THINGS I’VE LEARNED AS A PRIVATE PRACTICE THERAPIST

I moved into private practice during the pandemic after working for years in large behavioral health agencies in New York, California, and Texas. I started small—just me and my computer equipment in a converted guest room in our house in Southern California. The premise was it was going to be something I kind of dipped my toes into to see how it felt since I hadn’t been in a direct care role for quite some time. It didn’t take long for me to realize that this was exactly what I wanted to be doing and that everything before this was just preparation for the “main event.”

Like most therapists, I love the people aspect of the work, creating a safe space for people and cultivating relationships. But the administrative part can be very overwhelming. Starting out as a solo practitioner, I had to figure out how to set up and run a business while simultaneously building a caseload. This is not a task for the fainthearted, especially when you’re in the middle of a global mental health crisis and you’re being inundated with people who need and want help.

As I continued this journey, learning and growing, making mistakes and celebrating wins, I eventually found my way back to Texas where I am enjoying building a new practice once again—this time one that is in person. Once more it is a wild ride: learning new rules and regulations, making connections, figuring out how to help as many people as possible without harming myself in the process.

I thought it might be helpful to share some of the things I’ve learned as a private practice therapist. It’s interesting how the things I come up with that can help me feel my best are the exact same things I’m talking about and recommending to clients all day long everyday:

Just say no.
It is 100% okay to say no and, in fact, sometimes it is absolutely necessary to say no. I have a hard time turning someone down who is looking for help. I’ve had to learn the hard way through exhaustion and overwhelm that it is healthier for both me and the client, when I don’t have the bandwidth to add someone else to my caseload, to refer them to someone who does.
One size doesn’t fit all.
Not every client is going to be a good fit for me and I’m not going to be a good fit for every client. It’s better to recognize that up front and, again, provide referrals, rather than trying to make a not great collaboration work.
Practice what I preach.
When I remind people it’s good to set boundaries and that taking care of yourself is not selfish, I have to check myself to make sure that I’m doing the same. Otherwise, I become a plumber with a leaky faucet at home.
Self-care is not optional.
Checking in with myself and identifying what I need throughout the course of each day and finding ways to take care of those needs is essential. Otherwise, I get tired and cranky and am not grounded enough to be present for people in the way I want to.
Connection is vital.
Spending everyday active listening, taking in others’ struggles and traumas, and then completing the never-ending administrative tasks can feel very isolating. Finding ways to connect with others in our field helps normalize my feelings and experiences and makes me feel less alone in this deep, and often difficult work.
Laughter is a necessary daily medicine.
You will never catch me watching a serious movie on the weekends. I want light and fun. The more ridiculous the better. Getting together with friends and family for me is about tapping into joy and humor and finding the positive in whatever we are experiencing.

That’s a few of the things I’ve come to learn and realize in my journey into private practice over the past few years. I’d love to hear what you’ve learned about during your own therapeutic journey as either a client or a fellow therapist. Sharing experience, strength, and hope makes us all healthier.

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