Why Consultation is the Business Version of Supervision

If I were to tell you that all you had to do to become a therapist was to read some blog posts and  books and then you’d be prepared to manage clinical relationships, crisis intervention, relapse prevention, someone with delusions threatening you, sit with someone in their deepest moments of despair, what would you think? Some people with a voracious appetite for learning, friends who were therapists that they could go to, and a natural ability to navigate boundaries could turn out some great sessions. Lots of self-study and  motivation could make it happen. Most of us would’ve needed some more help than that. For us, the licensing boards have created this amazing requirement in supervision. Seriously, where would your clinical work be without the  guidance from your clinical supervisors? I still have moments in session 10 years post-licensure where I think “What would Tina do?” and it helps me find the right response.

What a lot of therapists considering private practice don’t realize is that practice-building consultation is the business version of supervision. Except you spent 2 to 4+ years in classes learning how to be a therapist pre-supervision and likely have zero business classes under your belt. In my opinion, learning how to set up a successful private practice is a lot easier than learning how to be an effective therapist so don’t worry, you’re not sign to need an MBA or anything. And if you’re a super go-getter, you may not need anything beyond books and blog posts and podcasts, but you’re still going to super-charge your success and speed up the process if you seek consultation or coaching.

Did you know that in the broader business world, therapists have a horrible reputation? We’re known as being cheap, crazy, and resistant. When I tell business coaches outside the field what I do they often raise their eyebrows and say “Oh, that sounds like fun. I worked with a therapist once…” and tell me some version of how emotionally dysregulated, unyielding, and unwilling to spend money on their business they were. It pisses me off to no end.

Here’s why we’re awesome at business if we get some training:
  1. We generally have great frustration tolerance, which you need in business.
  2. We have tons of skills to pull from for our own distress tolerance. Ditto about needing that in business.
  3. We have the skills to be patient. Great for life and business.
  4. We know how our ideal client thinks on a much deeper level than someone selling widgets can know how their ideal client thinks. This is great for providing quality care, anticipating needs, and marketing.
  5. We come into this field to do good. Very few people come into it for the money and the fact that you can make so much money in private practice is one of the field’s best kept secrets. Shhhh! Business-wise this is an advantage because we can stay focused on our message and consistent in quality care easier than a widget maker who hasn’t rooted himself in his “why.”
  6. We can shift and change aspects of our business with more seamlessness and controversy than other professions. Feeling like you’re passion for Niche 1 is waning and wanting to explore Niche 2? As your Niche 1 clients graduate from therapy, you can fill their slots with more Niche 2 clients.
Now, there’s a kernel of truth to the cheapness and the resistance (and hell, every field has some “crazy” folks in it, right?). If we’ve been working in agencies, we have very little money to throw around. And we haven’t been trained to see that investing borrowed money in your business isn’t the same thing as going into debt. That difference will be a blog post unto itself. We’re also one of the only professions I know where we can open a business and pay ourselves a salary within the first year. Most entrepreneurs I know go at least a couple years without a paycheck. Their tenacity and patience blows my mind because, to be honest with you, I don’t know that I have that in me. And thankfully we don’t have to! We’re so lucky in that way!

I think the resistance sneaks in when we hide behind rigid interpretations of ethics. Like, “I can’t market myself. I’m a healer and marketing is dirty so I am unwilling to do any of the things recommended.” Or we compare ourselves to how the generation ahead of us has done it,  “Dr. Soandso doesn’t have a website and he’s been full for 20 years!” Or we compare ourselves to other types of businesses, “That massage therapist used Groupon, maybe I should.” Sometimes, consultants outside of our field don’t understand our professional ethics and do encourage us to do things we shouldn’t, but usually it’s our own discomfort that gets in the way.

As for the “crazy,” yeah, some of us are dysregulated, but good luck showing me someone starting a business without a bit of emotion dysregulation. As therapists, we tend to be good about talking about feelings.  My theory is that some consultants and coaches, typically not of our field, get uncomfortable with our comfort with sharing our feelings.

Here’s my advice: if you’re going to invest in a consultant, interview them well first. Once you’re working with them, talk to them about your money fears, your concerns when resistance pops up, and what their boundaries are around feelings.  

Here’s a personal example: I was an awful boss. Really terrible. I was so invested in being kind and empathetic and understanding that I ended up being overly permissive, didn’t hold employees to the standards we discussed when I hired them, and basically gave them no reason to respect me. I mistakenly thought that as a clinician and a former employee of some really awful bosses, my instincts and clinical skills would make me good. It hadn’t occurred to me that some of those terrible bosses I’d had had been assuming the same things about themselves.

I got some management training as a part of the business consulting I was already investing in and holy moly! I don’t suck anymore! I know how to have good boundaries and be consistent and uphold standards and be respected without being feared.

Like my days as a supervisee, I realized I had a lot to learn, approached it with humility and curiosity and feel a thousand times more competent and able to lead effectively.

Some of you may think this post is really a plug for my own consulting services. That’s an assumption I would have, anyway. Here’s the truth, I don’t care if you hire me or someone else. Honestly. There are a number of awesome coaches and consultants out there and I want you to find your right fit. Like finding the right supervisor, you need to trust and feel safe with your consultant.

What I do care about is that you aren’t one of the therapists who tried and failed to have a successful private practice. I don’t want you to flail or quit or feel like a failure when there are well-qualified people who can fill in your gaps of knowledge, point you in the right direction, give you the pep talks you need, and help you create a thriving practice.

If you think I am a fit, cool. Schedule a free 30 minute fit consultation to make sure. Interview me. But I go on maternity leave in February so do it quick.

Where do you get hung up on hiring a consultant or coach? Let us know in the comments!


Allison Puryear is an LCSW with a nearly diagnosable obsession with business development. She has started practices in three different states and wants you to know that building a private practice is shockingly doable when you have a plan and support. After retiring her individual consultation services, she opened the Abundance Party, where you can get practice-building help for the cost of a copay. You can download a free private practice checklist to make sure you have your ducks in a row, get weekly private practice tips, listen to the podcast, hop into the free Facebook Group. Allison is all about helping you gain the confidence and tools you need to succeed.




Allison Puryear

Thanks so much, Heather! Really! My friend Jane over at the National Association of Counselors in Private Practice just wrote a blog post all about spending vs investing. You can check it out here!
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Allison Puryear

I totally get it, Natalie! I went a long time in Abundance without consultation (though mine was more stubbornness than anything). Should you decide you NEED consultation, I have no doubt you'll find the money, since I know you to be resourceful. Perhaps you don't need it, which is awesome! You're a go-getter for sure (with admirable balance), so I have no doubt you'll get where you want to be even if it takes a little more time.
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Allison Puryear

I'm way into relationships, Wendy! :)
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