Five Things I’ve Learned About Running a Private Practice
- Jul 15
- 4 min read
Written by Kelsey Irving, Licensed Clinical Therapist
Kelsey Irving is a licensed therapist and recognized specialist in OCD and anxiety disorders. She is the founder of Steadfast Psychology Group and author of the children’s book Jacob and the Cloud.
Opening a private practice can feel like stepping into the unknown. There’s excitement, freedom, and the opportunity to create a career that reflects your values and expertise. But alongside the flexibility comes a steep learning curve, one that graduate school doesn’t always prepare you for. After building my own practice, these are five lessons that have made the biggest difference.
1. Not every client is the right fit
One of the most valuable tools in my practice isn’t a treatment modality or assessment, it’s the free 15-minute phone consultation.
That brief conversation is just as important for the therapist as it is for the client. It gives both people the chance to determine whether the relationship feels like a good fit. If a client is struggling with something outside your area of expertise, or simply with an issue you don’t particularly enjoy treating, therapy can feel difficult and forced for everyone involved.
On the other hand, when you find clients whose needs align with your strengths, something special happens. You become the ideal person to help guide them through their challenges, and they feel confident and supported throughout the therapeutic process. The work flows more naturally, and both therapist and client benefit.
2. Build a strong support network
Private practice offers incredible independence, but it can also be surprisingly isolating, especially if you work solo.
Creating connections with other professionals is essential, not only for referrals but also for your own growth and well-being. Consultation groups, peer supervision, and professional organizations help keep your clinical skills sharp and remind you that you’re part of a larger community.
Some of the most meaningful professional relationships can come from unexpected places, whether that’s a Facebook group for therapists or an organization that connects specialists. For me, the International OCD Foundation became an invaluable resource for networking and consultation.
No matter your specialty, having colleagues you can brainstorm with, learn from, and lean on makes private practice far more sustainable.
3. Expect the ebbs and flows
If you own a private-pay practice, one thing becomes clear very quickly, business fluctuates. There will be seasons when your schedule feels unusually quiet and seasons when you’re juggling more inquiries than you can accommodate. Early on, those shifts can feel stressful. Over time, though, I’ve found that mindset matters.
When business slows down, I try to appreciate the extra time for professional development, administrative tasks, and self-care. When things are busy, I’m grateful for the financial rewards and the opportunity to do meaningful work.
The key isn’t eliminating the ebb and flow, it’s learning not to panic during either season. Setting my own rates and not splitting a percentage with anyone else has also allowed the busier periods to balance out the slower ones.
4. Know your worth
One lesson I wish I had embraced sooner is this, don’t be shy about setting your hourly rate. As therapists, many of us enter the field because we want to help people, not because we’re focused on running a business. But the truth is that you have invested years of your life, and often a significant amount of money, into your education, clinical training, supervision, and continuing professional development. Your expertise has value.
People routinely invest in their physical health and self-care through gym memberships, massages, chiropractors, and countless other services. Caring for mental health is no different. Therapy is an investment in well-being, relationships, and quality of life.
You are also a business owner, and your practice needs to support you financially. Early in my career, I set my hourly rate too low because I worried about charging what my services were truly worth. Looking back, I regretted it. I knew I was providing meaningful, high-quality care, and my fees should have reflected that. Charge in a way that honors both your expertise and the sustainability of your practice.
5. Know your ideal client and become an expert
Many therapists hesitate to specialize because they worry about limiting themselves or appealing to fewer people. In reality, developing expertise in a specific area can make you far more marketable.
When you become known for treating a particular issue, you stand out. People aren’t simply looking for “a therapist,” they’re often searching for someone who truly understands the challenge they’re facing.
Think about how many people in your geographic area struggle with a specific concern. If you become the expert in treating that issue, you may find yourself connecting with exactly the clients you’re meant to serve.
Specializing also leads to another important benefit, your caseload becomes filled with clients who are genuinely good fits. You’re less likely to feel out of your depth and more likely to feel energized by the work you do every day.
Private practice is equal parts business, clinical work, and personal growth. There will always be challenges, but finding your niche, building relationships, and trusting the natural rhythms of the work can transform private practice from simply a job into a deeply rewarding career.
If you’re considering private practice, know that you don’t need to have everything figured out from day one. Find your niche, build your network, and trust that your confidence and your business will grow with experience.
Read more from Kelsey Irving
Kelsey Irving, Licensed Clinical Therapist
Kelsey Irving is a licensed therapist specializing in the treatment of adults with OCD and anxiety disorders. Inspired by a close family member’s diagnosis and the widespread misunderstanding of OCD, she became deeply committed to providing informed, compassionate, and effective care. Kelsey serves individuals through her private practice, Steadfast Psychology Group, and extends her impact through her children’s book, Jacob and the Cloud.
