Transitioning from a group to solo counseling practice

The decision to open a solo counseling practice is the dream of many counselors. In a lot of ways, owning a private practice is the gold medal for counselors, the reward that justifies all those long, difficult, and often underpaid hours logged in other work settings. Especially while working in a group private practice, we can develop entrepreneurial ambitions and visions of an independent business. Not all that glitters is gold, though, and it is imperative that counselors evaluate the costs and benefits before starting a solo practice.

An enormous benefit of owning a private practice is the ability to pocket more income. Group practices usually have percentage splits, in which an allotment of counselors’ payments goes to the group practice owner. These funds pay for resources that the group members share, such as administrative staff salaries, rent, utilities, and supplies. This income sharing can be unsettling. For instance, if your group practice owner employs as 60/40 split, and you meet with a client for $100 a session, you only receive $60 for that session. The remaining $40 goes to billing and other administrative costs.

Contrastingly, a private practitioner who works from home and does their own billing would collect the full $100 payment. Thus, solo practitioners who manage their money well are able to earn far more than they did while working at a group practice. 

Complete scheduling freedom is another private practice perk. As the business owner, you decide how often you want to work and do not need to ask permission for time off. You can take vacations without losing income by increasing your hours before or after you are out of office. You can even schedule clients for nontraditional hours that serve you best, such as offering telehealth appointments in the evenings. This freedom allows counselors to work within their strengths, on their preferred schedule, in a very independent manner.

Developing entrepreneurial skills is another allure of solo practice. Rather than settling into complacency, counselors who own an independent practice regularly face business decisions. They address company matters on a daily basis, including marketing, networking, and money management, in order to make their endeavor successful. This skill diversification provides solo practitioners with increased energy and endurance to remain in the counseling field. 

Possibly the greatest advantage of owning a solo practice is the privilege to choose your own clients. Independent practitioners are not assigned clients as they are at a group practice or agency. Instead, they decide what type of client (and presenting problem) they want to accept. They can screen potential clients with their available resources and schedule in mind, before choosing to offer an appointment or make a referral. This freedom enables solo practitioners to craft more personalized and balanced caseloads, which drastically reduces their likelihood of burnout. 

The positive effects of owning a private practice mirror to reflect their opposites. In general, counselors are poorly prepared for business since most counseling programs do not teach entrepreneurial skills. Though counseling students develop cultural sensitivity and complete thorough assessments, many are ill-equipped for business management. A successful private practice requires proficiency in insurance billing, cash flow, and tax filing. Counselors who are not fluent in these areas must invest time and resources to increase their knowledge or contract with appropriate experts. If not, solo practitioners will find themselves unable to give their business longevity.

Furthermore, while the income at a solo practice may appear plentiful, so are the financial responsibilities. You must make payments for routine necessities, including rent and office supplies, as well as for surprises, such as water leaks and printer replacement. And if a client or insurance company does not pay for services rendered, you must collect that payment or write it off. 

Solo practitioners are also fully responsible for administrative duties, which involve appointment scheduling, collecting payments, and submitting insurance claims. These tasks, which are usually shared by therapists or assigned to office staff at group practices, can be quite exhaustive. Nevertheless, a solo practice owner must fill all their available counseling hours to generate a sustainable income.

A final adversity of solo practice is the “silo effect” which results from limited contact with colleagues for encouragement and consultation. At group practices, multiple counselors and administrative staff are available on a daily basis. This additional staffing provides counselors with regular access to increased accountability and interpersonal connection. Contrastingly, counselors who manage a solo practice do not have colleague interactions automatically built into their workdays. This deficiency can escalate a solo practitioner’s risk of burnout and unethical practice. 

For most of my career, I resisted the idea of opening a solo practice because it appeared too daunting. The idea of dealing with insurance panels, collecting outstanding balances, and attracting new clients was fiercely intimidating to me. However, after considering the pros and cons detailed above, I took the plunge and like the results. If you are considering a transition from a group to solo counseling practice, reflect on the following questions first:

An all-on-one platform like Tebra's EHR+ can make it easier to manage operations as a solo provider.

Opening a solo practice is a grand endeavor for counselors, full of new challenges and risks. The opportunities to learn a new skill set, personalize your caseload, and retain more income are just several of the many benefits available. This unique mixture of counseling and entrepreneurship blends well for those who are adaptable, driven, and lifelong learners. Before moving from a group to solo counseling practice, consider the questions and information above to make a wise decision.