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Dynamics of a Mental Health Practice

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Mental Health Practice

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Mental Health Practice

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Learn the pros and cons of both approaches to determine whether a group or individual practice is right for you.

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Learn the pros and cons of both approaches to determine whether a group or individual practice is right for you.

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News By Profession

Mental Health

Should you stick with the flock or fly solo?

By Chelsea Lacey-Mabe

Geese are known for flying together in a "V" formation. With each bird flying slightly above the one behind them, they're able to reduce wind resistance and conserve their energy. The bird at the very front has to work the hardest but the good news is that once they tire, another bird can take the lead. This is what it feels like to work in a group practice.

"Group practice allows mental health professionals to maintain a certain level of interpersonal connectivity by having other healthcare professionals within the practice to discuss cases, share overhead and operational costs, provide and receive moral support, and have access to other healthcare providers who have been trained differently or specialize in certain areas," explained Tamara Hill, MS, NCC, LPC, a child and adolescent therapist based in Pennsylvania. "Group practices allow mental health professionals to develop a team that can ultimately result in more clients."

And more clients mean more income. A mental health professional can pull in yearly revenue anywhere from $131,000 for full-time counselors to $165,000 for full-time licensed psychologists, according to the American Counseling Association. However, multiplying this number by the number of providers in the practice raises revenue exponentially. They estimate eight counselors, six psychologists or some combination of the two could bring in a combined $1 million.1

Mental Health Practice

Profit-sharing, and in most cases expense-sharing, also comes in handy considering vacation and personal days. Sole proprietors can only make money on the days they see patients. Many group practices though distribute profits based on equity, so therapists don't have to miss a paycheck when they are out of the office for a week.

One expense sole proprietors save on is insurance. Those who are self-employed can use the individual Health Insurance Marketplace to enroll in health coverage or be covered under a spouse's plan. Insurance experts estimated that employers paid $5000, or roughly 80% of the premium for each employee in 2015, and rates have been known to increase year to year around renewal time.Another advantage of going solo is flexibility.

"Having your own private practice means independence -- you call your own shots," said Hill, who has considered opening her own practice before. "You schedule the clients you ultimately want to see."

It also allows total freedom in how professionals define their practice, including what their specialty is, the type of clients they want to have and the physical design of their office environment. They don't have to compromise on their personal taste or work style like they would if they had to share a work space.

In this way sole proprietors are like owls who are only accountable for themselves. To ensure their success they need to plan for the right time to start this kind of venture. In this way, it's wise to wait. Ideally they should have a few years of experience in their field and be knowledgeable about business operations.

"For me, a solo practice would not be the best decision because although I've been a therapist for seven years now, I recognize that I still need to grow in the area of running a business; I simply cannot wear multiple hats at this time," noted Hill. "Decisions should be based on what your ultimate goals are and what skills you possess at this time in your career."

Before take-off, mental health providers must ask themselves the simple question: Would they be happy among other geese or are they ready to be an owl?

Chelsea Lacey-Mabe is a former staff writer at ADVANCE.


1. American Counseling Association. How much money can you make in group counseling practice? 2015.

2. The Henry J. Kaiser Family Foundation. 2015 Employer Health Benefits Survey.


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