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Private Practice Kickstart
with Miranda Palmer, LMFT
& Kelly Higdon, LMFT

Starting a counseling practice Part 1: Getting honest with yourself

Starting a counseling practiceLaunching a private practice is an exciting and terrifying proposition for most therapists. The truth is, many of us were trained in non-profit, agency environments and developing a vision of a for-profit business is foreign.

Therapists also often have limited experience talking or thinking about money and starting a private practice is starting a business. A business is about making money by definition.

So, where do you start when creating the perfect private practice for you? It all starts with creating the right vision. Truth be told, there are a LOT of different kinds of private practices:

  •      Insurance driven solo private practices focused on 1:1 services
  •      Insurance driven group private practices focused on 1:1 services
  •      Cash-pay driven solo private practices focused on 1:1 services
  •      Cash-pay driven group private practices focused on 1:1 services
  •      Cash-pay private practices that have equal parts speaking, consulting, and psychotherapy
  •      Cash-pay private practices that are focused retreats, workshops, and intensive therapy
  •      Agency like insurance group practices focused on group, 1:1 services, and low-fee workshops for the community

And, of course, there are examples of each of these models that are profitable, and examples that are not profitable (i.e. does the person bring home a decent wage). In some cases, the owners of the practice are profitable, while the employees are not. In other cases, the employees are profitable and the owner is losing money.

There are also great examples of private practices that start that are incredibly profitable, but the mental and emotional toll on the owner and/or employees isn’t sustainable.

Creating the right vision for your private practice

The first step to creating a great private practice, is to be honest with yourself about what you enjoy, and what you need to provide truly awesome clinical services. For some of you that means having employees, for others it means working on your own.

Some of you will be inspired by speaking to small or large groups, while others will be inspired by writing or taking photographs (yes this does matter when building a private practice). So let’s start with a “what do I like assessment?

Determine Your Private Practice Vision

Answer the following questions honestly to determine what you need to build into your perfect private practice vision:

  • I feel energized by speaking
  • I feel my most authentic when writing
  • I love supervising other people
  • I am best when I’m on my own
  • I grow most when in small consultation groups
  • I grow most when I got to intensive trainings
  • I grow most when I work with a private mentor
  • I get energized by working with many diverse clients
  • If I’m being honest- my best work is done with a smaller caseload
  • I love one-to-one relationship building
  • I love going to big group networking events
  • I love providing consultation and have something great to teach the world
  • I have a big goal that requires me to carve out weekly time (phd, book, etc.)
  • I work best when I have _______ free time each week
  • I love working with insurance and really get how it works
  • I’m not great with billing and organization and it’s best if I get paid immediately so there is less for me to track.

There are so many questions to explore when developing the right private practice for you. Honestly, it is something that starts with you. Your homework: Sit down with a cup of tea, and start to getting these things clarified. Whether you write it down, draw it on a white-board, type it up in a trello board- start to get clear about what you want!

Here is your free mini-workbook on getting clear with your vision. We included a bunch more questions for you to explore while you are doing your homework – click to download!

Miranda Palmer, LMFT is a therapist and business coach who sees how business decisions impact clinical work- for good or for bad. She wants to teach therapists how to make business decisions that allow them to do the best therapy work possible. 

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Starting a counseling practice Part 1: Getting honest with yourself

Miranda Palmer, LMFT

Miranda Palmer, LMFT is passionate about empowering therapists to be extraordinary. Palmer trains therapists how to develop private practices that not only thrive financially, but that provide excellence in clinical care through free private practice marketing trainings, the Business School Bootcamp for therapists, and free study group for licensing exams for pre-licensed therapists.


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APA Reference
Palmer, M. (2019). Starting a counseling practice Part 1: Getting honest with yourself. Psych Central. Retrieved on July 9, 2020, from