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Monday, September 19

GROW: The Who, What, Why, Where, and How of Starting a Private Practice

Jeff Zacharias, ACSW, LCSW, CSAT, CAADC

This article is intended to help you Grow Your Business. If you have practical experience and knowledge on the business of social work (ex., starting a private practice, marketing yourself, financial guidance), please consider contributing an article! Submit your article proposal online here.


Private practice—it’s often where most social workers want to go with their career at some point. Why work for someone else when you can be your own boss, the captain of your destiny? But most graduate school programs focus either on the clinical side of the field or the administrative/policy end of things. It’s rare that there’s a focus on what it takes to run your own small business which is the essence of being in private practice. What once sounded liberating in grad school can suddenly seem daunting at best and impossible at worst. Questions that will come up quickly in the decision-making process are who? What? Why? Where? How? This article will help to give you a brief glimpse into what I’ve found was needed to take the leap into the private practice world. Having done this for a number of years—along with running and owning my own agency—I’ve figured out a few things along the way and hope my experience can help you pursue your dream.

Who? The “who” is you and why you’re drawn to being a clinician. There are a variety of other clinicians wanting to do work along the same lines. The happiest and most successful therapists find a niche that few people are doing. Find yours; it’s out there. Get creative and think outside the box. What can you do that no one else can based on your experience, skills, talents, and strengths? Once you find that, the “who” in you comes alive and clients come your way. Don’t be surprised if you find several of these niche. 

Many therapists think that they’re going to only work one job, but I’m here to tell you that this isn’t going to be the case, at least at the beginning. Double jobs can lead to double referrals and more niche marketing for your practice. Be open to possibilities and do something most won’t do, like work on Sundays. Not many clinicians do, and you just might find a constant stream of clients who can only come that day due to work schedules.

What? What do you want to specialize in? What client population jazzes you up, makes you curious about their world and want to learn more? That’s your “what,” and you have to consistently fine tune it by staying current. Go to trainings, read the latest journal articles, put together a workshop so it’s ready to submit to a national training, write a blog—there’s many possibilities. Work with clients who stoke your passion and refer those who don’t to other clinicians who will feel that same passion. You’re just overwhelming yourself by trying to take everyone that comes to your door. The clients that you want to work with are out there, and they’ll come as you make sense of the building blocks of private practice.

Why? This is quite important. I would bet that nearly all clinicians know the “why” of being in this field. It’s most often that we’ve walked similar paths in some way to the clients we enjoy working with most. However, this doesn't mean that helping others comes at the financial expense of oneself. You’ve done the hard work, you’ve put in the long academic and clinical hours—you should be appropriately compensated. There’s a mistaken belief that social workers equate to financial deprivation, i.e., the stereotypically poor social worker. I choose to believe that this does not have to be your story. You may not be rich financially by any means (although who’s to say that can’t happen), but it’s vastly important to value yourself and the skilled work you provide and be compensated in a way that reflects your skills. I’m a firm believer in modeling skills for our clients, and there are some topics, like sex and money, which can be particularly loaded and difficult to discuss. If we can’t be comfortable discussing money with our clients, then we’re not modeling financial responsibility as we should be doing. We’re not doing them any favors and certainly aren’t helping ourselves either.

Think broadly about the following: How will I get paid? Cash? Credit cards? Checks? Do I want to take insurance? What are the benefits? How will I deal with co-pays, deductibles, and co-insurance? How can I do all this with at least some proficiency or find the experts who can help?

Where? I’ve found that if your location isn’t convenient to the type of clients you want to work with, then they aren’t going to come. Think globally about how you want to position your office. Public transportation? Parking? Your own commute time? Additionally you may want to be in a space where there are other clinicians, so look for those with similar interests and contact them directly. If you enjoy working alone, then that’s also a possibility but with different types of interactions.

How? Marketing is a word that causes many clinicians to flinch, but you are in essence your product. You have to put in the work to let others know that you’ve hung up your shingle and are looking for an expanded caseload. Marketing can take on many forms but most importantly, it begins with a great website. Make it concise, clear, and informative. Set yourself apart from others by letting the community know what your forte is. Secondly, get comfortable with social media. This brings up lots of visions of ethics issues and possible boundary crossings. But with a well-planned understanding of how they all work, this is a key building block to your success. Facebook (set up a private practice account), Twitter (again a private account), and LinkedIn are your best bets. There are others, but I haven’t found them to be that useful. However, part of this process is to throw everything at the wall and see what sticks. Tip: Hoot Suite links all three of these accounts, and you can just do one posting to all social media avenues—it’s amazing! Don’t stop there—write blogs/articles on your website, do Psychology Today mailings, post flyers around your area, and set up a newsletter to go out with an e-mail blast service like Constant Contact.

What did I get myself into? I can tell you it’s a wild ride at times, never the same day twice, and immensely rewarding. You don't have to do it alone. Put together a team of people who can take on those parts of the work you don’t enjoy. Find someone who knows insurance and billing issues, and let them do it. If you don’t want to deal with insurance headaches, get someone who can handle the financial end of things. Network, network, and network again so you’re consistently connected to others in the field, and you have a sounding board. Get a supervisor with whom you identify and works in the same area in which you are most passionate. Get clinical group supervision if you’re drawn more to human interaction than solo work.

This is quite a bit of info all at once. I will say it’s more than I got in grad school around the business end of things, and I even have an undergraduate in marketing/finance. The long and short of it is: capitalize on what you do well, find the niche of those with whom you most passionately want to work, find a space and location to compliment that work, pick a team of people to shoulder the work you don’t want to do/have the time to do, and be kind to yourself as you’re going through the process. It can be extremely frustrating, but there will come a day when you can say, “I think I got this!” That is, until the next day’s new bunch of clients and crazy insurance bills come in. 

To learn more about starting up a private practice, register for the 2016 The Business of Social Work: NASW Illinois Chapter Conference taking place Thursday, October 20, 2016, in Lisle, IL. Article author Jeff Zacharias will be presenting a session titled, “The Dichotomy of Being a Social Worker and Being an Entrepeneur: Yes, They Can Co-Exist.” Earn up to 7.0 CEUs including workshops on cultural competency and ethics. Register today at www.naswilmeets.org.


Jeff Zacharias, ACSW, LCSW, CSAT, CAADC, has extensive clinical experience in both the mental health and addictions fields. He is currently president/clinical director of New Hope Recovery Center located in the Lincoln Park neighborhood of Chicago; he has an additional private practice in Lincoln Square. His areas of interest include working with all aspects of addiction, severe and persistent mental health issues, personality disorders, trauma and its impact on recovery, hoarding and other obsessive-compulsive disorders, and issues within the LGBTQI community. 

Posted on 09/19/16 at 08:00 AM

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