The Difference Between Having a Private Practice and Building One
There is a difference between having a private practice and building a private practice.
10/18/20263 min read
The Difference Between Having a Private Practice and Building One
There is a difference between having a private practice and building a private practice.
You can have a website, a therapy room, professional insurance and several clients in your diary.
But that doesn't necessarily mean you are intentionally building a career.
For some therapists, private practice develops almost accidentally. A few clients come through word of mouth. Someone recommends you. Another person finds you through a directory.
Before long, you have a private practice.
But perhaps you haven't stopped to think about what you actually want it to become.
Having clients isn't necessarily the same as having a career
When you're newly qualified, getting your first clients can feel like a huge achievement, and it is.
But there can come a point when the question changes from:
"How do I get some clients?"
to:
"What am I actually building?"
That shift can be an important stage in your professional development.
You may want a consistently full caseload, increase your fees, you may want to specialise, you may want to work fewer hours but earn more sustainably, you may want to develop a strong professional reputation, you may eventually want to supervise other therapists.
Your private practice doesn't have to look like anybody else's, but it helps to know where you're going.
A practice doesn't grow simply because time passes
There can be an assumption that if you are good at what you do, your practice will naturally grow.
Sometimes it does, but often, growth requires intention. You need to consider how potential clients find you.
You need to communicate clearly about who you work with, think about your fees and availability, you need systems for enquiries, payments, cancellations and record keeping, you need to monitor your workload.
You need to keep developing clinically and you need to notice when something isn't working.
None of this takes away from the therapeutic nature of your work - it is what makes private practice a profession as well as a clinical role.
Are you reacting or making decisions?
One useful question to ask yourself is:
Am I making decisions about my private practice, or am I simply reacting to what happens?
If you have an empty week, do you panic and lower your fees?
If you suddenly receive lots of enquiries, do you take everybody on?
If another therapist appears to be doing better, do you immediately change direction?
If your diary becomes too full, do you simply keep squeezing people in?
A growing private practice requires you to become more intentional. That doesn't mean knowing exactly what you're doing all the time.
It means being prepared to stop, reflect and make decisions rather than constantly operating from anxiety.
Growth isn't always about seeing more people
One of the biggest misconceptions about private practice is that growth means more clients.
It doesn't necessarily.
You could have a practice that becomes more sustainable because you:
Work fewer evenings
Increase your fees appropriately
Develop a more manageable caseload
Reduce cancellations
Improve your administration
Become more selective about the work you take on
Develop a particular area of expertise
Create clearer boundaries
Take more time away from work
Sometimes building a better practice actually means doing less, but doing it more intentionally.
What does your ideal practice look like?
It can be surprisingly difficult to answer this question.
If you have spent years working within organisations, you may be used to somebody else deciding your hours, workload, policies and professional structure.
Private practice gives you autonomy, but autonomy also means responsibility.
You get to decide what your career looks like.
That can be liberating, it can also be uncomfortable. You may need to experiment, make mistakes and change direction.
Supervision can help you step back
When you work independently, it is easy to become focused on the next client, the next enquiry or the next problem.
Supervision gives you an opportunity to step back.
Alongside clinical reflection, it can provide space to consider your professional development, your caseload, your boundaries and the sustainability of your practice.
Sometimes the most useful question isn't:
"What should I do?"
It is:
"What am I trying to achieve, and is what I'm doing actually helping me get there?"
That is an important question for any therapist who wants their private practice to become a genuine career rather than simply a collection of appointments.
You can read more about my approach as a Clinical Supervisor here:
