I was meeting in private practice and at the university counseling center was excellent.

Therefore, I needed to step up my game so I could show up with a similar level of excellency for my own clients.

And so, I trained and developed my skills. I trained a lot.

This took a good  amount of personal discipline. In private practice there’s no one telling you what to do or how to allocate your time.

That said, my clients were my motivation. I saw how they benefited from the improvement in my skills, and I wanted to keep getting better—for me and for them.

Consequently, I signed up for consultations, CEUs, and additional training. 

6. I niched down

In private practice, it can sometimes seem like everyone works with the same specific specialties.

I quickly learned that I needed to clarify my specialties, and the specialities of my contractors. I needed to let people know the kinds of clients I love to work with, and how I can help them.

To do this, I honed in on some of the areas I love to work with, like couple counseling and EMDR therapy, and I started sharing some of that information in my marketing and networking efforts. 

7. I forced myself to network

Networking has never been my favorite thing to do as a therapist—something a lot of people will probably relate to.

And yet, so many people build their practices this way.

In my experience, networking hasn’t built up my practice. That said, it is true that networking helped me to personally build up good faith and a good reputation with my peers and my community.

And now, when a client isn’t a good fit for me, I have a solid network of people that I can trust to refer them to. 

8. I didn’t say yes to every client

I believe in making sure I’m only taking clients who are within scope for me, and appropriate for the level of care my practice provides.

It can be tempting to take every client who calls you when you’re first starting out. However, is not recommended as the best choice.

Clients are best served when they’re working with someone who has all the capabilities, skills, and resources they need—and sometimes, that won’t be you.

And that’s okay. 

9. I streamlined my processes

This can be especially difficult to do, because many clinicians like to be highly involved in every part of their business.

But, in order to grow into a group practice, I had to release some tasks that took up my time.

I had to figure out a way to reduce the amount of phone calls I took, emails I answered, blog posts I wrote, accounting I handled myself. You get the idea.

As soon as I was able to, I started delegating and paying other people to do the things I didn’t have to do myself. 

I know first-hand just how vulnerable it takes to step out into the business world. There are no certainties, and it’s a risk.

Some people don’t find that risk to be manageable for them, and that’s okay. The way I managed that risk was by making decisions aligned with my financial and personal needs.

I used the wisdom of other people and my communities, and worked hard to lean in when anxiety and shame tempted me to avoid or walk away—and you can do it, too. 

How SimplePractice makes it easier to run your group practice

SimplePractice is practice management software that includes everything you need to run your group practice—from booking and scheduling to insurance and client billing.

Your group practice clinicians can streamline all of their client engagement—like scheduling and payments—using the client portal.

Plus, SimplePractice keeps your group therapy practice efficient by offering your clinicians a robust template library of customizable notes and documentation.

And, your clinicians can speed up their documentation process by loading any notes they took from a previous session.

Try SimplePractice free for 30 days. No credit card needed.

READ NEXT: How to Hire Clinicians for Your Group Practice