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Private practice psychology – 10 indicators to help you decide if you should take the leap – by Rebecca Ray

Psychology, The Business of Health

So you’ve studied for years to get registered as a Psychologist and private practice seems like a good option, hey?

It’s a popular choice for psychologists for many reasons. As of 2014, the Australian Practitioner Health Regulation Agency reports that 32,000 psychologists are registered around the country. These psychologists work across a large range of settings, and private practice is by far the most common. In a report by Health Workforce Australia (Australia’s Health Workforce Series – Psychologists in Focus, 2014), 37.2% of psychologists were working in some form of private practice (solo, group, GP practice or other).

So, how do you know if private practice will be a good fit for you? Here are 10 indicators that will help you decide if you’ll thrive in private practice:


1. You like being your own boss
If you’re the type of person who doesn’t particularly like being told when to start and finish work, when to take leave, and how much you’ll be paid (basically, you don’t like being told what to do!), then private practice is for you. Set your own hours, take holidays when it suits you, see the sorts of client presentations you’re interested in and set your own income according to the fees and hours you set yourself. It’s your choice.


2. Discipline is your middle name
There’s a BUT to Number 1. And it’s a big BUT. Private practice is a hard road if you struggle with self-discipline. Do you have good organisational skills? Or are you likely to forget that you scheduled an early appointment and have your client arriving to a locked office? Managing your time, your paperwork, and your professional development efficiently will keep the Psychologists’ Board of Australia, your clients, your referrers and your accountant happy. It will also allow you to leave work on time.


3. You’re comfortable wearing many hats
Unfortunately, private practice isn’t just about the science and art of therapy. If you run your own practice, you are equally therapist and business operator at the same time. This means that on any given work day you might also be a receptionist, an administration assistant, a marketing expert, an accounts manager and a debt collector, all before lunch. If that sounds a little overwhelming, take a calming breath because there are ways around it. You can delegate these tasks if you are happy to accept higher expenses (and doing so also frees you up for a greater number of income-producing hours).


4. You love a good rollercoaster ride
As with any business, there is plenty of uncertainty in running a private practice. Where will your referrals come from? You’d be right in thinking that your local GPs are a good referral source. However, what happens when they are on leave or retire? Or decide to refer to someone else?

How will you cover costs when you have a run of cancellations or a slow period of new referrals? Your diary can be jam-packed, but the fact is that clients may cancel at a moment’s notice or not show up at all. Having a cancellation policy helps to counteract this (although discretion is key because some clients may refuse to pay and others may not return at all when you enforce it).

Having a cashflow management plan and solid relationships with your referral base can help with these issues, but ultimately you need to be able to cope with uncertainty because there is often no reliable predictability to these patterns.


5. You are weaving your own safety net as you read this
The only guarantee that comes with private practice is that people will always need assistance with their mental health. However, when you run your own business, there are no fringe benefits like those that come with full-time employment. For all the benefits of private practice, you need to factor in the lost luxuries of paid leave, guaranteed minimum weekly hours and earnings, and employer-managed tax and super.


6. You can detach
This item could be on a list called “Are you ready to be a psychologist?” However, it is particularly important here because private practice settings are often isolating which makes it easier to be negatively affected by the nature of the work. You may have difficult or complex clients and clients at risk that weigh on your mind. You may have to navigate legal requests, Medicare audits and/or the WorkCover system. And you will definitely have to set boundaries regularly and occasionally say no. Ultimately, without being able to detach at the end of the day, you’ll be at risk of burnout. Learn to detach now to protect your own health and extend your career.


7. You’re business skills are as good as your listening skills
Do you know the difference between profit and turnover? Have you considered whether or not you need to register for GST? Have you calculated the capital you may need to start your private practice? If these questions cause you to rock in the foetal position under your desk (like I might have been known to do when I first entered business), don’t panic! Be proactive instead and get yourself educated on small business essentials.


8. You’re cool with going it alone
Private practice can be very isolating if you work alone. Having a professional network, regular peer supervision and personal supports are essential if you want to make private practice a long-term career option. These supports act as a buffer when you have a heavy and/or complex caseload, and the demands of running a business on top. Some people enjoy working alone and happily access this type of support offsite, while others may be better suited to a group private practice or multi-disciplinary setting.


9. Routine is your favourite colour (or you create your own variety)
Even though presenting problems vary, private practice gives you a set routine, especially if you are full-time. For those people who thrive on knowing what they are doing well in advance, this can be a significant plus. However, for people who bore easily, consider mixing it up either by seeing a variety of presentations (couples, children, and adults), working in different locations, combining part-time private practice with employment elsewhere, or working across different domains such as group therapy, supervision, or research.

10. You can put a price on your head
You ARE worth it! In business, time is money. Many psychologists initially struggle with charging for their services but you have studied extensively to hone your therapeutic skills and you should be renumerated as such. Consider whether or not you will bulk-bill (some psychologists feel clients are less likely to value therapy when they are not paying for it which can increase cancellations and treatment drop-out rates). Consider making your fees comparable to other psychologists in the area so that you are not de-valuing yourself or your profession. Consider implementing a cancellation policy. And make sure you manage your time well!


If you’ve read through this list and ticked off all or most of these points then private practice will very likely suit you! Check out the links to the Australian Psychological Society and the Australian Government’s Business site for more practical tips to get you started on the right track:

Dr Rebecca Ray
Clinical Psychologist, Writer, recent Earl Grey (tea) convert




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