Streamlining Private Practice | A Guest Post from Erin M. Ruston

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counseling private practice

counseling private practice

Note from Joe: I invited Erin Ruston to do a guest blog post about her process. Erin is a long-time reader and supporter of Practice of the Practice. Her guest blog post is a great reminder as we get to the end of the year and we make changes in how we structure our businesses. Now, with no further ado, Erin!

There is so much involved in running a private practice. We try to get all our ducks in a row with picking the right name, deciding what type of entity we want to be, where we want to practice, start up costs, etc, that we sometimes don’t think about some of the basics-organizing.

When I started my practice almost 7 years ago with my business partner, I was working another full-time job. So, I would go to my office 6-9 pm 2 days a week after work to see clients and do most of my paperwork at home. I would be up all hours trying to come up with how I wanted to set up my paperwork, researching client base and referral sources, fees, and all the important things I needed to know to run a successful business.

I thought that I was doing everything right. I had Quick books for the finances, I set up the paperwork similar to previous employers’ paperwork, I had file folders to organize my intake paperwork and client charts. Then my business partner was not able to participate in the practice much for a few years due to also working full time and starting her family. When she returned, business really picked up for her. It became difficult to keep track of what she was bringing in for income and expenses because we did not have a good system in place for her to give me the information I needed to enter in Quick books. The information was sporatic and insufficient.

I found myself within this last year reassessing my paperwork, how I chart, how my charts are set up, having new charts already put together, and going back to basic spreadsheets to document my finances. I am more at ease with my documentation practices.

The times are continually changing and we must keep up. As a practitioner and business owner, it is important to stay informed
about what we need to change, as well as, assess what we want to change to make ourselves more efficient and organized. Keep an open mind, learn from others, and take time to reassess from time to time.

A few Action Items

From Joe: After reading Erin’s article, I thought to myself, “What would this look like?” Here are a few thoughts that might inspire you to re-think how you run your practice.

  • How much time are you spending on accounting?
  • Could you see more clients if you did less paperwork? If so, is your hourly higher than paying someone to manage it?
  • What is your system? Is it set up to add clinicians?
  • What do you want to do in the coming year? How can you grow your business, clients, and income?
  • Where do you fall short and waste time? Where can you cut the fat?


Click below to send a message if you want more tips!




Erin M. Ruston is a Licensed Mental Health Counselor in the State of New York. Erin received her Master of Science in Education-Agency Counseling Degree from St. Bonaventure University. She has been in the field for over 15 years and has a wide-array of experience, ranging from agency counseling and counseling preschoolers in the education settings, to crisis management in hospital emergency rooms and jail settings, as well as, working in day treatments and residential facilities, for both mentally-ill and developmentally disabled. Erin currently works in a Psychiatric emergency room and has had her own private practice since 2007. Erin’s focus of clinical practice includes Childhood Disorders, Depression, Anxiety, and Sexual Abuse/Trauma. She also enjoys working with couples, veteran’s, and families. Erin also has experience with Career Counseling, such as writing resumes, cover letters, exploring transferable skills, and job searching. Practices at Alden Counseling and Wellness LLC.


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Joseph R. Sanok, MA, LLP, LPC, NCC is amazed how much fun it is to help other people in business and counseling! He helps angry kids, frustrated parents, and distant couples at his private practice in Traverse City, MI at Mental Wellness Counseling. Also, he is the author of Mental Wellness Parenting | A remarkably simple approach to making parenting easier. To link to Joe’s Google+ .


Attribution Photo by JMR_Photography