Private Practice
Private independent practice (known historically as private practice) is a growing segment of the social work profession. Social workers entering this context are providing a range of services, including clinical and nonclinical. Major considerations for establishing, maintaining, and marketing a successful and ethical private independent practice should be considered.
The contemporary landscape of private independent practice reflects a myriad of services, both clinical and nonclinical, depending on individual state rules and regulations. Clinical work may include such services as counseling and psychotherapy to individuals, couples, families, and groups, and clinical supervision of social workers for licensing, community, and corporate interventions. Nonclinical work may encompass program development and evaluation, conflict resolution, mediation, training, and education. Traditionally, private independent practitioners have offered their services in a private office setting. Many now contract with agencies, as well as clients, for the delivery of services.
Resources for Clinical Social Workers in Private Practice
Starting a Private Practice
How many years of social work experience do I need to start a private practice?
NASW recommends a minimum of two years of post-master's experience in a supervised clinical setting.
Should I continue clinical supervision?
It is a good idea to continue supervision or some form of consultation when starting a private practice. Supervision and consultation are ways for clinical social workers to continue to improve their clinical skills and may also help resolve any legal or insurance problems that may arise.
How much malpractice insurance should I obtain?
The minimum amount of coverage available from the NASW Assurance Services is $1 million per lawsuit with $1 million maximum for the policy year regardless of the number of suits. The maximum availability is $2 million per $4 million. Because private practitioners may operate in what may be considered relatively high-risk situations, it is generally recommended that clinical social workers purchase $2 million per $2 million of malpractice insurance. Coverage should be maintained continuously to avoid gaps in time that would not be covered.
Does NASW have guidelines for clinical social workers in private practice?
Yes. NASW publishes the NASW Standards for Clinical Social Work Practice, which is available for purchase or download. This useful brochure guide is an excellent resource for any social worker in private practice.
How can I obtain a tax ID number?
If you are a sole proprietor or partner, your tax ID number may be your social security number. If you employ one or more persons, you may obtain an employer tax ID number from the federal government by completing IRS form SS-4. Forms may be obtained from the Internal Revenue Service or your state government.
What fees should I charge?
Fees vary and are influenced by several factors, including geographical location, fees of other mental health professionals who provide psychotherapy services in the area, and reasonable and customary fees that insurance companies set. There is no legal or professional requirement regarding the amount to be charged. Conduct a survey of psychotherapy fees in your area, and decide on an amount that is fair and reasonable for your practice.
Should my private practice be incorporated?
Discuss your business plans with a financial or business consultant to decide if incorporation is advantageous for you. Many clinical social workers begin a private practice and decide to incorporate later.
Record-Keeping
How long do I need to keep client records?
While the state of Illinois does not have Illinois-centric documents or specific guidance regarding record retention. General advice is to retain records indefinitely, with 10 years as the rule of thumb for best practices; if your client is a minor, no sooner than the minor’s 22nd birthday. Additionally, certain requirements under HIPAA require keeping records for 6 years; 10 years for Illinois hospitals; and 5 to 10 years for Illinois Medicaid and certain Medicare providers under CMS.
That said, the statute of limitations is a major concern. In most cases in Illinois, that would be 2 to 4 years after the incident for malpractice, depending on when the harm is “discovered,” but minors and people with disabilities can be longer than that. Hence the advice to retain records indefinitely, but social workers are on firm footing to keep records at least 10 years after stopping services or a minor’s 22nd birthday, whichever is later.
If you are retiring or leaving a job, inquire with your professional liability insurance carrier about the availability of tail insurance. Social workers can get sued a year or two after they leave a job or retire, and tail insurance can cover that period.
Additional Resources
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Read the Legal Issue of the Month article, "Social Workers and Record Retention Requirements" (NASW membership required).
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Read NASW Assurance Services article, “Client Records: Keep or Toss?”
Legal Issues
Check out our Legal page for more information around Legal issues. And don't forget the full archive of "Legal Issue of the Month" issues available on the national NASW website (NASW membership required).
Referrals
What is the best way to seek referrals?
The NASW-Illinois Chapter has moved our Private Practice Shared Interest Group listserv to the NASW Illinois MyNASW Community. For posting referrals as well as connecting with other NASW-IL members, sharing ideas and resources, discussing challenges, post questions, and more, go to the NASW Illinois MyNASW Community page, click on the red 'Join' button, and then the “Discussion” tab to join the conversation!
Marketing is also an excellent way to obtain referrals. Consider advertising through a variety of resources such as the yellow pages, local newspapers, and magazines. Develop brochures, flyers, and direct mail pieces to distribute to area businesses, hospitals, schools, churches, nursing homes, and so forth, and invest in a website. List your name in the NASW National Social Work Finder, which is a reference for referral services to the general public, agencies, and third-party payers.
How can I become a Medicare provider?
Provider enrollment contact for Illinois is 1-877-908-8476, Wisconsin Physician Services or you may go directly to their website.
How can I become a managed care provider?
Write or call the managed care company that you would like to work with and request an application form to become a member of its provider network as a clinical social worker. In addition, NASW provides to members a free listing of managed care companies with provider panels for clinical social workers.
Closing Your Practice
Available Resources
What books would I find helpful to read about starting a private practice?
NASW Press publishes several books for clinical social workers that may be helpful in starting a private practice:
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Prudent Practice: A Guide for Managing Malpractice Risk, Mary Kay Houston-Vega and Elane M. Nuehring with Elisabeth R. Daguio.
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Managed Care Resource Guide for Social Workers Who Are Private Practitioners, Vivian H. Jackson, Editor
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Marketing for Therapists: A Handbook for Success in Managed Care, Jeri Davis, Editor
Additional Help
What is the NASW Private Practice Specialty Section (SPS) and how may I join?
The NASW Private Practice Specialty Practice Section provides clinical social workers in private practice with networking, education, advocacy, and business tools needed to succeed in independent practice. Section membership is open to all NASW members who are clinically oriented and are full or part-time practitioners in solo or group settings. It is also open to others interested in promoting private practice.