Introduction
As you gain experience in your therapy career, you might start thinking about your next steps. Perhaps you’re drawn to the idea of having more control over your work life, setting your own schedule, or creating a practice aligned with your values. The idea of starting your own private practice can be exciting, but it's also natural to feel hesitant about the risks involved.
This guide will guide you through the key pros and cons of starting a private practice. By the end, you’ll have a clearer understanding of whether this path could be right for you, along with practical tips to help you make an informed decision. Let’s explore what’s involved.
The upside and the downside
There’s no doubt that running your own practice requires a mix of clinical skills and business know-how. It’s a significant shift from being an employee to becoming your own boss, which comes with a variety of new challenges. But if you take the time to weigh the advantages and potential drawbacks, you’ll be better positioned to make a confident choice.
Pros
Higher income potential
One of the most compelling reasons therapists start their own private practice is the opportunity to earn more. When you run your own business, you have the flexibility to set your rates, control your client load, and keep a larger share of your revenue compared to working for someone else. As you grow your client base and reputation, your earning potential can increase substantially.
The reality is that private practice, once established, often pays more than salaried positions. You have the freedom to adjust your fees as your skills and reputation grow, and over time, the financial rewards can be quite significant. Even a part-time private practice can bring in higher income than a traditional job if done right.
Increased autonomy
Do you feel limited by the rules or protocols in your current work setting? In private practice, you have complete control over how you work. You can create your own schedule, choose the clients you want to see, and decide what therapeutic methods or approaches to use without needing to seek approval from a supervisor.
This autonomy extends to every part of your practice, from the design of your office to the way you structure your client sessions. If you enjoy being in charge of your work environment, private practice could offer you the freedom you’ve been looking for.
Personal fulfillment
Private practice allows therapists to align their work with their passions and personal values. Without the constraints of an employer, you can focus on the types of therapy that you find most rewarding. Whether that’s working with a specific population or exploring new therapeutic techniques, you have the space to shape your practice according to what feels most fulfilling.
Many therapists find this freedom to be one of the most satisfying aspects of private practice. It allows you to provide care in a way that’s uniquely yours and develop deep, meaningful connections with your clients.
Financial independence
Building a successful private practice can lead to long-term financial independence. Unlike salaried positions, where your income is fixed, private practice allows you to grow your income as your practice becomes more established. Over time, this can provide not only financial security but also the freedom to make choices about how you invest in your future, whether that’s expanding your practice or saving for retirement.
Work-life balance
One of the greatest perks of private practice is the ability to set your own hours. If you need more flexibility in your schedule—whether it’s for family, personal commitments, or simply to avoid burnout—running your own practice can give you that balance. You can take time off when needed and design a workweek that allows you to prioritize your well-being.
Better client care
Many therapists find that private practice allows them to offer a higher quality of care. Without the administrative pressures and time limits common in larger settings, you can focus more on your clients' needs and provide personalized, attentive care. This can lead to better therapeutic outcomes and stronger relationships with your clients.
Cons
Financial risk
Starting a private practice does come with upfront costs, such as securing office space, purchasing insurance, and investing in marketing. If you’re not financially prepared, these expenses can add stress to the early stages of your practice. It’s important to have a plan for covering these initial costs, as well as an emergency fund to cover any gaps in income while you build your client base.
Legal and compliance requirements
Running your own practice also means you’re responsible for staying up-to-date with legal and ethical requirements, including maintaining client confidentiality and complying with HIPAA. Managing these regulations can feel overwhelming, especially for those who are new to running a business. Fortunately, many digital tools and software solutions can help you manage compliance, but it’s still something to consider before starting your practice.
Unpredictable income
Unlike a salaried position, private practice income can fluctuate from month to month. This unpredictability can be challenging, especially early on when you’re still building your client base. You might experience seasons of higher demand and others where client numbers dip. To manage this, you’ll need to budget carefully and be prepared for the ups and downs that come with running a small business.
Administrative burden
Running a private practice involves more than just therapy sessions. You’ll also need to handle scheduling, billing, insurance claims, and client records. While there are tools and services (like our very own Practicepicnic EHR) to help manage these tasks, many therapists find the administrative burden to be one of the most challenging parts of owning a practice. Consider whether you have the time and energy to manage these responsibilities, or whether hiring administrative support might be an option for you.
Loneliness/isolation
Therapists in private practice often work alone, which can sometimes feel isolating. Unlike a group practice or clinic, where you may have colleagues to consult with or share ideas, solo practice can lack that sense of community. If you value having peers to talk to, it might be important to find ways to stay connected—whether that’s through peer supervision, networking groups, or professional associations.
The verdict
If you feel excited by the idea of more autonomy, higher income potential, and offering personalized client care, private practice might be a great fit for you. However, it’s important to be realistic about the challenges, including financial risks, legal responsibilities, and the time required to manage the administrative aspects of your business. For many therapists, the rewards outweigh these challenges, but careful planning and preparation are essential to making private practice a success.
Private practice rubric
Use this quick rubric to assess whether starting a private practice is a good option for you:
- Desire for autonomy: Do you want more control over your professional decisions and how you practice therapy?
- Yes: 2 points
- Somewhat: 1 point
- No: 0 points
- Financial situation: Do you have the financial resources to cover startup costs and sustain yourself during the early stages of building your practice?
- Yes: 2 points
- Somewhat: 1 point
- No: 0 points
- Tolerance for risk: Are you comfortable with the financial and professional risks that come with starting your own business?
- Yes: 2 points
- Somewhat: 1 point
- No: 0 points
- Administrative skills: Are you prepared to handle the administrative tasks involved in running a practice, or will you outsource these tasks?
- Yes: 2 points
- Somewhat: 1 point
- No: 0 points
- Support network: Do you have a support system, such as mentors, business advisors, or peers, to help you navigate the challenges of private practice?
- Yes: 2 points
- Somewhat: 1 point
- No: 0 points
Results:
- 8–10 points: You’re well-positioned to start a private practice and should strongly consider it.
- 5–7 points: You might be ready but should take extra steps to ensure stability (e.g., financial planning, building a support network).
- 0–4 points: It may not be the right time for you to start a practice, but you can revisit the idea once you’re more prepared.
Private practice can be a fulfilling career path, but it requires careful consideration. Take time to reflect on these factors and use this rubric to guide your decision-making process. With the right preparation, starting your own practice could be the next great step in your therapy career.