Opening a private practice is a massive step for any mental health practitioner. It enables you to live the lifestyle you want, work with clients to make changes on your terms, and try new therapeutic techniques that interest you. But as the saying goes, with great power comes great responsibility. Knowing how to support and manage clients on a therapeutic level is quite a contrast to building and managing a successful business. One grim figure that always stuck in my mind and scared me off every time I thought about going out on my own was the U.S. Small Business Administrations' research which demonstrated that 50% of new businesses fail before the end of their first five years. Despite this, do not be discouraged- mental health is a significant issue within our society today. As a mental health practitioner, demand for your services is at an ever-increasing high, and therefore, you are merely going to be a part of the growing supply!
Knowing what you're in for 🤓
Going on this journey with an idea of where it will take you and what the destination looks like is an excellent idea. It will mean you won't be shocked at the myriad of new responsibilities you'll be required to have or the amount of time you'll need to spend focusing on the business side of your practice. The best way to do this is to talk to other private practitioners within your area and see what their experience was like; chances are they will be a treasure trove of information for you. Some considerations I wish someone had elucidated to me:
The Paperwork, wow - I have never done more in my life. Be prepared to take a couple of hours each day initially to fill out forms and applications, and then hopefully (with a good practice management software), you'll be able to reduce that down as you become more established. Things like compliance, insurance, billing, invoicing, and progress notes are things that take up most of my administration time.
Personal Motivation - When you start your practice, there are no deadlines to meet or consequences from your team leader for being on your phone for hours on end. Still, the repercussions of not working efficiently or effectively are far worse. Without managing your time and organization correctly, you'll find that your business won't succeed. I have never had any issues in client-facing time, but I find it difficult to muster the motivation to do Paperwork. Make sure you get on top of this and manage it from the outset of your practice.
The Cost - Regardless of the type of business, a start-up requires investment. You'll either need to be working elsewhere and slowly acquiring clients, or you'll need to have initial savings to start up a private practice. Consider costs such as phone bills, office space, internet, advertising, and education.
Every country will have its regulations that businesses are required to meet. If you aren't aware of what yours are, then that's at the top of your list. If you can afford to meet with a business lawyer, do so and have them explain things to you in layman's terms.
Some things to consider in detail are malpractice and professional liability insurance, the scope of your practice concerns, whether or not you need a business license, and if so, how best to incorporate it as a separate entity.
Yes… it would help if you made a business plan
Just open your door and wait for clients to walk in, right???
Unfortunately not! Starting a business is an active process; you want to go even further than that and be PROactive. Treat the business as if you're going to have a full caseload on the first day. Think about your processes, what your short, medium, and long-term goals are for the practice, and how much you need to earn per year to make all this extra effort worth it. Here are some questions I wish I had answered before I started my practice;
- What are my goals for the first year of my practice?
- What are my goals for the first five years of my practice?
- What is my niche/ specialty in terms of client treatment?
- At what number is my caseload full?
- Which practice management software am I going to use?
- How much income does the practice need to make to continue to function?
- What is my marketing plan?
- At what point will I consider hiring a second practitioner?
Answer all of these questions before starting, and you'll be far less likely to get a nasty surprise a few months in.
Your Office Space
While having a beautiful new office space is lovely, the most important thing about your office space is that it needs to make you and your clients feel at ease. Your room needs to be private, and feel safe to ensure you can practice at your best. First and foremost, in terms of being compliant with privacy and confidentiality, you'll need to provide the office is secure and not at risk of enabling others to listen in on your sessions. The next thing to think about is security in terms of client notes and documents; I would recommend using a HIPPA compliant software management platform such as Carepatron instead of worrying about locking paper files behind closed doors. This means good technology- a working computer, phone, and other simple things like lighting and heaters if it gets cool. The final consideration would be furniture and decor that mirrors the environment you want to create within your practice. The most important thing about the space you chose to work from is that it needs to reflect the practice you wish to carry out. It needs to feel safe and secure.
As I mentioned above, talking to other practitioners is a great way to get insight, support, and tips in the field. In addition to your supervision, your peer network can act as a sounding board for any issues you might experience or advice you might need around either the business or clinical side of your role. The best way I could network with other practitioners was to attend seminars, workshops and join groups on LinkedIn and Facebook. I did find it took me a good year or so to build up a network of practitioners I could work with, it did take a lot of effort, but they have been an invaluable source of support and insight throughout my journey, and I don't doubt they will do the same for you!
Marketing was not something I was very familiar with before starting a business and not something I felt comfortable doing in the classical sense. Still, there are plenty of ways you can market your business that doesn't involve being pushy to potential clients. One of the most important would be to make sure, through that miracle network I mentioned above is that other practitioners within the field have your details; GP's are an especially great way to get consistent referrals. Having a professional website where the contact details and specialization are easily accessible is also paramount for clients who wish to make a self-referral. Finally, doing excellent work in your field will ensure you get lots of referrals through word of mouth.
Starting a business in any field isn't easy; take it slow. Do your research, and when in doubt, talk to others in the same shoes as you!