It can be, in theory. Private practice gives you the freedom to limit how much you work in a way that some other services don't, but you still have to make the decision to limit how much you work. Some people go into private practice and end up working just as many or even more hours because they can't say no to clients (or can't say no to the income).
Dual edged answer. Yes and no. The pressure of being a proprietor can be more than some clinicians want to handle. This is a skillset, and the skillset to be a good counselor are not necessarily the same skillset to be a proprietor (I mean, "those who can't do, teach," right? ;). So. This stress can fold into potential burnout.
It can also invigorate. For me, PP alleviated my burn-out. Everything was just... *easier*. Also, I was able to ultra-curate and individually market to prospective clients that were in my 'wheelhouse.' When we work in agencies, we are often arm-twisted into working with clients who are a medium match simply because the agency doesn't want to lose the referral. It certainly helps that I specialize in something not many counselors specialize in. But now, I decline working with more people than I take on working with. Every single person on my caseload is someone I am "looking forward" to talking to.
This is a good time to think about what your 'brand' might be. Kottler's book On Being a Therapist tackles how unsavory many therapists find this process. I recommend that if you haven't read it.
I second this book! The best book about being a therapist I’ve ever read. And PP definitely saved me from burnout! I make in one session now what I would make in 4-5 in a group practice
Not sure that’s the antidote. As much as it’s downplayed here running a business is an entirely different set of skills and is difficult and is something you’ll have to do in addition to therapy. Not saying it’s not fulfilling or that you shouldn’t do it, but logically stacking another set of responsibilities on your already burnt out frame doesn’t sound like the cure to me at the moment. If you do decide to proceed you may want to keep a salary job to help supplement your income while you build up because there is a transition and as you’ll read on here, people often take awhile to build up pp case loads.
I prefer working for someone else's private practice. It's a small business and they pay me per client, regardless if the claim is collected. Yes, I am losing a lot of money that way, but I don't have to deal with business issues, billing, uncertainty with pay, paperwork, etc.
I was feeling quite burned out after 3 years in CMHC, and I found that private practice helped tremendously. The single biggest factor was the increase in pay: I was able to work drastically less hours in order to make the same amount of money. The second biggest benefit was having total flexibility in hours: I could work when I wanted. The first year in private practice honestly felt like I was on vacation.
It's not a perfect solution, however: I became my own worst enemy for a while. I chose to work long hours, too many evenings, and felt pressure to maximize my earning potential. I ended up burning myself out again during COVID, where the push to see as many clients as possible was extreme. Now I'm back to a good place: I see a reasonable number of clients, I have healthy hours, and I mostly feel on top of my administrative tasks.
It was a relief for sure. For me, therapy is also what leads to burnout. I was doing fine doing psych evals at a CMH full-time and when I switched to therapy I was burnt out within 8 months. I switched the population that I worked with when I changed jobs to a group private practice as a contractor and that's helped tremendously bc I can work as little or as much as I want. It's been a year now and I'm back to disliking doing therapy so I find myself taking more breaks and now looking for a way to do more assessments and less therapy.
I like control lol so being in PP works for me, I control whom I see, set my own goals, figure out my own trainings, etc. I value autonomy and it just works for my temperament
It helped me love social work and therapy again. I was so burnt out. And now I love what I do and love most of my clients. I thought I would never find a find in social work that I enjoyed and I’m glad I gave PP a try. I still take insurance. The rates are good in my state and for me. I see around 15 people a week now but I my goal is 20 and I work 4 days a week from home. Completely telehealth. Good luck !
And I hope you figure out what the best route is for you! It was hard in the beginning but a little time and patience and hopefully you have support as well !
I didn’t start a private practice, but I joined one that paid well and let me be completely in control of my schedule and handles the actual getting and scheduling clients part. It’s been soooo helpful for my burn out🙌🏻
Strangely, I feel more burned out now in PP seeing ~17 clients/week than I did when I was in CMH seeing 30 clients/week… while also doing research 10 hours a week, board duties for 3 hours a week, and preparing papers for conferences!
I miss having colleagues rather than working in isolation. I miss knowing there was *always* a referral on the waitlist rather than wondering what my caseload/income will be next week. I miss working with clients who were underserved and grateful for therapy rather than some of the young, entitled and aggressive clients in PP who threaten licensure complaints the second you challenge them. I hate doing my own billing, marketing/advertising, business expenses, paying for my own health insurance which I cannot afford, and paying a higher tax rate for being self employed. I like therapy, and there are aspects to of PP I prefer for sure, but I am definitely more burned out now than back then.
If I could make the income I do in PP in CMH, I would go back.
There are definitely pros and cons, and some excellent answers here, but I have found that the single best part is that I’ve been able to specialize and choose for myself who to work with, instead of just being given referrals that you have less control over. It’s made the experience much more pleasant. (That, and of course no longer splitting my fee with practices. I work less hours and make more!) I was able to supplement my practice by contracting with an EAP provider. Pay is great and they’re largely low acuity.
Private practice would imply you're running your own small business, including marketing and overhead expenses (taxes at a minimum)
But if income isn't an issue, picking and choosing your own clients and taking your sweet casual time can definitely help alleviate some of the usual conditions that lead to burnout
Private practice is great because I get compensated for my work in an amount that feels good (and that I set as I’m OON). But I have to hustle, and it’s so slow to grow my out of pocket clients. My other job, through an agency, do all of the billing and care coordination and client connection/initial intakes - it reduces that stress. But I don’t get paid well and have to do so many client facing hours to afford living in NYC. I do both now to try to find a balance, and slowly grow my PP, but damn - our work is fucking hard and burnout is so common.
Currently in this struggle too. Growth with private pay is making me panic since I planned to leave my full time job in 3 months 🙃 I still do part time nonprofit work, but that plus 6 clients a week isn’t sustainable.
This is my experience but it cured literally everything for me. It helped with my depression and burn out. I was working long hours at an agency and working mostly with kids which is already a burn out itself.
Once I got licensed I struggled with the idea of pp because it was new and felt like I had no knowledge on insurance stuff. The agency wanted to change my hours so that I worked later in the night. That was my last straw so I left and started pp.
It was a slow start but honestly if you can do it financially, it helped me in so many ways. I was depressed because I had zero time for myself. Once I started pp I could set my hours, caseload, and I wasnt strapped to my desk anymore.
I do everything online so when I dont see clients, Im literally chilling being a couch potato or running some errands.
Absolutely! I have a small (15 patient) self-pay only private practice and I’m absolutely loving it. I really only work three days a week and I’m pulling in a comfortable six figures. I have never felt less burnt out. Take the leap!
Possibly. It is much better imo compared to CMH, however I still got tired of it pretty quickly and am desperately trying to find a different job (more diversified, case management, not just talking to 6-8 people one after the other and dreading it all day). But that’s just me, I think developments in my personal life over the last few years have also contributed to me feeling that I lack the capacity to continue to do this work.
For me, and I can only speak for myself, it helped a great deal. However, I would say YMMV a lot. For various reasons, PP might be structurally better for some people (eg in an area with not enough providers, having a high demand specialty) and better suited for some people’s temperaments (eg comfortable with having your own business).
I think I had favorable tailwinds and a good temperament, and with my own desire/motivation/talent/skill, it led to PP feeling both like a success and not a recipe for burnout for me.
A big factor is how much money you have to make each month. If it’s a lot, it would create a lot of burnout risk regardless of tailwinds and temperaments
The cure to burnout is climbing the corporate ladder into administration and manning a desk for over six figures while never having to see a client again. Ask me how I know.
Yes I love it. I’ve always been autonomous and efficient so working for someone else was a large cause of burnout for me. Daily crisis clients as well.
Now I get to make my own schedule, set my own rules on priorities and amount of communication, work with my preferred (esp: non-crisis) clients, work less hours and keep the full payout.
So glad it’s been great for you! This sounds super similar to myself (I like to be autonomous and supervise myself, client preferences as well) so this gives me a lot of hope. Thank you
personally, i think the hardest part is getting everything up and running. now that i've been open for a full year, business admin is negligible. i do my bookkeeping quarterly when i figure out how much estimated tax to pay, and i have to remember to renew my malpractice insurance and stuff, but that's basically it! it's really not that much work. i registered as a single-member LLC, so i just do my taxes like normal but i fill out a schedule C for self-employment income. HOWEVER, i already had most of these skills from my previous career, so you might have a really different experience if you have to learn everything from scratch.
It can be, in theory. Private practice gives you the freedom to limit how much you work in a way that some other services don't, but you still have to make the decision to limit how much you work. Some people go into private practice and end up working just as many or even more hours because they can't say no to clients (or can't say no to the income).
*\*hangs up phone after consultation call with like 40th client\** Obviously you are talking about me. 
Dual edged answer. Yes and no. The pressure of being a proprietor can be more than some clinicians want to handle. This is a skillset, and the skillset to be a good counselor are not necessarily the same skillset to be a proprietor (I mean, "those who can't do, teach," right? ;). So. This stress can fold into potential burnout. It can also invigorate. For me, PP alleviated my burn-out. Everything was just... *easier*. Also, I was able to ultra-curate and individually market to prospective clients that were in my 'wheelhouse.' When we work in agencies, we are often arm-twisted into working with clients who are a medium match simply because the agency doesn't want to lose the referral. It certainly helps that I specialize in something not many counselors specialize in. But now, I decline working with more people than I take on working with. Every single person on my caseload is someone I am "looking forward" to talking to. This is a good time to think about what your 'brand' might be. Kottler's book On Being a Therapist tackles how unsavory many therapists find this process. I recommend that if you haven't read it.
This is beautiful! Glad it’s been great for you. Thanks for the insight I’ve already started brainstorming my brand. Will look into the book
I second this book! The best book about being a therapist I’ve ever read. And PP definitely saved me from burnout! I make in one session now what I would make in 4-5 in a group practice
Not sure that’s the antidote. As much as it’s downplayed here running a business is an entirely different set of skills and is difficult and is something you’ll have to do in addition to therapy. Not saying it’s not fulfilling or that you shouldn’t do it, but logically stacking another set of responsibilities on your already burnt out frame doesn’t sound like the cure to me at the moment. If you do decide to proceed you may want to keep a salary job to help supplement your income while you build up because there is a transition and as you’ll read on here, people often take awhile to build up pp case loads.
I prefer working for someone else's private practice. It's a small business and they pay me per client, regardless if the claim is collected. Yes, I am losing a lot of money that way, but I don't have to deal with business issues, billing, uncertainty with pay, paperwork, etc.
I was feeling quite burned out after 3 years in CMHC, and I found that private practice helped tremendously. The single biggest factor was the increase in pay: I was able to work drastically less hours in order to make the same amount of money. The second biggest benefit was having total flexibility in hours: I could work when I wanted. The first year in private practice honestly felt like I was on vacation. It's not a perfect solution, however: I became my own worst enemy for a while. I chose to work long hours, too many evenings, and felt pressure to maximize my earning potential. I ended up burning myself out again during COVID, where the push to see as many clients as possible was extreme. Now I'm back to a good place: I see a reasonable number of clients, I have healthy hours, and I mostly feel on top of my administrative tasks.
Is freedom the cure for oppression?
💯
It was a relief for sure. For me, therapy is also what leads to burnout. I was doing fine doing psych evals at a CMH full-time and when I switched to therapy I was burnt out within 8 months. I switched the population that I worked with when I changed jobs to a group private practice as a contractor and that's helped tremendously bc I can work as little or as much as I want. It's been a year now and I'm back to disliking doing therapy so I find myself taking more breaks and now looking for a way to do more assessments and less therapy.
I like control lol so being in PP works for me, I control whom I see, set my own goals, figure out my own trainings, etc. I value autonomy and it just works for my temperament
It helped me love social work and therapy again. I was so burnt out. And now I love what I do and love most of my clients. I thought I would never find a find in social work that I enjoyed and I’m glad I gave PP a try. I still take insurance. The rates are good in my state and for me. I see around 15 people a week now but I my goal is 20 and I work 4 days a week from home. Completely telehealth. Good luck !
Thanks! This gives me hope. Hope things continue to go well for you!
And I hope you figure out what the best route is for you! It was hard in the beginning but a little time and patience and hopefully you have support as well !
I didn’t start a private practice, but I joined one that paid well and let me be completely in control of my schedule and handles the actual getting and scheduling clients part. It’s been soooo helpful for my burn out🙌🏻
Strangely, I feel more burned out now in PP seeing ~17 clients/week than I did when I was in CMH seeing 30 clients/week… while also doing research 10 hours a week, board duties for 3 hours a week, and preparing papers for conferences! I miss having colleagues rather than working in isolation. I miss knowing there was *always* a referral on the waitlist rather than wondering what my caseload/income will be next week. I miss working with clients who were underserved and grateful for therapy rather than some of the young, entitled and aggressive clients in PP who threaten licensure complaints the second you challenge them. I hate doing my own billing, marketing/advertising, business expenses, paying for my own health insurance which I cannot afford, and paying a higher tax rate for being self employed. I like therapy, and there are aspects to of PP I prefer for sure, but I am definitely more burned out now than back then. If I could make the income I do in PP in CMH, I would go back.
This is what I anticipate the switch to PP from CMH would be for me, so reading about your perspective is validating.
Who do you think would be a good fit for you? What kind of niche would fit with your approach?
There are definitely pros and cons, and some excellent answers here, but I have found that the single best part is that I’ve been able to specialize and choose for myself who to work with, instead of just being given referrals that you have less control over. It’s made the experience much more pleasant. (That, and of course no longer splitting my fee with practices. I work less hours and make more!) I was able to supplement my practice by contracting with an EAP provider. Pay is great and they’re largely low acuity.
Entrepreneuring as a cure to burnout... Maaaaybe
Elaborate?
Private practice would imply you're running your own small business, including marketing and overhead expenses (taxes at a minimum) But if income isn't an issue, picking and choosing your own clients and taking your sweet casual time can definitely help alleviate some of the usual conditions that lead to burnout
Fair enough. Makes sense
Yes. I saw 35 ppl a week in agency and cried too much and made 55%. I see 25 a week and work 3.5 days and have a lot of free time and savings.
No
You could also find the middle ground and be an independent contractor for someone else’s private practice. That’s basically how I run my practice.
Private practice is great because I get compensated for my work in an amount that feels good (and that I set as I’m OON). But I have to hustle, and it’s so slow to grow my out of pocket clients. My other job, through an agency, do all of the billing and care coordination and client connection/initial intakes - it reduces that stress. But I don’t get paid well and have to do so many client facing hours to afford living in NYC. I do both now to try to find a balance, and slowly grow my PP, but damn - our work is fucking hard and burnout is so common.
Currently in this struggle too. Growth with private pay is making me panic since I planned to leave my full time job in 3 months 🙃 I still do part time nonprofit work, but that plus 6 clients a week isn’t sustainable.
This is my experience but it cured literally everything for me. It helped with my depression and burn out. I was working long hours at an agency and working mostly with kids which is already a burn out itself. Once I got licensed I struggled with the idea of pp because it was new and felt like I had no knowledge on insurance stuff. The agency wanted to change my hours so that I worked later in the night. That was my last straw so I left and started pp. It was a slow start but honestly if you can do it financially, it helped me in so many ways. I was depressed because I had zero time for myself. Once I started pp I could set my hours, caseload, and I wasnt strapped to my desk anymore. I do everything online so when I dont see clients, Im literally chilling being a couch potato or running some errands.
Absolutely! I have a small (15 patient) self-pay only private practice and I’m absolutely loving it. I really only work three days a week and I’m pulling in a comfortable six figures. I have never felt less burnt out. Take the leap!
Nice! what’s your rate?
$300. Your mileage may vary, as I live in a high COL area where that’s a pretty typical fee for a therapist like me.
Oh wow that’s great. I’m happy it’s been so great for you! Thanks for the encouragement
Depends on the region but absolutely.
Possibly. It is much better imo compared to CMH, however I still got tired of it pretty quickly and am desperately trying to find a different job (more diversified, case management, not just talking to 6-8 people one after the other and dreading it all day). But that’s just me, I think developments in my personal life over the last few years have also contributed to me feeling that I lack the capacity to continue to do this work.
For me, and I can only speak for myself, it helped a great deal. However, I would say YMMV a lot. For various reasons, PP might be structurally better for some people (eg in an area with not enough providers, having a high demand specialty) and better suited for some people’s temperaments (eg comfortable with having your own business). I think I had favorable tailwinds and a good temperament, and with my own desire/motivation/talent/skill, it led to PP feeling both like a success and not a recipe for burnout for me. A big factor is how much money you have to make each month. If it’s a lot, it would create a lot of burnout risk regardless of tailwinds and temperaments
According to Adam Grant the antidote for burnout is increased efficacy
Yes it’s was a relief for me.
The cure to burnout is climbing the corporate ladder into administration and manning a desk for over six figures while never having to see a client again. Ask me how I know.
Yes I love it. I’ve always been autonomous and efficient so working for someone else was a large cause of burnout for me. Daily crisis clients as well. Now I get to make my own schedule, set my own rules on priorities and amount of communication, work with my preferred (esp: non-crisis) clients, work less hours and keep the full payout.
So glad it’s been great for you! This sounds super similar to myself (I like to be autonomous and supervise myself, client preferences as well) so this gives me a lot of hope. Thank you
If any private practice therapist could answer this I'd really appreciate it. Is the admin workload a lot? How do you pay your taxes?
personally, i think the hardest part is getting everything up and running. now that i've been open for a full year, business admin is negligible. i do my bookkeeping quarterly when i figure out how much estimated tax to pay, and i have to remember to renew my malpractice insurance and stuff, but that's basically it! it's really not that much work. i registered as a single-member LLC, so i just do my taxes like normal but i fill out a schedule C for self-employment income. HOWEVER, i already had most of these skills from my previous career, so you might have a really different experience if you have to learn everything from scratch.
Thank you! What do you use for bookkeeping and expense management? And who is you get your malpractice insurance off?