Where New Businesses Get Stuck

Where New Businesses Get Stuck


There’s a theme I see in the folks who get stuck on the struggle side of their business. It’s wholeheartedly a mindset struggle. A space of desperation, fear, resignation, helplessness, scarcity.

It usually starts in three ways:
  1. The clinician has a great marketing plan but didn’t have realistic expectations about how quickly they would build.
  2. The clinician brought clients over from another practice but didn’t learn how to bring in new clients.
  3. The clinician had a dip and instead of seeing it as momentary, freaked out and created a self-fulfilling prophesy.
Here’s how to end it...

Unrealistic Expectations

It is unlikely that you will fill a full time cash pay practice in a matter of weeks or months. It may be possible with an insurance-based practice, but you’ll likely want to be full before you’re full.

Even if you do all the right things, remember that you are planting a lot of seeds. That networking coffee last Tuesday may not yield a referral for 3 months. The talk you gave may yield one or two the same week and then several more over time. That SEO takes a minute to build and being on page one of Google means people can find you easier. It doesn’t necessarily mean they’re more likely to call you.

No one can tell you how quickly you’ll build. Don’t trust any consultant, colleague, or friend who gives you a guarantee on that. Why yes, I am belaboring the point I made in this How Long It Takes to Get Full blog post.


Think about it like a home renovation; build in a contingency budget. That could mean more savings than you think you need or it could be a part time job.

This is a crucial part of starting out. Being realistic about the practical sides of things like finances can help you see the bigger picture. Picking up a part time job or filling in as a Per Diem counselor doesn't mean you're not putting your practice building first; it becomes a means to an end.

Starting Full

It’s an incredible gift to be able to start a private practice with clients from a previous job. AND it may sound crazy, but in some ways it works to your detriment. When you don’t have many clients, you have the time and energy to build your practice’s infrastructure, from your paperwork to your marketing plan.

I’ve worked with a number of people who had the gift of nearly full practices who forgot they were so good at their job that they would be graduating many of their clients from therapy. They didn’t have a marketing plan, they had to slap together their paperwork because they didn’t have the time to optimize it and make it efficient. Then as clients graduated they needed help to set up efficient practices in a way that yielded referrals. They’d grown accustomed to their new income and it suuuucks to take a big cut and have no idea how to get clients in the door.

Another potential downside of starting full(ish) is that they may not be within your niche or fit within the ideal client you would want for private practice. You may not have had time to even figure out what you want your practice to look like. You may have just stepped into Agency 2.0 with more responsibility to go with that increased income.

So if you were blessed with a ton of clients immediately, build in at least 1-2 hours per week to learn about marketing. Take a weekend day before you open and get your paperwork in order or buy a paperwork packet. Don’t be a slacker with this paperwork stuff. It’s the front line to CYA. Take some time to get clear on what you want for your practice. It may not be the high acuity you’ve been working with. It may not be the times or days you current clients can come (you know I want you to work when you want). This is your business. Build what you want.


Are You a Big Dipper?


There are some natural dips in the first few years of private practice. Summer, December, these times can be rough. They’re expensive times (vacations! holidays!) and it’s easy to assume your business is tanking if you get caught in an anxiety spiral.


When we lived in Seattle, we would take the last 2 weeks of December off so we could visit our family in the Southeast. I didn’t notice the dip quite as much then because I was gone anyway. When we moved to the Southeast I wanted to be available during that hard time for my clients and… crickets.

It can depend on your client population, too. As an Eating Disorder Specialist, I have never had a hard time staying full in the summers when body shame is at its highest. However, the diet mentality of “I’ll start on Monday” that is ingrained in many of my clients leads them to the magic and wonder of January 1st, so December slows down for my intakes. And the people-pleasing nature of my clients mean they are often out of town visiting family a lot in December despite not always wanting to (we work on that, don’t worry.)

If you work with Adult Children of Alcoholics, for instance, you may see an uptick in sessions in December as the family of origin stuff rolls to a boil. Summer may be your dip period.

The point is, you should expect dips in the first few years. They may even out for you, they may not. You’re not doing something wrong if your numbers slump. It doesn’t mean they will stay down. Plan your financials accordingly. Maybe you put a little into savings 9 months out of the year to accommodate the summer lull. The fear is less likely to grip you so hard if you can still pay your bills.


Which of these resonates most with you? 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, and get help from Allison and a small group of new, close friends in Abundance Practice-Building Group. Allison is all about helping you gain the confidence and tools you need to succeed.


1 comment

Allison Puryear

Thanks for reading! I'm really happy this post gave you some insight and helped you out!
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