5 Tips for the Reluctant Private Practice Owner

When I was in graduate school, well-intentioned friends and family began asking me if my long-term goal was to start my own counseling private practice. My answer was always a firm “no,” but the question continued to follow me. It began to feel similar to the inappropriate question that many young couples hear, like “When are you going to have a baby?” It felt full of assumptions, expectations and maybe a bit of ignorance. 

I never considered starting—let alone running—a private practice because it involved so much that I didn’t understand and wasn’t interested in learning. To start, anything to do with numbers had essentially been my worst enemy since I learned to count. The idea of handling client payments and determining things like my estimated quarterly taxes was enough to shut down any considerations of private practice. 

On top of that, I couldn’t even comprehend my own health insurance benefits—so how could I ever manage billing insurance claims for an entire caseload of clients? Just thinking about dealing with issues like billing and insurance was overwhelming—and that’s not even considering trying to market myself. The most terrifying question was, with all these factors that I wasn’t knowledgeable in, what if I failed?

Confronting My Fears

I spent seven years getting degrees and three years in the licensure process to become a licensed professional counselor because therapy is my passion. I didn’t go to school for medical billing, business management, accounting, or marketing, and I certainly didn’t learn anything about these topics in any of my programs. My education was in counseling, my license is for counseling, and my job is a counselor, so it made sense to me that my sole focus should be on my clinical role.

However, after finding myself in a toxic workplace, I started reevaluating my options. This was a painful, anxious time where I felt trapped and desperate for a lifeline. This apparently was the motivation I needed to confront my fears. The idea of being able to make my own decisions, develop my career on my own terms, and have transparency around my finances started to become more powerful than the fear I felt. Eventually, I came to the realization that private practice could provide me with what I needed: healing, freedom, flexibility, and growth. It was time to (reluctantly, I’ll admit) start my private practice. 

Fast forward about a year, and lightyears past my comfort zone, and I had a thriving full time private practice as a solo practitioner. I was managing it all—the marketing, networking, scheduling, verifying insurance benefits, billing, balancing the books, and, of course, providing therapy to clients. (These days, thankfully, I get a little bit of administrative support.) There were and still are significant challenges, but the effort it has taken to start and maintain my practice has been one of the most rewarding experiences of my life.

Learning to Love Private Practice

Most surprising and perhaps most fulfilling is that, as it turns out, the business side of running a practice that I was so afraid of ended up being something that I excel in. Creating my business and learning how to handle the administrative and organizational parts has strengthened my confidence in myself and empowered me to take more control in my life, which, in turn, allows me to be a better therapist. I’ve even developed a passion for providing private practice consultations and helping other providers overcome their fears and anxieties about starting their own private practice.

If there’s one thing I’ve learned from providing private practice consultations, it’s that feeling anxious and reluctant about starting this journey was certainly not a unique feeling. While some providers have had a long dream of building a practice and may feel confident about jumping in, others find themselves hesitantly dipping a toe into the water of private practice. If you find yourself in a similar position of reluctantly starting a private practice, rest assured that these are normal and valid feelings. Here are some tips to help guide you through the process of getting started. 

5 Tips for Reluctant Private Practice Owners

1. Ask all the questions
When you’re new to private practice, there is a major learning curve. Some questions may seem “stupid” or silly at first—but ask them all anyway. Reach out to seasoned private practice clinicians, join networking groups, search for private practice Facebook groups, attend training sessions, and meet with other professionals such as consultants and accountants. You don’t have to figure it out alone, and you don’t have to reinvent the wheel. (Shout out to every therapist who has answered questions for me!)

2. Stay organized 
After asking all those questions, keep track of the answers! Write down everything. Keep dedicated files (paper or digital, or both) with everything you learn and new questions that develop. Make lists of what has to get done and set reminders for when things need to be renewed, such as licenses, memberships, and insurance policies. 

3. Remind yourself of your reasons
You’ll likely face doubts and challenges when starting your private practice, especially if you’re reluctant. When this happens, remind yourself of your reasons for choosing private practice. It might be to leave a toxic job, to have more flexibility or control, to prioritize your self-care or your family, or to change your financial situation. 

Whatever your reasons are, focus on them when things get tough. Meditate on them. Put them on a vision board. Stick them on your refrigerator. Save them as your phone wallpaper. Put them wherever they’ll be most visible to you throughout the day, so when you’re having a hard time, you can easily remind yourself why you started this process in the first place, and why it’s worth persevering. 

4. Be patient with the process
A successful private practice doesn’t happen overnight. Give yourself time to learn and grow. Allow compassionate space for mistakes, because they will happen along the way. (For example, accidentally and unknowingly operating without the appropriate business license for more than a year—oops!) If possible, consider easing into private practice slowly before going full time.  

5. Identify your fears and have a plan for addressing them
What makes you reluctant to start a private practice? What’s holding you back? Figure out your fears and how you can best prepare for them. Find webinars, experts, mentors, and a community of your peers to help build your confidence in addressing them.

As therapists, we understand the benefits of facing our fears—but that doesn’t always make it any easier to actually do it. Today, I feel profound gratitude towards myself for choosing to take the risk and face my fears, and I celebrate that I approached it reluctantly as my reluctance served to better prepare me. For those who are also reluctantly choosing this path, I encourage you to give yourself a chance, and you too might surprise yourself.