Time is a funny thing. Sometimes it flies by, and other times it drags on endlessly. When I think back to nine years ago, when I started my private practice, time feels like a strange mix of both. Tax season seemed to arrive in a flash, but waiting on hold with insurance companies felt like an eternity. That hold music still haunts my dreams.
Over the past nine years, I’ve experienced periods of great success and moments where I seriously considered shutting everything down. Running a private practice isn’t just about helping people — it’s also about running a business. And, like many mental health professionals, I wasn’t prepared for that side of things.
If I could go back to when I started, there are three key lessons I’d tell my younger self. These lessons could have saved me time, money, and stress, and I hope they can help others navigating the same journey.
1️⃣ Hire a Bookkeeper From Day One
You’re never “too small” for a bookkeeper. When I started my practice, I assumed I could handle tracking invoices, payments, and bank balances on my own. Big mistake.
As my practice grew, so did the complexity of my finances. I became so overwhelmed that I ignored them altogether. Eventually, I had to hire a bookkeeper, but by then, there was a lot to clean up — and it cost me more time and money than it should have.
💡 What I Learned: Even if your business is small, a bookkeeper can save you hours of stress. A few hours of their time each month can ensure your finances stay on track and your nights stay sleeplessness-free.
2️⃣ Learn About Health Insurance (Even If You Don’t Accept It)
When I started my practice, I had only a basic understanding of health insurance. I didn’t know what deductibles or coinsurance were, let alone how to fill out forms to help clients use their out-of-network benefits.
Even if you don’t accept insurance in your practice, understanding how it works is crucial. Clients will inevitably have questions, and being able to guide them can strengthen your relationship and show you’re invested in their care.
💡 Pro Tip: I found the book and website Navigating the Insurance Maze, by Barbara Griswold to be a lifesaver. It breaks down the complexities of insurance in clear, easy-to-understand language, making it a valuable resource for any therapist.
3️⃣ Hire a Virtual Assistant
Even as a solo practitioner, having a virtual assistant (VA) can make a world of difference. Early on, I was doing everything myself — answering emails, returning calls, scheduling appointments, and handling billing. It was exhausting, and it took me away from what really mattered: providing quality care to my clients.
Hiring a VA helped me reclaim my time and energy. They handled the tasks that drained me, and I was finally able to focus on my clients and my growth as a clinician. Beyond the practical help, having a VA provided a sense of connection in what can sometimes feel like an isolating profession.
💡 My Advice: Even if it’s just a few hours a week, a VA can help with admin tasks, billing, client communication, and more. They can also be a sounding board to help you feel organized and grounded.
Building a Practice Is About More Than Therapy
As therapists, we’re trained to help others — not to run businesses. But the truth is, without a strong business foundation, even the most passionate and skilled therapist can face burnout and stalled growth.
Looking back, I see how much stress and frustration I could have avoided if I’d laid a stronger foundation at the beginning. A bookkeeper, a deeper understanding of health insurance, and a virtual assistant would have made a world of difference.
If you’re just starting out — or even if you’ve been in private practice for years — it’s never too late to make these changes. Investing in the right tools and support systems will set you up for long-term success.
💭 What’s something you wish you had known before starting your private practice? Let’s connect in the comments — I’d love to hear your story.
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You can find more information about virtual assistants at my website www.Assistanttothetherapist.com
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