Ready, set, grow: A guide to launching and expanding your therapy practice

Launching your own therapy practice is an exciting journey, but it can also feel overwhelming. The good news? You don’t have to figure it all out at once. Whether you’re just beginning or looking to grow, this guide offers advice to help you navigate the process with confidence. From choosing the right business structure to leveraging technology, here’s everything you need to know to build a thriving practice.

This guide is based on our webinar Ready, set, grow: Your first steps to a successful practice. You can watch the recording here.

Start with your goals and a timeline you can keep

Before you file a single form, write down why you want a practice, and how you want to structure your time. Do you see yourself working three long days so you can spend the rest of the week with family? Do you want to build a group practice in five years, or stay solo and lean? Do you want to specialize in a particular area or keep your focus broad? Will you take insurance, private pay, or a mix?

Your answers will shape your next steps. For example, if you’re unsure about long-term plans, a simpler business structure might be best to start. If you’re tech-savvy and want flexibility, telehealth could be a priority.

Put the answers on a calendar. List the tasks that feel hardest, like setting up bookkeeping, applying for insurance panels, designing a website, and block time for them first. Hard tasks drain less energy when you tackle them early. Tasks that feel lighter, like ordering business cards, can fill the gaps.

Pick the business structure that fits your practice

One of the first decisions you’ll face is selecting a business structure. The two most common options for therapists are Limited Liability Companies (LLCs) and sole proprietorships. Each has its own benefits and considerations: 

LLC (Limited Liability Company): 

• Pros: Shields your personal assets (like your home or savings) if your business faces legal issues. It also looks professional to clients and insurers, which might help you attract higher-paying clients or partnerships. 

• Cons: Costs a bit more to set up (state fees vary) and requires some ongoing paperwork. 

Sole Proprietorship: 

• Pros: Easy and cheap to start. You start working with clients under your own name. No extra paperwork or fees. 

• Cons: Your personal assets aren’t protected if something goes wrong.

If you’re just starting out and want simplicity, a sole proprietorship might make sense. If you’re worried about liability or plan to expand, an LLC could be worth the effort.

Keep in mind that requirements and costs vary by state, so consulting a tax attorney or business advisor can help you make the best choice for your situation. That conversation often saves money and stress later.

Choose where sessions happen: Office, telehealth, or both

Deciding whether to offer telehealth, in-person sessions, or a combination of both is another critical step.  

Telehealth offers convenience, continuity of care, and flexibility for both you and your clients. It can also help you reduce exposure to illnesses during flu season. However, it also comes with challenges like technical issues, privacy concerns, and the need for HIPAA-compliant technology. When glitches happen, have a backup plan such as a phone call. Rules about telehealth often vary by state. Check licensing requirements for where you and your clients are located. 

An office offers structure, clearer boundaries, and fewer tech headaches. It also brings rent, utilities, and commute time. Many new therapists start online to keep costs low and add office hours once revenue steadies. Whatever mix you choose, confirm that your license and malpractice coverage allow work in each state where your clients live. 

Offering both in-person and telehealth options can provide clients with the flexibility they need while allowing you to expand your reach. 

Set up the right tools before the first session

Investing in the right tools can save you time, reduce stress, and help you stay organized. You don’t need fancy tools to start, but a few key investments will make your life easier: 

An electronic health record (EHR) built for mental health pays for itself fast. It schedules appointments, creates notes, stores intake forms, handles credit-card payments, and submits insurance claims if you decide to panel. Do not start on paper or generic spreadsheets. They steal hours and raise HIPAA risk. Nowadays, many EHRs also include AI, so if that’s something you want (or dislike), be sure to check out how it works. Don’t use generic AI like ChatGPT; they’re not specialized, not secure, and not HIPAA-compliant.  

If you want help when trying to decide between a few EHRs, check out our evaluation guide here.   

Next, claim a web domain with your name or specialty. Use a simple site builder like Wix, Squarespace, or a therapy-specific service. A one-page site with photo, bio, specialties, location, and contact form is enough to start. Add an online scheduler when you can; clients love booking without phone tag. 

For marketing, pick one social platform you like and post useful content regularly. Authentic posts on common issues, coping tips, or behind-the-scenes practice updates engage far better than polished ads. Be sure to separate it from your personal account. 

Stay compliant the simple way

Keep a secure file with copies of your license, liability policy, and any business registrations. Update them on your calendar a month before they expire. Use HIPAA-compliant email or the secure message feature inside your EHR for client communication. When you add telehealth, get written consent that explains privacy limits, backup contact numbers, and emergency plans. 

If you bill insurance, learn each payer’s credentialing steps early. Some therapists outsource credentialing to firms that complete the paperwork for a flat fee. Outsourcing can cut months off the timeline and lets you see clients for cash while panels process, but it also adds to your start-up costs. 

Building your client base

Growing your client base takes time and effort, but a few strategies can make the process smoother: 

• Professional referrals: Build relationships with other healthcare providers, such as physicians and other therapists, to generate referrals. 

• Marketing: Consider creating a website, running social media campaigns, or leaving business cards at local medical offices. 

• Insurance credentialing: If you plan to accept insurance, research credentialing requirements and consider working with a partner to simplify the process. 

Guard your time and energy

Administrative work spikes at launch. Expect a stretch that feels like a full-time second job. Once the practice opens, aim to batch admin tasks into set blocks: one evening for notes and billing, one morning for accounting. An EHR and automated reminders shrink these blocks as you gain momentum. 

Set clear hours for sessions and hours when you do not check messages. Healthy boundaries protect you from burnout and model the self-care you encourage in clients. 

Build community so private practice never feels lonely

Private practice can isolate you if you let it. Join local or online therapist groups, attend niche conferences, and meet colleagues for coffee or peer consultation. Facebook and LinkedIn host many active clinician groups where members swap referrals, paperwork templates, and support. Collaboration beats competition; a trusted peer network also covers your clients when you travel. 

Avoid common pitfalls

Starting a practice comes with its share of challenges, but being aware of common mistakes can help you avoid them:

• Not asking for help: Don’t hesitate to seek advice from colleagues, supervisors, or professional networks. Reach out to mentors, join Facebook groups for private practice therapists, or attend webinars. Other clinicians have been where you are, and many are happy to share tips.

• Underestimating admin time: Paperwork, billing, and insurance credentialing can eat up hours. Use tools to automate tasks, and block time each week to tackle admin work.

• Overlooking technology: Invest in tools that speed up your work and reduce administrative burdens. This not only saves time but also helps maintain work-life balance.

• Waiting for perfection: You don’t need a fancy office or a 10-step marketing plan to begin. Start small, see clients, and adjust as you go.

Move forward, tweak, repeat

Starting and growing a therapy practice is a journey that requires careful planning, adaptability, and a willingness to learn. By aligning your practice with your goals, choosing the right tools, and building a strong network, you can create a practice that not only serves your clients but also supports your own professional growth and well-being.

Ready to take the first step? Many practice management platforms offer free trials. We do too, and it lasts 21 days. Start trials, set up a simple website, and schedule your first client. You’ve got the skills. Now it’s time to build the practice you’ve dreamed of.