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What does it really take to earn a sustainable, full-time income as a solo therapist? Is the freedom of private practice worth the financial and emotional trade-offs? Are therapists investing in the right areas, or overspending in ways that hold them back?
In this podcast takeover episode, Melissa Schneider speaks with Andrew Riesen, CEO of Heard.
Podcast Sponsor: Alma
As a clinician, you probably chose this field because you wanted to support people in navigating challenges and finding personal growth. But many mental health care providers end up spending almost as much time on billing, insurance, and other documentation as you do in sessions with clients.
That’s where Alma can help.
Alma supports clinicians in building rewarding private practices—with simplified insurance credentialing in under 45 days, enhanced reimbursement rates, and guaranteed two-week payback.
Plus, a free profile in their searchable, filterable directory—making it easy for clients who are the right fit for your practice to find you.
Learn more about how Alma could support you in building a thriving private practice at helloalma.com/joe.
Meet Andrew Riesen
Andrew Riesen is the CEO of Heard, a company dedicated to supporting therapists in building and managing financially sustainable private practices. An entrepreneur at heart, Andrew focuses on simplifying the business side of mental healthcare—helping clinicians navigate accounting, taxes, and financial operations so they can focus on their clients.
Visit Heard and connect on Facebook, Instagram, and LinkedIn.
In This Podcast
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Why Andrew helps therapists with their finances
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The value of independence vs the stress of being the boss
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Earning a “full income” as a solo practitioner
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Navigating risk in private practice
Why Andrew helps therapists with their finances
Andrew’s an accountant. He went to school to earn a degree in accounting and finance and started out working in accounting practices.
After a few years, his initial interest in accounting shifted away from the hard numbers, and he pivoted to working with small- and medium-sized companies and practices.
Despite my desire to escape accounting, I ended up helping shape more SMP accounting products and building an SMP accounting tax product … and here we are. (Andrew Riesen)
Additionally, Andrew has had personal experience with mental health practitioners and understands the value that they bring to people and their communities.
Therefore, he knew he wanted to support therapists in the work that they do, which led him to combine his accounting and tax skills into a product that serves therapists.
A lot of my best friends are clinical psychologists as well. So, when the pandemic happened … A lot of my friends shifted to independent practice, and they were like, “You’re an accountant!” … and so I got the opportunity to first-hand help a lot of folks, and that was the genesis for what got us interested in Heard. (Andrew Riesen)
The value of independence vs the stress of being the boss
The classic balance that solo practitioners try to find sits somewhere between the value of independence, flexibility, and autonomy, compared to having the benefits of shared overhead, consultation, and community.
However, Andrew says that this becomes a bigger deal on a case-by-case basis. For some mental health practitioners, community is more important than being your own boss.
It depends on you and what you are seeking from your profession beyond offering counselling to your clients.
There are a lot of folks that really enjoy the business side, and has you had alluded to earlier, stepping into this space of entrepreneurship and doing things your own way, building the brand, and taking on the administrative work, but there are also a lot of folks who open a practice that realize, “I’m in practice for one to two years, I’ve scaled up to a caseload … this isn’t sustainable for me …” There’s a number of different realities for folks that move into independent practice. (Andrew Riesen)
Earning a “full income” as a solo practitioner
Everybody has their own journey into independent practice, and what a balanced sense of professional work and freedom feels like to them.
Andrew shares a few case studies on the topic:
- Year one: There is often a nine-to-12-month ramp of work to go through before solo practitioners begin to see a meaningful shift in their income
Depending on how you are credentialed and how much your hourly rate is, after the two-year mark, some solo practitioners could even get into the $80k to $100k point in revenue, before expenses.
- Years one to two: Practitioners sometimes continue to supplement their income until their total revenue consistently reaches a higher point.
The $50k to $75k number is where it becomes possible to be independent and have this be a full-time practice for yourself, but I’d say it’s really about that $75k … where you’re able to start supplanting that difference from a group practice salary versus being in solo … But, $80k to $100k would be my common feedback around that. (Andrew Riesen)
Navigating risk in private practice
Andrew outlines a few of the biggest financial warnings and risks that could come up in private practice:
- Putting too much money in advertising and marketing spending rather than in relationship building and networking directly within the relevant community.
A lot of folks, when they move into independent practice, don’t have a lot of trust in their skills as a business owner, and this is not to say that there’s like … solutions that exist out there, but areas where we commonly see people overspending are advertising and marketing versus relationship building. (Andrew Riesen)
- Jumping too quickly into renting an office space. Andrew explains that, unless having an office space for in-person sessions is essential, therapists should look at telehealth to help keep their costs down at the start of their solo practice.
- Not working with a professional in managing quarterly tax payments.
- Not raising your rates every year.
Sponsors Mentioned in this Episode:
Learn more about how Alma could support you in building a thriving private practice at helloalma.com/joe.
Sign up for the 2026 Group Practice Boss Conference! Use code PJ between April 16th to 20th and get $200 discount on your Group Practice Boss Conference!
Resources mentioned in this episode:
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Check out these additional resources:
- Does Solo Practice Actually Make You More Money? An Expert Accountant Breaks It Down | POP 1365
- Practice of the Practice Network
- Group Practice Launch
- Group Practice Boss: www.practiceofthepractice.com/grouppracticeboss $149 a month
- PoP Group Practice Owners Facebook Group
- Free resources to help you start, grow, and scale
- Work with us
- Practice of the Practice Network
Meet Melissa Schneider
Melissa opened Resolution Counseling Center in Jersey City, NJ in 2019, a multi-site insurance practice with 65+ therapists. In 2023, she launched her second practice, Cultivate Therapy, a boutique out-of-network group. In 2026, both brands were successfully acquired by a national mental health platform. In her consulting work with us, Melissa specializes in strategizing with group practice owners who want to scale and change our industry for the better and with aspiring owners who want to plan a successful, low-risk launch.
