Can you make a decent income in private practice in 2025?
The mindset monkeys remain the same but what has changed and is it looking bleak out there?
I see you teetering on the edge. You can't keep going in a job that has you dancing with burnout every Friday, but you also can't quite bring yourself to jump in with both feet.
You're in private practice paralysis. Let's get you out of there.
This week, I've been pondering what you truly need to get started and thrive as a psychologist or therapist in private practice in 2025. Some things are the same as when I started back in 2017, but others feel very different.
Let's start with the constants, the things that were true then and are still true now.
The Constants
Shame
Yep, we still feel deeply ashamed when we go into private practice. Often, that's because we've been led to believe that making money from helping people is dirty and unethical. There's a whole heap of stuff I could go into about that, but I won't because I already did in a previous Substack post. You can read all my views on that here.
This shame often leads to financial avoidance. Many of us don't know our numbers. We refuse to understand concepts such as profitability, even though we're definitely intelligent enough to do so. It’s a pattern I went through back in 2017, I know many of my colleagues did too, and I still see it in so many of my students and coaching clients now.
The Foundations Remain Crucial
We still need a solid setup for our practice, for both ethical and legal reasons. We have to have a good grasp of data protection laws and strong processes for consent and keeping our admin in check.
Marketing is Still About Relationships
A robust marketing strategy has always been, and will always be, essential. Thankfully, our skills equip u well for it as relationships are solidly at the heart of a good marketing strategy for private practice. I’ve always recommended a focus on building referral networks and establishing your authority, allowing your skills and experience to shine through to the people who need you mos and that is still true now.
There is More Diversity and Complexity Than You Think
Back in 2017 I believed I would get bored in private practice because everyone I saw would be “worried well.” I was wrong and that was offensive. My independent work has opened my eyes to the volumes of people who do not receive a service from the NHS but who desperately need our help. I’ve also realised that there is much to independent work beyond the standard “private” client work and I’ve been privileged to help a lot of people who wouldn’t be able to afford that service through my “more than therapy” projects and my pro-bono work. I never expected that when I started in 2017 but it was possible then and it still is now. Listen to this podcast episode with Dr Esther Cole if you don’t believe me.
What's Different in Private Practice Now?
There’s a lot that has changed recently, but how much of that change has really impacted our work?
The Shifting Sands of Insurance Referrals
Back in 2017, many of us could rely on referrals from insurance companies to fill our diaries. And although the fees weren't fantastic, they were good enough to allow us to feel comfortable. However, those fees have largely remained stagnant. The volume of referrals they provide, especially for those of us not working with children and young people, has declined significantly as many insurance companies have started using third-party organisations or bringing their mental health provision in-house.
This means that insurance companies are no longer the steady stream of referrals they used to be. We have to consider marketing more seriously than we used to. A strong marketing strategy is even more vital.
The Evolving Marketing Landscape
While I still believe that referral networks and authority building are the cornerstones of our marketing, the role of Search Engine Optimisation (SEO) has become much more important than it was in 2017. There's also more of a role for social media, although this will never be the most important channel for most psychologists and therapists in independent practice.
Our New AI Overlords
Cheerfully, our private practice endeavours are now assisted by AI tools! I've written about these extensively in other posts and in my recent podcast episode on this topic, so I won't go into detail here. But they can make every aspect of running your business easier, including your marketing strategy. If you aren't currently investigating how AI can help you, I'd really encourage you to start. My toolkit for private practice gives you a good steer on how to get going.
Although in some ways, it is a more challenging landscape out there as a result of technological advancements and changes in the industry, AI is one way we can offset some of the difficulties by creating more efficiency and saving ourselves some money on tasks that previously would have needed to be outsourced.
Free Gifts For Your: Your Private Practice Starter Kit
If you're just starting out, I have some gifts for you that I hope will really help you get started and feel confident in your business journey:
My Free Checklist: This covers all that essential stuff you need for a solid foundation – GDPR, the legal bits, the ethical bits, the admin bits. Get it all covered so you can see your first clients with confidence.
The Ultimate Toolkit: I talk you through everything that's out there on the market at the moment to make your life in private practice easier and more profitable.
Podcast on Fee Setting: Listen to my chat with pricing expert Sally Farrant on how to price yourself for financial stability and sustainability.
Podcast on Legal Essentials: Join commercial lawyer Clare Veal and me as we discuss the key legal issues you need to consider.
Ready to Take the Leap?
If you're ready to dive into private practice and you want me as your cheerleader and guide, I would love to be in your corner.
The Startup Bundle: Get all the knowledge and support you need to build a successful, sustainable, and fulfilling private practice.
The Essential Legal Pack: This includes all the contracts, policies, and documents you need, plus training from commercial lawyer Clare Veal from Aubergine Legal, to make sure all your data protection and other legal issues are watertight.
Reflection over coffee…
For those of you who have been in private practice for a while, what do you notice has changed since you started out?
Let me know so I can have a mull over my coffee this morning!
Happy Saturday,
Rosie