Have you ever considered starting a group practice? It’s an option that appeals to many therapists as it allows you to grow your business, support more clients, and collaborate with other colleagues. But figuring out if, when, and how to start a location independent group practice can also be challenging. 

That’s why we invited Kelsey Hoff into the LIT Community to share her expertise in the area. A former LIT member, Kelsey lived abroad and travelled with her solo private practice before returning to settle in Canada, where she expanded into a group practice. 

In this blog post, we’ll share some of the key things to consider when deciding whether to start your own group practice. 

Introducing Kelsey Hoff – our guest expert 

Kelsey is a counsellor and the owner of Find Your Way Counselling, a group therapy practice that specializes in processing religious trauma and harm, spiritual abuse, high-control settings, cult recovery, and religious deconstruction. Kelsey also works with expats, TCKs, and travellers and offers a free initial consultation – find out more about her services here.

In 2021, Kelsey took the plunge to become a group practice owner. She made this decision in response to the growing need within her niche and her desire to provide more services while having more flexibility within her business. Now, she homesteads on her farm in Canada and works from her office in a converted sea can between her barn and chicken coop. 

Having spent several years working as a location independent therapist, Kelsey continues to see her clients online. Notably, her group practice also operates fully remotely. 

So, Kelsey was the perfect person to come into the LIT Community to talk about starting and growing a group practice, specifically geared towards location independent therapists. 

Read on to learn:

  • The benefits that come with building a group practice
  • The (sometimes surprising or unexpected) challenges of starting a group practice
  • What you should consider when deciding if a group practice is right for you 

The Benefits of Starting a Group Practice

Starting a group practice can bring many benefits to the owner, their clients, and the contractors or employees they bring into the business. In this blog post, we’ll focus on this mostly from the perspective of the practice founder. 

But firstly, it’s important to note that these are only potential benefits. They’re not a given until your group practice is up and running successfully, with a good flow of existing and new clients. (And understandably, that takes time – it’s a marathon, not a sprint). 

Here are some of the biggest benefits of starting a group practice:

#1: You can scale your business income: 

At some point, most therapists reach a limit to how much they can earn from seeing clients 1:1, as there are only so many hours in the week. Expanding into a group practice is one way to increase your income as you can take a cut of what your contractors or employees make. That could allow you to earn more money and hit your income goals without having to work all the hours under the sun. 

#2: You can have more flexibility in your business

Another benefit of starting a group practice is that it can also free you up to see fewer clients and still earn as much while having a better work-life balance. That’s ideal if you have other responsibilities or constraints, for example, those who have limited childcare or are living with a chronic illness.

#3: You can have a greater impact 

When you have other colleagues working with you, you can reach and support a greater number of clients. This can increase your impact and enable more people to access the help they need. 

You can also offer a wider range of services, which may allow you to better support new and existing clients. For example, you could bring on colleagues who work in different but complementary modalities, such as art therapy or couples sessions. There have even been times when Kelsey and her associates have worked separately with the same clients to provide a more well-rounded and deeper therapy experience. 

#4: You get the benefit of working with colleagues 

Being a location independent therapist can get lonely at times (which is one of the main reasons why created the LIT Community in the first place). It’s easy to miss those chats at the water cooler and being able to ask a colleague a quick question or for a second opinion. 

Growing a group practice can be a great antidote, as you have other colleagues in your business. Kelly has found it a real perk to have colleagues who are passionate about the same niche; they can offer each other mutual support or another perspective. 

Photo by SDI Productions on Getty Images Signature

#5: Your business can continue to grow

When you have a solo practice, you’ll reach a point where you’re booked out and can’t take on any more clients. But in a group practice, you can bring in more associates, allowing you to reach more people and have a greater impact. Kelsey found that there was a real need for more mental health professionals who work with religious trauma and deconstruction, and by taking on interns, she could train them in these areas to meet the demand. 

When you’re working in a group practice, you can also decide how much time you want to put into 1:1 sessions compared with group sessions or other opportunities. For example, you could scale back your direct client hours to allow you to take on more speaking opportunities, write a book, or develop a course. So, a group practice could be ideal if you’re looking to branch out with the type of work you do.

The Challenges of Starting a Group Practice:

While there are many benefits associated with starting a group practice, you should also be aware of the challenges (not to mention the amount of work) involved. Here are some of the crucial things to consider before deciding if a group practice is right for you:

There’s a lot of work involved (and unpaid hours)

The idea of earning passive income can be exciting but don’t be fooled. Growing a group practice isn’t passive at all in the beginning, as you have to put a lot of unpaid hours into building your group practice, onboarding colleagues, marketing, and more. You’ll need to be much more involved than you may first think, and the hours quickly add up. 

For example, Kelsey needed to set up a new booking system and EHR tool to streamline everything for working with multiple colleagues. She also needed to produce documents and policies for her group practice and update her website, directory listings, and marketing to reflect the change from a solo to a group practice. Beyond this, she needed to look for, hire, and onboard associates into her practice.

So, before you dive in, consider all the hidden work involved in starting a group practice. 

It may cost you more (at least initially)

Alongside the extra hours involved (none of which are billable), starting a group practice may set you back more money at first. You might think a location independent group practice would be relatively inexpensive, but there are many hidden costs involved, some of which are one-off while others are ongoing. 

Here are some examples of increased expenses to plan for:

  • New tools or more expensive plans to account for multiple colleagues
  • Paying for your associates to be on various/networks
  • Seeing a bookkeeper/accountant as your finances will become more complicated
  • Higher liability insurance 
  • Hiring a lawyer to write a contract for your associates
  • Additional marketing and website updates (if you outsource this work)

Photo by Prathan Chorruangsak

There’s a steep learning curve

As with any new business or endeavor, you’ll have a lot of new things to learn when you start a group practice. Everything becomes much more complex than if you’re working solo. Firstly, you’ll need to stay on top of effective communication with your associates and ensure they feel supported within your business. 

You’ll also need to have streamlined systems for managing and tracking incoming inquiries and following up with them. Plus, you’ll have to be on top of all the regulations for location independent therapists, not only for yourself but for all your associates, and they may have different credentials and requirements. (For example, Kelsey discovered that art therapists can see clients more widely in Canada than psychotherapists can).  

You have more responsibility

As you can see, starting a group practice creates a lot more responsibility – both for your clients and for your associates. 

When working with others, you’re entrusting your clients and your reputation to your associates. You may find it challenging to hand over aspects of your business to other people or worry that if something were to go wrong, it would reflect negatively on your business. 

Beyond that, you’re also responsible for providing a certain amount of hours and income to your associates, who will have expectations of specific benefits when they sign on with you. That can create more pressure, especially if you have periods of fewer referral requests and incoming clients.

And if you take on interns, you’ll need to factor in the time you spend supporting and supervising them (not to mention the energy and effort that goes into this). 

You have to wear all the hats

And finally, as a group practice founder, you’ll find yourself taking on many different roles and responsibilities. For example: 

  • Doing the administrative work for the practice
  • Managing the finances
  • The marketer and social media manager
  • Providing peer consultation and clinical supervision to associates/interns 
  • Seeing clients yourself 
  • Taking on the role of CEO/business owner – making the big-picture decisions
  • And the all-around go-to person for everything! 

The Wrap-Up: Is Starting a Group Practice Right for You? 

So, how can you decide if starting a group practice is right for you? It’s a very personal decision that will depend on your life and business goals. 

For example, you should think about your financial needs, how much you want to work 1:1 with clients vs. expanding, and if you’re ready to scale your business. 

Would you feel comfortable taking on the managerial/CEO role as the practice founder? And how much of the work would you need to do yourself vs. outsourcing (marketing, website, admin, etc)?

This blog post should have provided plenty of food for thought to help you decide if starting a group practice is the right decision for you. Take some time to think it all through, and let us know your thoughts in the comments below! 

If you would like to start a group practice but are unsure where to start or whether it’s the right decision for you, Kelsey Hoff offers consulting sessions for colleagues on all things related to group practices. You can reach out to Kelsey via her website or at info@findyourwaycounselling.com to find out more. 

And if you’d like to have a supportive community of like-minded colleagues around you and access to all our live events and resources, join us inside the LIT Community when we next open the doors! 

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