Over the past decade, I’ve worked as a therapist with individuals, families, and couples in my areas of expertise: love and connection, LGBTQIA+ identity, and gender-affirming and celebratory care for transgender individuals. Through my holistic and systemic approach to therapy, I aim to help my clients find alignment between their physical, mental, emotional, and spiritual health.
But being a therapist in this current environment isn’t easy. To set the stage, right now there is a concurrent mental health crisis and therapist shortage (APA). In the U.S., 1 in 3 people live in an area with a shortage of mental health workers (Kaiser Permanente), and this shortage can be felt more acutely in communities of color, rural communities, and low-income areas.
And, to compound this challenging environment, an overlooked reality is that therapists are small business owners, too. According to the Bureau of Labor Statistics, the most common work environment for psychologists is self-employment – which means many practicing psychologists are also navigating the challenges of being small business owners.
Balancing Act
When I decided to open my solo practice, I lived in Illinois and was moving to Georgia. Other providers warned me that the landscape for insurance, billing, and garnering clients as a LGBTQIA+ therapist in Georgia might prove challenging to run a private practice. Nevertheless, I felt determined to meet the needs of both the clients I still met in Illinois and my expanded clientele in my new home of Atlanta, Georgia.
Flashforward to now, and I run a thriving private practice, work as the Love and Connection Expert for Hinge, serve as a DEI consultant to businesses, universities, and organizations, and am a board member for It Gets Better, a global organization seeking to better the lives of LGBTQIA+ Youth. My experiences incentivize me to share the lessons learned, including how to balance priorities as a therapist and entrepreneur and how to pick the right tools to set your business up for success.
Therapists struggle to balance serving the mental health needs of their communities while growing a successful and sustainable practice. Here are a few lessons I learned that are critical to sustaining a small business as a practicing therapist.
Nurture and Prioritize Relationships In Your Professional Community
Building a strong professional network has been critical to my success. Professional connections led to real friendships, and these relationships sustain my commitment to my practice. Peers and mentors update me on the latest news and trends in the profession and offer support to navigate the ups and downs of running a business and serving client needs. It’s tempting to go into solo practice and then attempt to do everything alone. Instead, I watched and learned from colleagues who had either done what I wanted to do or were also in the process of setting up their practice.
Branching out into private practice allowed me to drastically expand my professional community. Since opening my practice, I have:
- Worked with clients navigating romantic partnerships, gender transition, or LGBTQ+ identity
- Shared my knowledge and expertise with fellow practitioners and providers who serve or desire to serve similar communities
- Supported the collective effort to infuse more empathy and therapeutic practices into society
Through my practice, consulting work, public speaking, and educational offerings, I am able to foster a nurturing and reliable community.
Reduce Your Administrative Burden by Choosing the Right Practice Management Tool
As a small business owner, you need the right tools to help you navigate the business world. Administrative burden is real for therapists so investing in the right tech can make life easier by streamlining processes, improving coverage and insurance issues, and providing a centralized home to manage your business.
For context, in late February 2020, I moved to Georgia, but a mere week later, the world went into shelter-in-place due to the COVID-19 pandemic. Suddenly, I faced many challenges to transition and grow my practice in my new home, with challenges exacerbated dramatically with the onset of the pandemic. I needed to choose a new electronic health record platform (EHR). My EHR in Illinois was cumbersome, lacked integrated telehealth capabilities, and was tedious to manage. In addition, the EHR lacked an app or any sort of messaging services, so I was unable to communicate with my patients.
Essentially, the previous platform was outdated, and the world had gone completely online. Fortunately, my wife is a Master of Health Administration and is an expert at setting up EMRs for large academic medical systems. I asked her to help me review my EHR options. She reviewed the systems with me, and without hesitation, confirmed that SimplePractice was the best solution for my practice based on my needs and future scalability.
For therapists, sinking or swimming in the profession requires finding the right practice management platform to build, scale, and run the business. I chose SimplePractice because it offers an all-in-one platform that eliminates the guesswork of opening a practice and comes equipped with:
- Comprehensive and empathetic customer support
- Step-by-step guides to setting up the insurance process
- Connection to a network of therapist peers
Since choosing the right EHR for my needs, I reduced my paperwork and billing time, and freed up more time to myself on weekends and evenings. This extra time was a dream because I became a first-time parent in July 2020. Because of the pandemic, my wife needed to stay on leave from her work at the local academic medical center for an extended time after giving birth. That meant I needed to keep my practice open instead of taking parental leave, and I needed all of my free time to bond with our baby. I didn’t want to sacrifice any of it for unnecessary paperwork.
Know The Signs of Burnout, and How to Practice Professional Self-Care
Beyond fostering a professional community and choosing the right EHR, understanding the signs of burnout is critical to running a successful small business.
In 2023, over two-thirds of practitioners experiencing burnout reduced their caseload, leading to negative impacts on access to care overall (SimplePractice), with causes stemming from work culture, healthcare ecosystem issues, and personal aspects such as managing work/life balance and compassion fatigue.
Staying vigilant in prioritizing my mental health care and looking for the signs before I reach a tipping point is crucial to maintaining my successful small business. Here are a few of the tips I offer anyone in private practice to reduce burnout:
- Take vacations. People in the helping professions are used to giving freely to others. I encourage you to give back to yourself just as freely. Remember, you can not give from an empty cup. Replenish yourself and give yourself plenty of rest.
- Get a quality EHR and reduce paperwork. Since using SimplePractice, my practice doesn’t require much work to manage. While it doesn’t run itself, it often feels like it does. When accepting new clients, clients essentially onboard themselves, and I take advantage of scheduling features, allowing new and potential clients to book a session with me online.
- Have your own therapist or consultation provider. Therapists need therapists, too. It’s okay to work with a therapist like me, who offers consultation to check in about challenges related to your practice or work with a therapist for personal reasons.
- Find ways to stay physically active. Sitting for 50 minutes at a time for back-to-back sessions can leave our bodies feeling stiff, unengaged, and exhausted. Deepening our presence in our physical bodies through the food we eat or the activities we engage in can boost our mental health and mood. Stretching, Yoga, a short walk, and mindfulness between sessions can be what your body needs to reset and engage before your next session.
Set Yourself Up To Succeed
As a therapist starting out building your practice, the groundwork of running a small business can be daunting and complex, and there will always be reasons to delay or even deny yourself the chance to run your own business.
However, if you implement the right technology to grow and sustain your practice, therapists can serve their clients and improve the mental health crisis at large.
Moe Ari Brown, LMFT (they/he), is one of the leading mental health experts in Gender Identity. Over the past decade, Moe Ari has worked as a Licensed Marriage and Family Therapist with LGBTQIA+ individuals, couples, and families. Through his professional work and journey as a person of Transgender experience, Moe Ari is now an expert in cultivating radical authenticity (the process of integrating, accepting, aligning, and celebrating one’s intersecting identities despite threats to belonging). As a public speaker, Moe Ari offers the lessons he learned, hoping that his story will inspire others to unconditional self-love and alignment.
