Introductory Guide to Private Practice Social Work - OnlineMSWPrograms.com
Introductory Guide to Private Practice Social Work
By Kaitlin Louie
According to the National Association of Social Workers (NASW), one of the most frequently asked questions from members is “How can I start my own private practice?” Building a private practice is a challenging endeavor, and one that requires a great deal of initiative, professional experience in the field, organization and business savvy, and maintenance of relevant licenses and certifications. However, many clinical social workers in private practice feel that the benefits of this career path outweigh the difficulties. For example, working in private practice can offer social workers the ability to specialize in a certain area of social work practice, control their schedule and the types of clients they see, and build creative and innovative ways of helping people address their problems.
Most licensed clinical social workers (LCSWs) who go into private practice do so as psychotherapists, though some LCSWs may start business consultancies or, if they have macro-level experience, practices that help social service organizations with program development and research.
According to the NASW, some of the key steps involved in working as a private social work practitioner are:
Earn an MSW from a CSWE accredited institution.
Obtain and maintain clinical social work licensure in one’s state of residence.
Complete at least 3000 hours or two years of supervised clinical work post-graduation.
Obtain a National Provider Identification (NPI) Number, which all mental health care providers must hold in order to serve clients.
Research and manage the necessary administrative and logistical aspects of setting up and maintaining a business, including potentially:
Obtaining a Federal Tax Identification Number and professional liability insurance, if applicable
Marketing one’s practice through a website, marketing materials, promotional workshops, and referral streams
Evaluating and addressing the costs of setting up a business, and obtaining relevant legal and/or accounting advice where necessary
Regularly consulting experts in one’s field and participating in continuing education and additional trainings to keep skills sharp and build one’s repertoire of therapeutic modalities
To help social work students and professionals better understand the challenges and rewards of starting their own private practices, and to outline some of the core requirements to build and maintain a private practice, OnlineMSWPrograms.com created this Spotlight on Licensed Clinical Social Workers in Private Practice Guide. This guide incorporates insights from experts in the field–that is, LCSWs in private practice who have built unique and fulfilling businesses according to their specific passions within social work practice and psychotherapy.
Types of Social Work Private Practices
According to the NASW, social workers can work in either individual or group private practice settings (or both).
Individual Private Practices
Social workers who run individual private practices manage all aspects of their business, including reaching out to, meeting with, and billing clients; purchasing malpractice insurance; developing marketing materials; and renting office space. While they manage and absorb all the costs of their business, individual private practitioners also keep more of their total earnings, relative to private practitioners who work as part of group practices.
Group Private Practices
Group private practices are established organizations that individual LCSWs can join. These practices generally have office space, billing and marketing infrastructures already established, and potentially even group liability insurance, which can be helpful for LCSWs who are just starting to work in private practice. Group private practices can also be helpful for LCSWs who would like to meet more professionals in the field and get more of a feel for private practice work prior to launching their own independent business. Group practices, however, tend to mean less pay (due to commission structures or fixed hourly rates), and LCSWs in group private practices tend to have less autonomy than LCSWs who create their own individual private practice from the ground up.
Whom LCSWs in Private Practice Serve
Licensed clinical social workers who establish their own private psychotherapy practices typically specialize in one or more client populations, depending on their past experiences in supervised clinical settings and their preferences in terms of the types of clients and specific mental, emotional, and behavioral issues they enjoy helping people solve. LCSWs in private practice can work with broad client populations (such as children, families, and adults experiencing a variety of challenges), but may also specialize in targeted populations, such as professionals who need help addressing the mental and emotional barriers to their career success, or military personnel who struggle with the mental and emotional ramifications of their job.
Below is a detailed description of the types of populations that LCSWs in private practice can support through individual and group psychotherapy, workshops, resource navigation services, and other services.
Children and Families
One of the most common types of populations that LCSWs in private practice serve is children and families. Couples, families, and children sometimes encounter mental, emotional, behavioral, and/or relationship challenges, including but not limited to marital problems; family conflicts; depression and/or anxiety; bullying, isolation, and other social issues; domestic abuse (verbal and/or physical); academic or professional struggles; and substance abuse. Child and family social workers in private practice can address these challenges through individual therapy, group therapy, or a combination of both in order to help clients sort through the underlying causes of their problems.
Karin Stortz, LCSW, who runs her own private practice in Chicago, Illinois, explained to OnlineMSWPrograms.com how she serves a variety of clients, but focuses mainly on children and adolescents. “Children and adolescents make up the majority of my practice, though I occasionally work with adults and couples. […] I also work with many young people who are either targeted by or exhibiting bullying behaviors.”
Social workers in private practice who specialize in supporting children and families often work for several years in settings that serve these populations before starting a private practice. For example, Amy Beaulieu, LCSW, who runs a private practice serving children and families in Bloomington, Indiana, explained how she worked with children, adults, and families struggling with a wide variety of mental health and behavioral issues for several years prior to opening her private practice. “My first job after graduate school was working in supported employment with adolescents with emerging serious mental illness and from there I moved onto working in foster care and just developed a niche working with children and families,” she said.
LCSWs who work with children and families can specialize in certain issues that these populations struggle with. For example, Ms. Stortz explained to OnlineMSWPrograms.com how her experiences counseling children who have been victims or perpetrators of bullying have helped her to develop expertise in bullying interventions and training other parties, such as parents, law enforcement, and school staff, in preventing and addressing bullying and cyberbullying behaviors in school settings. She also specializes in helping children and their families manage the emotional ramifications of bullying.
Similarly, Ms. Beaulieu found that her years of social work practice in pediatric, emergency medicine, and foster care settings, as well as her experiences in researching and developing programs for children’s behavioral health, has enabled her to bring a very broad and informed perspective to her work with children and families, and to assist colleagues in the development of treatment plans for children. “[My work in research and program development has been helpful in that] I have also been able to help colleagues identify treatment models that would be effective in certain cases due to my expertise in evaluating evidence-based practices,” she noted to OnlineMSWPrograms.com.
Child and family social work is a very broad field, and counseling these populations often helps LCSWs in private practice to see the commonalities present in the struggles that very different people experience. Whether she is working with children, adolescents, or adults, Ms. Stortz noted that her clients typically struggle with similar mental, emotional, and/or psychological barriers to their well-being, or to achieving certain goals. “What I find with most individuals, regardless of their age, is that they feel ‘stuck,’” she explained, “Sometimes that means they’re trying to figure out a career or relationship, and other times they feel trapped by anxiety, depression, or uncertainty.”
Depending on previous and current work settings and experiences, LCSWs in private practice may develop the knowledge and skills necessary to specialize in helping client populations that grapple with very particular life challenges. For example, Donna Maglio, LSCW who is an embedded military social worker for the U.S. Marine Corps in Camp Lejeune, North Carolina, runs her own private practice in Virginia. Ms. Maglio not only serves adults, children, and families, but also supports military veterans who are dealing with severe mental, emotional, and behavioral issues as a result of their past work. In her work for the USMC, Ms. Maglio’s main focus is helping active military personnel with the mental, emotional, and familial barriers to performing optimally at their jobs, while in her private practice, she works with veterans and military service members who need help managing the transition back to civilian life.
“Since the veteran population is either in the process of transitioning or has already transitioned to civilian life, we can start to unpack the stress and trauma that they have piled up over the years in a safe environment,” she said of her work with veterans specifically, “I do a lot more work with post traumatic stress, traumatic brain injury, anxiety, depression and sleep disorders in my private practice [relative to my work at Camp Lejeune].” Ms. Maglio also helps veterans with managing their relationships and meeting certain life goals upon their return to civilian life. “[Veterans] are typically struggling with how to interact on a more regular basis with their families, how to find or maintain a new career, or how to navigate life as a full-time college student,” she said.
Another LCSW in private practice who specializes in helping a very specific sector of the population is Buck Black, LCSW, who is a child and family therapist based in Lafayette, Indiana and the founder of Trucker Therapy, a counseling and therapy service for truckers. “Truckers face isolation for days, if not weeks on end. They are also involved in long distance relationships due to the fact that they are on the road for such an extended time. Relationships are so important for all of us to stay emotionally healthy,” he explained to OnlineMSWPrograms.com, “If truckers are not aware of this fact, or if they ignore it, their mood and emotions will deteriorate. As a result, truckers often have depression, stress, and relationship problems. Not only does the isolation cause problems, but the sedentary lifestyle, demanding schedules, the fact that much of the public does not like truck drivers, and strict regulations imposed upon truckers make life even more difficult.”
Mr. Black provides in-person, phone, and videoconference therapy sessions to truckers and their families to help them build a more positive mindset despite the challenges of their work. “Truckers usually cannot make office visits due to the fact that they are away from home for long periods of time,” he noted, “Without these distance services, the clients usually go without services or have several weeks between visits, which is not very effective.”
During his sessions with truckers, Mr. Black incorporates stress relief, positive reframing, and mind-body connection exercises, and helps them develop a holistic plan to improve their physical, emotional, and social health. “It is so important for the client to find positives in their life, replace negative thinking with more positive thinking, and develop new and healthier ways to think about their situation. There is also a need to help the client to find ways to relax, such as finding a hobby that they can do while in the truck or even practice relaxation skills that work for them. […] The mind-body connection should not be overlooked.”
Some LCSWs who work as therapists in private practice develop a specialization in helping corporate professionals who wish to understand the mental, emotional, and social barriers to their desired professional performance and career advancement. Mary Pender Greene, LCSW works as a psychotherapist, career coach, and corporate executive trainer in her private practice based in New York City.
“[In my work with corporate clients, I focus on] three main industries: healthcare, legal and media,” Ms. Pender Greene explained to OnlineMSWPrograms.com, “Issues include recruitment, retention, management, promotions, compassion fatigue, underachieving, leadership, staff development, staff relationships, networking, mentorship, team building, change management, compensation, negativity, supervision and self-esteem.”
Ms. Pender Greene conducts in-office sessions with adults seeking strategies for career development. She also creates and hosts individual and group trainings, workshops, and organizational assessments in corporate settings. Through her career coaching and corporate consulting work, Ms. Pender Greene combines her knowledge of psychology and relationships with her numerous trainings in organizational development, diversity and multiculturalism in the workplace, and group dynamics. She encourages social work students who are interested in helping individuals with career development (both in office sessions and in corporate settings) to gain additional trainings outside of their social work education.
“I took courses and workshops on staff development issues and studied organizational consultation and groups at the William Alanson White Institute and Tavistock. There I learned about organizational life,” she explained, “The most important thing that I learned, and truly internalized at The White Institute, was that an individual in a group or organization is no longer just an individual. In other words, it’s not about me, which makes dealing with criticism much easier.”
Despite her numerous corporate and organizational trainings, Ms. Pender Greene also emphasized the value of one’s clinical training in recognizing and addressing professional challenges among individuals and groups. “The clinical background is being increasingly undervalued,” she noted, “What is truly needed is a blended skill set of both clinical and business expertise. This combination of wisdom gained by experience and practice, compounded with business and financial education, is essential to address the complex issues that challenge present day social service [and other] organizations.”
Marsha Stein, LCSW-C, is another psychotherapist who developed corporate and organizational trainings as part of her private practice. “I do many different types of trainings. I do leadership development training, and trainings on challenges such as dealing with generational diversity in the workplace. Right now I’m working on a training that I’m going to be delivering called Social Intelligence for Leaders,” she told OnlineMSWPrograms.com, “I work with a lot of scientific people who then become managers and are unfamiliar with the managerial role, and would like to develop more soft skills such as people skills.”
Ms. Stein specializes in incorporating a specific therapeutic modality, psychodrama, into her corporate settings work. “My trainings use psychodrama, which is a particular methodology that involves action simulations,” she explained, “Instead of just doing lecture, I make these trainings interactive so that people enact and implement what they wish to learn. Psychodrama is an action psychotherapy that uses guided dramatic activities to explore and address issues that an individual or a group faces in a professional or personal setting.”
Larger Communities (Macro-Level Private Practice Work)
Some social workers in private practice also have experience in macro-level social work, such as research and program development. For example, alongside her child and family private practice, Ms. Beaulieu provides consultative services, technical assistance, and staff development services to children’s behavioral health systems of care.
“Systems of care is a much-used term that can imply many meanings. In the field of children’s behavioral health, the most common understanding of ‘systems of care’ is the notion of a responsive system of services for children, youth and families that is consumer-driven, family-focused, and cost-effective,” Ms. Beaulieu explained, “Systems of care initiatives often seek to ‘braid’ various funding streams together to more effectively serve families that often find themselves involved in multiple systems, such as juvenile justice, child welfare, and mental health.”
In her interview with OnlineMSWPrograms.com, Ms. Beaulieu explained how she developed the skills she uses in her program development consultancy during her past work as a Policy Associate for Children’s Behavioral Health and Child Welfare for the University of Southern Maine (USM) and the Maine Department of Health and Human Services, Office of Child and Family Services. “In this role, I coordinated program development, professional development, and research projects for staff of the State of Maine Department of Health & Human Services,” she said, “Most of my work focused on identification and implementation of evidence-based treatment models for children with disruptive behavior disorders and autism spectrum disorders.”
Ms. Beaulieu encourages social work students and professionals to see themselves as uniquely qualified to enter program development and research roles aimed at improving social and human services. “Social workers are crucial, at both a macro- and micro-level, in developing and delivering services within the system of care. Social workers are uniquely trained to be able to view services from a systems perspective and then translate this knowledge to how services will work at the individual and family level,” she said, “Therefore, social workers are very effective program developers–able to design systems that will flow logically from identified needs to desired outcomes.”
What LCSWs in Private Practice Do
Some of the main responsibilities that LCSWs in private practice fulfill include individual and group psychotherapy, workshops and other educational programming, and administrative responsibilities related to running a business.
Individual and Group Psychotherapy
The core of most LCSWs’ private practices is individual and group psychotherapy. LCSWs in private practice generally use the same methods to support their clients that they used in their past supervised clinical work; however, the flexibility of private practice also enables LCSWs to add less conventional methods to their practice or build a niche around one area of psychotherapy.
Conventional Therapeutic Modalities
LCSWs in private practice use core clinical social work modalities such as cognitive behavioral therapy, dialectical behavioral therapy, harm reduction techniques, and supportive psychotherapy. Such modalities generally focus on giving clients the necessary tools to manage difficult thoughts and emotions, while also providing them with support and validation during their progress towards their goals. (For more information on these and other clinical social work modalities, please refer to our Guide to Clinical Social Work.)
LCSWs in private practice typically work longer term with their clients, relative to social workers at agencies, hospitals, and other large organizations. As a result, social work private practitioners can often tailor their approach to their individual clients’ needs, and also incorporate less conventional modalities that they are particularly interested in or have found to be especially effective.
One way that LCSWs in private practice can develop a marketable niche is by specializing in one or more therapeutic modalities that they find to be particularly powerful, or which align with their interests. Examples of such specialized psychotherapies are Equine Assisted Psychotherapy, Psychodrama, Wilderness and Adventure Therapy, and Expressive Arts Therapy. Many of these therapies are more intensive and/or experiential than more traditional modalities and thus may require that LCSWs obtain additional training and certifications prior to bringing these methods into their practice.
Equine Assisted Psychotherapy
Equine Assisted Psychotherapy (EAP) incorporates supervised work with horses into a client’s mental, emotional, and behavioral treatment plan. Therapists interested in offering EAP must first obtain certification from the Equine Assisted Growth and Learning Association (EAGALA), and work with a horse professional during EAP sessions, which are typically held in an outdoor arena.
Donna Maglio, LCSW is EAGALA certified, and uses Equine Assisted Psychotherapy extensively in her private practice. In her interview with OnlineMSWPrograms.com, Ms. Maglio explained how EAP uses concrete and guided activities with horses to help clients build problem solving skills and address the mental and emotional barriers to their goals. “Equine assisted psychotherapy (EAP) uses horses experientially for emotional growth and life-skills learning in humans, as well as for organizational team building and leadership development,” she explained, “It is a collaborative approach between a licensed mental health professional and an equine specialist working with clients and horses to address specific goals.”
During EAP sessions, clients interact with the horses for emotional therapy or to complete goal-oriented tasks in the arena that illustrate their life mindset and approach to problems. Ms. Maglio noted, “The activities serve as metaphors for the issues or challenges that the clients want to work on. EAP can be a great alternative approach to traditional office sessions, or can also be used to enhance office sessions. Since EAP is an experiential modality, clients have reported that one session in the arena can be equivalent to about three sessions in an office.”
The exercises that clients complete in the arena can give both them and the therapist important information about clients’ attitudes and approaches towards various problems. For example, Ms. Maglio described one activity she completes with her clients in the arena, called Life’s Little Obstacles. “[In this activity, the] client’s task is to pick a horse from the herd and get the horse to go over [a small cross-rail jump] without talking, touching the horse or bribing it with food,” she explained, “Typically the client will name what the obstacle represents, such as a goal or issue they are experiencing. […] We do this activity all of the time and I’ve never seen it done the same way twice, because the way that a person completes that task is unique to them, and it also gives us information on how they typically approach life.”
After her client completes this and other activities in the arena, Ms. Maglio will often discuss the process and result of the EAP session with her client in an in-office session. “I have found over the years, especially with my military clients, that some people will need to process what they did in the arena while sitting down in my office a few days later, before they are ready to return to the arena, especially those who may have traumatic brain injury.”
Another example of an experiential modality is psychodrama, which is an action-based psychotherapy that uses dramatic exercises to explore and address issues that an individual or a group faces. During psychodrama sessions, participants act out certain scenarios under the supervision and guidance of a therapist and/or certified psychodramatist. These scenarios could be past experiences, future challenges, dreams, or hypothetical scenarios. By simulating these situations (sometimes with trained actors and actresses) and having clients act out their responses either as individuals or in groups, LCSWs trained in psychodrama can help clients see firsthand in a safe space how they would manage tough social, familial, and/or professional situations.
Psychodrama is also helpful outside of an in-office therapeutic setting. As both a licensed psychotherapist and certified psychodramatist, Marsha Stein, LCSW-C mainly uses psychodrama in the staff trainings she develops and implements for a wide variety of professional organizations. In her interview with OnlineMSWPrograms.com, she explained how she used psychodrama to train police officers in handling dangerous or rapidly escalating situations. “One of the techniques in this modality is role-playing, but it’s much more than that. For example, when I trained the police department, I did a jail diversion program with them where I trained them in deescalating situations with psychotic people,” she said, “So instead of just giving them a lecture I brought in trained psychodramatists who would play the role of psychotic individuals, and the police would have to intervene with them in real time.”
Expressive Arts Therapy (Music, Visual Arts, and Storytelling)
Another powerful therapeutic method is expressive arts therapy, which is defined as the use of visual arts, music, dance, and storytelling to guide clients through processing past experiences, and developing the insight and skills to tackle current and future challenges. In expressive arts therapy, LCSWs and therapists may ask clients to either be an audience to or a creator of art. For example, during a session the therapist may ask the client to listen to music, view one or more drawings or paintings, or read certain stories that relate to the challenges they are facing; clients’ reactions to these works can be a starting point to exploring the complex issues underlying problematic thoughts and behaviors. For example, mythic tales or fables might resonate with an adolescent who is experiencing obstacles in his or her life, and who could benefit from encouragement and a model of resilience and/or sound decision-making in the face of adversity.
Therapists may also ask clients to express their feelings, thoughts, past traumas, and/or aspirations for the future through writing, painting, drawing, or dance, depending on the clients’ interests and comfort level. By expressing their emotions through an artistic medium, clients can learn about their complex feelings while also benefiting from therapeutic self-expression and a creative outlet that boosts their confidence.
Adventure-based therapy is the use of journey or goal oriented activities to encourage clients to examine and discuss their personal challenges, while also developing the skills to address these challenges from a mental, emotional, behavioral, and social standpoint. Examples of adventure-based therapies include wilderness therapy and cooperative or team-building games.
Wilderness therapy is defined as the use of guided, supervised trips into the wilderness as a way of developing social bonds, processing and addressing personal challenges, and building problem solving, communication, and interpersonal skills, as well as emotional resilience. Wilderness therapy can take many different forms, and can be used to address a variety of issues, such as substance abuse, familial communication issues, and even corporate team building needs. Due to the potential risks associated with wilderness adventure-based therapy, LCSWs and therapists who are interested in this modality must undergo training and may be required to hold additional certifications on top of their clinical social work practitioner license. In addition, as wilderness therapy is a deeply involved modality, it is often delivered through a larger program consisting of a team of therapists that leads groups of adolescents or adults through exploratory trips, team building exercises, and/or discussion groups in a wilderness setting; wilderness therapy requires considerable supervision and structure, as well as client receptivity and resilience in order to be effective.
Cooperative or team-building exercises place clients in challenging situations that can rapidly build their insight into behavioral, emotional, and social problems that are hindering their ability to achieve their goals or connect with others. Cooperative games therapy can involve a team of therapists who facilitate a larger event that requires numerous clients to work together to achieve a goal; examples of such cooperative games include high ropes courses and other obstacle course games.
While adventure based therapy is often group based (both in terms of the client participants and the therapists who facilitate these therapeutic sessions) due to the challenging and involved nature of this particular modality, LCSWs and therapists in private practice may also incorporate elements of adventure based therapy into their individual work with clients. For example, a trip outdoors to a nearby park during a therapy session, or the assignment of smaller adventures that clients complete in between sessions, can quality as adventure based therapy due to the goal oriented nature of the therapeutic exercises and the emphasis on pushing one’s boundaries.
Workshops and Other Educational Programming
In addition to the wide variety of therapeutic modalities that they can incorporate into their work with clients, LCSWs in private practice also have the creative freedom to develop and deliver workshops and presentations on topics that interest them and are relevant to their practice. These workshops can serve a dual purpose of benefitting members of the community while also marketing practitioners’ qualifications and services. In addition, LCSWs in private practice can make workshops and educational programming a regular part of their services if they garner sufficient and sustainable community interest. For example, Karin Stortz, LCSW offers trainings to parents, school administrators, camp counselors, and other members of the community on topics that are relevant to children’s mental, emotional, and behavioral health, such as bullying, cyberbullying, and positive youth development.
Ms. Maglio explained to OnlineMSWPrograms.com how she hosts free workshops and presentations on mental, emotional, and/or behavioral issues that are relevant to families in her community. “When the opportunity arises, I also give presentations in the community on various topics like social skills or parenting styles that will also generate referrals,” she said.
Other social workers we interviewed who create and deliver workshops and educational programs on topics that align with their areas of expertise include Ms. Pender Greene and Ms. Stein. Ms. Pender Greene hosts workshops on relationships, professional skill building, leadership skills, and career development, as well as presentations for religious leaders who wish to provide resources and emotional support to members of their congregation. She elaborated on her corporate trainings and workshops in her interview with OnlineMSWPrograms.com. “My workshops cover such topics as building a Virtual Board of Directors (i.e. a group of trusted advisors who can offer creative solutions to diverse work challenges; in other words, it is your own ‘professional posse,’ upon whom you can depend for unbiased, informed, and educated opinions on a variety of professional and personal matters), team building, networking, self care, mentorship, expanding influence, assessing opportunities, exiting with grace and dignity, dealing with a difficult boss, difficult employees, managing up, down and across, coaching, supervisor as a coach,” she said.
Ms. Stein also hosts corporate trainings and interactive workshops in corporate settings to help employees and company leaders address mental, emotional, and social barriers to optimal productivity, efficiency, and workplace happiness. Apart from her work in training corporations, she also delivers presentations to work settings and communities on mental and emotional health topics, as well as behavioral or lifestyle advice. “I’m also called upon as a social worker to go out and give trainings on emotional health topics. For example, Aetna might call me and say, ‘Can you give a workplace training on stress management?’ Topics I cover during these trainings include work life balance, dealing with aging parents, emotional intelligence, and teamwork. These trainings are generally less interactive than the corporate trainings that I do that use psychodrama,” she said, “These workplace trainings generally involve a Powerpoint presentation during which I define a particular issue, discuss people’s experiences with this issue, and introduce strategies to manage and combat the issue.”
An important part of running one’s own private practice as an LCSW is handling the administrative aspects of one’s business, including billing clients and/or insurance, maintaining client records, managing office space rentals, paying quarterly taxes, obtaining professional liability insurance, marketing one’s business through an online presence and maintaining a steady referral stream, and other responsibilities.
“As a therapist in private practice, you’re not just helping people with their problems. You’re also running a small business, so you have to think about your location, your office, marketing, insurance — the list goes on,” Ms. Stortz noted. Ms. Maglio also described the numerous responsibilities one must balance when running a private psychotherapy practice as an LCSW. “When having a private practice, one needs to be especially diligent about certain administrative procedures that are typically handled by an office manager or are already in place by the larger agency/organization where you are working, such as making sure the proper intake paperwork has been both created and administered, charts are stored properly and you are up to date on various laws such as privacy laws, or laws specific to the state in which you are practicing,” she said.
Advice for LCSWs on How to Work in Private Practice
Working in private practice can be incredibly challenging, requiring LCSWs to manage working with clients while also concerning themselves with running a business on their own. LCSWs in private practice may also have to contend with a less regular or reliable income stream, as it depends entirely on client sessions. However, with proper organization, regular skill building, strategic efforts to gain expertise in certain areas of interest, and consistent marketing/community outreach, LCSWs may be able to build a strong client base and maintain a successful and rewarding business. The LCSWs whom we interviewed offered social work students and social work professionals advice about how to build a sustainable private practice, which we have summarized into the following action items.
Several of the LCSWs in private practice whom we interviewed explained the power of developing a niche–that is, becoming an expert in assisting very specific client populations, and marketing oneself accordingly. Amy Beaulieu, LCSW, whose clinical private practice primarily serves children and families, advised social workers considering private practice to develop a sense of the populations with whom they work most effectively, and to actively seek professional experiences with these populations in order to build expertise. “Once you are mid-career following several years of experience, I think it is wise to specialize and focus on your ‘niche’ population,” she said, “This will give focus to your work and help establish you as a true subject matter expert.” Building this expertise takes time, however, and Ms. Beaulieu also encourages social work students to start their career with an open mind. “Working with a broad lens in the initial part of your career will help you find the area where you can be most effective as you gain experience,” she said.
LCSWs in private practice may also find it helpful to specialize in certain modalities, as doing so may help them build a clientele of individuals for whom other modalities have not worked. For example, Ms. Maglio’s specialization in Equine Assisted Psychotherapy brings clients to her who have not been able to adequately address their issues in traditional office settings. “I [will] have other therapists contact me because they may be stuck with a particular client and they want to see if EAP would be a good option for them,” Ms. Maglio told OnlineMSWPrograms.com, “The therapist will either accompany us in the arena or will be in touch for follow up by phone.”
Stay Organized (And Hire Help As Necessary)
Our interviewees also strongly recommended that social workers in private practice stay organized. Ms. Maglio outlined some of the regular administrative tasks that LCSWs in private practice should complete. “If you accept insurance, you will need to stay up to date on billing procedures and understand how to submit claims to insurance companies, and make sure you allow time to follow up on these claims so that you will get paid,” she advised, “You will need to develop a book keeping method to keep track of your income, business expenses, mileage, etc, and learn how to file quarterly taxes or hire an accountant to assist.”
Hiring help for administrative duties such as developing marketing materials, billing insurance, or managing finances (ex. taxes, budgeting, etc.) can be helpful, particularly if it allows one to focus more on therapeutic work and connecting with clients. “One of the most important things I’ve learned is that if you don’t know how to do something well, elicit someone’s help! Paying for professional services is worth it,” Ms. Stortz said, “Personally, I rely on a website designer and an insurance specialist. Knowing that they’re taking care of more technical matters relieves a great deal of stress. […] I’d also say that it’s important to stay on top of things as you build your practice. Find ways to stay organized–for instance, I use an online appointment-scheduling service that sends automatic reminders to my clients.”
Market One’s Practice Consistently
Consistently marketing one’s services is also key, Ms. Maglio told OnlineMSWPrograms.com. She recommends that social workers in private practice market their business through multiple avenues. “I find clients through word of mouth, my website, advertising on psychologytoday.com and going to professional networking events,” she said, “A professional, informative website and business cards are essential to growing a private practice.” Connecting with colleagues, potential clients, and professionals in the community who interact closely with potential clients is also important. “At the start of my private practice, I made a point of personally introducing myself to key people in the community, such as doctors and school counselors, because they make a lot of mental health referrals and I wanted to make sure they had my business cards,” Ms. Maglio explained, “Now, I will send business cards out about once a year to the local doctors, guidance counselors and child study teams. Since I worked in the schools, I also receive referrals from teachers and guidance counselors with whom I previously worked.”
Seek Mentors and Educational Opportunities
Seeking the guidance of mentors, both at the outset of one’s social work career and when one decides to launch a private practice, can be incredibly helpful. Engaging in continuing education to broaden and reinforce one’s skill set is also important. Ms. Pender Greene told OnlineMSWPrograms.com how she engaged in continuing education and found mentors in the areas of organizational structure, corporate leadership, and workplace dynamics. “I was not informed early in my career about the need for specific hard skills in order to function as an effective leader. All I wanted to do was clinical work and I was quite comfortable not knowing or acquiring these business skills,” she recalled, “Nevertheless, I continued to expand my knowledge and learn my craft with continuing education in family, group and couple therapies, then short-term, long-term therapies, coaching, clinical supervision, administration and business. This is what my supervisors […and mentors] advised, and for their wisdom, I am most grateful.”
Marsha Stein, LCSW-C also recommended that students and practicing social workers seek additional training and certification in the areas in which they would like to specialize in their private practice. In discussing recommendations for social work students interested in corporate counseling, she said, “I would encourage them to seek out and earn any relevant certifications on top of their MSW degree to show their qualifications in training in a corporate environment and their understanding of corporate concepts.”
Social workers interested in starting their own private practice should also learn as much as they can about the processes and procedures involved in establishing an independent business. Starting a business can be an intimidating endeavor, but a wealth of resources are available in one’s community and online, often free of charge. Donna Maglio, LCSW highly recommends that social workers just starting their private practice look for seminars and workshops in their community that cater to prospective or new business owners, and to browse reputable online resources for helpful information.
“Taking a basic business and marketing class would definitely be helpful, whether in school, online or in the community,” she advised, “[T]here is so much available in the community, and much of it is low cost or even free. I met with an attorney and an accountant during my set up to make sure I was covering all of my bases and both offered free one hour consultations for the first meeting. I also took a free class offered in my community for small business owners that provided all of the nuts and bolts on how to get started. I think once people figure out that they want to do private practice, and they have gained enough clinical experience to do so, the resources are there, you just have to utilize them.”
Networking with colleagues and other LCSWs in private practice can also be enormously helpful for social workers who would like to learn more about the steps to starting and maintaining a private practice. “I consulted a lot in the beginning with my colleagues in private practice so that I knew how to obtain an EIN number, register my business both federally and locally, etc.,” Ms. Maglio said, “Finding a mentor to help guide you with developing the proper paperwork, record keeping, etc. is valuable. I had several assist me when I was starting out and I have helped many new therapists do the same.”
Ms. Maglio also recommends that social workers consult books about starting businesses, and to consult reputable and relevant web resources. “I also read several books on basic marketing for small business owners,” she said, “[Also, the] US Small Business Administration (SBA) is a good place to start (www.sba.gov) and each state has its own chapter. In NJ, it was called the Small Business Development Center and each county had its own chapter (www.nw-njsbdc.com/morris-county.php).”
Why LCSWs Decide to Work in Private Practice
Despite the challenges of starting and managing a small business, the private practitioners we interviewed noted how they find the independence of private practice to be deeply rewarding. Donna Maglio, LCSW explained both the drawbacks and the benefits of starting her own business. “One drawback has been financial, in that you never really know how much income you will earn at the end of each week due to inclement weather or client cancellations or no shows,” she noted, “Another drawback is potential isolation from colleagues depending on where your office is situated, so it is important to make an effort to stay connected through networking events or peer supervision.” Yet for her, these drawbacks are worth the autonomy that private practice affords her. “For me, the benefits of having my own practice gives me the flexibility to set my own hours and fees, offer modalities such as EAP that might not otherwise be feasible, and be selective about which client populations I feel I am best suited to serve,” she continued, “It also gives me the opportunity to expand beyond the direct client sessions, by presenting workshops, giving presentations, writing articles, and guest lecturing in graduate classes.”
Ms. Stein told OnlineMSWPrograms.com how being in private practice has allowed her to focus even more on the clinical work she enjoys. “It’s wonderful being in private practice. You’re your own boss. You don’t waste time with bureaucratic stuff, so you just do clinical work,” she said. However, she also recommended that social workers be cognizant of the potential challenges of private practice, such as isolation and the possibility of feeling overwhelmed at the many and varied tasks one must complete when running an independent business.
To address these and other challenges, Ms. Stein recommends that social workers stay active in the community (both by networking with professionals and engaging with members of the community through workshops and talks), and to continually check in with themselves to make sure they are enjoying their independent work. She also advises private practitioners to constantly seek ways to improve their practice and their job satisfaction. “In terms of managing the challenges of being in private practice, I would recommend that social workers engage in their own peer supervision groups. Networking with other therapists is crucial. You need to make sure to connect with other therapists and social workers, both in supervision groups and out,” she said, “Manage your own marketing and make sure that you are not isolating yourself. Know the strengths that you bring to the table as a clinician, and understand the types of clients you would be able to best help. Aside from the logistical challenges of being in private practice, I’ve found it to be wonderful, especially if you’re a person who is self-motivated and self-directed.”
Ms. Stortz emphasized the importance of knowing oneself (i.e. one’s motivations, capabilities, and limitations) insofar as possible before launching into the demanding endeavor of starting one’s own business. “First, I think it’s important to understand why you want to be in private practice,” she advised. She also explained how deciding to work in private practice is often a path that requires advance planning and the completion of several years of relevant clinical social work experience. “[It’s] important to experience a variety of environments as a therapist, because it will give you a better idea of where your strengths lie. Even if you do ultimately enter private practice, those early years in entry-level positions will always inform your work,” she said.
In order to build a successful private practice, LCSWs typically need an extensive and suitably varied background in clinical social work (and macro social work, depending on their desired specializations), a strong knowledge of therapeutic modalities, organizational skills, a proactive mindset, resilience, and self-awareness. By developing these and other professional experiences and strengths, LCSWs can build a challenging, engaging, and fulfilling career that grants them the freedom to create their own personalized approach to supporting and empowering clients and the larger community.
About the Author: Kaitlin Louie is a content writer and editor who writes articles for OnlineMSWPrograms.com. She received her bachelor's and master's degrees in English from Stanford University, and aspires to be an author of fiction and creative non-fiction.