What it’s like to start your own private practice
Written byFrank Anderson, MD
Last updated: 10/19/2023
For this four-part series, therapist.com sat down with Frank Anderson, MD, to talk about his experience in private practice. Anderson is a therapist, psychiatrist, author, and speaker with three decades of work specializing in trauma treatment. Here are his insights on how to launch your first practice.
The first year of my practice as a therapist was both exciting and scary. I was still in my fourth year of training when I ventured out on my own.
At the time, I was working part time at a trauma center practicing psychotherapy. Since I’m also a psychiatrist, I did medication management to supplement my earnings. I did this for years while also working part time as an outpatient therapist in my own private practice.
Taking the leap
One of the first things I did was decide to rent out an office space for three or four hours a week on Wednesday nights. I’ll never forget how exciting it was to get the key to my new office in downtown Boston, head over there at the end of my workday, and spend a few hours in my very own space.
As exciting as it was, it was also completely new territory for me. After all, I was used to having everything taken care of for me through the training program. Patients were provided to me, the necessary forms and paperwork were readily available, and there was always someone there to take care of all the billing work.
When you’re in training, it’s hard to recognize just how coddled you are. That really starts to sink in once you take the first steps toward opening your own private practice.
Reckoning with imposter syndrome
I remember getting my first patient through a friend and colleague from my training program and thinking to myself, “I’m finally doing what I wanted to do.” I certainly looked eager and professional, but on the inside, I was kind of freaking out.
It wasn’t really my office. I was renting someone else’s space. My desk and my chair weren’t actually mine. I was only there for four hours a week. But I had to remind myself that my patient didn’t know any of this. They thought it was mine, and that was just thrilling to me.
When you get that first patient, you reach this moment of feeling like a real, official therapist. It’s important to stop and recognize this, because it’s one of those things that takes a really long time and tons of training to get there.
Taking care of business
Along with the many wonderful and exciting opportunities that come with opening your own private practice, there are also a lot of challenges. For instance, in addition to being a therapist, you also have to be an entrepreneur—a businessperson.
This isn’t what we go to school for. We were busy learning about psychosis, bipolar disorder, anxiety, and how to treat all those conditions—not how to run a business. We primarily want to help people.
It does take time to figure it all out. But eventually, you’ll be able to get someone else to do some of those things for you, like billing and paperwork.
Seeing the bigger picture
My experience is likely very similar to other therapists who go on to open their own private practice, because you can’t go full time just starting out. Over time, as your practice evolves, you get to do more of what you love.
At therapist.com, we understand that opening your own practice comes with a unique set of challenges. In part two of this series, hear how Frank Anderson overcame some of the most common struggles faced by new therapists—and what he wishes he knew when he was starting out.
About the author
Frank Anderson, MD, completed his residency and was a clinical instructor in psychiatry at Harvard Medical School. Both a psychiatrist and psychotherapist, he specializes in the treatment of trauma and dissociation and is passionate about teaching brain-based psychotherapy and integrating current neuroscience knowledge with the IFS model of therapy. He maintains a private practice in Concord, Massachusetts, and serves as an advisor to the International Association of Trauma Professionals (IATP).
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