Ten Tips for New Business Owners: What Therapists in Private Practice Wish They Had Known in Their First Year
Summerland Psychology recently passed an exciting practice milestone: its first birthday. I opened my virtual doors in September 2025, and the first year of practice has passed in a blur of video meetings, google searches, rabbit holes, and deep dives into topics I never had to think twice about working in a public service setting (web design! marketing! practice policies! no-show fees! and so on).
It has been a challenging yet productive year. In addition to clinical care, I have built an entire network of therapists and other healthcare providers. I have learned countless skills. Through trial and error, I’ve figured out what schedule works best for me, how to set boundaries around my time, and the nuances of SEO/AIO.
Looking back, there are many things I wish I had known before opening my doors – yet there are a handful of things I’m glad that I learned the hard way. The perfectionist in me wanted to “ace” private practice, and yet the ACT therapist in me knows that challenge gives opportunities for growth, transformation, and learning. And boy howdy, there has been a whole lot of growth, transformation, and learning this year.
Whether you’re in the earliest stages of considering starting your own practice or barreling through your first year, you don’t need to have all the answers right out of the gate. There’s no perfection in business ownership; it’s truly a marathon - not a sprint.
I asked 10 therapists in private practice what they wish they knew in their first year. Here’s what they shared.
1. There’s a learning curve with marketing, but these are learnable skills.
“In opening my small business as a private practice psychologist, I knew I would need to market my services, but I had no idea how much it would be a marketing-focused job. The plus side to this is the vast variety of ways in which a business owner can do it! I worried that I would be lonely going into private practice, yet with my marketing and networking efforts, I feel anything but lonely. I have become acquainted with caring professionals in my local area and across the country who have not only been receptive to my outreach, but who have often become collaborative partners. The bottom line: the marketing part, grounded in relationship-building and service, is actually pretty cool.” – Dr. Weston Donaldson, Licensed Psychologist and Owner of Proud Heart Therapy (Wisconsin and 40+ PSYPACT states)
2. Know your niche, and find your people.
“I wish I had clarified my niche earlier, because knowing exactly who I serve best has shaped every other decision in my practice. I also wish I had understood sooner that a full caseload isn’t the same as a sustainable one, and that declining a referral outside my niche is what protects my energy for the work I do best. What has supported me the most has been building a network of other people who are growing their own practices.” – Dr. Kelly Dickinson, Licensed Psychologist and Owner of Pathwise Psychology (Washington and 40+ PSYPACT states)
3. Pace yourself! The administrative side of owning a small business is a whole thing, and you don’t have to do everything all at once.
“As someone who is now 10 months into private practice, I wish I had known that it takes a lot of work "on" the business (i.e., marketing, networking, understanding and maintaining compliance with laws regarding small businesses and taxes) to have work to do "in" the business (i.e., clinical care). It can be challenging to figure out the balance in order to meet my financial needs while not burning out by working longer hours than I did as a W2 employee in a large health care system.” - Dr. Chris Chiros, Licensed Psychologist and Owner of Dr. Chris Chiros, PLLC (Minnesota and 40+ PSYPACT states)
4. You won’t have all the answers, and you don’t need to. Tap in a professional when it’s needed.
“I wish I had invested in a business coach earlier. As a social worker, I had the clinical experience to start my private practice, but no background in business or marketing. Working with a business coach who specializes in supporting therapists in private practice has helped me address imposter syndrome and self-doubt, feel more confident about my fees and policies, and improve my marketing strategies. You don’t have to figure everything out on your own!” – Jenna Rumberger, Licensed Independent Clinical Social Worker and Owner of Aging with a Plan (Washington)
5. Be kind to yourself – starting a business is hard work!
“You are doing something brave and new. Remember, you are BUILDING a practice. Little by little. If you can, buy yourself time, maybe through creating some savings first, or starting your business before you leave another position. Make sure you are compassionate with yourself. Try Dr. Kristen Neff’s compassion break: 1) Notice you are suffering (are you afraid? Embarrassed? Criticizing yourself?). 2) Join the club of fellow sufferers! Any small business owner who is honest will tell you it’s a bumpy road full of “learning opportunities.” 3) Do your best to offer yourself what you can—comfort? Validation? Reassurance? Protection? Provision? Guidance?” – Dr. Jaimie Lusk, Licensed Psychologist and Owner of Threshold Psychological Services (Oregon, California, and Idaho)
6. The administrative side of owning a business can be a lot – routines and a plan can help.
“If I could go back five years to my first year of business, I'd tell myself to better structure time for administrative work. The first few months of starting my business were a lot of administrative work, but after that I primarily focused on clinical work, marketing, and education. I wish I had anticipated how much ongoing administrative work I'd need and how much time it would take, such as bookkeeping, tax preparation, license renewals, annual reports to the state, technology updates, and keeping my paperwork up to date with current laws. A plan and consistent schedule for administrative tasks can be very helpful, whether you schedule them weekly, monthly, or quarterly!” - Dr. Kelly Caver, Licensed Psychologist and Owner of Kelly Caver Psychology, PLLC (Washington and Texas)
7. Chip away at things with small steps, and set and maintain boundaries around your time.
“My advice is to set small, actionable steps that make the work of business ownership practical and efficient. A well-run structure and routine have been vital for me. When you're in business for yourself, it can be easy to work all the time, so having internal boundaries for yourself that are aligned with your personal well-being is important.” – Elizabeth Bryant, Licensed Marriage and Family Therapist and Owner of Flourishing Life Therapy (Washington)
8. Be true to yourself, and “hike your own hike” so to say.
“As I made the jump from a salaried position to owning my own practice, I knew I would have to find ways to grow my business and let people know I existed, particularly so as I did not already have a strong network of potential referral sources. When you step into the (probably foreign) role of business owner and marketer, you start to learn there are a lot of strategies people will suggest you use to grow your business. I wish I knew that I didn't have to do all the things. Forcing yourself to do something that doesn't "fit" for you is likely to lead to avoidance, burnout, and, frankly, to be unsuccessful. That isn't to say that you shouldn't step outside of your comfort zone - you should. But it is ok to do so by leaning into strategies that are more aligned with how you like to work.” – Dr. Sarah Jones, Licensed Psychologist and Owner of Wavecrest Psychology (Washington and 40+ PSYPACT states)
9. Support is everything – community matters!
“Starting my private practice felt like jumping off a cliff without a parachute. I’ve learned that building a community of trusted colleagues to provide mutual support for the journey was essential to create a practice that is uniquely mine.” Dr. Eric Clausell, Licensed Psychologist and owner of Destiny Psychology, PLLC (Washington and 40+ PSYPACT states)
10. If you take insurance in your practice, hire a biller before you need one.
“If I could go back and give myself one piece of advice before starting private practice, it would be this: find someone to handle your billing, and do it before you see your first client. I started out moonlighting in private practice while I was still with the VA. I saw two clients a week at most, and I accepted exactly one insurance plan. It should have been simple. Instead, managing my own billing turned out to be one of the most frustrating experiences of my adult life--or at least of the decade since I became a psychologist. So when I decided to go full-time, my very first move was to hand that work to a local billing expert for 7% of my revenue. My professional life has been a breeze ever since. That money is worth every penny. Part of that is the suffering I’m spared, but I also feel good about paying someone who makes my work life incalculably better. My advice: ask the therapists you know in your community whether they love their biller. When you hear a resounding yes, contract with that person immediately.” Dr. Christian Zal-Herwitz, Licensed Clinical Psychologist and owner of Dr. Christian Zal-Herwitz, PLLC (Montana and 40+ PSYPACT states)
Closing Notes
In summary:
It’s okay for this to feel hard (because it is hard!).
Pace yourself.
Find your people and lean on them.
Break things into small steps.
Be open to where this new chapter takes you.
And be kind to yourself along the way.
Parting question: If you’re a business owner, what else was helpful for you in your first year? Drop a comment at the end of the post below.
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Author Bio
Dr. Annie Mueller is a licensed clinical psychologist and founder of Summerland Psychology, a private practice serving adults in Washington and 40+ PSYPACT states via telehealth. Her work focuses on midlife burnout, anxiety, depression, trauma, grief & loss, and the unique emotional terrain of outdoor athletes. Interested in getting started with therapy? Reach out to schedule a free 15-minute consultation call.