What It Really Takes to Grow a Private Pay Practice

I’ve worked with hundreds of therapists and coaches who are seeking to build private pay practices and do you know what I hear again and again?

It’s either: 

“I work and work and work and work and WORK. I write blogs, I post on Facebook, and I tweak my website… it’s nonstop, I’m never done… And NOTHING is happening.  How do I know what to do, what to stop doing, and what’s really going to return on investment?”

50% of the people I talk to


“I DO NOT KNOW WHERE TO START. The internet is an avalanche of conflicting information encouraging me to do things that feel inauthentic or pushy. So I do nothing. I know I need to promote my practice, but I feel overwhelmed and paralyzed.

50% of the people I talk to
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Three Secrets That Will Grow Your Practice Faster

In October 2018 I launched my first group coaching program. The group that came together was a fun-loving, passionately dedicated, extremely supportive crew.  Together we dove into refreshing websites, rewriting copy, getting out into the world, and generally going all-in on our private practices.

To our collective delight, everyone’s schedules were completely full by the end of the program. I am talking, no more spots for private clients, starting a waitlist, FULL.

Imagine that, will you?  We started as a group of people who had private practices and amazing therapeutic skills, along with a lot of confusion (and, if we’re honest, some fear) about how to get clients.

The next round of this program (the Thrive Mastermind) starts up in 2 weeks and to prepare I’ve been watching recorded calls from way back when, looking for clues about how and why the program worked so well. While I was watching, one of the mastermind members spoke directly to the mystery of it all:

“You know, it’s strange. I’ve been trying to figure out what we’ve been doing that has been so effective. I mean, my website is a lot better and I’ve got all these ideas, and I’m enjoying the business side of having a practice for the first time EVER… but it’s not like people are mobbing my website and I’m not running around all over town networking with lead magnets… the only thing I can come up with is confidence… and clarity… and the fact that I’m actually doing something to promote my practice for once.  Do you think that’s all it is?”

Is my client right?  Is it ONLY confidence, clarity and action? And, maybe most pressingly, is the word “ONLY” even appropriate in that sentence?

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Why You Need to Make New Friends in 2021

It’s 2021! We made it! And what better way to start a new year than with new friends?

Why do I need new friends, you ask?

Well, let me first go on the record to say that your old friends are GREAT. There’s no problem with them and you don’t need to kick ’em curbside unless you want to.

And yet, that doesn’t negate the need for new friends! Friends, for example, who want the same things that you want. Who see the world the way you see the world (or even better, friends who see the world the way you WANT to see the world). Friends who will watch you grow your practice with their hearts on FIRE for your success.

Friends, who will push you to be:

  • Strategic and hopeful
  • Powerful and authentic
  • Successful and resourceful

Where can you find such AMAZING friends, you ask?

As always, I’ve got you covered.

INTRODUCING: The Build Your Practice Series!

In collaboration with Mountainside (you remember Lloyd, right?!), I’m launching a *BRAND NEW* monthly workshop focused on growing your practice with practical, matter of fact strategies grounded in a community of fiercely supportive coaches and therapists who are as invested in your success as they are in their own.

The first of these magical events is happening NEXT TUESDAY and we are kicking off with our most popular topic: Nicheing!

The one and only Dr. Alyssa Adams and I will be sharing why the fastest path to growing your practice is to narrow your focus.

It’s so counter-intuitive, but categorically, fundamentally true. Yes, I said it. Come argue with me about this on Tuesday!

Register here!

Here are some fun details:

  • The 2021 series is running on the second Tuesday of every month.
  • Every event will benefit a different mental health charity. This month we are benefiting Callen-Lorde Community Health Center.
  • The dates have been set for the WHOLE YEAR. And you can snag the infographic and save the dates, here.

See you on Tuesday? It’s going to be epic.

Oh yeah!

Register here.

2020 Year in Review: Not great

Is it just me, or have we been wrapping up this year for a decade? The week between Christmas and New Year has always been chock full of year in review articles, best and worst lists, and lessons learned… it’s usually one of my favorite weeks of the year! I love a good retrospective- there’s something glorious about laughing again at something you laughed at in March.

But, this year it feels different, somehow. Rather than the usual lighthearted lifestyle fare, these articles feel a bit desperate.

Desperate to make sense of a year that didn’t go as planned. Or perhaps, desperate to regain control of a world that has shown us how little control we actually have? I’m not sure what the desperation is about exactly, but one thing is for sure:

It’s all kind of a bummer out there in the interwebiverse.

But wait! What about the clothes and the performances and the ridiculousness!?! Where are the listicles that make me smile? Where do I discover new moments to enjoy, way after the fact?

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How to Strengthen Your Connections During Socially Distant Holidays

As I was walking my puppy around town yesterday I noticed a LOT of cars with Christmas trees on the roof. With Hanukkah starting on Thursday and Kwanza, Solstice, Festivus, and New Years on the horizon, there’s no denying it, the holidays are upon us. Though things will certainly look different this year (Zoom Caroling? Fireside Facetime? TikTok New Year’s Eve Parties?), the heart and soul of the holidays is the same: it’s the season of connection.

This is the Perfect Year to Strengthen Connections

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It’s Time to Be Awesome! – Rainbow Dash

The kids (as you know) are home for the foreseeable future. One unexpected benefit of this (in addition to random, mid-day hugs) is that I get to hear the soundtrack to their current movie obsession over and over and over again. Lately, it’s been “Hey Siri, play the My Little Pony: The Movie Soundtrack.” Mostly (to be honest), I just tune it out… but every now and then one of those songs will make its way into my brain and get lodged.

This time, it was “Time to Be Awesome” by Rainbow Dash. She’s talking to a group of parrot pirates encouraging them to stop doing the bidding of the Storm King, and instead do their own AWESOME thing. It’s catchy, and worth a listen (click here).

(My favorite lyric is “Hey Scallywags, it’s time to be awesome!” 

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How To Give Up On ‘More’

Every time I run a group program—EVERY SINGLE TIME—the one topic that emerges from the group is time management.

The ask usually goes something like this:

“How can I do everything that I already do, AND these practice building things that you are teaching us.”


“I was feeling overwhelmed already. How could I possibly add anything more?”

Embedded in these two questions is a tiny, destructive kernel that will stop your time management efforts (and your business building efforts… and your happiness) in its tracks.

Can you spot it?

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I Guess We Live Here Now.

My first pet as an adult was an adult shelter cat that I rescued from the PetCo in Union Square. The night before we met, I had a dream about an orange cat who slept at my feet. Then, as my then boyfriend, now husband, David and I were wandering around the city, there he was. Now this is not the cat you think you are going to rescue – he was “7-9 years old,” enormous, and plainly disinterested. And yet… he was so soft. And his eyes were a piercing green. I liked him.

“What do you think?” I asked.

“About what?” David said.

“The cat.”

“This cat?”

“Yes, what do you think of him? Is he OUR cat?”

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What It Takes to Grow a Private Pay Practice During a Pandemic

I’ve worked with hundreds of therapists and coaches who are seeking to build private pay practices and do you know what I hear again and again?

It’s either: 

“I work and work and work and work and WORK. I write blogs, I post on Facebook, and I tweak my website… it’s nonstop, I’m never done… And NOTHING is happening.  How do I know what to do, what to stop doing, and what’s really going to return on investment?”

50% of the people I talk to


“I DO NOT KNOW WHERE TO START. The internet is an avalanche of conflicting information encouraging me to do things that feel inauthentic or pushy. So I do nothing. I know I need to promote my practice, but I feel overwhelmed and paralyzed.

50% of the people I talk to

Let’s cut you some slack: Therapists weren’t trained in marketing… or sales… or social media… or graphic design… In fact, the skills of therapy can feel wildly out of sync with these business-building strategies (they aren’t, by the way, as you’ll see).

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Why Time Management is So Overwhelming

There are two kinds of people in the world:

Those whose work is mostly or entirely dictated by outside forces and those whose work has to be driven mostly or entirely from their choices.

Think of the first group as all the people you know who have JOBS. Even those who have high pressure, high paid managerial jobs have the boundaries of their work largely set by organizational priorities.

The second group can best be summarized as people who are, to a significant extent, self-employed. This can include the partially self-employed like therapists who have a private practice on the side of their agency job, or side hustlers who offer services or consulting outside of their full-time, corporate or non-profit jobs. Or it can be the entirely self-employed, like therapists and coaches in full-time private practice or founders of small to medium sized companies.

Most of us were raised with the expectation that we would have a job and we were prepared by the schools to do just that.

We did work that was assigned to us and were graded on other people’s expectations. Unless you were raised by entrepreneurs, this kind of cog-in-the-organizational-wheel was likely the foundation of your understanding of work.

Now, just to be clear, there’s nothing wrong with thinking about work that way. I’m not saying that doing your part for the mission or finding safety and comfort in a large organization is somehow “less than.” And I’m certainly not saying that a job is somehow less demanding than being self-employed. In fact, the busiest people I know have jobs!

When you are working at a demanding job these days it tends to look like you are chipping away at a mountain of relational tasks (send this report to Anna, follow up if you haven’t heard by Thursday, re-send your availability to nail down a time to meet… and on, and on, and on). Anyone who has ever worked in consulting, or on Wall Street, or in any number of other high-pressure, project driven careers knows exactly what I’m talking about.

For these people, who are largely managing incoming requests, working through projects they’ve been assigned, and trying to figure out timelines for when work can be completed, traditional time management is a HUGE RELIEF.

The most famous time management system is David Allen’s Getting Things Done (or GTD, as its called).

It’s a high-touch, super structured way to get your to-do list out of your head and managed. By following the tenets of GTD you can take the drama out of all those little commitments and find headspace for the strategic and managerial aspects of your work. It can be a lifesaver; it was for me when I was a consultant and drowning under the weight of 14 projects.

The problem arises when someone who is self-employed attempts to utilize a typical time management system to manage the messy interdependency that is their life and business and finances.

Here’s an example: A therapist tries to use GTD and within a few hours gives up. “I could never do all of this!” she begins, throwing her pen down. And, then (and this is the tragic part), “I guess I just wasn’t meant to do this. I’m so disorganized and such a procrastinator… If I can’t even get myself to do what I put on my to do list, I’m never going to make any progress.”

This happens because traditional time management programs don’t support you in considering the following stone-cold realities of being self-employed:

  • You might be over-committed on things that don’t matter and under-committed on things that would move the needle. Are you doing what matters or just keeping busy? How would you know?
  • You might not believe that you CAN do the things that matter. This usually sounds like “I’m not the kind of person who does: sales, marketing, promotion, math, book-keeping, speaking, social media, or exercise. When the only person deciding what you need to do is YOU (and not those organizational priorities), then your lack of belief in yourself will be a major hurdle.
  • You might be doing a poor job of managing your work-life balance. At least when you have a job people will sometimes encourage you to take time off. You have vacation days that you’ll lose if you don’t use them, for example, or your company is straight up closed on Christmas and the 4th of July. If you are the only person deciding when you should work and you are in any way concerned about your finances, you are probably working around the clock, 365 days a year. This is not a recipe for success under any circumstances, but it’s especially devastating when the core of your work is vision-setting.
  • You might be working like an employee, instead of as a founder. One of the most important shifts required to succeed as a self-employed person, is to shift away from the default, job-based settings of our upbringing and move into an understanding of ourselves as the visionary for our business. When you are the founder of a business (instead of the single employee in your private practice), you know that the most valuable time is spent setting strategy: figuring out what you want and why. Putting together the plan to move in that direction. Hiring people to help you get those things done. 

But what seems to happen instead is that the self-employed cast around looking for certainty from a boss that doesn’t exist. (Un)Fortunately, the internet is full of (ill-conceived, probably irrelevant) advice. Because we just want to be told what to do, we take on these expectations in an almost unconscious way. “Finally, here’s the checklist on how to do this the right way” we say, and then we run ourselves into the ground on the hamster wheel of “best practices” and “tips and tricks.”

These realities (which are DIFFERENT from the realities of our friends with jobs) are why any serious attempt at time management can result in panic.

Now, just to be clear, this doesn’t mean that time management isn’t possible for the self-employed.

It just means that your time management practice has to begin in a more foundational place.

We don’t get to start with a list of foregone tasks based on a job description or the guidance of a supervisor.

Instead, we have to dig in and build a messy, imperfect vision. What do you want your practice to be like? How many clients are enough clients? How much time off do you want? How important are those other areas of your life (health, family, adventure, friends)? 

It’s very important that you operate from a place informed by the answers to THOSE questions.

When that is in place, you will be ready to manage your time.

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