In talking with numerous pre- and provisionally-licensed clinicians, I’ve found there are several misconceptions about getting into a private practice while being pre-licensed. These misconceptions inhibit graduates and clinicians from moving forward with getting their practices started, which could help them prevent burnout, be income producing and overall life changing. Or these misconceptions can lead them down other paths that turn out unfulfilling, or toxic to their health and well-being. Here I’m busting the myths, so you can make more informed decisions about your future and career, because I don’t want another pre-licensed clinician to have to suffer unnecessarily.
Myth 1: You must wait until you’re fully licensed to get into private practice
Nope! In most states in the U.S., it’s legal and ethical to get into a private or group practice, provided you follow certain rules and guidelines. The top rule is that you must practice under supervision. In some states you must be employed by the supervisor and share their office space whereas in other states, you simply need to pay them per supervision hour and you can remain an independent contractor.
The biggest takeaway with this is to check your state licensing board’s website for the specific parameters they require. For instance, Licensed Professional Counselor-interns or associates sometimes have different rules than an Associate Marriage and Family Therapist, so review your licensing board’s requirements to ensure you’re going about things legally and ethically. And if you’re curious what you can do while you’re still in grad school to get momentum going, check this article out. There are myriad things you can do now to put yourself in a stronger position to get your practice going.
Myth 2: You must perfect your clinical skills and pay your dues elsewhere before breaking into private practice
No on that one too! If you think you’d like to eventually have an established, thriving practice with the clinical know-how to handle a private pay clientele, it’s best done experientially. By seeing clients in a private or group practice early on in your career, your training encompasses learning how to get private pay clients and how to be a therapist in private practice.
It’s not just the business side of private practice you get to learn, it’s all the other important clinical components too. When you work entirely in an agency or county mental health facility while you’re pre-licensed, you’re not only missing out on learning what it’s like to run a private practice, but you’re acclimating yourself to that agency’s way of being a clinician. So, there’s a lot of unlearning that occurs for therapists who get into private practice after they’re licensed. If you want a smooth, less stressful transition, start as early as possible and learn while you earn.
Myth 3: Being in a private practice is too hard and overwhelming
Certainly, being a therapist is no easy feat. And to succeed we must continually hone our clinical skills—but I wouldn’t say it’s too hard. In fact, in some ways it may be easier. It’s easier than having to meet unrealistic productivity demands that a lot of public mental health agencies require. And easier than having to see 30 clients a week with inadequate supervision. And it’s easier to build a practice while you have the support of a supervisor and the time to learn as you grow.
Usually the sense of overwhelm comes from not knowing where to begin and feeling incapable of getting clients. If those concerns are answered and clients start coming in the door, the next concern becomes what to do session after session, as far as handling all the components that go into the therapeutic process. That, all too, can be addressed through education/training and practice. You can learn how to network and how to implement strong Search Engine Optimization to a blog or website you start.
Getting into private practice while you’re provisionally- or pre-licensed doesn’t have to be overwhelming, because you can learn the steps it takes, implement them one step at a time and before you know it, all the pieces will be put together. Overwhelm tends to happen when it feels like too much or that your return on investment of time and money won’t pan out; but it can when you boil things down to learning and implementing.
Invest some time and effort
If you’re able to invest some time, effort and a little money, and you’re willing to dedicate yourself to becoming more effective, then it’s likely you’ll succeed.
A little caveat to this: Some pre-licensed counselors will do better in other environments, such as non-profit agencies, treatment centers, hospitals and clinics. If these organizations have good leadership and pay decently, they may be decent options. These jobs can be nice to have because there’s a level of predictability and structure. But please do your due diligence and vet out the agency or workplace. Find out as much as you can about the leadership, requirements, culture, etc. I say this because there are, unfortunately, many unpleasant workplaces within the mental health field.
The best adjunct jobs I’ve found to accompany a private practice while pre-licensed are in substance abuse and eating disorder treatment facilities. For one, substance use and abuse, as well as eating and body image issues are issues rampant within our communities. You’re bound to come across clients in private practice who have these kinds of issues even if those aren’t the presenting problems.
Myth 4: I’ll never be able to make a decent income
While you won’t make a ton of money immediately, it’s possible to increase your income over time. While I was pre-licensed nine years ago, I was grossing $3,500/month in my first year. This was with seeing less than 10 clients a week and working in my pre-licensed practice (under supervision with Dr. Steve Harris, PhD) a total of 15-20 hours a week. This allowed me to pursue rigorous post-graduate training. I could also consult with top clinicians in my area, part-time work at treatment centers and had the ability to invest in marketing and advertising.
Some pre-licensed counselors worry that all their effort and investment will not convert to earning enough money to make it worthwhile. Let me tell you, the time and investment are well worth it. Being in private practice allows you to earn more money per hour than in any other position. That’s just one of the perks although an important one when you’re just starting out and in need of income. When you start while you’re provisionally- or pre-licensed, your income can increase over time as you get more clients and acclimate to being a therapist in private practice. And while the income can ebb and flow because there are busy and slower seasons even once you’re licensed, you can do other work or projects in addition to your practice to supplement your income. So, if you’re working 10 to 20 hours in a practice, that frees up a lot of time to do other income-producing activities and self-care.
Tyra Butler is a licensed therapist and helps pre-, provisionally-licensed and early career therapists navigate the maze of licensure and advance in their careers. She offers consultation for important career moves and supports the emotional development of therapists. As a professional writer provides copywriting coaching for web site and marketing content. Don’t miss out on signing up for her email list where she delivers exclusive content, including blogs, motivational and inspirational pieces, and must-know industry facts. She’s also the founder of the Facebook group Early Career Clinician Community where she gives some of her best tips and inspiration to succeed on the road to licensure. Tyra has been in private practice for 10 years, with 15 years in mental health, business and professional copywriting.
