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Setting up in Private Practice

Getting started in private practice is one of the scariest things I’ve ever done, but it’s also one of the most enjoyable and fulfilling. Since making the decision and taking the leap, I’ve never looked back.

However, I did experience a lot of uncertainty at the beginning. Will I be able to build up a caseload? How will I manage risk? What if I can’t earn enough money? What if referrals stop? What if I feel isolated? The ‘what ifs’ can feel endless, but they do subside over time.

Ultimately, working in private practice has enabled me to help people on my own terms, work creatively, receive high-quality supervision and complete the training I’m passionate about. It’s also allowed me to structure my business hours and holidays in a way that works for my family and lifestyle.

The Business of Running a Business

Having worked in the NHS for several years, I knew how to provide therapy, but I had little experience of running or marketing a business. I soon realised getting a handle on these things had to be a priority.

If you’re going to be successful in private practice, it’s important to focus on developing a resilient caseload. This means having a regular stream of referrals and a good financial buffer. Unfortunately, being a great therapist won’t bring clients to your door until you’ve been established for a while and begin to benefit from word-of-mouth recommendations. Until then, you need to think about making your business visible so people can find you and book appointments. Will you have a website? Will you work with referral agencies? Will you invest in paid advertising or should you focus on social media?

If You Build It, They Will Come

No matter how you decide to market your private practice, getting started requires patience and consistency. Following the launch of my website, it took three months for me to generate my first enquiries and another year for me to reach a consistent referral rate at the level I wanted.

Initially, I also worked with referral agencies and insurance companies. This was useful at the time because they find the referrals for you, but my goal was always to work with self-funding clients as much as possible.

Why? Well, referral agencies can close, reduce their rates or suddenly choose to work with other therapists whenever they want. This means your referral stream is not guaranteed or within your control. It’s a bit like people who build and market their business using a Facebook page. If and when the algorithm changes, they have no say in the visibility of their own business.

In short, you can’t rely on other platforms to stay the same, so it’s vital you build your own.  Developing an effective website with good SEO is essential. Read SEO for Therapists for more advice and a link to my free local SEO guide.

Other Things to Think About

* Where will you work from?

* What hours will you work?

* How much will you charge?

* What are the data protection requirements?

These are just a few of the things you need to consider if you want to build a strong foundation for your business. For those who need a more comprehensive guide, I’ve created The Getting Started Checklist you can down yours here The Ultimate Getting Started in Private Practice Checklist

Getting Started in Private Practice – Useful Links

Download your free checklist covering all the areas to consider when setting up your practice

Business Planning for Private Practice – Websites and Resources for therapist‘s

Referral Sources in Private Practice

Should I Niche My Private Practice?

If you’d like to work with and learn from a fellow therapist who’s been through it all before, take a look at my coaching programmes.

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Sarah Rees

Sarah is a fully accredited Cognitive Behavioural Therapist and mental health writer delivering Modern Mental Health for you and with you in Mind. Sarah is the author of ‘The CBT Journal’ which helps you write for your wellbeing incorporating CBT techniques. For more information and to keep in touch have a look at