Why I Chose Solo Practice vs. Group Practice

I love people! Why I chose the solo path anyway

Solo practitioner vs Group Practice. 

Why I am now excited to provide the choice for others. 

When I decided I wanted to move to private practice mental health counseling, the world of possibilities opened up.  It was liberating to learn that I had an opportunity to form my next career step.  I started gathering all of the information available and meeting with practicing professionals to get some insight into what my private practice move could look like. Through zoom calls, coffee dates, and lunches I was able to meet with solo practitioners, group practice owners, and group practice therapists. I even had a few sessions with a therapist who specializes in working with other therapists.  My biggest takeaway? Working professional therapists want to help other counselors.  Every person was kind, helpful, and knowledgeable. My job was to gather all of the information and make some decisions about what was best for me.  

Arthur Brooks recently wrote about what factors to consider when looking for new employment opportunities.  He wrote  “The one (feeling) that should never be absent when you’re considering a job is excitement. Another way of defining this sort of excitement is prospective happiness or joy about having a better future in sight. If you don’t have that sense of excitement when you hear about an opportunity, your subconscious is telling you something important—that this opportunity is unlikely to provide enjoyment, a sense of accomplishment, and especially meaning.” What about moving to private practice was exciting to me? Which pathway could provide the most meaning? How can I capitalize on that excitement and keep it central in my decision-making? 

In making decisions, I considered the following factors.  The solo way is not the best way for everyone and some people are perfectly happy and thriving in wonderful group practice settings.  The following is true about MY journey only. 

Exciting: Serving a client population that can best benefit from my skill set, experience, and interest. The term “ideal client” is frequently used in our field.  I see this as the client population that I am excited about working with and who I can help in the best way possible using my experience.  I can safely say that my current client caseload, although all hurting in some way, provides a sense of meaning and purpose to my days. Being a solo practitioner allows me to be the sole decision-maker around who my clients are. 

Less exciting: Someone else filling my caseload or making my schedule. I have had friends who love this.  They love to show up to work and have their schedule decided for them.  They are great clinicians who opt for group practices.  This does not excite me and I am so happy I identified that ahead of time. 

Exciting: Retaining all of my client fees and having control of my expenses.  I knew I would be working hard to make it easy for my clients to find me and I knew I would be providing excellent clinical care to all of my clients.  I want to retain as much of my fee as possible. 

Less exciting: Providing a percentage of my client fees to a group practice (35%, 40%, 50%) regardless of my expenses. If I see 20 clients per week at an insurance reimbursement of $110 per session or a self-pay rate of $150 per session, the group practice I contract with will be retaining (at 40%) $3520-$4800.  I feel confident I can keep my expenses lower than this and can save that additional money to take time off with my family without worry. Some group practice settings are better than others and offer valuable incentives, just not enough to excite me in the way I was looking for. 

Exciting: As long as they wish, the clients I have built relationships will be able to see me. Remaining client-centered here, I did not want to start in a group practice and then leave for a solo practice if I thought there was even a chance solo practice was in my future.

Less exciting: Non-compete agreements. The group practice owners I know, who are friends, do not operate with non-competes. They retain counselors by providing a supportive environment.  I understand that group practice owner use non-compete agreements to protect their businesses but the requirement to sign a non-compete agreement is a breaker for me.  I also never want to feel like I am “taking” someone else’s clients even without a non-compete agreement.  

Exciting: Creating the space I work in and the “brand” I want to put out in the world. Some people hate this part of the work but I love it.  I find joy in presenting a calm, clean, professional environment to my clients.  If I want to spend time here, my clients likely will too. Every time I walk into The Collective I instinctively take a big breath and smile.  This also provides some variety to my day which I appreciate. Part of my workday includes marketing, branding, and networking.  I love one-on-one sessions but adding variety to my day is a source of excitement. 

Less exciting: working in a space that someone else likes with less freedom to decide how I want to be presented as a professional to the world. 

Exciting: Creating a collaborative environment with a great vibe where clinicians can create their own practice. The scariest part of moving to a private practice was the prospect of not having coworkers. I get energy from the passionate people I work with every day.  I want to continue to work alongside hard-working, passionate, professional people.  This is the reason I opted for enough space to rent to other counselors.  Finding space was not an easy process and I was surprised to learn that renting nice, clean, single office spaces isn’t a thing.  I wanted to make it a thing.  

Less exciting: Working alone without collaboration in an environment I do not want to spend time in. I wanted to be picky about the space that I am.  

Through this exploration, I found a new passion that excites me: Talking to others about their next step into private practice.  I have found that becoming a solo practitioner is not as complicated as it once was and there are a million tools to help us figure it out.  Things I was intimidated by earlier in my career (scheduling, paperwork, billing) are a breeze with the available software options. Some people are still intimidated by parts of the process and I love talking to them about what is holding them back from making the jump.  I have two office spaces left to rent to other therapists so there is definitely a self-serving motivation but most of all: I want to work with and learn from great people who are excited about what they do, the populations they serve and the life they live. 

Contact me for a chat about your next step.  

www.carinocounselingcolletive.com/team

Why You Should Trust Your Gut. Arthur Brooks, The Atlantic. Shared with a temporary gift link.

Purpose Driven Burnout vs Compassion Fatigue

In my 22 years in social service and mental health, I have balked at the term “compassion fatigue.” Instead, I have adopted the term “purpose-driven burn out” to try to describe the special type of weariness that those of us who have worked in social services, non profit, education and public sector settings experience.

The free workshop offered to helpers to combat “compassion fatigue”? I’ll pass. Conference session titles with “compassion fatigue” in the description? No, thank you. I  do not judge those who participate in or facilitate these sessions; as a therapist, I teach many of the same techniques in individual sessions.  I believe that learning to lower cortisol levels, set boundaries, and commit to self-care are all necessary tools for those working in social services. Often, these practices, meant to alleviate individual stress levels are not going to be enough.  It is critical that we are honest with ourselves and aware of what is really making us tired, and even jaded, before we can regain our lost passion and energy. 

The reason I cringe at the term compassion fatigue is the implication that the act of caring for others causes the fatigue. That, maybe, the problems of my clients, patients, or students seeped into my soul during after-work hours and made me weary. Compassion Fatigue feels slightly self-indulgent. You think I’m tired? What about the mother I work with who put her child in daycare while she worked the night shift at Amazon, got her kiddo ready for school in the car, and slept in her car for a few hours after drop off? She’s tired.

If exhausted while helping others, it’s not solely coming from your compassion or your clients’ heartache. It’s coming from broken systems, lack of resources, and wealth disparities. In other words, it might be better - and healthier - for us to understand that it is not so much that our compassion for the individual has been exhausted, but that we are continually disappointed for our clients when the system doesn’t come through for people who need it most. 

It is not that you are tired from caring. It is hard to care so much when the system doesn’t come through for people who need it. You are tired of not enough accessible food when there is clearly enough food.  You are tired of telling someone that there is an extensive waitlist for shelters and housing support, or that they do not meet the criteria for the support.  You are tired because agencies that are meant to help those in need have too many system-made barriers to be helpful.  You may even be tired because your own employer focuses on the liability of helping others more than providing the help that is needed. All of this can lead to a real sense of hopelessness.  

When we begin to pinpoint areas of hardship in our positions as well as within the system in which we work, we can tackle the struggles at the source.  In therapy, I work with clients to define the sources of fatigue and frustration.  What has changed since you last felt excited about the work you do? What do you have control over and where can you celebrate successes more robustly?  Can the kindness and care you gave someone today impact their day even though you didn’t resolve all of their presenting problems?  Similarly, we, as a community, need to ask ourselves where we can advocate for systemic change? 

For those who are struggling with Purpose-Driven burnout, there is help available. As a therapist who serves professionals who work in these settings, I have been where my professional clients are and I know that they need someone who understands and can help define the source of the fatigue. Therapy can be an important part of your journey.