ACA Blog

Anthony Centore
Mar 05, 2012

4 Reasons to NOT Start a Counseling Practice; and 9 Ways to Become a High Paid Agency Employee

I often talk about the benefits of starting a private practice. However, owning your own business isn’t for everyone, and working for a counseling agency is not an inferior alternative. Listed below are 4 reasons to not start a private practice. If any one of the following applies to you, starting a practice may be a bad fit.
1) I need money now!

I have stated that a licensed counselor can start a practice for as little as a few thousand dollars, and that the practice could become cash flow positive within a few months. This is still true. However, one shouldn’t expect to bring in much net profit in year one. Hence, if you are undercapitalized or need a fulltime income right away, starting a practice might not be the best career choice.

2) I want to keep my work separate from my life!
Due to the nature of the job, counselors often struggle with leaving their work at the office—if you own the office, multiply that struggle by 10. For the small business owner, work is intertwined with life. It’s like having a child: the business requires constant attention. You will be home with it on Friday nights. You will be up at 4am comforting and feeding your business.

3) I hate business! / I just want to be a counselor!
Running a private practice has little to do with counseling and a lot to do with operations (billing, staffing, administration, etc.). I have never met a successful private practice owner who dislikes business. If you’re starting your practice longing for the day that you can focus exclusively on client care, you should think about joining an agency.

4) I don’t want to start from scratch!
When starting a practice, often both the business and the clinician are starting from scratch. Get prepared to enter a whole new world of learning. Successful practice owners have read a library’s worth of business books, and have aggressively sought information and mentorship. In addition, building a company is a gauntlet of successes and failures. If you’re not interested in getting an MBA from the School of Hard Knocks, think agency.

Becoming a High Paid Agency Employee
Some counselors think about working for a counseling agency as a “pay me a wage, an I’ll come to work” situation. In contrast, to become a high paid agency employee, it’s better think about agency work as a partnership where both parties bring value to the table. Traditionally, an agency provides office space, clients, clinical supervision, insurance, branding, and a variety of administrative services in exchange for a share of the money a clinician’s services produce. This is the case regardless of whether one is paid hourly, salary, or a percentage of counseling fees.

Hence, to become a high paid agency employee, a clinician needs to bring more to the table. For example, counselors become more valuable to agencies when they:
1) Get the word out about their services instead of asking the agency to market their services for them.
2) Speak publically, and mention the agency.
3) Speak with reporters to get quotations in print, or on the news (especially if they use the agency’s name).
4) Publish, tweet, and build an online or offline audience.
5) Build a reputation that brings in more clients. This is especially true if their reputation also brings in clients for other providers at the agency!
6) Offer specialized services. This is valuable to the extent that their presence allows the practice to accept clients they would otherwise need to refer (e.g., children, foreign language speaking, autism).
7) Self manage, or request less administrative support from the agency.
8) Provide supervision or help to other providers at the agency.
9) Are credentialed with various insurance companies (note: some agencies now require clinicians to be on insurance panels to even apply for a position).

Done right, one might find that working for an agency affords more freedom, and sometimes more money, than private practice. Finally, if you’re bringing serious value to the table, and your agency isn’t recognizing it, it might be time to look for a practice that will!


Anthony Centore is a counselor, and helps other counselors build successful practices. For more information on private practice and insurance panels go to http://thriveworks.com .

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