The Therapist Collective

What Graduate School Never Taught Me about Private Practice

By Natasha Kendal, Ph.D. ( and (

In 2003, when I graduated from Michigan State University with a Doctoral Degree in Marriage  and Family Therapy, I had a big old belly (our daughter Abigail), a huge student loan debt, a great understanding of therapy theory, a decent understand of therapy practice, and absolutely NO understanding of the business of psychotherapy. So, I set out to earn as much as I possibly could while being away from home and from my baby as few hours as possible.

I have learned so much along the way in the last 15 years, that I feel that I want to pass on the know-how, the business expert referrals and the inspiration to all therapists in private practice. This, in part, was the idea behind our Therapist Collective. So, here is a non-exhaustive list of things I learned:

1. If you have a question or a concern, chances are someone has written about this – in print, in an article, in a blog, on Facebook support group. Here is a short list of my personal favorites: 

  • All of the books by Lynn Grodzi, such as “Building your Ideal Private Practice: a Guide for Therapists and Other Helping Professionals”:
  • All of the books by Casey Truffo, such as “From Clinician to a Confident CEO” (currently residing on my nightstand):
  • Business books on developing a niche, and attracting your perfect clients, such as Mike Michalowicz’s “The Pumpkin Plan”
  • Michigan’s own Joe Sanok with Practice of the Practice – A remarkable resource for all clinicians in private practice, with new content daily.
  • A support group for owners of group practices at The Group Practice Exchange with great resources for group practice owners and extremely supportive and informative Facebook community.

2. Surround yourself, both in person and virtually, with people who support, applaud and encourage your growth. No Debbie Downers allowed! Your brain is probably already supplying you with all the negative thoughts about how scary it is to be in private practice, how you will never make enough money, how your kids will never go to college and on and on – and you don’t need these negative limiting thoughts to be echoed to you by family and colleagues!!! I found Mastermind groups to be very useful in learning to set great goals and having positive encouraging friends with whom to check in on a regular basis. The Therapist Collective will start our very own Mastermind groups shortly, stay tuned!

3.  I found myself literally lonely when I was in my office by myself for days and days, with only clients to talk to. As an extrovert, loneliness is a slippery slope from the blues to discouragement to an overly close relationship with Ben and Jerry’s. I find that peer supervision is a wonderful tool to process tricky cases, learn about what’s new in our industry, and bounce new ideas. I am lucky enough to have many many therapist friends – and I met most of them by emailing them and asking to meet for a cup of coffee. Do you know, I have NEVER been turned down! If you are looking for a peer supervision group, stay tuned – The Therapist Collective will start running groups in late spring. 

4. Sometimes, you have to bite the bullet, and hire an expert. The best experts have both a deep understanding of their own industry (law, finances, marketing etc. ) and an appreciation for what psychotherapists do on daily basis. Through trial and error, I’ve found that it’s a bad investment of time and money to work with a marketing expert who comes up with ideas that violate HIPAA, or to speak to an attorney who has no understanding of how contracts are structured in our discipline. 

Here are some of my favorite people to work with:

  • Daniella HarPaz Mechnikov at K2M Creative Media. Daniella builds websites, manages social media presence, comes up with innovative marketing ideas, and above all – hounds me until I deliver the materials I promised her – talk about a great accountability partner!
  • The personnel at Intelligent Office Virtual Office Services are my virtual assistants and some of my favorite people in the world! They are HIPAA compliant, fully trained in all major EMR systems and all around wonderful people. I admit, it was hard for me to give up the control over incoming phone calls. I gave out my cell phone number to pretty much everyone for 15 years (Hint: if you are still doing that, please stop now!), and I had to work hard to hire and train someone to take over this crucial responsibility. I was amazed how smooth the transition was, and how many times my existing and my new clients praised their professionalism and promptness.

There are so many other things I learned in 15 years of private practice! I can’t wait to share and hear what things you wish you knew before starting your practice.

Stay tuned for Part 2 of this blog topic! There is so much more to share.