1

Can I just start with a quick pep talk?

Therapists are inherently good entrepreneurs. We

are trained to cope with the emotions that often

sideline business owners. We hold pain for a living;

we see resilience every day; we connect easily and

deeply. We entered this field because we care

intensely about people, which makes us naturals with

customer service. Our training requires clinical

supervision, so we know how to admit our ignorance

and ask for help from someone who knows what we

need.

We already have what it takes to do this, we just need

direction.

B E F O R E Y O U S E E Y O U R F I R S T P R I V A T E P R A C T I C E C L I E N T

A Tasky, Confidence-Boosting. Checklist!

www.abundancepracticebuilding.com

2

Be properly licensed

Get (or find) your National Provider Number (NPI) if you're in the U.S

Get Malpractice Insurance

Get an Employee Identification Number (EIN)

If you want to take Insurance, start that process ASAP

Have an office with four walls

Have two chairs in the office, a clock, and curtains if necessary for privacy

Get a business license if your state/city requires one

Decide on what phone number you’re going to use

Have an email plan

Have this necessary paperwork:

Informed Consent

Financial Agreement

HIPAA Statement

Release Of Information (ROI)

Superbill

Intake paperwork

Written Practice Policies

Create an Assessment Form to complete during session

Have a way to keep track of money

Have a documented plan in case you have a HIPAA breach

Before You See a Client (in rough order)

www.abundancepracticebuilding.com

3

Have a telephone spiel written out

Have a transition plan in place

Maintain hope, confidence and belief in yourself

Now the Why’s… The Explanation/Resource Pages follow. For more tips to help you prepare for your first

clients, check out the last pages.

Before You See a Client (in rough order)

Open a business bank account

Start paperwork to become an S-Corporation

Decide on a Practice Management System

Decide on a credit card processor

Choose your business cards

Build a website

Establish a sliding scale plan

Before You See a Client in an Ideal World… (These can wait a bit)

www.abundancepracticebuilding.com

4

Be properly licensed

It may seem obvious, but just in case there’s aaaaany question, I want to be clear. In some

states you can do therapy as soon as you have your associate license

(LMSW, LPCA, LMFTA, LMHCA, etc). In others you have to have your associate license for

two years before you can have a private practice and you have to be in regular supervision

while you do it. Some fully licensed folks aren’t legally allowed to have a private practice.

What?! If your state offers a LCSW AND a LICSW, make sure you get that LICSW, otherwise

you probably aren’t compliant. No matter what, check with your state board.

NPI

This may sound weird, but first, see if you already have an NPI by clicking here. Search any

other last name you’ve gone by just in case. If you’ve ever taken insurance, your agency may

have applied for an NPI on your behalf. That sucker is yours for life, at least if you remain a

sole proprietor. If you aren’t showing up on the search, you can apply for one here by

creating a new account here. It’s free.

Get malpractice insurance

Make sure it covers you if your business is a corporation, which we’re going to talk about in a

minute. Some of the companies marketing to therapists don’t cover corporations but are

appropriate for sole proprietors. I like American Professional because they cover

corporations, various levels of various licensures and their rates are pretty low. You’ll want at

least $1,000,000/$3,000,000 coverage no matter what company you go with.

Explanations and Resources The Why's and the How's

www.abundancepracticebuilding.com

5

Explanations and Resources The Why's and the How's

Get an Employee Identification Number (EIN)

Just click here. It’s free, it’s fast, and it’ll save you from handing your social security number

over to your clients (who may be incredibly ethical people, but also may not).

If you want to take insurance, start that process ASAP

It takes about 3-4 months. I’d put it first but you have to have a license, NPI, EIN, and

malpractice insurance to get it. Whether or not to take insurance is a loaded issue. I’m pro

whatever you want for your practice and help people build whatever makes the most sense

for them. You can get tons of your questions answered to help you sort through this and tons

of other private practice questions in the free Abundance Practice-Builders Facebook Group.

Also be aware during this process that if you get a letter from the insurance company saying

you are “participating” or that you’ve moved from “non-par to par” that is NOT the same as

being in-network.

Have an office with four walls

You may take walks with clients, I get that, but there also has to be an option for strict

privacy. I have heard of therapists doing therapy exclusively at Starbucks, I'm not even

kidding. Do not do that. That is not okay for one million reasons. Your office doesn’t have to

be stylish (you can spruce it up when you are more established,) but it should be private and

both information and people should be safe.

www.abundancepracticebuilding.com

6

Explanations and Resources The Why's and the How's

Have two chairs in the office, a clock and curtains if necessary for privacy

That’s all you need. This is one of the great excuses for not putting yourself out there to

referral sources. I have a really nicely decorated office that I love and I can’t tell you how

many times someone I’ve seen for months has said “has that painting (that’s huge and above

a mantle and 4 feet from them vertically) always been there?” Yes, homey or upscale or

modernist-chic is awesome in an office, but when you're starting out it’s not always possible.

Please remember that some of your clients are the type to not notice the socks they’ve left

all over their own homes or the dishes overflowing in their sinks. They probably won’t judge

you for your 2 Ikea chairs + thrifted clock, especially if it is the only place they talk about the

things that they can’t tell anyone else.

I recommend a clock because it’s good for both of you. You should definitely not be

checking your cell phone for time. Having a clock visible to both of you keeps you on the

same page. Please, please, please start and end your sessions on time. Don’t do 15 minutes

more because it’s really going well when you don’t have a client immediately afterwards.

Boundaries are important. They create safety. A client needs to be able to count on the

agreed upon amount of time. You need to not feel resentful because your client now expects

75 minute sessions instead of 50 minute sessions because you trained them that way.

Boundaries are good for everybody.

Decide on what phone number you’re going to use

You can use your cell phone. But be clear on what that means, especially as it relates to your

specific client population. If you’re a DBT specialist working with folks with BPD, I wouldn’t

recommend it. If most of the clients you work with or plan to work with are high functioning

www.abundancepracticebuilding.com

7

Explanations and Resources The Why's and the How's

and have low crisis risk, it may be cool. You can also go with a work cell phone, additional

line that goes to your cell phone, or an office landline. If you’re storing client info in your

phone, I’d recommend encrypting it.

A note about Google Voice (a free phone number from Google): I had a practice-builder have

the messages meant for her go to a stranger. Use with extreme caution. Additionally, when

someone leaves a message, Google Voice identifies itself as Google Voice, which doesn't

really scream "I'm a professional.“ The truth is, it’s hard to find a HIPAA-compliant VoIP (a type

of online phone number) that doesn’t cost an arm and a leg.

Oh, and a note on outgoing voicemail messages for those of you coming from agencies

where you were trained to say “You’ve reached the confidential voicemail of…” Your agency

paid big money to ensure confidential voicemails. Neither your Google Voice, iPhone,

Android or office phone is confidential, just like your email probably isn’t HIPAA compliant

(more on that in a second). I recommend something like this “Hi! You’ve reached the office of

[your name]. If this is a clinical emergency, please hang up and dial 911. Please leave your

name, number, and a brief message and I will return your call within one business day.”

Now listen to your voicemail. Does it sound like you’re headed to a funeral? Do you sound

like you’re talking to a toddler? Do you sound robotic? If so take a minute, picture your best

friend or your partner, smile and re-record. Keep it short, sweet, and upbeat (well, except for

the 911 part).

Have an email plan

Email is usually only HIPAA compliant if you are paying for it. Some practice management

systems like Therapy Appointment, have a secure email system. You can also check out

www.abundancepracticebuilding.com

8

Explanations and Resources The Why's and the How's

Hush Mail, which creates a HIPAA Compliant portal for you to email with clients. You can pay

for a secure email through Gmail, but if your clients aren’t paying for a similar service, it’s not

HIPAA compliant. That’s why your doctors use patient portals and why we should too.

Some people don’t want to use email with clients and prefer to keep all contact in the office.

That’s fine too. Consider, though, some potential clients prefer to send an email to a provider

than to call them. Maybe it’s less intimate, maybe it’s because most people don’t love the

phone, but I will say it’s quite nice to be able to edit your response before sending it.

Emailing with a potential client is great if you're a little awkward or nervous on the phone.  

Another email option is encryption. Encryption sounds really complicated and difficult but if

you can work email, you can probably do it yourself. Google your computer model and

encryption and look for the most recent article you can find. If encryption sounds like a pain

in the ass to set up, only store client information on HIPAA compliant cloud software; don’t

keep any client info on your computer. Even scanning something in to upload into your

practice-management system and then putting it in the virtual trashcan counts as Protected

Health Information on your computer.

Necessary Paperwork

Informed Consent: Your board determines what you need and it should be findable on their

website.

Financial Agreement: I love a financial agreement. Partly because it forces money into the

conversation and most of us want to avoid it. We’re all clear that avoiding conversations isn't

good for us, right? Decide your boundaries and for the love of all that’s good in the world,

HOLD those boundaries. So much of what we do is modeling for our clients. Model this

www.abundancepracticebuilding.com

9

Explanations and Resources The Why's and the How's

boundary well. Most of us have money “baggage.” Don’t let it affect your care. I see this a lot

so I get all up in money issues in both my offerings: the Abundance Practice-Building Groups

and the Abundance Party.

HIPAA Statement: This can be rolled into your Informed Consent if you prefer.

Release Of Information (ROI): Because collaborating with current or past providers is so

good for both you and your client.

Superbill: To give to client after s/he pays if s/he wants to file it with their insurance. Typically

used if you’re out-of-network with their insurance.

Intake paperwork: What you want your client to fill out about her/himself before seeing you.

Demographic info at the very least as well as relevant clinical information.

Written Practice Policies: This can include a social media policy (please make sure you have

privacy settings for relevant social media)

In the Abundance Party I share the exact forms I use so that you can tweak them then hit the

ground running and get clients in sooner.

Create an Assessment Form to complete during session

I love rules. I know it’s not cool, but it’s true. It follows that I also love structure. As I was

gaining confidence as a therapist it really helped to have an outline for my initial

appointments. Those appointments yield the bulk of the information you draw on session

after session. Being able to ask the right questions while also maintaining connection and

building rapport is a skill that takes some practice. The form I created for myself makes sure I

www.abundancepracticebuilding.com

10

Explanations and Resources The Why's and the How's

don’t miss anything important and eliminates those awkward pauses. I highly recommend

creating one that fits for your ideal clients.

Have a documented plan in case you have a HIPAA breach

Is it getting hot in here? If the idea of a HIPAA breach makes you want to vomit and hide

behind an agency, take a breath. If you want to skip over this part because you think it's

boring or won't apply to you, take a number. Most of us HATE this stuff but listen up because

it's important. Roy Huggins at Person-Centered Tech has tons of free and paid resources to

walk you through every potential HIPAA risk in an entertaining way.

Have a telephone spiel written out.

It is totally normal to feel nervous when you get those first 20 calls or so. Personally, I find it

really helpful to have a little script or bullet points written out, like that first time you called a

person you liked in elementary school. C’mon, don’t act like you don't know what I’m talking

about.

My PROFESSIONAL* script goes something like this…

Client: Hi, I was referred to you by [awesome person]. Um, I wanted to make an appointment.

Me: Great! If you’re in a place where you can talk about it, tell me a little bit about what you're

wanting to work on in therapy.

Client: I’ve been throwing up after I eat for about 3 years. It’s not all the time, but it’s really

starting to freak me out because I recently tried to stop and I can’t. I feel really guilty when I

eat and keep it down and really guilty when I throw up. I am also constantly fighting with my

boyfriend and I just feel like my life is falling apart.

www.abundancepracticebuilding.com

11

Explanations and Resources The Why's and the How's

[If you take their insurance]

Client: (Possible Answer 2) I have [Insurance you take]

Me: Great! I encourage you to call the number on the back of your insurance card to find out

what your benefits are just so there aren't any scary financial surprises. Find out your co-pay

and if you have a deductible you have to meet.

[If you don’t take their insurance]

Client: (Possible Answer 1) I have [Obscure Insurance No One Takes]

Me: I don’t take [Obscure Insurance No One Takes] but we can navigate this. I am happy to

provide you with a form you can send in to your insurance for possible reimbursement. That

means you’re responsible for the fees at the time of our appointment and, depending on

your plan, a certain percentage of that may be paid to you by your insurance company. I

encourage you to call the number on the back of your insurance card to find out what your

“out-of-network” benefits are just so there aren't any scary financial surprises. Ask them the

best address to send a “Superbill.” I’ll give you everything you need for that, you just need

the address.

Client: Ok, cool.

[If you have a practice management system]

Me: So, let’s look at our schedules. (We find a common time) Ok, so I’m going to get you into

my system (get name, email address, phone number). Do you have internet access?

Client: Yep.

Me: Cool. I’m going to send you an email with a link to my client portal. Driving  

directions and all your intake paperwork are there. Please complete the paperwork at  least

a few hours before our appointment. I’ll review it before we meet. If you have any  questions

or concerns before then, please don’t hesitate to call.

www.abundancepracticebuilding.com

12

Explanations and Resources The Why's and the How's

[If you don’t have a practice management system (they aren’t necessary, just easier)]

Me: Cool. I’ll have your paperwork with your initials on it in the waiting room if you can arrive

15 minutes earlier

[over-estimate here]. I am located at [your office address]. [Here’s a weird thing about finding

me you should know]. If you have any questions or  concerns before then, please don’t

hesitate to call.

Note: make sure you write out your office address on your script. It’s likely new to you. You

wouldn’t be the first person to accidentally give a stranger your home address while on

autopilot.

If you read that and felt a wave of relief wash over you, you may be into my What to Say

When: Scripts and Templates for Counselors in Private Practice eCourse, which has over 60

scripts for the business side of private practice. It’s one of several courses in the Abundance

Party, which you should totally check out.

Have a transition plan in place

Not to be a downer, but you could die. You could get injured. You could have all sorts of

things happen that could leave your clients high and dry. A transition plan is important to

provide good care. I recommend this ebook, written by a therapist and an attorney, which

includes templates and everything you need to know to do this easily. Don't worry, you have

years ahead of you and they'll be more enjoyable if you CYA. Let's move to something a little

nicer...

www.abundancepracticebuilding.com

13

Explanations and Resources The Why's and the How's

Hope, Confidence and Belief in Yourself

This is one of those ongoing pieces. You wouldn’t even consider going into private practice if

you didn’t have some of this going on inside. Even if you only feel 10% hopeful right this

second, it’s enough to get you started.

Open a business bank account

This is important for so many reasons. For one thing, it allows you to track your income and

expenses sooooooo much easier than if you just plopped everything into your personal

account. If you’re buying things for your office, from a couch to tissues, it can be written off

on your taxes. Call your bank to find out what documentation they need for you to open a

business account. I also suggest a business savings account. That way, you can easily save

for taxes as you go. I take 20% off the top of everything I earn and have always been

covered. No one likes being surprised come tax time.

Start paperwork to become an S-Corporation

Why an S-Corp? The short version is because it will decrease the amount you will pay in

taxes. You should also ask your accountant when they think you should get started on one,

you’ll probably want their help setting it up.

www.abundancepracticebuilding.com

14

Explanations and Resources The Why's and the How's

Decide on a Practice Management System

You don’t have to use anything fancy. I used only free systems for the most intense 3.5 years

of my practice. Some states require an Electronic Health Record (EHR), so check with yours.

My favorite free resources:

Practice Fusion as an EHR. It’s made for doctors but you can create your own templates and

make life easier on yourself. Talk with them about not sending your clients surveys. When I

used it you could just uncheck some boxes but I’m not sure if that’s still the case.

I also think Office Ally’s free billing is awesome. I could literally bill each session in less than

30 seconds.

I just used my paper book-keeping, which works if you’re super-organized and is also

available in the Abundance Party’s What to Say When: Scripts and Templates for Counselors

in Private Practice eCourse.

My favorite paid resource:

Currently I use Simple Practice* and it does all of that, as well as online scheduling and a

client portal, in one system. I resisted paying for something because my free systems, plus a

cheap online scheduling system that I wouldn’t recommend, worked for me. But, as I built my

practice-building business and began task-shifting a lot during work hours, my organization

got a bit lax. Simple Practice made everything so much easier and is perfect for people who

are not strong on the organizational front or just too cool to be uber-organized (Can I

reframe it like that?). I wish I’d started with it. A lot of my practice-building clients are all about

it.

www.abundancepracticebuilding.com

15

Explanations and Resources The Why's and the How's

I want to be totally honest; I'm not the expert on this. These are just the systems I've used

and there are so many out there. The great news is that my friend, Rob Reinhardt, of Tame

Your Practice IS the expert on this. He has reviewed the 70 million* different practice-

management systems, electronic health records and electronic medical records on his

website. He also has a service where he will talk with you about your practice's needs and

recommend a system for you. He is my go-to for systems information.

*If you sign up through this link, we both get a free month

** this number is approximate

Decide on a credit card processor

You can tell your initial clients that you only take cash or checks, but credit cards make their

lives easier and don’t add too much to your bottom line. If you have a compatible smart

phone or tablet, Square is a great service.

If you’re using a practice management system like Simple Practice, Stripe is integrated and

you can click two buttons to process cards. Both of these systems work by taking a small

percentage of whatever you charge. I’ve also known people happy with Paypal and the

Amazon credit card processor.

Choose your business cards

Don’t get too perfectionistic on the first round of business cards. You need your name, office

address (again, be careful what you write!), phone, email if it’s secure, and website. Some

states require you to include your license number. Don’t get the free cards that advertise for

the card maker on the back on flimsy paper. I happily pay a few extra bucks for 16 pt

cardstock. It feels so luxurious. (In this exact moment I realized how incredibly lame I am.)

www.abundancepracticebuilding.com

16

Explanations and Resources The Why's and the How's

Build a website

You can build your own website!  Squarespace, and Wordpress.com are drag and drop style

websites. Take the time to watch the tutorials on whatever site you choose to keep yourself

from wanting to throw your computer out the window.

If you’re more tech savvy and want the best possible option (or plan to hire someone to build

yours,) I recommend a Wordpress.org site. I use the Divi Theme on the Abundance Practice-

Building website and it’s easy to use.

Blogging is a great way to increase the Search Engine Optimization (SEO). I help my practice-

builders come up with relevant, valuable blog post ideas and have them commit to a

schedule. You can also spend a lot of money hiring someone to increase your SEO, but

always vet them well; there are some scam artists out there. If you spend all that money,

make sure your website and its copy are damn good. This is an art and a science and

something I teach in my programs as well as talk about constantly, even in my sleep.

Establish a sliding scale plan

If you are considering taking a sliding scale, check out Open Path Psychotherapy Collective,

a non-profit whose mission is to connect clients in need to therapists who can help at a

reduced rate. I take sliding scale clients exclusively through this service and think they’re an

awesomely ethical.

www.abundancepracticebuilding.com

17

Also…

Nervousness is normal

Even if you’ve been a therapist for 20 years you may be wracked with anxiety when

someone calls to schedule an appointment or find your hands shaking in the 5 minutes

before an initial appointment. Get all ACT-y on it or use your CBT skills or tap or mindfully

employ DBT. That anxiety wanes over time and you can handle it while it’s present.

If you have a red flag during that initial phone call, refer them out

I’ll be honest. I don’t love working with every kind of client. Further, I'm not good at working

with every type of client. I’ve been doing this long enough that I can tell in that first phone

call if someone isn’t going to be a good fit. When I get that inkling on the phone that they

may not be a great fit, I refer out from the phone call. I happen to know people who LOVE

working with populations I don't love working with, and that makes referring out a lot easier.

Referring those clients to the clinicians who will help them much more effectively while

helping those clinicians fill their practices with the clients they enjoy is a win-win-win. I know

it hurts to refer out when you need clients, but dreading going to work isn’t going to inspire

you to build your practice.

www.abundancepracticebuilding.com

18

Also..

Before your first session, arrive early, and sit in your chair

These aren’t checklist things, but if you’ve read this far, chances are you’re new to private

practice and I want to tell you this:

Wear comfortable clothing that you feel good in

Fashion advice? Look, if you’re starting out you may be a little shaky or your stomach may be

a little upset. Just give your sweet body a break and wear something that doesn’t cut in to

your waist, make you have to sit up totally straight in order to avoid cleavage-ing someone

crying across from you, or a skirt that requires you to keep tucking it under your leg so you

don’t flash too much upper thigh. You will probably have plenty of anxious thoughts vying for

your attention and your client needs you to focus. You’ll do a better job if you’re not

physically uncomfortable and not worrying about your appearance.

Hope, Confidence, and Belief in Yourself

Wha-What? Did I just repeat myself? Totally. And, it’s not going to stop. This is an ongoing

process. In the first few months of starting a practice we have days we feel a little taste of

grandiosity and days we’re pretty sure we should put our tails between our legs and fill out

some job applications. No, you’re not diagnosable, you're just growing. It’s overwhelming

sometimes, but it’s something you can manage, using all the tools you encourage your

clients to use. You can do this. Think of all of the therapists in private practice. They all

figured it out. They all took the leap. It isn’t rocket science. Every bit of it is doable. Your

natural talents and abilities are perfectly aligned with private practice. We weren’t taught this

stuff in grad school so instead you get to learn it now. Older, wiser, badassier.

www.abundancepracticebuilding.com

19

You’ve got this! And if you need more support…

Whoa! That was a lot. I just gave you a ton of information, which I’m sure feels overwhelming.

Here’s the great news: you can’t do all of this in one sitting. If you’re not on a deadline, work

on this an hour at a time. When you start to complete the forms, you’ll see that it’s less of a

time commitment than you thought. A good tip: keep a document with your important

information, like your NPI and EIN, in a secure place, like your brain or in a note on your

locked, wipeable phone.

As you explore private practice it may feel like when you finished grad school, or got your

first job in the field, or brought your first baby home… this aching sense that there’s a ton you

don’t know but should. Please know that this is part of the process and that I’ve got your

back.

For an organized walk through of what you need to do to get referrals, how to handle the

businessy conversations, how to figure out your niche, monthly trainings on things like how

to create and fill a therapy group, how to be okay charging for therapy, and how to pay

yourself, a tight-knit community of others building, and a chance for a 1:1 with me each

month, check out the Abundance Party for Practice-Building Help for the Cost of a Copay.

www.abundancepracticebuilding.com

You’ve got this!

Allison