Why Some Shrinks Fly Solo

In past posts I've explored the the positives and negatives of joining a group private practice. Now, it's time to focus on the pros and cons of running a solo private mental health practice. When I opened Wasatch Family Therapy nearly 10 years ago, it started out as a solo practice that slowly built over time into a group practice. While I like being "in charge" and autonomous, I'm also an extravert and I highly value my connections with others.

I reached out to other private practice therapists who practice alone to see why they chose to "fly solo."

Autonomy

Florida social worker and healthy eating expert Therapist Karen R. Koenig, LCSW, M.Ed. grew up as an only child, so she's used to being independent and working alone. That autonomy and comfort level has helped her to succeed. “I love being in private practice. I make my own schedule, decide whom I want to see and whom I don’t, set the fee schedule and slide if I want, and get to have an office in my home which makes both life and work easy,” Koenig shares.

Self-expression

Creating an environment that accurately reflects who you are is important to North Carolina therapist Erika Myers, LPC. "Having your own space in which to practice in a way that feels authentic to you, building an individual reputation rather than relying on a group name for recognition,” are reasons why Myers chooses to practice in a solo setting.

Flexibility

Illinois counselor Melanie Dillon, LCPC of Center For Wellness, Inc. practiced independently for 17 years. Of her experience she says, "Private practice gave me a very flexible schedule and autonomy. It also helped me grow to learn all aspects of being a small business owner. It was ideal for parenting and having a second income.” Eventually Dillon developed a mind/body group practice with two chiropractors when she found herself as a single mom and needed to provide a stable income.

As the second oldest of nine children in my family of origin I am used to being "in charge" and in having close connections with others. So, it makes sense that eventually, I grew my own solo practice into a group practice where I am still the sole owner and decision maker. Guess I just can't get away from being the "bossy" older sister.

photo credit: cuatrok77

Adventures In Private Practice: Play Therapist Pam Dyson, LPC, RPT

"I provide practical solutions to child behavior problems," says Pam Dyson, LPC, RPT of St. Louis. What parent couldn't use some practical solutions?

As a child development expert, parenting coach, licensed professional counselor and registered play therapist, Dyson is clear about her mission to help children and families through play therapy and parent coaching. Learn more about Dyson's private practice journey, how she manages the ebb and flow of income impacted by the school year sessions, and how play plays a role in her own self-care.

Why did you decide to open a private practice?

I entered graduate school in mid-life with the goal of opening a private practice. Having been an early childhood educator for many years I knew there was a need in my geographic area for a therapist specializing in working with children 3-10 years of age.

I knew how to reach my target audience and I knew there was a market for additional specialized services such as consulting and coaching.  I also wanted the freedom to set my own hours. I knew that only by having my own practice would I be able to achieve all of those goals.

Clients that therapists find to be the most "difficult" are sometimes the ones who can teach them the most. What have you learned from your toughest clients?

Young children with challenging behavior problems try the patience of parents and caregivers and can be challenging for therapists. The younger the child, the less they have the ability to express their feelings and their needs.  Play therapy gives a child the freedom to express their feelings through toys and play materials.

By being with a child and observing their play I gain an understanding of what the child needs. Once a child is heard and understood we can begin implementing strategies to meet the child’s needs and overcome challenging behaviors.  Understanding the child from the child’s perspective is the key to the process.

What's your biggest pet peeve about private practice?

The unpredictability of steady income. There are cycles when I’m busy and when I’m not.  Mine is related to the school year. When school is not in session during the summer and holiday breaks children are not being brought to therapy. My busiest times of year are in the fall after school starts and after the winter break. I supplement my income with consulting services to schools and other professionals, parent coaching and play therapy training to mental health professionals.

How did you discover or develop your practice "niche"?

I was an early childhood educator before I became a therapist. When I enrolled in graduate school I knew I wanted to work with children using play therapy. I took course work related to counseling children, completed an internship at an agency specializing in child therapy and attended seminars and workshop specific to play therapy. Once I was licensed and opened my practice I already had a solid skill base as a play therapist. Having been a teacher I also had the skills necessary to work collaboratively with parents. It was a natural fit.

What resource (book, website, person) helped you the most when setting up your private practice?

I stumbled across an article by Lynn Grodski in Psychotherapy Networker Magazine that inspired me to pursue private practice. I felt she addressed my questions realistically so I read more of her writings and subscribed to her email newsletter.

What has surprised you most about being in private practice?

How much I enjoy every aspect from seeing clients to paying the bills. I anticipated not enjoying the routine, mundane tasks but I take pride in overseeing every detail.

Has your private practice helped you grow professionally? How so?

I’ve gained a lot of experience as a play therapist and two years ago I put those skills into training other therapists in the modality of play therapy by founding the St. Louis Center for Play Therapy Training. www.stlplaytherapy.com  As an approved provider of continuing education for the Association of Play Therapy www.a4pt.org I offer training opportunities for mental health professionals who are pursing credentialing as a registered play therapist.  As word of the quality of my trainings has spread I’m receiving requests to bring play therapy training to locations across the country.

Has it helped you grow personally, too? How so?

I’ve gained a lot of self-confidence not only in my ability to provide quality therapeutic services but in my ability to manage the business side of my practice. Presenting at conferences and seminars has helped me develop public speaking skills.

Being a therapist can be emotionally exhausting. What do you do to care for your own emotional and psychological health?

When I lock client files in the file cabinet at the end of the day I symbolically lock away my emotional connection to them as well. It ensures I don’t take my work home with me. I make it a priority to do things that are fun and playful such as listening to music, going to concerts and making handcrafted items. It would be challenging to be an effective play therapist if I didn’t make time to play.

How do you cope with the inevitable stressors involved with being your own boss?

I handle all of the day to day details of my practice myself. I’m a very organized person and I rely on to-do lists. While it’s time consuming it’s not overwhelming.  I network with other private practice therapists for support and encouragement regarding the challenges of private practice.

What personal strengths have helped you succeed in private practice?

Growing up on a farm in Kansas helped me develop a strong work ethic.  I’m not afraid to push up my sleeves and tackle whatever needs to be done in order to be successful.  My social skills are strong so networking and marketing come easy to me.  I also have a lot of self awareness and recognize that growing and maintaining a private practice is a process that takes a lot of patience and perseverance and that I sometimes need to reach out to my peers for support and encouragement.

To learn more about Pam Dyson's private practice visit PamDyson.com

If you'd like to be featured in "Adventures In Private Practice Column" please submit a practice summary, and answers to the above questions here.

5 Common Myths About Private Practice

1) If you build it they will come

One of the most difficult challenges of private practice is finding consistent referral sources. Come up with a marketing plan and secure a few referral sources before you hang up your "shingle." (Read Private Practice Marketing Made Easy)

2) My only overhead expense will be leasing office space

Not so. Plan on buying software for billing and record keeping, malpractice insurance, business license, incorporation fees, professional consultation, website costs, paper goods, furnishings, marketing materials...

3) I'm a good therapist so I'll have plenty of clients

There are plenty of great therapists who don't make it in a private practice setting. While being a skilled therapist helps you keep clients and makes it more likely that your current clients will refer friends and family to you, it has nothing to do with actually getting clients in the door of your practice.

4) I'll make a lot of money

Unfortunately, most start up businesses fail, and a private practice is a business. While there is potential to become very profitable, that isn't always the case. In my experience there's a lot of ebb and flow in terms of referrals and direct care hours so you can expect some months will not be as profitable as others. Additionally, all of your taxes will come directly out of your profits each year.

5) It'll be much less work than working for an agency

While it is amazing to be the "boss" and have the freedom to set your own schedule, see the clients you want to see, decide what paperwork you'll require, there is a flip side. You'll also be dealing with all of the billing, marketing, client complaints, and practice management tasks that were once taken care of by someone else.

What are some myths you used to believe about private practice?

photo credit: jeangenie

Multiple Income Streams Soothe Therapist's Financial Anxiety (part 1)

Relying solely on direct clinical hours may leave private practitioners financially vulnerable to income instability. Since client hours in private practice can vary greatly depending on the time of year, state of the economy, number of new referrals, and several other factors, developing multiple income streams can help you to create a more stable income. "By having the other income streams in place, I have been able to be less susceptible to the ebbs and flows that occur in private practice during difficult economic times," says The Rev. Christopher L. Smith, LCAC, LMHC, LMFT. In addition to providing income stability, diversifying your professional activities with multiple income streams allows therapists to explore a variety of interests, to express creativity, and to get paid for their passions.

In addition to clinical hours, I own and serve as clinical director of a private therapy clinic where I oversee and supervise 10 therapists, write for PsychCentral and other publications, work as a relationship and emotional health media contributor, do public speaking, provide consultation to therapists building a private practice, and I'm currently writing my first book.  Curious about what other private practitioners are doing to add to income stability I reached out to several successful colleagues to see what additional income streams they've developed. Here's a sampling of what other therapists are doing to diversify their professional life and achieve greater income stability.

Write and publish a book

Many therapists have taken their clinical expertise and turned it into a book. For example, Frank J. Sileo, PhD has  written three children's books, including Bug Bites and Campfires: A Story for Kids about Homesickness (Health Press, 2009). Clinical Psychologist Dr. John Duffy took his passion for parenting and authored a book The Available Parent: Radical Optimism For Raising Teens and Tweens (Viva Editions, 2011). What areas of expertise could you write about?

Write for print publications

Supplementing clinical work, Terrie Browning, LPC, CFC, DCC writes for a column "My Healthy Mind" for a local magazine My Metro You. Not only does it provide additional revenue but she says it's also personally fulfilling. Of writing for publications she says, "Writing allows me to share knowledge on topics that are a concern for many people and offers a way for me to network myself."  Therapist Karen R. Koenig, LCSW, M.Ed. has successfully written for professional publications including Social Work Focus, Social Work Today, Addiction Treatment Forum, and The Newsletter for the Society for Family Therapy and Research, adding an additional income stream.

Create a therapeutic product

Have you considered creating and selling a product based on your clinical expertise? Stephanie Ann Adams, M.A., LPC of Beginnings Counseling & Consulting, created a hybrid counseling/video series for premarital counseling through Twogether in Texas. To help families deal with the stress of relocation Jill Kristal, President of Transitional Learning Curves, developed a game and book series called 'Our Move'.

Develop a professional online network

The internet allows for many options for therapists to create passive income through membership sites. In addition to writing a local magazine column and providing clinical work, Browning, with the help of her adult children, developed a professional wellness center online called Experts Now. This online center offers wellness experts an avenue to offer services and sell products for a commission creating additional income for Browning.

Contract as a consultant

Consider asking yourself, "Which companies or organizations may want to tap into your areas of expertise?" Therapist Dr. Mario Kirk, LPC, Director, A Blessed Child, LLC, performs psychological testing for local attorneys and schools. Women's reproductive health specialist Pec Indman EdD, MFT consults and trains for county health programs and for the US Federal government.

Are you developing multiple streams of income to supplement your direct care hours? Please share your ideas in a comment below.

Watch for multiple income streams part 2 later this week!