Taking Your Private Practice to the Next Level

When I speak with new therapists and counsellors, or practitioners who are new to private practice, I often ask them what their goals are for their private practice.

Typically, I hear something along the lines of, “My goal is to work four to five days per week, seeing five to six clients per day, with a full caseload. I’d love to have two or three days off each week and take two to four weeks of vacation per year.”

Sound familiar?

Then, when I ask therapists and counsellors who have been in private practice for several years about their dreams for private practice, I start to hear something very different.

Many experienced practitioners tell me that they have reached their initial goals, and although they love their work and are proud of their success, they want to figure out how to scale back to two or three days per week. 

They tell me they have realized that their income is capped by seeing one-on-one clients, and after many years in private practice, seeing 20-25+ clients per week is a lot. I frequently hear from experienced practitioners that their next steps include seeing less one-on-one clients while earning more money through other income streams.

But how exactly do you do this?

If your private practice is full, and you’ve been working four to five days per week with a full caseload for some time now, you may very well be in this boat. How do you go from a full caseload of one-on-one clients to diverse income streams that increase your earning potential?

Having a full caseload is a perfect place to start. This probably means that you also have a waitlist or are turning clients away. These are exactly the people you want to start with. 

Consider what you could offer that would meet the needs of your current clients and the people who want to work with you—the clients you’d love to help, but you simply don’t have space or time. I want to offer you a few ideas.

Groups

Groups are a great way to offer a more affordable option and serve more clients at a given time. Typically, groups are structured over a period of many weeks (anywhere from 4-12), and the number of people in the group can also vary from four up to 12 or 15. The number of people in the group will depend on the type of group and number of facilitators. It is common to meet on a particular day of the week for 90 minutes up to three hours.

Groups often include a mixture of psychoeducation, group interaction (debriefing/sharing), processing with the facilitator, and potentially, the other group members. If you are trained to offer group work, you might be ready to lead your first group right away. If not, you should seek out an experienced facilitator and ask to team up with them so you can learn the ropes.

Workshops

Workshops differ from groups in that they are typically offered once—whether it’s a couple of hours, a half or full-day, or a short series with different content each week. Workshops tend not to include the “therapy” component as much as groups and stick more within the realm of psychoeducation, self-reflection, experiential exercises, and group work.

The nice thing about workshops is that you can typically charge a bit more than groups (depending on the content and the clientele). The participants in your workshop aren’t necessarily your clients and don’t have to become clients in your practice, so you can reach a wider number of people, including friends, colleagues, and even family members (if you wish).

Courses

Courses have become increasingly popular in the last decade, particularly for practitioners who work online or have an online following. You can run an in-person course, an online course, or a mixture of the two.

Generally speaking, courses are strictly for psychoeducation and may include self-reflection and experiential exercises. Of course, you will have less one-on-one contact with the participants in an online course, so it is essential to be clear about the nature of the course. Include proper disclaimers to clarify that you are not their therapist and are not providing therapy through the course.

Unlike groups and workshops, courses can be packaged and sold online as a form of “passive income.” That said, I’m not a huge fan of the term “passive income” as it implies that you don’t have to do any more work, which couldn’t be further from the truth. Even if you have a pre-packaged product (like a course), a ton of work still has to go into marketing and keeping the product up-to-date.

Books / E-books

In today’s digital age, anyone can become a published author! If you have something you want to say or information that you’d like to put in a book or e-book, it is not that difficult to have a manuscript edited and published online. I have lots of friends and colleagues who have done this and now sell their books on Amazon, their website, and other online marketplaces.

Clinical Supervision

Becoming a clinical supervisor is another great way to shift away from one-on-one client work. If you have at least five years of experience in the field (depending on your location and the guidelines of the governing body you are registered with) and an interest in supporting other therapists with their clients, consider taking a course in clinical supervision!

As a clinical supervisor, you can take on practicum students if you like. You can also offer one-on-one and group supervision to other therapists. Typically, the rate for this is higher than therapy/counselling, and by offering groups, you can increase your income further while reducing the number of hours you spend working.

Owning/Operating a Clinic

If you are interested in management and administration, you might consider expanding your practice to include other therapists or wellness practitioners. You don’t need to have a certain number of years of experience as a mental health practitioner to have your own clinic (although having experience in the field will certainly help), but you do need management and administrative skills.

You can rent a space with multiple offices and sub-lease them out separately to other entrepreneurs. Just be sure to check the lease agreement prior to signing to make sure that’s permitted!

You can also bring other practitioners under your practice name and take a portion of their earnings in exchange for providing office space and potentially supervision, client referrals, and a receptionist.

As you can see, there are LOTS of ways to move beyond one-on-one client work. If you’re ready, but don’t quite know how, I’d love to help you figure it out!

If you’re not quite at the stage of going beyond one-on-one work and are instead looking to grow your practice by getting more clients, check out our Accelerate Your Practice Program.