An experienced therapist shares lessons learned and busts myths about starting a new social work private practice.
When Allison Puryear, LCSW, opened her first full-time social work private practice, she was riddled with fear. She was afraid she would fail. She feared not having money for rent. She feared she wouldn’t be as good as other established practice owners. She even had an unfounded fear that she wouldn’t know how to do therapy as if she could lose her skills in a different setting.
At the time, she and her husband had just moved across the country so that he could attend graduate school full-time. Puryear decided to “go whole hog” into full-time practice in a saturated market for therapists.
Despite her fears, Puryear managed to fill her client roster for her social work private practice in a few months. She did that two more times in other cities. What Puryear found is that there’s a formula to successfully opening a practice.
“If you use marketing best practices, you’ll get full. Period.”
Puryear continues to practice as a clinical social worker, supporting clients with eating disorders. As the founder of Abundance Practice Building, she also teaches thousands of therapists how to open a successful private practice.
In honor of National Social Work Month, Puryear shares advice on how to open a successful social work practice – or any therapy practice, for that matter.
What do you need to start a private practice?
There are three things every social worker needs before opening a therapy practice. The first, according to Puryear, is a safety net. This might mean starting the practice on the side of agency work and saving that additional income. “Don’t get used to that increase in pay. Create a cushion so you can leave when it’s time.”
Puryear recommends crunching numbers to determine the income that replaces your agency salary. She typically finds that most therapists need between 11-13 clients per week in private practice to make the same income as agency social workers seeing 30+ clients.
A specific therapy niche is essential to fill up a practice, especially if you only want to accept private pay. “It also helps to prevent burnout and build a sense of well-being and competence.”
Malpractice insurance is one item you’ll want to check off your list before opening a new practice. CM&F Group offers clinical social worker malpractice insurance, which provides liability protection against claims associated with mistakes or negligence (whether true or false) that result in bodily injury, medical expenses or even claims of mental anguish or pain and suffering. Malpractice insurance for clinical social workers is essential as it allows you to work without fear of litigation.
Common mistakes therapists make in the early stages of a social work practice
There were few resources when Puryear launched her first private practice over a decade ago. Today, she and others teach how to build a successful practice in paid courses, free podcasts, videos, blogs and social media posts. Puryear hopes educational content helps more social workers avoid common mistakes.
Starting without a marketing plan
Many therapists open a new practice only to find that nobody comes. Even the idea of marketing can seem antithetical to new private practice owners. “They feel like they shouldn’t have to market because marketing is not very therapeutic in their minds,” says Puryear.
Much of Puryear’s work is to help therapists reframe that idea to understand that marketing is a service. “It helps people find you. It helps people learn about how you help – in a less profound way than therapy but in a deeper way than Google. It also helps clients decide whether or not you’re a good fit for them.”
Marketing content is a significant indicator of whether the therapy is going to be effective or not.
Waiting until everything is perfect
Puryear sees many new private practice owners unintentionally place hurdles before every next step. “They’ll say they don’t want to make the website live until they get headshots and can’t get headshots until they have an email address. You never get started that way.”
Instead, Puryear recommends starting by simply networking with people you already know
Many new social worker private practice owners fall into the trap of waiting to become an LLC and buy malpractice insurance until they pick the perfect business name. Puryear recommends instead just using your name, followed by “counseling.” She did precisely that and says, “My practice has always been my name because I could never think of a great therapy name. If I had waited, I would have missed out.”
Starting a group practice by default
Once private practice owners get too many referrals to handle, Puryear sees many open group practices without considering that it isn’t what they want. Many assume this is the next logical step, so they hire some associates. “What they want is to work less and make more.”
Puryear recommends only opening a group practice if you want to manage therapists or have a higher desire to serve your community. In her Abundance Practice Building business, Puryear says, “I get a lot of students who come from toxic group practices where somebody started on the fly without thinking about how to treat their people well.”
3 myths about building a private social work practice
After coaching thousands of private practice owners, Puryear hears many inaccurate assumptions about what it takes to own a private practice. Following are some of the most common myths.
Work in an agency before starting a private practice
While it’s true that in a few states and with some licenses, new therapists must work in an agency or group practice first, this is unnecessary. “If your license allows you to go straight to private practice, and that’s what you want to do, then find yourself an amazing supervisor and do it.”
Private practice is more work than an agency job
Another myth is that opening a private social work practice is more work than an agency or group practice job. Instead, says Puryear, it’s harder emotionally at first, but private practice owners typically work less once referrals come in. “It’s almost comical.”
Choosing a niche is like dating, not marriage
Knowing that a therapy niche isn’t permanent can make choosing one less intimidating. “The truth is that you can change it,” says Puryear.
Changing your niche adds extra work to rewrite your website and notify your referral sources, but it’s not prohibitively hard. “For those who aren’t great at committing to a niche on the front end because they want to have the absolute perfect fit, choose a ‘good enough for now’ niche and leave that open to change later.”
Puryear’s best advice for social workers looking to start a private practice? Go for it. She says, “The thing I hear most from my students is they wish they’d done this sooner.”
Allison Puryear is a therapist who burned out on agency work and built successful private practices in three different markets. After her caseloads grew faster in each “saturated” market, Allison realized that practice building is not rocket science when you have clarity, confidence and a formula. She launched Abundance Practice Building to help other therapists build their own full and happy private practices. Grab her free checklist for how to start a private practice here.
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