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Stop Selling the Private Practice Dream

Fri, 22 Aug 2025 21:01:22 GMT

It's not what you think

Maybe the title is off putting because it is written by a private practice owner. But the glorification of starting your own private practice must stop. In today’s world, it is completely oversaturated and actually can cost you significantly more money. I remember being in graduate school and always having the dream of having my own practice. Before I did, I worked in community mental health, a hospital, a day program, and at a group practice for someone else. All of these experiences gave me well-rounded knowledge and had I known all I know now, would I do things differently? Maybe?

But here is my advice to the baby therapist, or anyone considering starting their own private practice, think long and hard. Not once. Not twice. Not three times. A dozen times. Running your own practice isn’t a straight shot to success, it’s a maze of overhead, competition, and tough lessons.

Here’s the unfiltered truth about private practice…

1. It’s expensive as hell! You have the big expenses: rent, utilities, malpractice insurance, business insurance. And then you have the “smaller expenses” that add up QUICK! Monthly EMR costs, advertising and marketing, paying for your website and email addresses, fees for claim submissions, fees for running credit cards, phone service fees, cleaning fees… the list does not end. Add it all up, and it’s way more than you think. Here’s the kicker: I’ve had therapists working for me walk away with bigger paychecks than I did at the end of the year. So much for “being your own boss,” right?

2. It’s completely oversaturated. Starting your own practice sounds like the dream, right? Well, here’s the problem: when everyone’s chasing the same dream, it quickly turns into a crowded nightmare. Recent research from 2024–2025 shows that many solo practice owners actually make less than therapists in group practices. Why? Because when it’s just you, it’s tough to keep a steady client flow. Bigger practices have bigger brands, more visibility, and the ability to pull in more clients, while the solo therapist is left hustling just to be seen. Yes, there are exceptions. But most of the time, the one-person show struggles to compete with the main stage.

3. But I want to just do telehealth… I wouldn’t. Over the last 3 years, we’ve seen a MAJOR swing away from telehealth, and this continues to rise consistently. COVID times pushed everyone into the virtual world. Now, people are swinging back. Telehealth still serves its purpose, but the number of clients that call my office asking for in-person therapy is significantly more than those calling for telehealth.

4. Get ready to become best friends with insurance companies. Think you’ll spend your days doing deep clinical work? Think again. Once you own a practice, you’re not just a therapist, you’re also the billing department, the insurance negotiator, the tech support, marketing team, and the office manager. Want to outsource the admin so you can actually focus on therapy? Great, add another expense to that ever-growing pile.

5. But I’ll just accept cash pay clients. Okay, some clients do pay cash, but the build up to a full case load will be significantly longer than if you partner with insurance providers.

These are just SOME examples of why private practice ownership isn’t what you think. If I were baby therapist, or just someone thinking about starting their own practice, I’d say don’t do it right now. Maybe the tide will shift again one day, but today isn’t that day.

The smarter play for now… partnering with a well-established group practice can give you everything you are looking for: freedom, flexibility, higher pay all without all the additional work.

So, think smart, think critically, and don’t let society sell you the dream that’s not as "dreamy" as it looks.

Neurofeedback: Physical Therapy for the Brain

Mon, 27 Jan 2025 01:37:30 GMT

Exploring a different kind of mental health therapy.

What if someone told you there was a way for you to learn to control your own brainwaves? And that by learning to do so, you’d be able to alleviate a host of unpleasant symptoms ranging from anxiety, low mood, insomnia, and even managing migraine headaches? Neurofeedback, otherwise known as neuro-biofeedback, is a psychological tool we can use to attempt these changes.

Neurofeedback is a form of brain training in which an individual learns to uptrain or downtrain specific brainwaves based on real-time data they are receiving, in the form of auditory or visual feedback. The excess or lack of certain brainwaves in specific locations of the brain are correlated with increases in certain symptoms. For instance, high levels of beta in an area of the brain called F4 are associated with struggles with hypervigilance, anxiety, and rumination (Collura, 2014). Thus, the premise of neurofeedback is to train the brain to create the most optimal brainwaves and reduce negative symptomology with a noninvasive, no-medication treatment.

Individuals are given real-time data in the form of EEG’s. They are then given a feedback system, which can be auditory (e.g., music or tones), or visual (e.g., videogames, movies, or moving illustrations). When the targeted brainwaves are performing at the desired threshold, the feedback system plays. When the targeted brainwaves "fall out" of the desired threshold, the feedback system freezes or fades out. This trains the brain to understand that if the feedback is to continue, the targeted brainwave must remain at a specific threshold. Over time, the brain learns to maintain this "position" and negative symptomology begins to dissipate and reduce in intensity and frequency.

Does it Actually Work?

The origins of neurofeedback date back to the early 1950’s and 60’s. Dr. Joseph Kamiya trained individuals to achieve an alpha state with the sound of a bell, and Dr. Barry Sterman taught cats to increase their sensorimotor rhythm, which reduced their epileptic seizures (Kamiya, 1971 and Sterman, 1972). Since then, neurofeedback has been used to treat a variety of conditions ranging from anxiety, depression, OCD, autism spectrum disorder, substance use disorders, insomnia, to medical conditions such as epilepsy, seizure disorder, and migraine headaches. When such a wide variety of conditions are being regarded by one treatment modality, skepticism naturally raises.

Neurofeedback is not a magic wand. I was first introduced to neurofeedback in my undergraduate studies and began actively practicing neurofeedback several years ago. I have worked with many individuals, and some improve more than others. Neurofeedback works best as a supplement, an additive to other treatments. I encourage all my patients to be actively involved in therapy and practicing skills taught in sessions. I have seen incredible results with patients who were at a standstill with treatment, maxed out on medication, and burnt out with therapy sessions. Neurofeedback provided the additional boost that was needed to break past the standstill. For individuals actively invested in their treatment, neurofeedback can be a wonderful addition.

Physical Therapy for the Brain

Think of it as physical therapy for the brain. Presumably, one goes through weeks to months of physical therapy before major progress is seen. Additionally, at-home exercises are prescribed. Such is true with neurofeedback, the brain’s physical therapy. Clients attend training sessions two to three times per week and are further instructed to engage in behaviors, skills, and lifestyle choices outside of sessions that support their changed brainwave functioning. Those are the patients that benefit most.

Recently, there has been a surge in individuals seeking out nonmedication treatment modalities such as neurofeedback and TMS (transcranial magnetic stimulation). Most patients have either exhausted medication options or are looking for more natural routes to wellness. I have personally worked with clients who made exceptional gains in their treatment once neurofeedback was incorporated. One specific client had such high levels of social anxiety that she struggled to function in work, personal relations, and social functions. Around session 10, she became more talkative with me and had a brighter demeanor. Around session 15, she began talking about wanting to pursue a different job and perhaps moving away, something that was once unthinkable for her.

For those looking for a different kind of therapy, neurofeedback can be an excellent alternative. It’s important to do your research and find someone who is well-trained and can set realistic expectations.

Stop Telling Adolescents to Find Their Passion

Wed, 14 Dec 2022 16:33:48 GMT

Encourage them to find their path instead

The pivotal years of adolescence come with many pressures, one being finding a future career path. Adolescents are told to seek out their interests, pursue their goals, and find their passion. For some of us, this may come easier than for others. Perhaps little Sally knew she wanted to be a nurse from a young age, and the transition to college and then nursing school is a no-brainer. But what about Katie? She knows she likes art, acting, and theater, but how can this translate into a career? And is pursuing a career within her passion, the arts, the best career decision? Does satisfaction come only from pursuing a career in your passion? These are serious questions that adolescents and others face daily, and sometimes parents, teachers, and schools add to the pressure. But perhaps there is a different, better way to approach this topic.

Let’s talk about passion. In many ways, it is marked as the gold standard by phrases like “if you find your passion, you’ll never work a day in your life.” But it also subconsciously implies that if you don’t know your passion, can’t seem to find it, or can’t translate it into a career, something is wrong. The fact is, not everyone has a strong conviction or passion for a certain topic or area of interest, and we need to normalize this. In my work with adolescents and young adults, by far one of the biggest stressors they bring to sessions is feeling the need to have to find their passion. These individuals are misled into thinking that career equals passion. But some passions simply cannot translate into careers, or are not “smart” career decisions.

Here is a different perspective: Billy works as a plumber. He is good at it, makes good money, and gets time off that he can spend with his family and travel. He is not passionate about it. However, for Billy, it is enough to create life satisfaction. He is able to go to work, complete the tasks of the day, and live a life in which he has time for hobbies such as woodworking. On the other hand, Nancy is passionate about animal rescue. She has saved up enough money to open an animal shelter but is struggling to financially make ends meet. She finds herself working over 60 hours a week due to the demands of her business, and struggles to find time for family, friends, and self-care.

These are two opposite scenarios and many individuals would fall somewhere in the middle, but maybe there is more to life than simply finding your passion to obtain life satisfaction. When working with individuals, I instead encourage them to "find their path." A path is a direction that includes work/career, hobbies, values, and a social sphere. It can be outlined by the following principles:

Finding work or a career that I like . This is something that I like doing most days, or at the least, that I can tolerate. I also find myself good at it. Again, this will translate into a passion for some, but for others, it’s simply, “I can see myself doing this and overall enjoying it.”

Can I fulfill my hobbies? Outside of work, I have enough time to emphasize my interests (e.g., time to go to the gym, cook, take vacations, paint, etc.).

Can I live in alignment with my values? Perhaps I value quality time, freedom, or flexibility. Does my current path allow me to align with my values or does my career choice impede living out in accordance with my values?

The social sphere. As human beings, we are social creatures. We need time for friends, family, and community. Does my current path allow me the time to be with my social circle, or do I work among others to create comradery and connections?

The pressures of having to find a passion in many ways can exacerbate feelings of stress, anxiety, and uncertainty. Finding a career that does not translate to a passion can still provide a meaningful and satisfying life. Seeking out a "life path" can be an equally satisfying, and even sometimes healthier, life direction. Making sure we tend to all major pillars, including hobbies, values, and our social circle, ensures that we create balance to obtain that satisfaction and happiness we all desire. So, the next time someone isn't sure what they want to do for a career, don't tell them to find their passion; encourage them to find their path.