Ok. First I want to say this post isn’t about my usual tips for therapists building their practices.

If you’ve been following our work at Higher Practice you know how much we talk about how a private practice is a business and therapists don’t typically receive business training.

You may have seen our materials showing you how to use Facebook & Linkedin to drive traffic to your website. Or how to create websites that will convert prospective clients into new client calls ten-fold.

We often focus on showing you ways to pinpoint your best local referral sources to gain access to immediate clients in your region. And how to create multiple services to meet your highest financial goals.

That list goes on and on.

This stuff isn’t rocket science. But it’s completely necessary in order to have an effective foundation to succeed in private practice.

However, in this article I’m not going to tell you about more tips and tools to grow your practice.

Today, I want to talk to you about what no one else is telling you about when building a practice.

I want to reveal to you the painful secrets that I and so many other therapists faced, but never discussed due to fear of judgement, shame and embarrassment.

I’m going to list it out plain and simple.

This list is not meant to deter you in anyway from pursuing your dreams as a therapist.

In fact, this list is an acknowledgment that I’ve been there, suffered from it and somehow came out the other side.

And you can as well. And to keep it real I will simply spell out what I went through in my own life and career.

So, here it goes:

  • I was terrified of leaving an office job.
  • I truly didn’t think I could make it financially on my own.
  • I never imagined I could make more than 45k a year.
  • I wanted my clients to like me, at times, more than I wanted to help them unconditionally.
  • I suffered from debilitating insomnia partly from the stress of building my practice.
  • I underwent a massive spiritual emergency for years, barely making it through client sessions.
  • I felt like a fool after a series of poorly executed networking sessions with psychiatrists.
  • Early on, I returned to an office job as a result of not “making it” in private practice.
  • When I felt desperate for money, I blew at least half of my initial consults with clients.
  • I had an adolescent relationship to money.
  • I rejected money, but craved it at the same time.
  • I left my bookkeeping to the end of the year, which created a mess.
  • I often felt small, scared, young, immature and behind-my-peers.
  • I only marketed myself in short bursts, leaving my practice nearly empty at times.
  • I thought there was something wrong with me over and over.
  • I felt like a failure.
  • I wanted to impress my parents and didn’t feel like I was doing it.

I could go on and on.

I’m sure you can relate to some of these things. And you likely have your own list of patterns, behaviors, emotions and secrets that you’re working with in the process of growing a practice.

I want you know that none of this shit determined my ability to achieve my goals in private practice.

Sure, in the very beginning, these painful beliefs and struggles impacted my ability to thrive in private practice.

But after revealing these things to my friends and family and doing some inner work I was able to rise above them and completely thrive.

Let’s start a culture of sharing our vulnerabilities as therapists. Please leave in the comment section some of the things you’re going through. The more we normalize our insecurities, the easier it will be to overcome them.

I know you can achieve your dreams! Never let those voices inside your head get in the way of your heart. The world needs you right now.

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Keith Kurlander

Keith Kurlander is the founder of Higher Practice, a company dedicated to helping therapists achieve their highest potential in private practice. He has two decades of combined experience in business administration, group facilitation, teaching at the undergraduate and graduate level, yoga instruction and as a licensed professional counselor in private practice.

16 thoughts on “What No One Told You About Building Your Private Practice

  1. I am stuck in the ” what will happen with no golden handcuffs” syndrome. I can completely relate to the terror of leAving a full time job at a prestigious institution for private practice.
    I think it’s also related to feeling fearful of being but a small insignificant part of the world of work.

  2. Thanks so much for sharing so vulnerably Keith. This type of honesty and vulnerability is so important for us all not to feel so alone. I left an agency job four months ago without having done any preparation for private practice at all – I was just too exhausted to, but knew I needed to leave the agency. I can relate to much of what you shared above. I go from feeling jazzed and confident to fearful and insecure. This time, I want the private practice to work for the long term and I find the business aspects extremely challenging. I am hearing that public speaking is necessary to make it and this is not a fit at all for me and I run the other way.

  3. Thanks so much for sharing. Public speaking is definitely not necessary. You just need to develop a marketing plan that’s right for your personality style and strengths. Feel free to reach out if you would like some more ideas.

  4. Thank you for posting on this topic! I’ve been following your blog for a while now as I start to finally get serious about my private practice (after 3 years of being in and out of it) and this post very much resonated with me. Balancing vulnerability vs trying to prove to myself I can be successful is a constant struggle. I suck at the business side of my practice and some of the vulnerabilities you shared really hit home for me. Thanks for being open and honest about what it took (and takes) for you to run a successful business!

  5. Thanks so much. This is sooo “bang on” to reflect most of my concerns as I leave a structured job to get into private practise. Although I am renowned in my area, I still have concerns about building a client base and being able to manage them without any support from a colleague.
    Thanks also for ypur encouraging words about following your heart by ignoring the voices in your head 🙂
    Keep sharing such inspiring words.

  6. Thank you for sharing. I cycle through waves of anxiety and depression as a result of obsessing over my business. I started taking Xanax at 51 years after starting a private practice. Navigating all the business aspects in addition to balancing self care and boundaries in this field has proven to be challenging. Knowing I’m not alone is encouraging. Thank you.

  7. Hi Keith
    I’m a GP in private practice. I used to work abroad for a big hospital, then for a charity organisation. It was not financially viable and I thus had to turn to probate practice. I diversified, doing psychotherapy and trauma counselling, complementary medicine and aesthetics.
    I’m constantly plagued by feelings of failure and inferiority, especially when comparing to colleagues in nearby practices. It is a death trap. I’m so familiar with your experience and wonder how I can extricate myself. I’m not even doing that badly financially but the fear (of failure and insecurity) takes over. Dreadful. …
    I need to get a grip on it and trust life. That’s when I’m more at ease. Submitting to a higher force.

  8. Reading this blog and other therapist’s comments was an AWESOME breath of fresh air for me!!!
    It seems like such a “given” concept that we should, as mental health professionals, practice what we preach to our clients regarding self-care…. an awareness of & vulnerability to each of these VERY human internal struggles.
    A powerful counseling reminder to employ for ourselves the same level of “normalizing” that we provide our clients. ?

  9. I just closed my private practice office after 4 years of work as I made all the mistakes you mentioned. I am devastated and want to get back on track in another town. My husband works 2 hours away and it seems like that is a better location for us. I have to figure out how to fix my mistakes. I went from making a profit to losing money because I wanted to save the world.

  10. I definitely still struggle with wanting my clients to Like me and wanting to make sure they are getting their moneys worth. I don’t struggle so much with money anymore since 90 percent of my clients are insurance and they only have small co-pays.

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