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Starting Up In Private Practice - do you know where to start?

photo by Christian Stahl

I will be honest; I don’t quite know where to start. As with most new business owners/sole-traders/entrepreneurs, my head is spinning a million miles an hour with endless to-do lists, worries if I have tracked every expense so far, and getting my head around tax returns. Deep joy. So, when I was approached if I would like to write for the Counsellors’ Café, it was such a welcome surprise, I nearly fell over.

Recently, I’ve started private practice. I’m a serial procrastinator, I talk and talk and talk about doing something but never get around to doing it. So, after six to nine months of thinking, talking to (and annoying) people, I took the plunge in February this year. There were many things that I worried about when I deliberated and eventually set up. I was fortunate to have some counsellor/psychotherapist folk around to answer some of my ponderings, but as I found during my training, we aren’t given much direction or practical advice when entering private practice. Or if we are, it’s another course! I thought I might tell you how I got to where I am now, the raw truth, no holes-barred account. Consider this a shorter version of the secret diaries of a junior doctor, instead called, And How Do You Feel About That?

Things to consider before starting..

Your background and level of training

My background in counselling & psychotherapy is all over the place. My first degree is Film Studies. Yes, you read that correctly. I qualified (with BACP standards before Scoped) with a Level 4 Diploma and then did a Certificate of Proficiency. I thought I would start private practice after this. By all means, there is nothing stopping some, and I would put this down to personal feeling and choice. I felt that I did not have enough confidence in my counselling abilities, so I went on to do a Post Grad Diploma in Integrative Counselling & Psychotherapy.

After doing a placement for Level 4 and Post Grad courses, experience of 4 different third sector counselling agencies, office politics, watching the difficulties in acquiring funding, frustration of never-ending waiting lists and not enough money to see the most vulnerable, I was almost relieved to work for myself! I was glad for the more in-depth theory teaching I received on the Post Grad course, and also for the experience in the placement, even if I did feel frustrated for the most part thinking “I could be working for myself right now, I don’t need to do this.” It was hard, but I gained character, resilience and confidence. I would seriously recommend evaluating where you are, your training, your experience, and how you feel about it. It’s an individual matter, I’m not going to get involved with the Scoped debate here, as that requires wine. Or chocolate. Or both.

Your Specialism

When I finished the Post Grad course, one of the key things the tutors told us as they prepared us to finish, was find your niche, find your specialism. For me, I’ve always worked in general counselling agencies, as I wanted to gain experience in a wide variety of issues. I do not like to be put in a box. I don’t want to put a tick beside one option. I’ve had to reflect on myself, on what I specialism would sit best with me. It’s been difficult, because my specialism(s) are somewhat evolving. I see individual clients, although after having an inquiry from a couple and discussing it at length with my supervisor, I’m testing the waters with them. And before you ask, I have been congruent with that couple, that I have never seen a couple before, and they are happy regardless. As am I. In fact, I left the last session smiling like a fool after watching them argue. After doing some couples CPD before and after our first session, I’m currently looking into Couples Counselling courses.

Going back to you, when it comes to marketing yourself, a specialism does help. Whether it be Children and Young People, Couples, Relationships, LGBT, whatever you have a passion for. And of course, doing what you are passionate about makes for a happy counsellor! An honest reflection here, a specialism will cost you more money in training. Look around for the course most local to yourself; saving money on travel expenses and saving the environment. And most of the courses I’ve looked at near me are also the cheapest.

Money Talk

Whilst I’m on the subject of money, I thought I’d put a few pointers here. We are British, we don’t like talking about money, other than complaining about how much energy, fuel and food prices are rising. But I would really recommend finding out about local business support. For example, myself here in Wales, I have accessed Business Wales. They have supported me in giving advice, registering my interest in different workshops they have available (all free of charge), all geared towards growing my business and making me environmentally responsible. One such workshop I went to recently was Tax and Book Keeping. Cue yawning. Yes, I needed to lie down in a dark room afterwards, but it was incredibly helpful. For anyone who find HMRC jargon confusing or feels generally daunted by the prospect of self-assessment, I would highly recommend finding some such seminar/workshop near yourselves.

A few things I gleaned:

  1. If you are renting a room in a town or city near you, and you are traveling to that room to meet clients and back home again, you cannot count this as travel expenses. It is a commute unfortunately, and not claimable.

  2. Accountant Fees: This really does depend. If you keep your books, receipts etc and it is in good order and not confusing, the accountant fee would be less. Give or take £250 for the year. Makes sense; they don’t have to do so much work. However, if you have made no effort at all, and just dump everything on their desk for them to sort out, you can expect up to £3000 for the year. Do get quotes and ask around for reputable accountants.

A few things I’ve learnt since being in private practice:

  1. Do keep your books up to date, sometimes checking every day to be sure. 5 minutes every day or every other day, is a small price to pay for when self-assessment would take ticking three boxes as you know all the figures.

  2. Keeping books – I use an Excel spreadsheet. If you already have it as part of Office then brilliant. If not, there are many other Apps available (like QuickBooks) but these often have monthly or annual fees.

  3. When looking into business advice from non-therapeutic folk, be aware of your ethics. You will know what feels right and wrong, trust your gut and intuition.

  4. You WILL have to chase for money. I’ve been doing this for three months and already I have chased clients for payments. At the beginning I learnt a hard lesson of trusting clients to turn up, and when they didn’t, I still had room rent and no earnings. I have had clients try to get around my cancellation policy to avoid paying. I thought, perhaps naively, that this wouldn’t happen because it’s a private practice and people would value my service more than a voluntary service. Think again.

Self-Care – Taking Your Time

I cannot presume to know how you feel about setting up private practice, or even how you felt if you already have. But for me it was a case of ripping off a plaster. I set up, got a room, printed business cards, put profiles on various websites within three days. I needed to do it as quick as possible, because if I spent too long deliberating on how I felt about my picture and my services being public knowledges I would scare myself to death. So, I learnt quite quickly that my self-care was going to be paramount to my success.

You cannot run a business on empty. And you definitely cannot run a therapy business on empty. I’d like to think that, when I’ve earnt enough money, I could take regular weekends away. Go and escape to a local hotel maybe for a night or two, with nothing but Netflix and a book. Maybe treat myself to a massage to release tension. But for now, I will stick to my walk along a local beach, and regular days off. And that is what I love about running my own business. It’s my day off and as I am writing, I’m at home in my pyjamas. I’m the boss, and the boss wears the pyjamas. Taking dress down Fridays’ to a new level.

Author's Bio


Kate Howell is a Counsellor & Psychotherapist in private practice in the Swansea & Carmarthenshire area of South Wales. She also works voluntarily as a counsellor for the NHS Bereavement Service in the local area. Her hobbies include, playing the piano, watching films, eating chocolate, baking, self-love and generally avoiding supportive knickers.

Get in touch with Kate via Facebook or Instagram.

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