Starting a Private Practice In Counseling Checklist
Takeaway: If you’re feeling lost trying to start your private practice, you’re not alone. While it’s exciting, it can also be totally overwhelming. My comprehensive private practice checklist is designed to help therapists like you feel confident in their next career move. I’ll cover all the essential steps you need to launch a practice that aligns with your needs and values and offer a few tips for focusing on your pleasure during the process.
You probably want to start your own private practice in the hopes of making more money and having more control over your schedule. But starting a private practice can also be scary. You may worry that you can't actually do it, that there are too many decisions to make, and that you won't be able to make enough money to cover your own business expenses let alone pay yourself a salary.
While it's true there are a multitude of decisions to make when setting up your counseling practice and certain requirements that are specific to mental health professionals, your dream practice is within reach.
This "Starting a Private Practice In Counseling Checklist" will walk you through each decision and task one by one so you can get started building your dream counseling practice today. If you love to consume content via podcasts, check out Episode 43 of The Bad Therapist Show.
The ultimate private practice checklist
This checklist is broken down into three main categories: legal requirements, financial tasks, and logistics. Remember, you can only take it one step at a time. Many of the tasks will require less than 30 minutes to complete while others will require more time.
If you're crunched for time, know you can actually get your business entity set up and ready to accept payment from clients in as little as one day! Throughout the guide, I'll connect you to other resources and tell you when you should be consulting with a lawyer, accountant, or local professional association or board.
I also include key tools and resources I've already created that will help you make important decisions like what to charge, how many clients to see, and how to create your cancelation policy.
5 things to do take care of yourself and find joy in the process
We're starting with this because you are the most important part of your private practice. You're the most valuable business asset and nothing happens without you being in good shape. On top of that, you deserve to enjoy your life. If you're going to go through the trouble of becoming an entrepreneur, we want to make it worth your while and help you build a sustainable private practice, right?!
That means creating a standard of care for yourself that is grounded in pleasure.
1. Make it special.
Whether it's your favorite cafe with a view of the city, the historic main library branch with its hardwood desks and soft lights, your couch with your favorite mug of tea and cat curled up by your feet, or a noisy outdoor space, choose a place that lights you up. Wear something that feels great to you. Get fancy or cozy or professional. Get into the vibe that makes you feel like a million bucks.
This will make the more mundane, tedious, or challenging moments of setting up your business just a little sweeter.
2. Let go of perfection.
I'm gonna be totally honest with you, the business you set up will change over time. Don't get bogged out in what to name your business or stall on building your website because you "need a logo first" (you don't need a logo to start a business). Your business is a living, breathing entity that will (and should!) change over time.
Notice if you're sabotaging yourself by getting lost in the weeds. Perhaps you're trying to avoid something? If this is happening, then you would probably benefit from doing some mindset work to help unstick yourself. Remember, almost nothing in your business is set in stone. You can always update it after you get it set up.
3. Check your head.
You'll hear me say this a lot, but building a business is actually really straightforward. It may not be easy, but it's also not complicated. The biggest thing that stands between you and having a successful business is not lack of talent, information, time, or even money.
It's your mindset.
Every entrepreneur needs a solid mindset practice to help them weather the ups and downs of running a counseling business. (Join my free Facebook group, Healing Money, and get my Daily Mindset course for free.)
4. Have a support team.
This can look a lot of different ways. From working one-on-one with a private practice business coach, being in a supportive community of other private practice owners, or recruiting a trusted group of friends to be your cheerleaders throughout the process, having people to vent to and celebrate with can make a huge difference.
When you work 1-on-1 with a therapist business coach, you'll have someone to keep you accountable, track your progress, support you when you hit a rough patch, and celebrate your success.
5. Celebrate every milestone big or small.
This is a big deal! You're starting a private therapy practice! Celebrations can be as small as doing a lap around the house waving your arms every time you complete a step or be as big as buying yourself that new computer or international business retreat you've had your eye on for a while. (Did someone say fun business expenses?)
Now that you've got your self-care items handled, it's time to start taking radical action and build your dream practice!
Private practice checklist for legal items
To set up your counseling private practice, you will need to choose your business entity type, choose a name for your private practice, register your business, and create your documentation. For many therapists, this is the scariest part of setting up your practice since you may fear that you'll somehow get it wrong or make a mistake that will get you in trouble.
I want to reassure you that this rarely happens. This checklist will be a helpful guide, and when in doubt you can always call your professional organization or head down to your local small business administration (often at your city hall) for help. Ensuring your therapy practice has met all legal requirements is the first step to being able to welcome your future clients.
1. Choose your business structure.
Sole proprietorship? S Corp? Check with your state licensing board to see what your options are. Some states may restrict what type of structure you can choose.
I highly recommend speaking to a lawyer and an accountant to understand the benefits and disadvantages of different business structures. If you plan to start a group practice this will be even more important to factor in since you will hire employees and other therapists.
Check with your professional organization, city hall, or other local nonprofits for small businesses to see if they have professionals you can speak with. Reach out to your network and ask around. You may find that your friend has a connection to a lawyer or tax accountant who would be happy to speak with you. I'm a big fan of WellnessFi for solo practices and the Private Practice CPA for group practices.
If you plan to start a group practice you will need to find out which type of business structure is right for you.
2. Choose the name of your business.
The entity name of your therapy business may have to meet certain requirements depending on your business structure, your license type, and where your business is located. For instance, LMFTs in California must include certain words like 'marriage', 'family', or 'child' in the name of their business. If you're an LMFT in CA, check out this article from CAMFT for guidance.
Generally, a quick Google search or a phone call can get you the information you need. A great place to begin is on the SBA website.
If you’d like your business to go by something other than your entity name, you will need to file a DBA (doing business as). For instance, an incorporated therapy practice in California could have the entity name, “Thomas Family Therapy Inc” and file a DBA for "Clarity Therapy." More on this specific example in a moment.
3. Register your business.
Start with registering your business on the local level. You may also need to file on the state, and/or federal level depending on the business structure you choose.
Requirements vary depending on location so check with your local Chamber of Commerce or check to see if your city or county has an office of small business. Begin on the SBA website for more on this.
4. File a DBA (optional).
If you want to publicly use a name other than your entity name, you will need to file a DBA (also known as an FBN or "fictitious business name"). Once you file to be recognized by your DBA, it will need to be published in a local newspaper. Proof of publication must be submitted back to the local agency that you filed with.
If this sounds a little strange and complicated, I promise it’s actually quite easy. The whole reason for this process is to ensure that the public knows that your business entity, which has one name, will be known publicly by another.
The idea is to not mislead the public. Back in the day, publicizing this information in the newspaper was the way to ensure the public knew. These days, there are newspapers that more or less have the sole purpose of publishing DBAs. You can even pay a little extra for them to do the follow-up filing for you. Your City Hall or Small Business Administration may have all of these departments under one roof or can tell you where to go to get things filed.
5. Get malpractice and liability insurance.
Mental health professionals in private practice must maintain malpractice and liability insurance. If you belong to any professional associations, check to see if they have any trusted partners. You can often get a discount with one of these providers.
6. Create your informed consent and intake forms.
Just like everything in this checklist, the forms you're required to give to clients vary by license type and state.
In general, you will need an intake form, informed consent document, consent for treatment of a minor form (if you plan to work with minors), telehealth consent form, a "good faith estimate form," and a release of information document (in the case that you need to speak with someone about your client), and a "no secret"' policy if you plan to work with couples or families.
Your local professional organization will often have sample forms that have been reviewed by staff lawyers. For instance, if you're an MFT in California and a member of CAMFT, you can check out their website to ensure you're using the right forms.
I highly recommend being a member of your local professional organization, which often gives you access to consultations with staff lawyers and discounts on things like liability and malpractice insurance. If you plan to use an EHR (electronic health record) platform like Simple Practice, you can also start with their templates and customize them for your therapy practice.
7. Ensure your practice is HIPAA compliant.*(not applicable to all mental health professionals)
HIPAA compliance generally refers to how a client's private health information (PHI) is shared. All therapists must protect client privacy, but not all therapists are HIPAA-covered entities.
According to the U.S. Department of Health and Human Services, a provider becomes a HIPAA-covered entity if they "electronically transmit any health information in connection with transactions for which HHS has adopted standards."
This refers to submitting insurance claims using the internet. Faxing or physically mailing insurance claims or giving your clients superbills to submit themselves, does not make you a HIPAA-covered entity. So if you have never been on insurance panels and don't plan to be, then you probably aren't a HIPAA-covered entity.
That being said, most private practice therapists choose to comply with HIPAA because it's the industry standard for client privacy and protection. This means ensuring that your documentation, storage of clients' records, and any software you use meet HIPAA requirements.
Software made specifically for therapists (like Ivy Pay or Simple Practice) is usually HIPAA-compliant. But if you plan to use Google Workspace or Zoom in your practice, you will need to sign a BAA or Business Associate Agreement to ensure HIPAA compliance.
This is a legally binding agreement that ensures the software you use protects your clients' private health information. Learn more about signing a BAA with Google. Check out the American Counseling Association's guide to HIPAA-compliant documentation for your private practice.
Private practice checklist for financial items
All private practices need a solid business plan to ensure that the financial aspects are set up properly. You will need to obtain an NPI or EIN, choose how you'll accept payments from clients, open your business bank accounts, and set your fee!
This is often a place where therapists get rattled. However, I challenge you to trust that you can make progress and start reaching your financial goals before you know it by following this checklist step by step.
If you'd like to consult with financial professionals like accountants, my favorite accounting firms for therapists are WellnessFi and the Private Practice CPA. Make sure to tell them The Bad Therapist® sent you!
1. Get your NPI.
You may already have a “national provider identifier” if you’ve done agency work. This number represents you as a treatment provider and follows you through the rest of your career regardless of who your employer is or if you are running your own practice. You would include your NPI on insurance reimbursement forms provided to clients or on claims you submit directly to insurance panels.
If you need to get an NPI, it's free and only takes a few minutes. Get your NPI here. If you plan to only accept private pay clients and not panel with insurance providers, then you may not need an NPI. However, it's good to have just in case.
2. Get an EIN.
Your EIN (Employer Identification Number) is a unique number used for tax purposes. It is also referred to as your “Tax ID Number.” It is essentially a social security number for your business which you will use when filing taxes. You can apply for your EIN here.
A special note for clinicians who have been small business owners before: If you've ever been issued an EIN for a sole proprietorship, you won't be able to get an additional one. You'll need to use the original EIN you were issued for your previous sole proprietorship, whether it was therapy-related or not.
3. Open a business bank account.
You will need the documentation you generated when registering your business to open your business bank account. The bank will would like to use will tell you exactly what documentation is needed to open a business bank accounting.
In Liberated Business, we use the “Profit First” method. I recommend using a bank that has no minimum balance requirements, no fees, and allows you to open multiple accounts. Your local credit union or an online bank could be a great option.
4. Decide how you will accept payment from clients.
Decide what forms of payment you will accept and how. Depending on which record-keeping tool you’re using, payment processing may be included. If not, you may need to sign up for a service specifically for this.
Check out Mentaya's payment processor and try their Benefits Checker for free for 30 days with the discount code THEBADTHERAPIST.
5. Set your fee.
I'll do a brief breakdown of the factors you should consider when setting your private practice session fee. For an in-depth guide on how to set your fee, go here. To see sample private practice schedules and get support around choosing the right number of clients for you go here.
Your fee should be based on:
All the expenses you currently have--personally and in your business
Your desired expenses, i.e., the things you want to have and do but aren't currently spending money on
How many sessions you will provide each week
Your number of vacation weeks you'd like to take each year and optional sick time you'd like to prepare for
Your cancellation policy
As you can see, I recommend basing your fee on numbers and math rather than what you “feel” like charging. We often feel like charging way less than we actually need to sustain ourselves and have more than enough money to enjoy our lives.
I say this as someone who has avoided numbers and math for much of my life. But avoiding math is avoiding reality. And avoiding reality leads to burnout and resentment, which we are not about.
Based on my experience working with therapists, your fee is likely 2 to 3 times lower than it should be. But if you do the math, you will know exactly what your fee needs to be with zero guesswork.
Use my Magic Sheets tool to discover your perfect fee. And if you feel nervous, know that's normal.
This topic tends to be really evocative and it’s one that we cover extensively in my signature coaching program, Liberated Business. You can also join my free Facebook group, Healing Money to be in a supportive community with other entrepreneurial therapists like you.
Private practice checklist for logistical items
Now that you've moved through the legal and financial aspects of your private practice business plan, it's time to handle logistics. Some of these items will be familiar to you as they intersect with legal and financial tasks, but here we'll be looking at them through a logistical lens. You'll also need to make some key decisions about your practice's policies.
Let's dive into the logistics of starting a private practice!
1. Get an office (optional).
It used to be a given that therapists needed to have an office space to meet with clients in person. In recent years, that's no longer the expectation and many therapists and clients alike enjoy the freedom that telehealth affords.
That said, you may still want to have an office outside of your home. This can be useful for a number of reasons: providing in-person work, having a clear separation between work and home, and taking advantage of Google Business as part of your marketing strategy.
2. Get an address.
If you choose to not get a therapy office, there are a lot of different reasons to have an address other than your home address associated with your business. You may not be comfortable using your home address and would prefer to use a PO Box.
As an MFT in CA, you can use a PO box for your business address. (Check with your local state licensing board to ensure you're in compliance.) However, insurance companies may have different requirements for your address.
That being said, if you want to take advantage of Google Business you will need to choose an address tied to a physical location. Some office buildings allow you to use their address for a smaller fee.
3. Decide how you will keep your client records and what platform you will use to meet with clients virtually.
How will you store your therapy notes? In a file cabinet? Using an online record-keeping system specifically made for therapists? Or use something like Google Workspace after signing a BAA (business associate agreement) with them?
Remember that security is important whether or not you are a HIPAA-covered entity. Jump up to the previous section for more information on HIPAA compliance.
4. Get a phone number.
You'll need to choose which phone system to use for your practice. These days, many therapists choose to use Google Voice because it allows you to protect your personal number without having to have a second phone.
This is what I chose for my private practice. If you choose to use Google Voice, you will want to sign a BAA with Google which requires having a paid Google Workspace account ($6/month).
As part of the Google Workspace Referral Program, I am able to share discount codes with you to get 10% off your first year of Google Workspace Business Starter and Standard plans. Fill out this form to get the discount codes sent to you via email.
5. Decide how clients will get in touch with you.
While having a phone number is important as a business owner in general, it's not the only way for potential clients to get in touch with you. Consider how prospective clients will get in touch with you if they're interested in working together.
Will they fill out a form on your website? Call you? Email you? Schedule their own intake via a calendar link? Make sure you have a clear and simple CTA (call to action) so potential clients know exactly what step to take next.
6. Create your intake and onboarding process.
What does your intake process look like? Do you schedule an intake call via email? Does the client receive a link to schedule themselves? How do you screen out clients who aren’t appropriate for your practice?
Depending on what you’ve chosen for your record-keeping system, you may already have templates and protocols you can adjust. Having a clear roadmap for how potential clients become new clients, will allow your practice to function with minimal friction.
7. Determine your office hours.
Give some thought to when you do your best work and set a schedule based on your needs. Remember this is your practice--it should be a great place to work for you.
When you’re getting started, sticking with this is one of the hardest things you will do. You will likely be tempted to see clients outside of your office hours, but this will lead to resentment, burnout, and poor client care on your part.
Don’t do that to yourself or your clients. Instead, get crystal clear on when you want to work and ONLY see clients during those hours. Potential clients can adjust their schedules if they strongly desire to work with you and you can trust that there are enough clients who will be a good fit for what you have to offer, when you want to offer it.
Go here to see some sample practice schedules.
8. Determine your policies.
What is your cancellation policy? Your rescheduling policy? Your time off policy? Contact outside of sessions? What will you and won’t you provide? What can your clients reasonably expect from you?
Determine these policies based on what works for you. If you craft policies that work for your clients but not for you, you are on track to frustration and burnout.
I recommend a limited or no cancelation policy. This means that clients may only cancel a limited number of times per time period without incurring a fee. More and more therapists are adopting policies like this to create a more consistent schedule and reliable income.
Private practice checklist for marketing items
Do you feel dread when you think about marketing your practice? You're not alone. I used to feel the exact same way, but I have shifted my attitude about marketing over the years. I've gone from seeing it as something icky or that I should already be great at to something I get to learn about and experiment with.
Check out episodes 5 and 6 of The Bad Therapist Show to hear how I changed my relationship with marketing (and got so much better at it!) and get actionable tips to turn your marketing around.
When it comes to marketing, there are a few things I believe are mandatory, including professional-looking photography, a website, and one active marketing strategy. Everything else is optional.
While you will likely need to challenge yourself and get out of your comfort zone, you should not create a marketing plan that's overwhelming or complicated. Keep it simple and nail one strategy at a time before adding more.
Get my Marketing Strategy Clinic to create a simple marketing plan for your private practice and start attracting new clients.
1. Get a professional headshot.
Professional photography goes a long way. In addition to improving your website, directory listings, or social media marketing, it helps YOU feel more professional and legitimate. Look around for local options in your price range and if you aren't able to spend the money right now, ask a friend to help you do a photoshoot using your phone. Work with what you've got!
2. Build a website.
Websites range from being the equivalent of a modern business card to high-tech SEO machines. If you're just starting out and have a limited budget, keep your website simple.
Tell your ideal clients why you're the therapist for them, say where you are based/licensed, share your private practice fee, and allow them to take the next step in working with you whether that's filling out a form, making a phone call, or booking a consultation.
Don't get stuck in the minutia. Keep it moving. Remember your website is an evolving document.
3. Consider Search Engine Optimization (SEO) and blogging.
With effective SEO, you can increase traffic to your website thereby increasing the number of potential clients who learn about your counseling practice. SEO is often a time and financial investment upfront, but once it's in motion, it typically takes less time than a social media marketing strategy to maintain.
SEO is a highly technical marketing strategy. You'll need to learn about things like keyword research and search intent. But if you love to write, it could be a great option for you. My favorite SEO firm for therapists is Therapie SEO. Tell them The Bad Therapist® sent you.
There are ways to get started with a smaller budget or you might decide to make a bigger investment upfront. In order to get the most out of SEO, it's helpful to know your niche going in. Listen to Episode 4 of The Bad Therapist Show to learn how to pick the right niche for your therapy practice.
4. Build your network.
Many of my clients prefer to avoid digital marketing and would rather focus on networking. Networking is still a fantastic strategy. Look for practitioners who may work with a similar population as you but using different modalities. It can also be valuable to connect with therapists who might be receiving client referrals that are outside of their specialty or scope of practice but within yours.
I recommend choosing a few new people to contact and nurturing at least two of your existing contacts every month. Remember that networking is ultimately about relationships. Show a genuine interest in others's businesses and look for ways to add value to the exchange. Use a spreadsheet to keep track of the people you meet, the important details you learn about them and their businesses, and make sure to follow up more frequently with those who send you referrals.
5. Get on listservs.
Get on listservs that are relevant to your specialty or local area. This can be a great way to network with other counseling practice owners and get referrals.
6. Join a therapist directory.
Therapist directories can feel like a black box. Do they work? Are they worth it? To be totally honest, I think most of them aren't.
But one therapist directory I am really excited about is Best Therapists. It's not like the other directories. Rather than having your profile lost in an endless scroll of therapists, you're featured on a page with a limited number of therapists. This gives you a higher likelihood of actually receiving a client inquiry.
Best Therapists was built with therapists' best interest in mind. How do I know? Because I'm the Clinical Advisor at Best Therapists and have been able to watch it grow from its inception. We're passionate about not reinforcing hustle culture in therapists.
7. Create a freebie to grow your email list.
Email marketing can be a great marketing strategy for building and filling your private practice. The best way to attract people to your email list is to have a freebie you can offer to folks signing up. Keep your freebie simple and relevant to your ideal client. Listen to Episode 40 of The Bad Therapist Show to learn more about how to create your own freebie or get my freebie, The Magic Sheets, to see an example of one.
After folks have joined your email list, continue to nurture your potential clients by send regular newsletters providing value and education. If this is completely new to you, start with a frequency you can commit to like once a month or even once a quarter. Once you have down you can gradually increase the frequency of your newsletters to weekly.
8. Create a social media presence.
More and more therapists are using social media to attract private practice clients. This is a great way for potential clients to get to know you a little better, and social media is a great platform to share advice and demonstrate your expertise.
You can market your freebie in your social media bio to attract new people to your email list. A social media following is also a great asset to have created if you plan to create scalable offers in the future.
9. Google Ads.
Google ads can be a fantastic way to drive traffic to your website but it's best done with the help of an expert or some level of training. Like SEO, it's quite technical and it's easy to spend a lot of money and not get results if you don't know what you're doing.
As I said before, when it comes to a solid marketing plan, you should have a professional headshot, website, and and pick one other avenue through which you'll actively market your practice. Everything else is optional and you should nail a simple marketing plan that you can follow through with consistently BEFORE adding additional strategies.
Get my Marketing Strategy Clinic for help crafting your own custom marketing plan and never feel lost or overwhelmed again.
I’m here to help you feel empowered as a private practice owner.
Let me be the first to say congratulations on becoming a business owner! I know this list is long, but I promise you can do it. And if you want help moving through it step by step, I've got you.
Are you an ambitious private practice owner? Join my signature program, Liberated Business, and get everything you need to launch a thriving private practice. Or learn more about private business coaching and day-long coaching intensives.
