A Partner's Perspective

After publishing When Partners Have Concerns, a counselor requested a post from the perspective of a partner to share with his wife. I thought this was a pretty brilliant suggestion and immediately knew who I wanted to ask. 

I'd like to introduce you guys to my good friend, Jeff Hardesty. When my husband and I moved to Seattle, Jeff and his wife Allison were among the first people we met (you first met Allison in my maternity leave blog post). They invited us to a party a couple days later that started at their house and ended at the famous Fremont Solstice Parade. Watch cyclists ride around naked with a group of strangers and almost all of Seattle? Count us in!  

Turns out Allison is a fellow therapist. She was working at an agency at the time and must've thought I was insane for starting out in a new city in private practice but she never said so. I was new to full time practice and though I had a plan, I certainly wasn't in a position to give advice. After gaining my own success and watching my friend working so hard in her agency job and part time practice, I decided to share some unsolicited advice.

Jeff gives his account here as a partner, along for a ride he had very little control over.  Add a cross-country move and two maternity leaves in 4 years and it's a fair assumption that he and Allison have more practice-building experience than the vast majority of clinicians.

Here's Jeff:

I’ll start by saying, if your partner currently works in an agency job and wants to go into private practice for therapy, jump on board right now. Just do it. DO IT. You have no money? Can’t live without the income right now? Do it anyway. Borrow it. Pile it on a credit card. Rob a bank. A year from now you will be shaking your head in disbelief that your partner ever put up with so much for such little pay (and likely brought that stress home to you). That being said, business ownership of any kind is not for the meek at heart. There will be scary times; there will be a building process; there will be times when you want to shake your partner and say, “How many more people do you have to take out to coffee before these people start sending you some friggin’ clients!” But fear not, if you’re reading this, your partner has already found the guidance of Allison Puryear (a huge step in the right direction) and assuming your partner is a competent therapist and is motivated enough to follow Allison’s advice, the clients will come, as will the money, the flexible schedule, longer weekends, and a more relaxed lifestyle. The networking meetups will payoff and money toward trainings, overhead, accounting, etc. will all pale in comparison to what your partner made at her agency job.

How can I be so sure? I’ve gone through it with my wife four times now—twice while she was pregnant, all four times while I was making peanuts freelance writing or stay-at-home parenting, and in two different cities now. You want to talk about scary? We’ve had our share of anxiety with private practice building. Hopefully, you will only have to go through building a practice once, but I’ll  share our story anyway, so you can be sure, regardless of your circumstances, it’s possible and more than worth it.

In 2009, my wife finished her Masters in Mental Health Counseling and immediately took a job at a mental health counseling clinic in Seattle, Washington making $15/ hour with a modest healthcare plan. After taxes, she brought home about $550/ week, $2300/ month (this number is truly unbelievable to me now). After two years of coming home daily with stories of stressful incidents helping clients (who may or may not have even wanted to be helped) manage severe psychological conditions, she decided she needed to start her own practice. She rented a super-tiny, windowless office space for $275/ month and started blindly advertising as a generic, catch-all mental health therapist. I helped her design some fliers and business cards, which we hung up around town like she was a garage band looking for fans, she got on some very low-paying insurance panels and over time she started getting calls. She would work all day at the clinic, drive to her office after work to see a couple clients and get home around 8 or 9 at night. What really kept the practice afloat in those days was a connection with an immigration law firm that needed her to do psychological evaluations for political asylum cases. She charged about $150 doing these, and thought that was a crazy amount of money to ask for, only to find out later that most counselors charge $500+ for such services (Pricing is just one of the many issues your partner will struggle with while learning to be a business person in addition to being a therapist). Anyway, long story short, she plugged along with a few clients a week, while working her agency job fulltime, for about a year before Allison Puryear intervened.

Now, I know this is Allison’s blog, and I am Allison’s friend, so I don’t want to seem like I’m just shamelessly promoting her program here, but she really did plant and foster the seed of change that turned our stressful, meager life into something we are now truly proud of and that will greatly benefit our children. We met Allison through some common friends around the same time my wife had started her private practice. She and her husband had just moved to Seattle for her husband’s graduate school program and she was also starting a private practice from scratch, but in a foreign city where she knew no one, and she planned to support herself and her husband through his two years of schooling. At the time, we thought this sounded a little crazy, but we didn’t yet know the ambitiousness that is Allison Puryear. A year later, she took my wife aside and said, “You have to get out of your agency job and focus on private practice.” She told us how much she had made in her first year after having just started her business and we guffawed. No way, no how did we ever imagine this kind of money was possible with counseling. When my wife finished graduate school, we hoped, at best, she might find a cushy job at a college counseling center making forty or fifty grand.  We had been tolerating a public clinic job making less than thirty thousand.

Now, if you’re like me—a former Catholic school boy and student of liberal arts with left-wing tendencies toward serving the poor—you might, in addition to fearing the risk of your partner going into private practice, take issue with her making a bunch of money serving a higher functioning population when there are so many people really struggling who need good mental health care. My wife and I both struggled with this. I think many therapists do (especially if you’re coming to therapy from a Social Work degree). After three years of justifying her poverty-level wages whilst holding two Master’s degrees (she really likes school) with the rationale that she was contributing to society, it was hard to shift to an entrepreneurial mindset. Then, it occurred to me that she never would have gotten the position she did had someone else not moved on from it to leave an opening. There will always be students graduating with counseling degrees who have zero experience who truly need the kind of experience a public agency job provides. To this day my wife credits her confidence as a therapist to those three years seeing every possible variety of mental illness and having had the freedom to try out various counseling techniques and start groups and meet with psychiatrists, learn about medications people may be taking, and become comfortable with the risks involved with being a therapist. It was a fantastic training ground for what she does now and whoever took her position when she left is no doubt experiencing the same level of learning. The sad reality of our public healthcare system is that public agencies require high levels of education and can’t pay their employees what they’re worth, thus, they are not sustainable for most people (my wife actually counseled people who were getting more in federal aid than she was getting paid). Your partner shouldn’t feel bad for leaving or feel bad about what she is about to make in private practice.

With that justification out of the way, allow me to continue. After a pep talk from Allison Puryear and some advice on higher-paying insurance panels and networking opportunities, my wife, with my support, decided to take the plunge into fulltime private practice, and gave her agency two months notice. This was in March of 2012. In May, when she had one foot out the door, we found out we were pregnant with our first child. Eek! The urge to call off the plunge was strong, but I was making decent money freelance writing for Amazon at the time and she had a steady flow of psych evaluation requests (which she didn’t enjoy, but paid the bills) so we decided to stay the course. At the end of May she left her agency job. In June, Amazon decided to move to all in-house writers for their content and I was let-go as a freelancer. Double-eek! It was do or die and frankly, we were scared out of our minds. However, my wife had just been accepted on a high-paying insurance panel with one of the bigger insurance providers in Seattle and several therapists had claimed to have been full quickly after being accepted. We took a deep breath and hung in there. Six months later, we were jumping for joy.

By September, after 3-4 months of fulltime private practice, my wife was seeing 25 clients per week and bringing home as much each week as she made in a month at her agency job. Not only was the money great, but she only worked four days a week (plus a few hours on Friday for office management stuff) and we had the time and money to take long weekend trips around the beautiful state of Washington.

In February of 2013, our daughter was born. One of the downsides of owning one’s own business is that all the responsibility falls on you. She was only able to take one month’s maternity leave on the savings we put together in less than a year and when she returned to work, many of her clients were miraculously better (i.e. no longer needed/ wanted therapy). The terror set-in once again, but she had started her business once already, we knew it was only a matter of time until things would be moving along again. Three months later, her practice was full again and peace of mind returned. I was staying home with our daughter while editing the novel I had written the year prior (another perk of a partner who can pay the bills) and life was good.

2014 was the first year (and only year so far, due to our own choices) where my wife had a full practice for a full year. She grossed $113,000 working four days a week and taking three weeks vacation. Not too shabby.

However, in 2015, we decided to uproot our entire life and move from Seattle to Asheville, North Carolina to be closer to family and experience a lower cost of living, affordable housing, etc. So, in June of 2015, we tested the viability of the counseling trade once again, this time in a smaller town that was supposedly saturated with private practice therapists. Before we even left Seattle, my wife had more than 50 networking connections setup in Asheville, signed the lease on an office space, and had gotten on the Blue Cross Blue Shield of North Carolina insurance panel. We had saved a fair bit to live off of while she started up (again) and had a lot of confidence going in, but it was new territory, and definitely scary. Oh, and did I mention we were pregnant with our second child during this? Yeah. We were.

By August, she had 10-15 clients a week, but the savings was running on empty and the credit card balances were mounting. I started thinking about what kind of job I could take in the evenings and weekends to help pay the bills, but what it came down to was that my wife could work an hour or two and make as much as I could make working an 8 hour day at any part time job or freelance gig I could chase down. It made much more sense to support her using evenings and weekends coming up with ways to get new clients than for me to be running off to work at Home Depot (or some such thing) and leaving her with our daughter. We had to continuously remind ourselves that this would work and when it did we would pay off any accumulated debt within a year. By September, she had a full practice again…for two months.

Our son was born in November of 2015. Since my wife’s one month maternity leave was going to end right around the holidays, when people don’t tend to schedule counseling appointments anyway, she took six weeks leave before coming back in January to start her practice yet again. As of writing this, it is June, she is seeing 20 clients a week and just made a referral connection with an organization that told her to, “Be prepared for us to start knocking down your door with referrals.” So, I think we’re in good shape—hopefully, forever, now.

This has been our rollercoaster ride in private practice. If it sounds stressful or scary, keep in mind that most of our ups and downs have been due to our life circumstances and choices. Had we not had two kids and moved across the country in the same four year period that my wife has been in private practice, things would have looked much differently. If the coming years look the way 2014 did, and we have no reason to believe they won’t, we will have an extra $20,000-$30,000 a year beyond our expenses to put toward debt/ retirement savings/ buying a house/ (insert your financial need here). A six-figure salary to someone used to making $30,000 a year is a life-altering experience. We’re 37 years old and have 30+ years before retirement of making more money than we ever imagined possible (and enjoying the ride at the same time). Our kids will get a life we didn’t think we would be able to provide just five years ago. We will get a life we didn’t think we would be able to provide just five years ago. I am getting to stay at home with our kids and plan to get back to writing novels when they’re in school. My wife has the flexibility to schedule clients around life events. She’ll be able to come to our kids’ soccer games and school plays. We can afford three weeks of vacation a year and weekends are now three-days long.

When having your doubts, keep in mind that your partner is not starting a business that ebbs and flows with the economy. She is not borrowing from friends and family to invest thousands in a hope and a prayer. She is not coming up with the next great gadget that will be obsolete in five years leaving your family scrambling for what’s next. Healthcare will always be in demand and the overhead for a therapist is comparable to a lemonade stand (okay, not that low, but pretty darn low). And, finally, she will be getting paid to help people. She gets to come home every day feeling like someone’s life was improved because she went to work. It doesn’t get much better than that.

So, fear not partners, with some hard work, it will happen. It may be scary at first. It may get stressful at times and you may lose your patience with all the work that goes beyond just showing up, counseling, and coming home. You may have your moments of doubt and believe it or not, your moments of greed. If your partner is seeing 25 clients, why not 30 or 40? Why not make $200,000 a year? The answer is, A) Free time is as valuable or more so than more money, B) It’s ultimately bad for the practice. If your partner is stressed, she’ll do bad work and get a reputation for doing bad work and the flow from word of mouth referrals will stop, and C) There are many other things that go into managing a business than face-to-face time with clients. So, rather than getting in your partner’s way and putting more pressure on her, I recommend that you, instead, support your partner, build her up, and conjure your patience, because it will only be to your family’s benefit. And, since you’re reading this on Allison Puryear’s blog, do yourself a HUGE favor and let her help your partner obviate the potential pitfalls of starting a private practice. Had we had her advice in my wife’s first year and a half of private practice, my wife would have made tens of thousands more than she did. Whatever she’s charging, it is way less than what you’ll lose figuring this out on your own.

Good luck and Godspeed!

Jeff Hardesty is a novelist, editor, and stay-at-home dad. He blogs about parenting and politics. If, like me, you know you need someone to make sure your commas are in the right place and that you aren't butchering the English language, you can hire him to edit your blogs, copy, etc. Get in touch here. He'll have availability in the fall; I'm first in line though.