Starting My Practice, What I Wish I Knew

I wanted to create a simple guide to help you start your ideal private practice. I know that when I was considering leaving my agency behind I was scared, nervous, and very unsure of myself. I had no idea where to start. I met with several colleagues of mine who had graduated before me who were working for themselves and picked their brains. I bought them lunch, coffee, offered to pay for their time, etc. I followed the appropriate Facebook groups, listened to podcasts, etc. All of this was helpful yet I still had doubts about the process.

If you’re like me you question literally everything and anything. Call it anxiety, call it perfectionism, call it obsessive thinking. Whatever you call it, that mentality creates blockages. Almost like putting your own barriers in your way to ensure that you will stumble over them. I’ve written about Impostor Syndrome before and how damaging that type of thinking can be.

Starting a private practice is like building a house, and guess what? I’ve never built a house and I’m sure that most of you haven’t either. Nevertheless, the foundation is the most important part.

The foundation consists of the following: Office space, furniture, intake documents, a way to accept payment, liability insurance, a business name (even if you’re doing business as yourself), an EIN (employee identification number) attached to said business name, and a way for clients to contact you. This is it. Nothing more, nothing less. And it does not have to be perfect by any means. We can get caught up in that mentality that things need to be absolutely perfect or they won’t work. Just get two chairs from a garage sale and put them in an office. Make sure that you have informed consent paperwork, a professional disclosure statement, privacy policies, and releases of information. Getting an EIN is quick and painless and takes less than 5 minutes on the IRS website. It is completely free (please do not fall for any scams where they ask you to pay for one). Find a HIPAA compliant payment method. IVY Pay is easy to use and meets that criteria. It is a HIPAA compliant app designed for therapists. The client puts their card info in on their phone, it encrypts the information, and you hit “charge” whenever you see them. The client gets a text telling them their card has been charged. Easy! And obviously make sure you have a way for clients to contact you. A HIPAA compliant phone/text is recommended. I use Spruce Health. It’s HIPAA compliant phone, text, and fax, all in one!

After building the foundation of the house/private practice we need to start on the walls. The walls are also essential but not as critical as the foundation. The walls consist of a landing page/website or some way to find you and contact you. Sometimes I think we can assume that clients are just going to appear. They need to be able to find you via internet search. If you are a part of local/national therapist Facebook groups you’ll need a place to link your contact information to when asking for referrals. The walls consist of an electronic medical record system to keep yourself organized and to bill appropriately. I prefer using Simple Practice but you may have a platform you feel more comfortable with. All of the EMRs offer free trial periods. Try them out, see what feels the most comfortable. You will also want a business bank account. I hear this time and time again. You do not want to use your personal bank account. Please make sure to open a business bank account with your EIN #. This is so important for tax purposes. Most banks offer business accounts. Choose one that has 0$ fees, is accessible for support, somewhere you can develop a professional relationship with.

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Patrick Casale, MA, LCMHC, LCAS

Patrick Casale, MA, LCMHC, LCAS

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