Making the decision to open your own private practice or join an existing group is one of the biggest choices you’ll make as a therapist. Each path has its own rewards and challenges, and understanding those early on can save you time, stress, and money down the road.

Let’s break it down in real terms.

Being Independent: Freedom With Responsibility

Owning your own private practice gives you total control, your schedule, your clients, your brand. But that freedom comes with a lot of behind-the-scenes work.

When you’re independent, you’re not just the therapist, you’re also the:

• Billing specialist – following up on claims, denials, and insurance calls.
• Scheduler – answering phones and managing appointments.
• Marketer – maintaining visibility, networking, and building referral sources.
• Administrator – handling business expenses, taxes, and compliance.

If you don’t have the time (or desire) to juggle all these roles, you’ll likely need to hire help. That means factoring in payroll costs or contract fees, and adjusting your rates so your business remains profitable.

It’s absolutely possible to thrive independently. Many clinicians do. But the honest truth? Time is never on your side. You may find yourself stretched thin or struggling to keep up with the business side while trying to maintain the emotional energy needed for your clients.

Joining a Group Practice: Support and Structure

Being part of a group often means you can focus more on your clients and less on administrative stress. Groups typically have:

• Established referral sources – no need to build your caseload from scratch.
• Billing and scheduling staff – they manage insurance claims, denials, and calls.
• Office management – maintenance, utilities, and facility concerns are handled for you.
• Marketing and web presence – often already in place, saving you time and effort.

Most groups also hold their own contracts with insurance companies, meaning you can begin seeing clients under their established agreements instead of starting that process on your own.

Of course, you’ll pay a percentage of your income to the group, but when you factor in the cost of running your own practice, website, phone lines, EHR systems, marketing, liability insurance, and more, the payout difference often balances out.

For 1099 (independent contractor) positions, make sure the group operates ethically and transparently. If your percentage split roughly matches what you’d spend running your own business, and you gain stability and support, it can be a win-win.

Hidden Costs to Consider as an Independent

If you’re leaning toward opening your own practice, make sure to account for all the “little” things that add up quickly:

• Website hosting and annual domain renewals
• Marketing content, photography, and branding updates
• Psychology Today or other directory listings
• Scheduling and billing software subscriptions
• Wi-Fi, phone lines, utilities (if you have a physical office)
• Liability insurance and business coverage

You’ll also need consistent, quality content to keep your website ranking well, something that takes time or the cost of hiring someone to manage it for you.

The Bottom Line

Both paths, independent practice and group practice work can be fulfilling and successful. The key is to weigh your time, energy, and goals just as carefully as your finances.

If you’re energized by autonomy, systems, and building from the ground up, independence may be for you.

If you want structure, support, and community while maintaining flexibility, a group might be the perfect fit.

There’s no one right choice, just the right fit for where you are in your professional journey. If you are considering contracting with a group practice reach out to us at applicants@carolinacounselingservices.com.

Ebone L. Rocker, LCMHCS, is one of the Owners and Vice Presidents of Carolina Counseling Services. She is a Licensed Clinical Mental Health Counselor Supervisor in the State of North Carolina.