u/NewResearcher98

Hi therapists. I’m 28 years old and have had my LCSW for about two years now. I opened my private practice at 26, just a few weeks after obtaining my LCSW. I initially ran it on the side while working full-time elsewhere, but eventually transitioned into the practice full-time. Since then, I’ve grown it to include three clinicians, and we accept insurance.
The first year and a half was manageable, but the past six months have been absolutely terrible for me. I’ve developed a significant amount of stress and anxiety from both sides of the job; seeing clients clinically, but also directing and managing the practice, dealing with employees, billing, insurance companies, and everything else that comes with being a practice owner.
I’m at a crossroads now and genuinely don’t know what to do. The practice is covering my bills, but that’s about it, so financially, the amount I’m making doesn’t feel worth the level of stress and anxiety I’ve been experiencing.
I keep wondering whether this is just a difficult phase that I need to push through until I’m in a position to hire someone to handle the administrative and management side, allowing me to focus primarily on clients, or whether I’ve reached the point where I need to seriously consider closing the practice.
Everyone around me seems to tell me not to close it and to keep going. I also feel like some people think I’m exaggerating how much this has affected me, but I genuinely feel awful about 90% of the time lately, and it feels directly connected to both running the practice and being a therapist.
What makes the decision even harder is that I don’t know exactly what I would do if I closed it. At the same time, I’ve reached the point where I’m reconsidering whether I even want to be a therapist anymore not just whether I want to own a practice.
I’m feeling really stuck and unsure of what the right move is. I would genuinely appreciate hearing perspectives from other therapists and practice owners, especially anyone who has experienced burnout like this or reached a similar crossroads. Did you push through and eventually find a way to make it sustainable, step away from practice ownership, leave the field altogether, or do something else?

I own a small group practice that accepts insurances. I have one of the therapists trying to schedule her sessions with her clients for 30 minutes and I found out about it. I don’t want my practice to offer 30 minute sessions. Am I allowed to say that? I’m assuming insurances will pay significantly less for that as well.

I own a tiny private practice and accept insurance. I recently hired a w2 who stated at the start of the job that she can do a few evenings and can come in person for sessions and so I leased a new office space for her to see clients in since the office I’m in is fully booked by me all week. A week into her working for me she changed her availability to only one day/evening and I found out through questioning her that she is working for another private practice that is fully remote. I gave her an extra $5 an hour to her original pay in order for her to give me two days/evenings in-person and she agreed. She’s been with me for a few months now and today she called me said she wants to move to fully remote and only see 10 clients instead of the 25 she’s currently seeing and basically hinted at not wanting to see kids anymore although she agreed to that at the start as well. I’m covering her supervision fully and it costs a lot to keep her on and I truly don’t make much profit if any from having her on. She also is about a month behind on her notes which I have flagged twice. I don’t get many referrals for virtual and don’t think the clients she currently has will want to do virtual as they all came in wanting in person. I have a strong feeling that if I tell her what she’s asking for (fully virtual and 10 clients) doesn’t work for my practice that she will sue me since I’d be saying it right after she disclosed the pregnancy. I feel like I’m a baby business owner and truly don’t understand the complications of owning a business so I’m not too sure how to navigate this one..

I have a serious feeling one of my clients might me recording our sessions on his phone just by the way he typically positions his phone (speaker facing me, ensures nothing is covering his phone, telling me he records other things, etc. ). I own a private practice, I’m wondering if I should create a form and send to existing clients and new clients asking them not to record? Is that what other therapists/practices are doing? What can I include in this form?

Hi! I opened my practice about 2 years ago and have since hired three therapists who only see a few clients each. Lately I’ve had no referrals come in. We are an insurance only practice because I truly wanted to be accessible to all. Lately, I’m not getting many referrals even though I’m advertising in the same way; psychologytoday, google, other directories, etc. is there other ways I can get my practice out there to get myself and the therapists in the practice more clients? I’m truthfully not very social so the idea of networking within the community by physically being outside and handing out cards isn’t exactly something I want to do, any other ways working for you?