5 Mistakes to Avoid When Starting a Private Practice in Counseling

An increasing number of therapists are choosing private practice – a whopping 74% of mental health professionals surveyed by the Journal of Health Service Psychology were operating privately during the Covid-19 crisis. 

It’s no surprise that therapists are attracted to starting their own practice. Being your own boss means you have control over your time and schedule and the flexibility to adapt quickly to new situations, like moving your counseling practice online when the pandemic hit. We’ve written before about how to start an online therapy practice.

The sky’s the limit in private practice: you can create exactly the kind of treatment plans, niche focus, and online or office space that represents you best. But adjusting to private practice can be tricky. This article shares the five most common mistakes therapists make when they start out and tells you what to do instead to boost your chances of success. 

Nuna is an all-in-one practice management tool for therapists that makes starting a private practice much, much easier. Try it, it’s free!

The challenges of private practice

Creating a private practice can be a challenge. Therapists often make major mistakes in the first year or two, for various reasons. 

Firstly, mental health professionals just aren’t taught how to manage the business side of things. Counseling education focuses on clinical skills while making the move to private practice means thinking of yourself as an entrepreneur or small business owner, running your very own start-up. 

Many private practitioners jump right in with no business plan and get in over their heads. There’s a lot to do in a small business, and therapists need to learn how to juggle several different roles, as counselors, marketers, and administrators. 

The flexibility of private practice can be both a blessing and a curse, making it difficult to establish boundaries around your work. 

Finally, therapists can stumble because they simply don’t know what to expect – they don’t understand what running a successful private practice is really about. 

Avoid falling into private practice traps

But it’s possible to sidestep the typical first-year blunders. We spoke to our community of therapists about what they wish they’d known when they started out – and we’re sharing their wisdom with you.  

By understanding their mistakes, you can anticipate and avoid these pitfalls. This article outlines five of the most common mistakes private practitioners make and shows you how to build a thriving private practice, create structures to weather challenges, and stay happy and healthy with a strong work-life balance.   

Mistake 1: Not taking advantage of all-in-one practice management tools

Mental health professionals often dive right in at the deep end, without thinking through their processes and getting properly organized to manage their practice. They use different tools to manage the business side of things and the health services they offer, jumping from one service to another. 

Using different scheduling software, telehealth platforms, invoicing tools, note-taking devices, and therapist directories can be confusing, stressful and a waste of your valuable time. 

Therapist Victoria Niven, who offers treatment for anxiety and depression among other issues, says the number one tool she wishes she’d had when she started was “a better internet connection and a safe platform”.

Nuna offers a secure, all-in-one solution for mental health professionals with a teletherapy platform that’s end-to-end secured for peace of mind. Our practice management software for therapists includes features like invoicing, real-time therapy notes, and client files. 

Appointment scheduling features help new therapists to reduce no-shows from the start, with automated reminders and a system of real-time changes and updates to your calendar. You can learn more about the best therapy scheduling software in our previous article. 

Luisa Mannu, a therapist who specializes in grief counseling and the psychology of transition, told us she wished she’d had “a platform to help increase the number of clients” in her first years of private practice. That’s why Nuna helps therapists to find new clients and promote their practice through our therapist directory, which also matches therapists with new clients. 

Mistake 2: Not considering the therapist-client fit

Often, private practitioners say yes to every client when starting out. They may not consider whether new clients are a good fit for their services. By saying yes to everything, therapists can end up overstretched or even dealing with burnout. 

This is also a key mistake because it means therapists don’t establish a specialized niche, which is important for the effectiveness of their services and will attract more clients in the long run. 

To avoid falling into this trap, mental health professionals should define their ideal client, in line with their own areas of expertise and experience. It’s also important to design a first-session client interview procedure, where you can check if your therapy will be a good mutual fit for yourself and the client. 

When deciding whether to take on a new client, you should consider what a potential client’s needs are and whether you can meet them. If they’re a high-needs client, and you’re too busy to respond to crisis situations, it may not be a good fit. 

When you do take high-needs clients,  it’s also crucial to think ahead and establish a strategy to deal with emergencies, which may include a referral to urgent care or emergency service clinicians. As teens, families, and couples psychologist Saakshi Tikku advises new private practitioners, “it’s important to always have an emergency protocol in place to deal with high-risk clients.” 

Mistake 3: Not establishing boundaries with your time

It’s easy for work-life balance to slip when starting in private practice. One of the most common mistakes therapists make is not valuing their time. Many new private practitioners let sessions run over time, don’t expect or insist on punctuality from their clients, and don’t have a policy in place to deal with last-minute cancellations. 

Being your own boss is hard work, and it can also be difficult for private practitioners to establish boundaries between working hours and personal time. Many end up working unexpectedly or taking phone calls from clients during weekends or vacation time. 

This is a clear recipe for burnout and makes it more likely that you’ll end up with clients who don’t respect your time or professional boundaries. 

Victoria Niven remembers that one of her biggest mistakes when starting out was “not respecting my work time – the sessions were extended to more than an hour, or I was flexible when someone was arriving late.” Victoria encourages therapists starting a private practice to recognize that “it’s important that if you say that each session is of one hour you should respect that and your client too – the same goes for punctuality”. 

Overstretching yourself has both personal and professional consequences, and setting clear boundaries is the best thing for you and your clients. To avoid the most frequent timing slip-ups, you should establish a policy from the start on lateness and cancellations and strive not to go over the session time.

You may even want to consider starting out part-time, rather than full-time, to ease your way into the challenges of private practice. 

As we’ve mentioned, it’s also important to have an emergency procedure in place for clients who are in crisis outside of ordinary work hours, which may mean a referral to another mental health professional or service when you are not available.

Mistake 4: Not working marketing into your business plan 

Therapists getting started in private practice often don’t know how to market themselves effectively, and don’t take active steps to find new clients. Some invest their time and money in less effective techniques like print media ads rather than in marketing strategies that have real impact.

Luisa Mannu told us one of her key regrets, in the early days, was “advertising my practice in the wrong ways”.

As a result, mental health specialists may not find the steady stream of new clients they need. 

Luckily, there are several ways to avoid falling into the passive marketing trap. Private practitioners should incorporate a marketing strategy into their business plan. Joining online therapist directories is a great place to start in finding referral sources and new clients, but most therapists launching a private practice will ultimately need a website or a strong social media presence. 

Individual, couples, and family therapist Elena Blackwood told us about her biggest mistake when starting up: “I didn’t set up a website for a long time which I now regret. A website is a great way to present yourself and tell potential clients all about the work you do, get that started as soon as you want to get clients coming into your office or doing online sessions. Also having a business social media account is a great way to reach more people, and put yourself out there!”

Therapists should build a strong online presence that emphasizes their specializations and gives clients a sense of how they can impact their lives. 

Aside from a website, social media is a great option to reach clients directly. Blogging is another effective content marketing strategy – you could guest blog on lifestyle sites or even Nuna’s client blog, or start up your own blog on your website or WordPress. 

You could even agree to be interviewed for popular podcasts. For more ideas, take a look at our in-depth guide on how to get more therapy clients

Mistake 5: Not thinking through your pricing strategy 

All too often, new therapists who feel insecure around attracting clients set their prices too low or offer too many discounts. Many therapists don’t consider the business side and fail to regularly revise and update their pricing structure to account for inflation, changes in the market, and your increased experience as a mental health professional. 

Undervaluing your services means you may struggle to make ends meet, or find yourself overworked with tons of low-paying clients. Charging low prices also makes it more likely that new clients won’t value your work. 

Therapist Victoria Niven regrets initially “charging not much because I thought that I would have more patients”. She reflects: “This isn’t true – when your prices are lower than other professionals you are not giving enough value to the time you have spent studying and working on each case. You are also pulling down the price of the market. Remember you have to make a living from this profession, so the price must be fair.”

To avoid this mistake, therapists should take time to work out a full pricing strategy as part of their business plan, before opening their doors as private practitioners.

Consider how much income you need and how many new clients you can take on, as well as what your market is willing to pay and whether you want to offer limited sliding-scale discounts. Then, you should continue to monitor and adjust your prices each year to ensure they remain viable. 

Avoiding pitfalls when starting your private practice 

Going into private practice is an exciting opportunity for therapists and clinicians to do things their way. If you do it right, you can enjoy more flexibility, reap financial rewards, and make a real difference in your clients’ lives. 

But it’s also hard work, and many therapists fall into common traps in their first year or two in private practice.

  • Not using an adequate practice management platform
  • Not specializing or filtering clients 
  • Not valuing their time
  • Not investing in marketing and social media strategies
  • Not charging enough

Joaquín Juliá Salmerón, who helps clients with anxiety, depression, quitting smoking, and weight loss, mentions another big mistake: “walking the path on my own”. As he says, learning from other mental health professionals and “establishing alliances with other colleagues” can make all the difference. 

With our tips and Nuna’s network of supportive private practitioners, you don’t have to go it alone. Mistakes are natural. But by getting savvy and anticipating the major pitfalls of private practice, therapists can plan for success and get ahead of the curve by preparing for challenges.

Nuna is an all-in-one practice management tool for therapists that makes starting a private practice much, much easier. Try it, it’s free!


We're the team behind Nuna. Nuna is an all-in-one solution for mental healthcare professionals around the world. We help you save time and connect with new clients to run your practice. To join, visit expert.holanuna.com and get started for free!

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