Show Notes

Welcome back to The Designer Practice Podcast, and I’m your host, Kayla Das.

In today’s episode, Sarah Rees, CBT therapist and owner of Therapist Corner, will share how to transition from being an employee into private practice.

Hi Sarah, welcome to the show. I’m so glad to have you here today.

It is an absolute pleasure. It’s lovely to be here. Thank you very much for inviting me on.

Sarah, before we dive into today’s episode, please introduce yourself, where you’re from, and tell us a little bit about your own practice and business journey.

Okay, so my name’s Sarah Rees. I’m based in the UK. I’m in the north of the UK in Cheshire. My background professionally as a mental health nurse. And then I got into counseling and psychology and trained as a CBT therapist. And at that point I then realized that, oh, I have now a skill for the first time ever that could lead me into having my own business in private practice. But that was quite scary for me. I’d had no business training. None of our clinical qualifications set us up for running our own business at all. So it felt very far away from anything I’d ever thought of because my background was in nursing. I always thought I’d be a nurse and be in the NHS.

But the demands of working within an organization as a CBT therapist were, I found really exhausting. Seeing five to six clients a day. Only having a very limited number of sessions to offer people. So I felt really clinically very constrained and I was excited to work more creatively, to be able to work with people for months or sometimes years, and use a different depth of my skill base.

So as this kind of organizational stress started building up and this idea that could run my own business, I started looking into it. And with no business training at all, I was very excited and jumped straight in and used what lots of therapies I find use is a real scatter gun approach to setting up in private practice, Googling everything, searching everything I learned about marketing. And just put myself everywhere.

If I could advertise, I would. I joined all the referral companies, all the health insurance companies. And ended up building a business that I really wasn’t enjoying because I’d gone from having one boss in an organization to having 15 different companies. I was working with 15 different structures, 15 different bosses it felt like, and it was too much and I actually became quite unwell with a thyroid condition. I’d worked in an organization with all that safety for lots of years, and then I found myself without any sick pain and working in private practice. And that was really scary for me because I didn’t have sick pay anymore and I hadn’t thought about that before. I actually started to invest in my business to get business coaching, to do business training and thinking, okay, I had really good supervision. And think about what business I wanted to create for myself that was sustainable and one that I could enjoy. I loved the creativity. I loved the way I was working with clients, but the way I developed my business was making me very unhappy and I wasn’t very well and I had to make it sustainable.

So with the business training and business coaching, I then created a private practice. That I absolutely love being in, and I work solely really with self referring clients. I’ve got a clear marketing strategy. I, structure a week to fit around my health and, my work life balance because when we’re working at our best as therapists than our clients get the best version of us and clinical outcomes improve. And we use our minds for the work we do. So our minds and our bodies have to be at optimum health. So we can do what’s a really tough and challenging and demanding job. So that’s where I am now.

And I suppose as part of that journey, because there wasn’t really anybody doing what I was doing when I started. I know there’s more people now, which is really exciting. But I started blogging and writing about my journey and that transitioned into write a book. So I worked with the publisher, I wrote the book, A Therapist Guide to Private Practice Building a Values-based Business, which was important for me to maintain sustainability and reduce burnout in the field.

So that was published a couple of years ago, and then I’ve developed a course for therapists getting started because that was such a pain point for me and the community therapist corner. So I do part-time working with other therapists now in helping them build thriving practices with self-funding clients. And then part-time I’m in clinical practice in my clinical rooms in Wilmslow Cheshire, where I see three to four clients a day. Generally, I’m working down to three and this year for the first time, I’m going to have the whole of August off. I’m starting having every other the Friday off. So I feel like I’m really where I want to be in my private practice journey now and enjoying sharing it.

That’s so amazing. And I think one of the biggest words that really come to my mind is you pivoted when things weren’t working well. And I know we’re gonna talk about some of the fears of going into private practice and all of that very shortly. But one of the fears that I know that tends to come up for people is what if it doesn’t work?

And for you it was working financially, but it wasn’t working for you for why you wanted to develop a private practice, that values-based component, and you pivoted, you made the changes that you needed to make instead of, being unhappy and, sitting in an environment that, yes, you may have created, but being unhappy while doing it.

I think I actually built my business from the common fears we all have when we set out, will I get any referrals, therefore put myself everywhere. And yeah, I did get the referrals they came in, but it was totally overwhelming. So I built my business out of fear and managing fears rather than thinking what do I want? What’s best for me? What’s best for my clients? Who do I want to work with?

I think this is a great place to really discuss, what are the biggest fears a therapist have when moving from an employee work situation into private practice?

 I think it is that, will it work if you’ve never run a business before? You’ve no idea. And it can feel like, there’s nobody looking for a therapist out there when actually we know that demand for mental health support and mental health care is absolutely in growth. People care more than ever about their psychological wellbeing as much as we do our physical wellbeing, because the two go hand in hand. But I think it’s a real big fear. We can feel like there’s lots of therapists out there. There’s hundreds of us because we’re in that little bubble where we know lots of therapists.

So I think one of the key things you can do to offset that fear is by being in communities where therapists are doing exactly what you are doing. And often, especially in the UK therapists set up with working with referral companies. because it feels easy to get the referrals through. But you end up being underpaid, and there’s a lot more additional admin that goes with that. So actually, you’re getting the referrals, but are they the right referrals for you? And then you can end up in these bubbles of communities online where it just feels like nobody gets self-funding clients. Everybody is working for health insurance companies and that’s just not the case. It’s looking to work with people that are where you want to be eventually. I think it is back to really thinking about who is the client you want to work with, how do you want to set up your ideal week? Starting with that and actually starting with business planning, which I think, we do feel that’s very much for the corporate world and it’s absolutely not.

I was very avoidant of any kind of business planning, but we know that’s one of the reasons, along with the lack of financial planning that most businesses fail within the first few years. I’ve developed a business plan for therapists that kind of maps onto the therapeutic framework that we use, around assessing needs, what do you need, what do your clients need? And then formulating a treatment plan where it’s formulating a business structure. So you can map it onto the treatment plan. But I think having a really solid plan in place and just having your destination of where you want to get to. Because if you don’t know where you want to get to, how do you know the path to get there?

Planning it out. And often it’s a bit of a financial buffer. Because I think that brings a lot of uncertainty with it when you go from having a monthly guaranteed salary to an income that can fluctuate and can be more than what you’ve been earning before, but you will have months, especially I think in the first year of lower income at times, until you get the consistency of referrals and consistency of income. But I think it’s completely achievable. You just need support and a good community around you.

I couldn’t agree with you more, and I actually think about when I first went into private practice. First, I did for two months have a like kind of a private practice on the side, while I was still working my full-time job, but then I put in my resignation and went into private practice.

But the hardest part of the entire process was the workup of putting in my resignation. I tried to find all of the supports, like asking my family, my friends colleagues, people in private practice trying to find someone to tell me, yes, quit your job. But of course, no one did that because of course I am the only person that could have made that decision.

The workup, the two weeks, three weeks, while I was contemplating putting it in, was absolutely the hardest. When I think of, therapists wanting to move from being an employee to be in private practice, I do think that work up to, should I do it? Is this the right decision? At least for me in my situation was the hardest part. Once I actually submitted the resignation. Once I actually finished the last two weeks and went into private practice I felt so much better. Now, I do want to say, and I think this goes back to your business plan. Is that I did have an idea of how I’m going to structure my business, what I was going to do, like I said, I even had a plan in place where I worked for two months and kept all of that income from my like part-time practice to help cover the time while I’m filling up my practice. I also kept my vacation time so that I could bank all that out and take it all out with my last pay. So I did plan and prepare. So I don’t want to say I just did it, out of the blue, but I think that, at least for me, that definitely was the hardest moment.

Yeah, I was exactly the same. I actually, that was a big struggle for me actually handing in my notice, I went from full time to three days a week, two days a week. And then I said, can I do one day a week? And they were like, no, you can’t. Because that’s ridiculous. And that was just about keeping myself safe. And then I used to write the date, I had my resignation letter. I used to write the date in my diary. And I think about, I did it about three or four times and talked myself out of it.

And then I think once I got a kind of a bit more of a plan in place and I did think, if this doesn’t work out, what will I do? And I thought, I’ll just find a job. That’s the worst that can happen is that I go back to an employed role at some point. And as soon as I settled with that, I thought I’m going to give this a go. But it is tough.

I absolutely love that. I think one other fear that comes up for therapist too is the unknown, right? Not just will I make money and will this help me financial? But will I like it? Even though I might not necessarily be happy right now in my current situation, I’m comfortable with the current situation. I’m not really comfortable with the unknown. Especially in a world in private practice where you don’t have the same supports as you would in environment, right? You would have colleagues, you would have someone to talk to whereas private practice can sometimes, at least if we don’t create those supports can feel quite isolating, especially initially.

Absolutely. And I think the fear of will I feel isolated and be on my own is one of the key fear that most therapists struggle with initially. But I’d say I’ve never feel felt so supported ever because I have created a network around me. I have clinical supervision, I have business coaches. I’m in memberships, I’m in masterminds.

I’ve also, one of the things that really helped with, because I do online and face-to-face, I work and I have a location, is getting to know other business owners in my community. It was a huge source of referrals, that really getting to know other business owners. And in this next year, I think I’ll be looking more at creating networks and communities around me.

Absolutely. Yeah it’s about finding those communities. And what’s beautiful nowadays is a lot of this is online. You can create your communities virtually and still get to meet people across the globe for that matter. So there’s lots of supports and like you mentioned, business coaching and all of these good things.

So I think the big question here though is how would a therapist know that they’re ready to make this transition emotionally, practically, and financially?

I think ready doesn’t ever have to mean a hundred percent confident. It is just you have the passion and the desire to do it. You have some structure and you have some support as well. I get asked a lot because I do the getting started course about is it right for me? Am I at the right point of my journey? I’ve just qualified or I’ve only been practicing for six months. And the truth is, everybody’s at different levels and what’s right for one person isn’t going to be right for another person. But I think it’s about knowing that if you didn’t do it, you’d be a bit disappointed. And having that clear vision, a bit of clarity on what you want to create, and having the good support around you and a bit of a plan so you have a clear vision, you have your few months planned out and giving it a go because what’s the worst that can happen? You don’t have to stay in private practice.

I think that’s really great advice. So what’s the most sensible first step to take when going into private practice?

I think you really need to know what you want your life to look like. So I’d be creating what you would like your ideal week to look like, how many clients you want to see, and most importantly, who are you going to work with? What are you creating and who’s it going to be for? Because when you are really clear on that.

Then your potential clients will be clear as well. There’s this saying around marketing, if you confuse, you lose. And clarity brings a lot of confidence with it, the path. And I think that stops the scattered gun approach of, just trying to go for referrals.

When actually clients that are the wrong fit can turn up in your clinic room, and that’s a waste of time for them, and it’s a waste of time for you as well. So being really clear on who you’d like to serve, who are the clients that you are excited to see in your diary? And who are the ones that do really well from the work you do that’s going to be really a nourishing business for you and for your clients as well. And with that clarity in mind, you will create a business that’s a lovely place to be. And that’s I think one of the things I didn’t do when I started and I wish I had.

Oh, I can appreciate that. So what are the key foundations you need in place to make private practice both safe and sustainable?

I think there’s two elements. I suppose there’s clinical and your business. So clinically we all have our professional codes of conducts, that’s whether you work in a business or in private practice, you need to be following your professional code of conduct, having data protection in place, how you manage notes, the correct insurances. Know how many clients you can actively see in a week. Because some people might say, although I’ve never been able to I wouldn’t recommend it. But some people say, I can see six in a day, and that’s no problem. But some people can only see one or two. And I think it fluctuates depending on what’s going on in our lives.

And I think that’s one thing in private practice can give you that flexibility where organizations can’t. But really thinking what is a sustainable number of clients you can see in a week and how many hours you can work. And that will start to give you the kind of fee range that you need to charge and whatever fee you have in place to keep your business sustainable. Lots of therapists really struggle with charging and can often undervalue their services because it can be difficult for people to charge for care when actually what you’re providing is hugely valuable. And if you don’t value it, it’s difficult for other people to value it. But also it means that when you charge the correct amount, your business is financially viable. So getting that in place is really important. So some people have coaching around that. So you charge based on the facts of what your business needs to be sustainable, not based on mindset. And then getting a really good business coach that can guide you through that journey. And a community of therapists who have done what you’ve done and then. So you are looking at two areas, your clinical safety, making that sustainable, and making sure your business is financially stable and you’ve got the location where you’re going to operate from. And there’s a whole kind of checklist of things.

I know there’s a number of checklists and I can send one out as well that people can work through. So you get the foundations in place.

I love that. So how do you actually get clients in the early stages without relying, say, on these big referral companies that you mentioned, signing up for all of them. How do therapists actually get their clients?

One of the biggest way, because I have quite a big community and this is question comes up time and time again. So I always ask people how do you get your first clients and therapists often say through their peers. Some of us do forget to start shouting from the rooftops. We’re in private practice, we’re open for business and we can take referrals. And that can feel a little cringe at times. But I think it’s shifting how you see that and start to think about the clients that need your service. You need to let them know. How can you build the know, like trust factor? So how can people know that you have available ability to see them? How can they decide whether they like you or not, and how can they decide whether they’re going to trust you or not.

And word of mouth referrals is gold standard. So starting to let people know that you have availability. And then people need to be able to book in with you. And I think still most people go for word of mouth. So they ask people, they know, have you seen a therapist? Do you know a therapist? And I think that builds trust very quickly.

And then secondly, I think people still Google. They still look at websites and look for pictures of therapists and start to research them and read about them. So if you’re not ready for a website yet you need a directory listing or you need some kind of home base on the internet where people can come to. And you need to make that point from the person finding you to making that inquiry quite easy and effortlessly so they can book in with you really easily.

And I think some people who need to get up and going quite quickly do Google ads, and that works quite well. So either it’s putting in your time of getting that visibility out there, maybe doing social media, blog writing, writing content, or if you don’t want to do that and social media isn’t for everybody, then you can pay for your visibility and do Google ads.

What helps people stay consistent and not quit during that middle stage of building a practice.

A plan helps people stay consistent, so there’s business planning in the first instance, but I really encourage therapists to also do quarterly planning. So most corporate businesses plan three months of the business at a time, and that’s something that I do. And since I’ve started doing that really helps me keep consistent because I’m not looking at everything I’ve got to do in this next year. I’m just focusing on the next three months ahead of me, what I’ve got to focus on and what I’m doing. And then at the end of three months, you look at your last plan and you think, what’s been working well in the business? What am I really enjoying and what’s not going so well? And that helps you move away from things that are not working for you.

I rent out therapy rooms to other therapists, but for a time, every quarter it was popping up that I’m not enjoying being a long lady. I don’t understand it. I don’t want to be getting the taps fixed and the lights fixed, and that kept coming up so I couldn’t ignore it. And I got somebody else to manage the building for me. And that problem’s gone away now. And it’s nice and easy, but you need some way to review, just like you’d review your clinical work with your clients, you need to be doing that for your business so you can map on your clinical work. It’s the same in business review regularly and assess.

I love that. Sarah, you have a therapist community that you would like to share. Can you tell us what it is and how it can help listeners?

Yeah, so I run a platform on Substack called Therapist Corner, and I developed this because of this worry about feeling isolated. I think, what we do as therapists, we go into our work because we want to care for our clients and we want to deliver great therapy and help people get to where they want to be in our lives. And that sometimes can mean that the business side of things falls flat or falls to the wayside, and we can end up working in businesses where we get this boom and bust. It’s doing well. So we forget about marketing and then we come back to it. So I created Therapist Corner as a place where we can all come together. And empower people, reduce isolation, but also learn from one another and be accountable. So, on the platform, I share weekly blog posts about running sustainable private practices. I share things that are happening, things that I’m doing in my business, things that people are finding helpful and we do weekly q and as. And today we had a coworking session where we just. All came online and we just worked on our to-do list for an hour on Zoom. Nobody was speaking. It sounds very strange, but it’s really effective, and that date is in your diary. So you are guaranteed to spend time working on your business, not just in your business, because when you start to run your own business, you are wearing a different hat. You’re wearing a number of different hats. You can be an accountant, a marketer, a salesperson. And you’re having to give space for lots of different hats as well as being a therapist, because if you don’t give space for that, you’re going to head towards burnout. So it being part of a community is one way to do that.

And we focus on we want to change the landscape of private practice and empower practice owners to be able to attract self-funding clients, which is quite a different skill than just working with companies as well. Because you have to focus on the marketing and other elements.

Absolutely. So to sign up for Sarah’s therapist community, Therapist Corner, check out therapistscorner.co.uk or you can simply scroll down to the show notes and click on the link.

Sarah, thank you so much for joining us on the podcast today to discuss how to transition from being an employee into private practice.

It is a pleasure. Thank you for having me,

And thank you everyone for tuning into today’s episode, and I hope you join me again soon on The Designer Practice Podcast.

Until next time, bye for now.

Credits & Disclaimers

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