Private Practice: What Does It Take To Be Successful?

Bob Walsh and Norm Dasenbrook

Being a well-trained and ethical counselor is the foundation for being successful in private practice. While competence is essential, you also need to challenge yourself to think outside of your “helper” training. But “just” being a good counselor doesn’t mean you will make it in private practice. You need to challenge your belief system in order to see yourself as a businessperson.

As a counselor in private practice, you must think of yourself as the CEO of your own corporation. Not only do you need to make good clinical decisions, you also need to make good business decisions. Making business decisions inherently involves some risk, and risk taking has a tendency to make us feel uncomfortable. However, if your professional aspirations include private practice, you will need to deal with feeling uncomfortable on occasion. Feeling uncomfortable may come from competing with other mental health professionals, ensuring collection of your fees, justifying to a managed care company why they should pay you, promoting yourself to the public, public speaking, or other ways of demonstrating the confidence you have in your own abilities. On the plus side, being uncomfortable will make you a better businessperson.

As a counselor in private practice, you will need to think of yourself as an entrepreneur. An entrepreneur, as defined by Webster’s Dictionary, is someone who “organizes, manages and assumes the risks of a business or enterprise. Rather than seeing obstacles and threats to starting your practice, look for ways to practice better, smarter and more efficiently, with an eye on the bottom line.

As a counselor in private practice, you will need to think of yourself as a consultant. You are an expert in human behavior and relationships. These skills apply not only to clients and their families in your office, but also to business, industry, organizations and institutions. Anywhere people interact with each other there is a potential need for your services.

As a counselor in private practice, you will need to think of yourself as a marketer. Interactions with others are always good opportunities to promote yourself. You can promote yourself by attending a school staffing on a client, making appointments with potential referral sources, offering to give a speech at a gathering, or advising a managed health care company of your specialties and that you have evening and weekend appointments available. You need to seize every opportunity to promote yourself and your services. If you do not self promote, another counselor will.

As a private practitioner, you will need to think of yourself and your practice in terms of diversification. It is rare these days to make a satisfying living from a traditional office practice only. Generally, it takes multiple “income streams” to have a thriving practice. Some of the income streams to investigate are part-time employment at an agency or school, providing EAP services, teaching at the local community college, writing, lecturing, consulting, supervising, coaching, or sub-leasing your office space. Be cautious of putting of all your eggs in one basket.
Lastly, as a counselor in private practice, you will need to clarify your vision. Is it a limited practice (never say part-time) where you will see a few clients per week in the evenings and on Saturdays while maintaining full-time employment elsewhere? Or do you envision a full-time private practice, seeing over 25 clients per week while maintaining multiple income streams? Or perhaps, the owner of multi-disciplinary outpatient clinic? How are you going to get there if you don’t know where you want to be? Steven Covey once said, “Begin with the end in mind”. Your vision can either help you succeed or limit your potential.

Hopefully, we have challenged you to keep that “helper hat” but add a “business hat” that may feel unfamiliar at first, but that will grow to fit you well over time. Just as your approach to private practice needs to be diverse, so does the way you think of yourself. Rest assured that you can wear all of the hats described above and still be a compassionate counselor; these qualities are not mutually exclusive.


Norm Dasenbrook and Bob Walsh are counselors in private practice, consultants, and authors (www.counseling-privatepractice.com)

3 Comments

  1. David says:

    I must say that despite the final words “Rest assured that you can wear all of the hats described above and still be a compassionate counselor; these qualities are not mutually exclusive.” I find this article to be a little suggestive of the ideal where one is trying to make a killing, not a living. I’m anticipating a reasonable existence on 20 clients a week, with family time and a healthy, relaxed lifestyle. This would see me with an income of around $70 – 80,000. Isn’t that enough? Why does it have to be “over 25 clients per week while maintaining multiple income streams” with “part-time employment at an agency or school, providing EAP services, teaching at the local community college, writing, lecturing, consulting, supervising, coaching, or sub-leasing your office space”? If that’s a counselling lifestyle, I’ll stick with volunteer work and a benefit. Sorry, Maybe I’m being to idealistic but really, this seems to go against the ethic of ‘self care modelling’ for the people we are working for.

  2. I agree with Norm and Dad that you were multiple hats running a private practice. In my neck of the woods, the clinicians in private practice don’t work together due to fierce competition for clients. I tried to unite them as a collaborative group but it seemed to ruffle their feathers. I run my practice of having a few clients a week; teaching if available at a local college and doing some consulting if available. The poor economy in Massachusetts has put a damper on the private practice industry.

  3. I’m a LPC-Intern and I am so glad to read this article. New counselors need to read this ASAP, because it’s important to have a realistic picture of what one should expect as one doing counseling as a business.
    I’m curious if David is already working in counseling or still a student. I, too, have high hopes for a decent salary but from my experience so far (2 years practicum/internship in private practice) I don’t know yet if that will prove realistic. My supervisor and her husband (both counselors) counsel, work with foster children, teach at a private school, and she just came out with a book. I tend to believe that it might be more difficult simply because so many people don’t show up, cancel appointments, or the field has a temporary lull. The income is naturally irregular in private practice.
    However, I do believe strongly in self-care, so for me, I have peace with the possibility of “multiple income streams” because I genuinely enjoy writing and believe there are several other pursuits that would be enriching to my private practice and my personal life: groups, foster children, maybe working as a university counselor…etc.
    I just don’t know yet. There are so many variables to consider, location – like Robbin said – low/high SES, economy, and more.
    Interesting discussion.

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