Avivit Fisher

How to Stop Fears from Ruining Your Private Practice Dream

The biggest fear for therapists in private practice

Last week I talked to my client who conquered one of the biggest fears that therapists experience in running a private practice. Not taking insurance. She had an opportunity to test this in a new location where she opened a new office. She knew that she wanted to work this way for a long time, but her fear of missing out on potential clients was holding her back.

I am not saying that you have to stop taking insurance right now. What I am saying is that working from fear will not bring you the results and the satisfaction that you want. You, more than anyone else, know that fearful thoughts can often disguise themselves as common sense.

"I have to take insurance, otherwise I won't have a full practice."

"I can't choose a niche, because I will miss out on potential clients who might contact me."

These thoughts might seem rational to you, but they are not necessarily a correct representation of reality. That said, if taking insurance makes financial sense for your practice, by all means, don't stop taking it. And if you are loving working with a wide array of issues and are equally excited about working with addiction as well as children, then I won't recommend that you narrow your niche.

But if you are overworked, spread too thin and annoyed that the only clients that come to you are the ones who need you to be within their insurance network, you probably need to reexamine your strategy. Because your irritation and a lack of enthusiasm will show in your communication and the service of your clients. And this will ultimately hurt your finances.

So how do you stop working from your fears and still grow your practice?

Focus on what you want. This is a very simple but extremely challenging concept for many of us. You would have to set the time and have an honest conversation with yourself in which you envision how you want your life to look like. How many patients a week you want to take. What kind of clients bring you the most joy. How much do you need to charge to sustain this vision and how many insurance clients you will be accepting (if any).

You would have to set the time and have an honest conversation with yourself in which you envision how you want your life to look like.

Test it out. You don't have to be drastic and go all in after you make these decisions. You can run a test by changing how you present yourself to the world. You can start by talking about your self in this way: "I help.....(a specific group if people) to overcome....(a specific problem) by.... (offering your method)." You can judge people's interest by the reactions that you see. Present yourself in this way to other providers who send you referrals or talk about yourself this way in public.

But that's just one way of testing this out. If you are opening a new location, you can test your new strategy in that location only, just like my client did.

Measure and adjust. Like with any test, it's important to measure your results. If you see that scaling back on your hours doesn't make financial sense right now, but that you are happy with the type of clients that are coming to you, you can adjust your hours. And if you see that the niche that you have selected is not responding in the way that you are expecting, you need to understand what might be affecting your reach. The important thing to remember is that you need to give the testing period some time. It will be tempting to revert to the way things were before, but then you must remind yourself how you were feeling then. Adjust, but don't revert back.

I am not naive, I know that fear has a common place in running your own business. But when our fears lead our business, we end up feeling frustrated and resentful. Leading from fear will not bring you the satisfaction that you craved when you opened your practice. If that is your situation, find the time you need to reflect and adjust your strategy.