MFM#23 What no one tells you about starting a therapy practice

Creating a private therapy practice (or any new business) is hard. 

There are so many things that you don't know you don't know. So many new things to learn.

One thing that often comes as a surprise is just how long it takes. A big part is the time required to figure things out—learning the non-clinical aspects of running a business, like marketing, admin, and finance. Once you work out what needs to be done, especially with marketing, it then takes time to start seeing results.

Another surprise of creating your own business is the emotional hurdles that start popping up in front of you.

When you work for someone else, you feel somewhat protected by the organisation. But when it's your own practice, it feels vulnerable. Suddenly, there is nowhere to hide. "What if people don't like me? What if I mess it up?"

These feelings are often tied to marketing tasks like networking, reaching out to potential referrers, creating social media content, making videos or writing for your website.

Perfectionism can also show up. The need to get it "just right" can be paralysing. Even deciding on your niche can feel overwhelming. "How do I figure out who I want to work with? What if I pick the wrong one?"

These feelings and experiences are common, I hear them from many therapists I work with.

Here are some thoughts to help you navigate these challenges:

Take the Financial Pressure Off
If you can, ease the financial stress by keeping a part-time job or doing agency or EAP work while building your practice. There is nothing worse than constantly worrying about client numbers and money.

Money stress can lead to poor decisions, like saying yes to every client, even those who you know aren't the right fit.

Consider starting with online therapy to save on the costs of an in-person practice. Or, if it's possible for you, seeing clients from home can also reduce expenses while allowing you to offer in-person sessions. For example, running your practice from home in Australia can mean significant tax benefits.

With less financial pressure, you can be more patient and focus on slowly filling your practice with clients you love working with.

Take Imperfect and Sensible Action
There's a lot of advice online from business coaches about taking massive action. While I am a big fan of taking imperfect action and of the view that taking steps forward and making mistakes is better than standing still. I am also a fan of sensible action, and whenever you are making a business decision, think about what the worst-case scenario would be, and if that happened, would you be okay.

Practice Doing the Hard Things
Overcoming emotional barriers is part of the journey. Whether posting on social media, creating videos or reaching out to referrers, the only way to get comfortable is to start practising. A year from now, you'll look back and see how far you've come, not just in your practice but also in your self-growth and confidence. It takes courage to put yourself out there. Be proud of yourself, and don't underestimate what an enormous achievement this is.

Be Consistent
Consistency is one of the most important (and hardest) parts of growing a business. It's easy to feel discouraged when you don't see immediate results. But the work you do now will pay off. The key is to keep doing the work week after week, even when it feels like nothing is happening. This consistency is what builds momentum and will result in you filling your caseload.

For those who haven't downloaded it yet, my 2025 Solo Therapist Marketing Checklist provides clear direction on the marketing tasks you need to focus on to grow your practice. Commit to following this checklist, and you'll be well on your way to filling your practice.

You can build a thriving practice
Starting a business is hard, but it's possible to succeed. Every therapist with a thriving private practice started from the same place. There is absolutely no reason you can't create your dream practice filled with clients you love working with.