How to Decide if Private Practice is For You

Joe Sanok is a private practice consultant and also a speaker and podcaster. Joe has the most downloaded podcast for counselors since 2012, The Practice of the Practice Podcast.

With interviews with thought leaders in therapy, counseling, entrepreneurship, and digital marketing, Joe is a rising star in the speaking world. Joe is also a writer for PsychCentral, has been featured on the Huffington Post, Forbes, GOOD Magazine, Reader's Digest, Bustle, and Yahoo News. He is a keynote speaker, author of five books, and is a top-consultant.

When I was in grad school, I never thought I’d be in full time private practice. It seemed so risky. What if clients don’t show up? What if I have a down month? I’m not good at business, can I go into private practice?

In 2006, I started at a group practice. I was a 1099 contractor and received 65% of whatever I brought in. It was a side gig that helped me pay off student loans. My wife and I moved to our hometown in 2009. I started my own practice as a side gig while I was a foster care supervisor. Again the intent was to bring in a little extra money. I would see 5-7 clients per week before work, over lunch hours, or after hours. Over time, I started adding additional clinicians, while still keeping my full-time job.

I wish that I had someone walk me through considering private practice while I was in grad school. There are three big things to consider before going into private practice:

  1. How much control do you want over your income?
  2. How much of a sense of community do you want from work?
  3. Do you enjoy on-going learning?

So let’s examine the typical agency or government counseling job.

Control over your income in private practice

Here’s what often happens in agency, government, and university settings for counselors. Depending on the average wages, you may start between $30,000-$80,000/year. Each year as a counselor, you get raises (if you’re lucky). In fact, many counselors don’t get raises every year. These raises are often 1-5% and are based on grants, donations, government funding, and a variety of other factors.

In addition, you often receive benefits such as health insurance, retirement, and long/short term disability. However, often the rising cost of health care, retirement contribution, and inflation makes it that each year you actually make less than the previous year. So if you want a raise in these settings, you need to move up the leadership ladder.

In private practice, there are very few guarantees. One approach that many private practice counselors are taking is to opt-out of taking insurance. This is known as being “private pay,” where clients pay for services out of pocket or “out of network.” You can set your rates if you are private pay, work with insurances that you prefer, and create additional streams of income.

In considering private practice, it is usually wise to look at the following:

  1. Your own personal finances and budget.
  2. What populations you want to serve.
  3. Are there therapists working with that population?
  4. What business skills do you have?

We’ll talk about the on-going learning that is needed to be successful in private practice, but first, something to consider is how much you want to work with others.

Private Practice can be lonely

When I worked in agencies, community mental health, and for a community college, I felt that I was in meetings more than I was doing therapy. This was frustrating at times, but I miss the social aspect of working in a larger setting.

In those settings, productivity, optimization of time, and increasing the bottom line profit is rarely part of the conversation. Whereas, private practice success often relies on thinking about these topics. In an agency, you don’t have to worry as much about wasted time and the impact on the budget. For example, in a private practice, if someone is late for a meeting, a counselor will usually find something productive to work on. However a benefit of an agency is that when someone is late for a meeting, you may chit chat. This can build rapport with co-workers. In a solo practice and even a group practice, most of your time will be with clients. Some practices have monthly team meetings, but for the most part, private practice can be very isolating.

Do you like learning?

Before going into private practice, you should evaluate how much you like learning. There are the straight forward parts of having a practice such as:

  • Setting up accounting and banking
  • Filing PLLC or LLC paperwork
  • Starting a website
  • Getting business cards
  • Letting people know you exist
  • Finding a location
  • Setting counseling rates

However, there are always new ways to market your practice to stay relevant. Here are a few that I recommend right now:

  • Learn how to do Facebook Live
  • Start blogging
  • Listen to podcasts
  • Discover how to rank higher in Google (SEO: Search Engine Optimization)
  • Examine social media and learn how to help drive traffic
  • Build networking skills

There are a ton of resources out there to help you with launching a practice, including my podcast and website, Practice of the Practice, but first make sure you consider: how much control do you want over your income, how much community do you want from work, do you enjoy on-going learning?

Last updated: April 2020