You’re a Business Owner
The two most common reasons for UK CBT Therapists setting up private practice are:
- Escaping the burnout of NHS work
- Wanting more freedoms to work in a client centred way
These were both certainly motivations for me. It’s important though to remember that it isn’t just doing therapy under your own steam, it’s owning and running a business. With that comes lots of decisions, lots of elements to consider, and likely mistakes along the way. It requires determination, patience, desire to learn, willingness to take risks and a head for business to succeed. Most therapists can have a little private practice, but only a small percentage achieve a thriving full-time practice.
The curse of comparison – all is not as it seems
One of the first lessons I learnt was the damage in comparing myself to other therapists. I’ve learnt along the way that unfortunately many small business owners are not transparent when discussing where their business is at, the advantages they had to get it to where it is, or the journey they took to get there.
Like with many other areas of life, it can be smoke and mirrors, this can be for commercial reasons to portray a lifestyle or business success that will entice new clients, but it can be misleading.
Succeeding as a private practice therapist will mean you have lots of mistakes along the way no matter who you are. It will have money mis-spent, and time wasted. If you’re thinking you’re the only one getting it wrong and trying to figure it all out, you’re not but continuing and trying again are the biggest steps to success you can take.
Imposter syndrome
We’ve all come across imposter syndrome with our clients, but when setting up your own private therapy practice, you’ll most likely gain first-hand experience.
That moment when you suddenly feel like you don’t know anything, lacking confidence in your therapy skills, feeling like you shouldn’t charge much, the general feeling of not being good enough.
Of course, we can always learn more, we can always improve, but that doesn’t mean your self-doubt is valid. Just like you do with your clients, learn to look out for unhelpful should rules, toxic assumptions, overcompensating behaviours etc, and try to break the cycle of reinforcing your fears.
Healthy work habits
Owning and running your own business comes with extra freedoms but also extra stresses. The temptation therefore is to take as much work as you can and take as little time off as possible.
But this isn’t sustainable. Don’t just come out of the frying pan and put yourself in the fire. The therapy session itself is the only chargeable bit of our work, but there is a lot of time put into all the other aspects. Make sure you keep track of the hours your working, take your lunch breaks, still have time for work-life balance, and take as much if not more annual leave than you did in employed work. Ensuring a structure is always best, I try to start the year and book at least one long weekend off per month to ensure that I am taking breaks and recharging. This will not only benefit you but also your clients.
Self-funding clients
The ambition of most therapists is to get a full-time caseload of self-funding clients. Understandably too as well – it means getting to set your own fees and choosing which type of clients to work with.
I love my self-funding client work; I get to work on my niche areas that I’m hugely passionate about.
I will always be honest with my supervise and coaching clients though – there’s a lot of hidden costs. Websites, social media, blogging, marketing, branding and more – all these things require either a lot of time to learn them for yourself, or financial investment in professionals that know what they are doing.
There’s also the part where you get it wrong before you get it right. My first website was terrible when I look back now, and it couldn’t be found on google so was a poor investment on both counts.
That isn’t to say don’t pursue self-funding clients, but my advice is simply to be realistic on what to expect.
Sources of referrals
Self-funding therapy clients can come from several sources – direct from your website, from social media, from recommendations, and from 3rd party websites. These websites include monthly fee directory websites such as psychology today or counselling directory and referral websites where they take a percentage of your session such as Harley Therapy or My Therapist Online.
There are other sources of referrals other than self-funding which is sub-contracted work. There are 5 main types of work in this field – NHS subcontracted (IESO and Xyla), Health insurance work direct (AXA, Bupa, WPA, Cigna), Health insurance work subcontract (Efficacy/OneBright, PLE Health, Psychhealth and Nuffield), Employee Assistance Programme which is when large companies fund therapy for their employees (Nuffield, Vita Health, CBT clinics/OneBright) and finally insurance claim work (Bodycare clinics, PLE Health, Curian etc). These are just examples of some of the 3rd party website and subcontracting companies.
At one point I was set up with about 30 of these companies/websites, so there are lots out there. Some that can provide large volumes of work, some which is far more sporadic, some of which pay good rates and quickly, others which are lower payers and slower payers, and the admin requirements vary across the board. But I would recommend trying them all and then seeing which ones work best for you.
Patience is key
Creating a successful and profitable Private Practice Therapy business takes time. There’s a lot to learn. Many mistakes that can be made. You can’t do it all at once, there’s so much to do. It takes years to achieve a thriving private therapy practice. Set yourself achievable goals, pace yourself, and keep being willing to learn.
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