A year after Cyndi Briggs graduated with her master’s degree in counseling, she was working as an addictions counselor. The work and the clients were important to her, but it was also a difficult job, and the hours were long. She eventually found herself dealing with symptoms of depression.
Briggs went to talk with a career counselor, and the meeting led to an “aha!” moment for Briggs. “He said, ‘Why do you take low-paying, high-stress jobs?’” says Briggs, a member of the American Counseling Association. “And I [had] literally never considered that there was another option.”
Fifteen years later, Briggs is living her ideal life as a counselor. She works full time as a core faculty member in the clinical mental health counseling program at Walden University, but she also maintains a number of what she calls “side gigs,” including corporate training work and speaking engagements. Briggs has run a private practice in the past, earned her coaching certification and, for a handful of years, wrote a blog aimed at helping counselors think outside the box. While writing the blog, one of her central messages to counselors was that they could apply their many skills and talents in a variety of professional settings where they could also earn a good living.
Deb Legge shares a similar message with her clients in the coaching and consulting practice that she runs, in which she helps mental health professionals build and grow private practices. Like Briggs, Legge knows from personal experience what it’s like to have a desire to become, and then succeed in becoming, your own boss.
Counseling was a second career for Legge. At the time she was earning her master’s degree in counseling, she was a single mother, which meant that taking her new degree into an entry-level, low-paying job wasn’t an option. From day one in graduate school, Legge says, she was laying the foundation to establish her own private practice, which she now runs in Buffalo, New York (her private counseling practice is separate from her coaching/consulting practice).
Counselors and other mental health professionals who approach Legge for help with the how-tos of starting their own private practices have a variety of reasons for wanting to become their own bosses. But oftentimes, Legge says, it boils down to seeking freedom and better financial opportunities. “My experience has been that most people decide to do it because they are either really burned out from working for someone else, overworked [and] underpaid for too long, or their life circumstances change and they really do need more autonomy and money,” explains Legge, a member of ACA.
When Briggs presents on this topic, there are often weary counselors in the audience who raise their hands and want to know more about how to transition into private practice or become their own bosses in another way. Many times, Briggs says, these counselors have been working in nonprofit settings for many years and are feeling burned out because of overwhelming caseloads and too little pay. “For a lot of people,” she observes, “it’s just rediscovering the joy of why they wanted to be counselors in the first place.”
Risks and rewards
Running a private practice comes with a variety of upsides for counselors, Legge says, from control over their schedules to control over which clients they work with and what work they do with those clients. For example, some of Legge’s clients who are starting out in private practice will ask if they can conduct a daylong seminar, a weekend retreat for couples or an hourlong session with a particular client. “As long as you’re being ethical, and as long as you’re being legal, and as long as you’re abiding by the rules of an insurance company if you’re participating with them, there are no rules,” Legge tells her clients.
But before launching a private practice, counselors need to become licensed. And once they’re licensed, Legge says, they also need to honestly evaluate whether they possess enough clinical experience to set out on their own and whether they have set up the necessary supports and guidance, including supervision, to lean on as they get established.
Going into private practice isn’t the right fit or even the desired end goal for every counselor. For one thing, it requires embracing a certain amount of tolerance for risk and responsibility, Legge cautions. “I don’t want to give people the impression that it’s for everyone or that it’s a bad thing not to be in private practice,” Legge says, adding that she is grateful for all the counselors who choose to work in agencies, schools, hospitals and other settings.
Starting a private practice also isn’t the only way that counselors can become their own bosses. In fact, putting your counseling skills to use in a variety of “gigs” — from consulting to running a private practice to adjunct teaching — can be financially beneficial, says Briggs, who has served as a consultant in various settings. “There’s lots of security from that,” she says. “You’re not relying on one entity to pay your income every month.”
Whatever the environment, working for yourself is creatively empowering, Briggs says, in part because of the flexibility it allows. “You get to decide what you do every day and change it if you need to change it,” she says.
But that freedom also comes with risk and responsibility, Legge points out. “You have to be OK with the fact that when things go wrong, the only person you can look at to turn things around is yourself,” she says.
Likewise, when you become your own boss, some of the security that comes from working for someone else goes away, such as a steady paycheck and covered benefits. Legge refers to those kinds of benefits as “golden handcuffs” because, while valuable, people tend to cling to them at the expense of their larger dreams. They’re “the things that can and do keep them from getting what they say they really want,” Legge observes. “Each one of those things is just a dollar figure that can be figured into a budget so you know how much you need to make to pay for those things yourself.”
Before launching a private practice, Legge recommends that counselors imagine the kind of life they want to live and then design their private practice to fit that life. For instance, if counselors imagine living a life in which they spend more time with their families, then they might want to choose target markets based on clients who won’t routinely need appointments on weeknights and Saturdays, Legge says.
The question counselors need to ask themselves before jumping into anything, Legge says, is “What are you willing to do to get what you say you want?” For many counselors, in the end, the benefits of going into private practice or becoming their own boss in another way far outweigh the risks, she says.
Even so, when counselors strike out on their own, one of their biggest initial fears is that they will fail, Briggs says. “I think we all carry that [fear], like ‘I’m going to fall on my face, and the world’s going to laugh at me, and I’m going to be broke and living in a box under a railroad trestle.’”
Along those same lines, Legge says, counselors who are transitioning to private practice commonly worry whether they are skilled enough and qualified enough to warrant clients coming to their practice. They might start questioning why anyone would choose to see them when there are already so many other counselors in town. “Unfortunately, there are more than enough people who are in need to go around,” says Legge. She encourages the clients from her consulting practice to view those other counselors in their communities as colleagues and potential collaborators.
Some counselors even worry that they’re somehow selling out by moving into private practice, Briggs adds, recalling that when she left her job as an addictions counselor, she initially felt guilty. Because working with clients who struggled with addictions felt so meaningful and honorable, Briggs even wondered whether she was shallow for leaving that position to find a job she enjoyed more.
“A lot of us struggle with that: ‘People are going to think I’m a bad person if instead of working with the homeless population, I’m going to choose to work with college students,’” Briggs says. But her thinking has evolved since those early days. “Everybody’s got their place, and you just have to find the right place for you,” she asserts.
Let’s talk money
Counselors striking out on their own commonly worry about their bottom line, wondering if they will be able to make enough money to survive and keep their doors open. Complicating those worries, Legge and Briggs agree, is that the topic of money is already uncomfortable for many counselors. “I don’t know how it happens, but we’re socialized in [the] helping professions to think that helping others and making lots of money are contradictory,” Legge says.
Briggs concurs. Many times, she says, when counselors enter the profession, they hold tight to the attitude that they are choosing this career path to help people, not to make money. “It’s almost like those things are mutually exclusive, and I have a really big problem with that,” she says. “We’re never taught to be empowered around our skill set. We’re never taught how to ask for a livable wage around what we do. We sort of think, ‘If I’m not helping people directly, if I’m not with the most needy population, then I’m being greedy and squandering my skills.’”
That viewpoint is “absolutely inaccurate,” Briggs stresses. “Helping people and earning a good living are not mutually exclusive.”
Legge has received her fair share of criticism through the years for talking about how mental health professionals can make more money. She says much of the criticism has come from her fellow mental health professionals, including some who label her views as “mercenary.”
“What I come back with is, if you want to be in private practice in three years for [the sake of] your clients, then you have a responsibility to be a good businessperson and to make a living [so] that you can continue to be in private practice,”
Counselors planning to go into private practice need to address any hang-ups they have around money early on, Legge says. “If you want to draw money into your business, you’ve got to deal with your issues regarding money,” she says. “You just have to do it. If you’re afraid to ask for a copay, your client is going to pick that up in a heartbeat. If you’re uncomfortable telling a client over the phone what your fees are, they’re going to pick that up in a heartbeat.”
Legge has found that the more comfortable counselors are talking about money, the more comfortable their clients are with the topic, and the less likely it is to become an issue between them. In addition, counselors need to keep sight of their worth when talking about their fees or collecting payments from clients, she says.
“What is it worth to save a marriage? To save a kid? To live a better life? To save that job? What is it worth to my client?” Legge asks. “You’ve got to think about your worth in terms of what the value is to your client.”
When Briggs was doing a job for one of her first corporate clients a few years ago, she cited her fee for a one-hour presentation. The client replied by suggesting that she research the company and come back with a different price. Briggs returned with a quote five times that of what she had originally asked for, and the client accepted it. “That was really good for me to hear,” she says.
Although Briggs acknowledges that fees are still a topic she wrestles with from time to time, she says it is important for counselors to reach clarity on what they truly need as a livable wage and then to feel confident in stating that to others. To that end, Briggs says, when counselors are determining the fees they will charge, whether in private practice or in another setting, they should calculate what their livable wage is. That number should take into account expenses that are typically covered when working for someone else, such as health insurance and some amount of paid vacation, she says.
Putting yourself out there
Although business owners are responsible for growing their businesses and attracting clients, many counselors bristle at the concept of marketing and sales. When Legge works with helping professionals who want to start or grow a private practice, she reassures them that sales and marketing don’t have to feel “slimy.” A “brand” needs to be nothing more than how you want to be seen in the world — whom you serve, what you do and why you do it, Legge says.
Marketing starts with a paradigm shift that encompasses “going from the fear of being sales-y” to the perspective of getting to know your community and your target market in particular, Legge says, “so they can rely on you, build a relationship with you and so that when they need you, they’ll know where to find you.”
Briggs echoes the point about counselors changing their perspective on what it means to market or sell themselves. Many people equate business with greed, marketing with sleazy sales tactics and networking with schmoozing, but that isn’t necessarily true, she says.
“Networking is walking into a room full of really cool people and getting to know them. Counselors are great at that,” Briggs says. “And marketing is about building relationships — counselors are great at that. And business is about finding a way to apply your skills so that you can benefit the world and earn a decent income. There’s nothing sleazy about any of it when you reframe it in a way that’s authentic for you. The goal really becomes to redefine it in a way that’s authentic for you and [to] own that. And then it stops being creepy and weird and starts feeling more natural.”
David P. Diana is a marketing consultant and licensed professional counselor who runs a marketing firm specializing in serving health care organizations and practices. He is also the author of the book Marketing for the Mental Health Professional: An Innovative Guide for Practitioners. He points out that marketing isn’t a quick-fix process for mental health professionals but rather something that happens over time based on a clinician’s work and actions.
“Too often, people look at marketing in crisis mode,” Diana says. “Perhaps they lose several clients, and then they say to themselves, ‘I need to get the word out about my work to fill these holes.’ The problem with this reactionary mode of marketing is that it rarely works. People often make the decision to advertise their practice, hand out fliers, etc., in the hopes that the phone will ring again. However, marketing involves much more work than that to create change and interest.”
That said, Diana offers a few key points for mental health professionals to consider when they think about marketing. First, he says, put the emphasis on why you do what you do as a counselor, offering potential clients a mission and a story with which they might connect.
Second, Diana says, don’t devote time, energy and resources trying to be the right clinician for everyone. “If you focus on your why, then you have a chance to share a story with an audience that wants to hear that story,” he says. “When your values [and] purpose match up with a group of people with similar values [and] purpose, then you have found your audience.”
Diana concludes by reminding counselors that advertising is not marketing. “Marketing is about conversations and connecting your story to an audience that wants and needs to hear that story,” he explains. “Marketing to a mass audience via advertising yields very little results because there are so many fragmented markets and because we, as consumers, have access to so much information.”
Marketing comes from a “heart of service,” Legge adds, and from a desire to help the community. “If you believe you’re meant to serve others,” she says, “then you have a responsibility to let the community know you exist as a viable resource for them.”
Putting that brand of marketing into action begins by building relationships, Legge says. Especially initially, it means that counselors concentrate not on where they’ll get their next referral, she says, but on finding out more about their target market — what those potential clients in their community need, what their biggest problems are and how that counselor can help.
In getting to know people in their communities, Legge says, counselors will learn about what those people need and where to find them. In turn, those people will learn about the counselor, see that the counselor has credibility and come to rely on and trust the counselor, she says.
Briggs calls word-of-mouth a huge force in driving new clients to counselors. Having a web presence can also help counselors get their message out, “even if it’s just a professional Facebook page where you’re advertising who you are, what you do and what you’re about,” she says. At the same time, Briggs says, social media requires that counselors engage in a “delicate dance” in which they take advantage of the inherent marketing opportunities while simultaneously ensuring that they don’t violate any ethical boundaries.
Briggs also recommends that entrepreneurial counselors offer something for free — but get feedback in return. For instance, if you have a presentation for which you would eventually like to be paid, start out by offering it somewhere for free, but ask for comments and critiques. Another idea Briggs suggests is starting a blog or website focused on what you are interested in offering as a counselor. If you want to work with children, for example, establish a blog for moms and offer parenting tips. “Once people see the information and knowledge you have, they’re much more likely to pay you for it,” Briggs says.
The business of balance
Seeing clients while simultaneously running the logistics of a business can be challenging. Juggling both means a heavy dose of decision-making and delegating, Legge says. For example, it may not make sense to do business with every insurance company, she says. Consider the workload each insurance company would require of you and whether the company pays fairly before choosing to work with it.
Similar decisions must be made about other business tasks such as bookkeeping, billing and taxes, Legge says. “Depending on your talents and your interests, you may choose to do some of those things. But it may be much more reasonable to farm out some of this stuff, even though you’re going to pay to do it,” she says. Private practitioners have to consider the return on investment, she adds. “Does it make sense not to pay the $80 a month for the billing platform when you’re spending three hours a week on billing by hand?”
In terms of juggling client work with business tasks, Legge says each counselor has to figure out what process works best. She likes to finish her to-do list at the end of every workday, but she knows other mental health professionals who are more productive when they pile up their business tasks and do them all at once on a deadline.
Making it all work is a balancing act, says Briggs, who has side gigs that take up 20-30 hours a week on top of her full-time teaching job. One key for her has been learning to say no. She clarifies what her priorities are and dedicates time for them, even if it means saying no to another interesting opportunity.
Both Legge and Briggs recommend that counselors who are running their own businesses reassess their situations and business models regularly, but ideally every 90 days. They suggest reviewing what you’ve been doing, how it has been going, what you might like to change and whether you’re still enjoying the work.
Look before you leap
Although graduate counseling programs are already packed with requirements, Briggs says it seems “criminal” that electives in marketing and entrepreneurship aren’t offered more widely considering how many counselors are interested in private practice.
Many counselors feel very much on their own when they are learning to run a business, Legge says. That’s why many turn to books and blogs for helpful tips and information. In addition, she points out, some communities of mental health professionals have come together to support one another, and business coaches can also help.
One piece of wisdom Legge sometimes passes along to clients starting out in private practice is that they won’t be able to serve everyone all the time. That’s not always welcome news. Legge says some of her clients have expressed frustration that she can’t show them how to make a comfortable living working exclusively with individuals and families with low incomes, for examples. In that instance, she might tell counselors that although some of their practice can be dedicated to working with that client population, they also have a responsibility to supplement that with higher-paying work so they can stay in business for all of their clients. “Dollars are dollars, and it’s got to balance out at the end of the month,” Legge says.
It’s imperative for counselors to have a sense of what they’re stepping into, plus an understanding that it might require them to take baby steps in that direction rather than one big jump, Briggs says. “I’m not an advocate of quitting your job without a plan,” she asserts. Instead, counselors might consider giving themselves a two-year timeline during which they work full time and take a couple of side jobs to “test the waters,” Briggs says.
“Don’t think the bravest thing you can do is quit your day job,” Briggs counsels. Instead, go at the pace that’s right for you as you explore your entrepreneurial options, she says. “Take whatever time you need to take the leap, and don’t push yourself beyond where you’re comfortable.”
Legge further suggests finding support through a national association, continuing education classes or a group of peer clinicians who can provide guidance, encouragement and even group supervision.
Reflecting back to her advice about marketing, Legge says it is also important for counselors to build a foundation before launching their practice. Sometimes, she says, counselors work hard to start their business, hand out business cards and create a website, but then the phone doesn’t ring. The preemptive solution, she says, is to build relationships before starting a practice so that people in the community will know who you are, what you do and why you want to serve your fellow community members.
And perhaps most important, Briggs says, is for counselors to know their true value. “Get really clear on what you’re worth,” she says. “Know that what we do has immense value to others. People are going to be willing to pay for what you’re worth, and you can ask for it.”
To contact the individuals interviewed for this article, email:
Lynne Shallcross, a former associate editor and senior writer at Counseling Today, works for Kaiser Health News as a web producer. Contact her at firstname.lastname@example.org.
Letters to the editor: email@example.com
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“Look before you leap,” an in-depth piece on what it takes to go into private practice