Undermining Yourself as a Novice in Private Practice
Audio Version
Starting out in private practice is exciting but it can also be intimidating. Many new therapists unintentionally undermine their confidence and business growth by allowing fear and assumptions to dictate their decision making process.
Concerns about client scheduling, discussing copays, and anticipating barriers can keep new clinicians from stepping into their role as capable professionals. But the truth is, these are normal growing pains that can be managed with preparation, understanding, and mindset shifts.
The Fear of Scheduling: Confidence Comes with Structure
Many novice therapists worry they’ll inconvenience clients or lose them if they can’t offer “perfect” availability. This can lead to overextending hours, double-booking, or avoiding firm scheduling conversations altogether.
Instead:
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Set and communicate clear boundaries for your availability from the start.
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Use a secure scheduling platform that offers reminders and client portal options.
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Practice the process of scheduling regular appointments so that your clients adhere to your scheduling boundaries.
The U.S. Small Business Administration (SBA) emphasizes that structure and clear systems are essential for small business success and private practice is no different.
The Copay Conversation: It’s About Clarity, Not Confrontation
Talking about money can be uncomfortable, especially early on. Some new therapists delay discussing copays or deductibles out of fear they’ll scare clients away.
Avoidance can lead to unpaid balances and unclear expectations.
Instead:
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Bring up copay amounts and payment expectations before the first session.
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Offer multiple payment options (card on file, online payment portal, HSA/FSA cards).
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Keep tone warm and matter-of-fact: “Your copay is $25, and we collect it at the start of each session.”
The Centers for Medicare & Medicaid Services (CMS) indicates that transparency regarding the cost of care is essential to ethical treatment and the smooth delivery of services.
Worrying About Barriers: Don’t Solve Problems Before They Exist
It’s common to imagine every possible barrier a client might face transportation, finances, internet access and overcompensate in ways that compromise your own boundaries.
While being sensitive to client needs is important, making too many assumptions can undermine your client’s authority and limit their growth.
Instead:
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Ask clients what their needs and preferences are rather than guessing.
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Have a resource list ready for common challenges (sliding scales, telehealth options, local support services).
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Remember, you can be compassionate without sacrificing sustainability.
The National Institute of Mental Health (NIMH) recommends open, collaborative conversations with clients to address barriers, rather than making assumptions about your clients needs or limitations.
Mindset Shift: From Novice to Professional
Early in your practice, it’s easy to see yourself as “just starting out”, but your clients see you as their therapist, not “the new therapist.” You can build confidence by:
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Celebrating small wins in client progress.
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Seeking regular supervision or peer consultation.
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Remembering that you bring unique skills, training, and empathy to every session.