How To Start a Private Therapy Practice (Without Burning Out or Going Broke)
Dr. Lisa Marie Bobby is a licensed psychologist, licensed marriage and family therapist, board-certified coach, AAMFT clinical supervisor, host of the Love, Happiness, and Success Podcast and founder of Growing Self.
So you’re wondering how to start a private practice as a therapist? Amazing. You, my friend, are brave, brilliant—and maybe just on the verge of making a giant decision without realizing how big it actually is. Let’s fix that.
In a recent episode of my podcast, Love, Happiness and Success for Therapists, I peeled back the curtain on what it really takes to start a successful private practice. Spoiler alert: it’s not just “more therapy, your way.” It’s building and running a full-blown business—whether or not anyone warned you in grad school.
How to Start a Private Practice
Here’s the mic-drop moment that kicks it all off: Do you want a private therapy practice? Or do you want to own a business? Because those are two things that are totally different.
That right there is where so many amazing therapists get stuck. We leap into private practice to escape therapist burnout, financial strain, or clinical overload with high intensity clients (valid!), but don’t fully realize that being in private practice also means being a business owner.
Translation? You’re now the CEO of marketing, operations, admin, billing, branding, networking, SEO, and still doing your client work like the rockstar therapist you are.
And if nobody’s said this to you before, let me be the first: if you don’t love the idea of entrepreneurship, private practice might not feel like the dream you imagined. But if you’re even a little excited about creating something that’s truly your own, keep reading.
The Two Doors: Insurance-Based vs. Private Pay Practice
When you’re thinking about how to start a private practice, just know that you’ll need to pick a lane—insurance-based vs. private pay practice—and each lane has trade-offs. We covered this in the episode in detail, but here’s the CliffsNotes version:
Door #1: Insurance-Based Clinical Practice
✔️ Steady client referrals, easier to fill your schedule.
✔️ Lower cost to clients = higher retention.
❌ High admin burden (billing, audits, documentation).
❌ Must diagnose clients for reimbursement.
❌ Ethical landmines if you’re doing non-medical work under the guise of treatment.
Honestly? If you’re diagnosing “adjustment disorder” like it’s confetti at a wedding just to justify services… we need to talk. (We did, actually. Listen to this episode on therapy insurance fraud. I went there.)
Door #2: Self-Pay Private Practice
✔️ Total freedom: set your rates, choose your clients, do growth-oriented work.
✔️ Lower admin work and more room for creativity.
❌ You’re now your own marketing department.
❌ No insurance referrals—clients have to find and choose you.
If this sounds intimidating, you’re not alone. But I promise, there are clear, ethical, effective ways to make this work.
Free CEU Training for Therapists!
4 Steps to Finding Your Niche
As a Therapist
If you feel like you’re on the verge of burnout, questioning your career path, or wondering why the work you once loved doesn’t light you up anymore — this is your moment to find clarity.
Learn how to align your strengths, passion, and expertise with a niche that fits who you really are and earn 1 CEU credit.
Marketing Isn’t Optional—It’s the Engine
I said it in the podcast and I’ll say it here again:
“If you build it, they will come… is a Kevin Costner movie, not a business strategy.”
Therapists often make the mistake of putting up a pretty website or starting a therapy social media account and waiting for the phone to ring. But if your messaging is “safe, warm, and nonjudgmental,” well… congrats! You sound exactly like every other therapist on the internet.
At the very least, your marketing strategy as a therapist has to answer two things:
- Who do you help?
- Why you?
That means identifying your niche, speaking to it clearly, and showing people exactly how you can help them get results. I created a free CEU training on the 4 Steps to Finding Your Niche as a Therapist to help you get clear on who you want to serve and your marketing strategy to attract clients. I hope you check it out.
Therapy or Coaching? Know the Difference (and the Risk)
One of the biggest reasons therapists flounder in private practice? They’re using therapy tools with coaching clients—and vice versa—without really understanding the difference.
Coaching clients are often high-functioning, goal-oriented, and results-driven. They expect tangible outcomes. If you’re giving them traditional therapy without forward momentum, they’ll bounce after three sessions and leave you a little bewildered.
If you want to serve those clients—and do it well—get coaching skills. Real ones. With structure, tools, strategy, and a clear ethical framework. I created a training program for this because the need for therapists trained in coaching psychology is real.
Check out my Coaching Certification for Therapists to expand your scope and get credentialed so you can coach ethically without jeopardizing your therapy license.
Your Next Step (And a Loving Nudge)
If you’re seriously thinking about starting a private practice, please don’t wing it. Join me in my free CEU training: 4 Steps to Discovering Your Niche as a Therapist.
I created it to help you get crystal clear on who you are as a practitioner, who you want to serve, and how to attract your dream clients. It’s everything I wish I’d known when I started my private practice. You’ll also receive one CEU credit for completing the training and acing the knowledge check.
Let’s do this together. No burnout. No confusion. Just strategy, clarity, and creating a practice that actually supports your life, your goals, and your energy.
👉 Access the 4 Steps to Finding Your Niche as a Therapist training.
Also, if you’re in the messy middle of your professional evolution, or if you’re just craving more real-talk conversations about the behind-the-scenes of life as a therapist—let’s stay connected.
I hang out on LinkedIn more than I probably should (hey, it’s where the smart, soulful professionals are). That’s where I share exclusive content for therapists, updates on my latest free CEU trainings, insights into private practice success, and the occasional nerdy deep dive into clinical ethics, coaching, or how to market yourself without selling your soul. Find me on LinkedIn!
Xoxo
Dr. Lisa Marie Bobby
P.S. Know another therapist who’s dreaming of going solo? Forward this to them. Share it in your consultation group. Drop it in your Facebook therapist community. Let’s help each other rise. 💛
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