Jackie Schuld Art Therapy Blog

When our Private Practice Model No Longer Serves Us

In a previous essay, I shared about how I attained traditional “success” as a therapist (i.e. full caseload and 5 figures a month), but was also emotionally and mentally drained.


In that essay, I shared how I then restructured my business to honor my needs.


A therapist sits with her arms wrapped around her legs. An arrow points back at her and the words are written "Can't I have my energy go back to me"
"Therapist Needs" Illustration by Jackie Schuld

After I wrote that essay, I attended a feminist copywriting class with Kelly Diels (she’s amazing and you should check her out). During that class, she mentioned to one of the participants that “sometimes we outgrow our business models.”


I realized that is EXACTLY what happened to me.


It’s not that there was something wrong with the way I was doing it. When I started my private practice, I did what worked for me. An open schedule, full range of fees, flexibility in meeting commitments (meeting clients weekly, bi-weekly, or monthly), and more helped me to build my business.


When you are new to private practice, so much is unknown and scary. I had huge concerns like, “Will I get enough clients? Will my income be sustainable?” (I write about fear in my essay Living with Fear as a Therapist).


The flexibility in my fees (allowing a sliding scale) and schedule (seeing clients whenever they were willing to schedule) enabled me to get clients quickly in the door. Getting clients in the door helped me to build my own self-trust.


The flexibility also allowed me to experiment and learn. For example, I learned that only meeting monthly with a client leads to sessions that are often just “checking in” rather than the deep therapeutic work I enjoy.


I learned that when doing in-person art therapy, my sessions are far more effective when they are 80 minutes versus 50 minutes.


But as my caseload became full, it was evident that I had outgrown the business model that helped me build my business and enhance my self-trust and self-understanding.


While I could handle an open schedule when I was trying to build my client list, it was untenable with a caseload of 40 clients. I also learned that holding 40 clients in my mind was simply too much for me, even if I only saw some of them monthly (which I write about in The Emotional and Mental Demands of Being a Therapist).


I was exhausted - and I was the one responsible. What had started with good intentions, quickly evolved into something that didn’t serve me.


It was anguishing. And I wanted someone else to solve the problem for me.


But there wasn’t someone else. There was just me.


These feelings were especially poignant as Mother’s Day approached. My mom died in 2014. She was the one person who would drop anything to help me. Who would always welcome me home with yummy food, a comfy bed (complete with super soft sheets and chocolate on my pillow), and a desire to hear how I was doing.


Mourning all that she brought to my life made me realize that I have to be my own mother now. I have to take care of myself and nurture myself the way she did.


This realization was the impetus I needed to make changes and explore different business models. I wanted to find a way to structure my business that took care of me.


As I researched different ways, I also found and paid to be a part of a wonderful community of therapists who were doing the same thing with their private practices (you can check them out here).


While I would have loved to overhaul my business immediately, change didn’t happen like that. No one handed me a new way of doing it. They couldn’t have - because I needed something tailored to me.


It took months of discernment. I looked at how much income I would need in a year, how many clients I could energetically see in a day, what were the best hours of day to see clients, and more.


I also examined who were my ideal clients and why. This led to me no longer working with adolescent clients. I chose to work with a client population that was invigorating and that I’m good at - adults who have overwhelming emotions and thoughts.


I looked at what practice policies would contribute to the best therapeutic outcomes for my clients, which included requiring weekly meetings, a no-cancellation policy, and 80 minute sessions.


I say these things like they were easy. They weren’t. I cried myself to sleep when I realized it was time to stop seeing adolescents. I was only willing to go through the pain of concluding with my teen clients because I had listened to my own intuition and knew it was the best decision for me in the long-term.


How we choose to run our businesses as private practice practitioners is an incredibly personal decision.


It’s why I sometimes feel a little defensive when others question my private practice choices (i.e. “You charge what?!”)


It’s why I continually do my own self-work to examine my choices and stay grounded in honoring my needs.


It’s why I am passionate about helping others discern their needs and structure their private practices accordingly.


There is no “best” or “right” way to run a private practice. And there shouldn’t be. Just as we treat every client as a unique individual, we need to do the same for our private practices.

 

I provide consultation for therapists who want their private practices

to be tailored to their needs.


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