Private practice can feel like the ultimate goal — until it becomes financially and ethically overwhelming.

So many therapists dream of starting a private therapy practice for freedom, flexibility, and a higher private practice therapist salary. But what happens when the reality of private practice therapy doesn’t match the expectation? In this episode, I’m breaking down the private practice business fundamentals most therapists were never taught — and why misunderstanding them can quietly turn the dream of starting a private therapy practice into a nightmare.

Using a simple “airplane model” framework, I explain what actually keeps a therapy business in the air — and what causes it to crash.

If you’ve been wondering how to start a private therapy practice without burning out, under-earning, or compromising your ethics, this conversation is for you.

After 20 years as a private practice therapist and founder of Growing Self Counseling & Coaching, I’ve learned (sometimes the hard way) that doing great clinical work is only a small fraction of what it takes to run a sustainable private therapy practice. Cash flow, operations, marketing for therapists, sales conversations, and understanding what it truly costs to earn revenue all determine whether you build something stable, or something fragile.

And if you’re considering starting a private therapy practice, this episode will help you slow down and think clearly before you leap — so you can build something aligned, informed, and sustainable.

Episode Breakdown:

00:00 The Airplane Rule: If You Run Out of Gas, the Business Crashes

03:10 Why Private Practice Feels Like the “Holy Grail” for Therapists

07:40 The Fuel Tank: Cash Flow and Private Practice Therapist Salary Realities

15:25 The Fuselage: Operations, Overhead, and What It Costs to Earn Revenue

23:40 Marketing for Therapists vs. Sales (And Why They’re Not the Same)

34:10 Ethical Risks When Your Practice Isn’t Financially Stable

42:15 Insurance-Based Models vs. Full Fee Private Practice Therapy

52:00 Employment, Supported Group Practice, or Starting a Private Therapy Practice — Choosing Your Path

If you’d like more support as you build a sustainable career as a private practice therapist, I’d love to invite you to The Growth Collective for Therapists — a professional home where you can receive consultation, community, and guidance around marketing for therapists, business fundamentals, and ethical growth. You don’t have to figure this out alone.

xoxo,

Dr. Lisa Marie Bobby

Growing Self

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