I offered to help someone who is writing a manuscript about opening and maintaining a private practice. I decided to share his questions and my responses. (it was so fun and helpful to reflect)
Name: Jacquie Drury
Profession: Licensed Professional Clinical Counselor
Name of Practice: Jacquie Drury Counseling
What prompted you to start a mental health private practice?
So many reasons! I knew early on that self-care would be the single most important factor in my effectiveness as a counselor. I love this work and wanted a sustainable path. I do my best work when I am consistently tending to my own well-being. Unfortunately, most community mental health agencies aren’t designed to prioritize and support their provider’s well-being. I also wanted the freedom to work with people who might not qualify for (or desire to work within the framework of) a mental health diagnosis.
What do you enjoy most about private practice?
I greatly enjoy the people I work with! Each day looks and feels different. I can never fully prepare for what people walk through the door with. I learn so much and feel humbled each day.
What annoys you most about private practice?
The ebb and flow of busyness can be nerve-racking! Many factors contribute to this. For example, the summer months are slower for many practices since people take more vacations during these months. Private practitioners rely on their per session rate as their core source of revenue. It’s not like being paid a consistent, reliable salary. This makes financial planning more difficult.
What has been some challenges in owning and operating a private practice?
The biggest challenge for me was starting out without realizing how much support was available regarding operations. Unfortunately, the graduate school I attended did not offer a class for students wanting to start a private practice. It helps that my first degree is in business and marketing. Also, I have a background in finance. Still, I struggled a lot more to find my footing than I would have had I know about the amazing online communities of support and podcasts – such as Selling the Couch, and Abundance Practice Builders.
Another challenge has been overcoming my own self-limiting beliefs about owning a solo-practice. For example, I had a friend once say to me, “I imagine in my head that a person in private practice is older.” I get that! The image in my head of a therapist in private practice is totally Robin Williams from Good Will Hunting. One day, that will be me. Well, I will never be a middle-aged white male, but I will be older and wiser nonetheless. That doesn’t mean I’m not an effective counselor right now. Someone once said that biases can smear the counseling process. I agree with that.
(Let’s be honest, I can never live up to that perfect face and demeanor)
What mistakes have you made in your private practice that helped you learn and grow?
I started my practice without an EHR (electronic health record) because I was afraid of the extra expense. This means I was keeping paper files for all of my intake documents and clinical notes AND doing all of the scheduling and appointment reminders manually. The extra time and space it took up in my head and office was not worth sparing the financial expense. Using an EHR has been game-changing and I wish I’d had one from the beginning. I learned to make wise financial investments more readily, especially into systems that would help me focus my energy with clients and help my business succeed.
What has been some of your greatest successes in private practice?
Growing my practice to full-time is my greatest business successes so far! I started my private practice while also working part-time at a community mental health agency. Although I often miss my old co-workers and clients, it feels good to focus solely on the needs of my business. And by growing my practice, I have been able to help more individuals and couples in Cincinnati.
What is your business structure and why?
I like to keep things small because I want to provide a quality, attentive, and individualized service to each and every person I come into contact with. I like having the time to personally respond to inquiries from existing and potential clients. I meet with clients three days of the week (Tuesday-Thursday). Monday and Friday are business days. This is a good balance for me right now. It’s important for me to dedicate a portion of my time at a reduced rate for individuals and couples who cannot afford services at the full fee. I do this through Open Path Collective.
What EHR do you use? Do you like it?
How do you attract clients? What methods have worked best for you?
Online directories, like Psychology Today and one-on-one networking with colleagues have worked best for me. Some of the best advice I’ve heard is to network in ways that feel good to you personally. This helps prevent resentment or burn out. For example, the reason I prefer one-on-one networking is to accommodate my introvert tendencies. It’s also important to have a good website since it’s where people go to learn more about a counselor before reaching out. You can use my website as an example; they are many good ones out there!
Are you paneled with insurance companies? What was your experience with paneling and credentialing?
I am an out-of-network/self-pay provider. I like having the freedom to work outside of a required mental health diagnosis and other insurance-related stipulations. Still, many of my clients receive out of network reimbursement for the cost of their sessions and I help them with that process.
Have you hired anyone? For what and why?
I have no plans at this time to hire anyone administratively, or to grow into a group practice.
How essential is self-care to your professional and personal health?
VITAL. It’s the most important thing. We can’t pour from an empty cup.
Where do you see your private practice in 5-10 years?
My love is working face-to-face with people. Many of my colleagues are writing books and growing their business to a group practice, or adding coaching and consultation services to what they already provide. This often means less face-to-face time providing psychotherapy. I respect those paths and understand the importance of adding additional streams of income. I’m not saying I will NEVER do any of these things, but right now I’m happy maintaining and refining my current business structure and clinical skills as a solo-practitioner.
What’s your advice those just starting out?
Do it NOW! Don’t wait until you’re a middle-aged white male. (no offense to middle-aged white males; see Good Will Hunting reference above regarding my own self-limiting beliefs)
And, get support, including a knowledgeable accountant. There is so much support available. Be cautious of the naysayers because you CAN do this.
What question did I miss that I should have asked?
I can’t think of any right now! This was a good list of questions!