Originally posted on Therapy Reimagined (https://therapyreimagined.com/dont-have-to-be-thought-leader/)
You have undoubtedly heard that you should start a private practice and that you should not take insurance or that you should have a side hustle or that you should definitely not work in community mental health. You may have even inferred these things from what we and our interviews with fellow #moderntherapists have said on the podcast and in our blog posts.
Don’t believe it.
Or at least don’t swallow it whole.
There are SO many ways to be a therapist. Please please please don’t fall prey to the notion that there is a single right way to do this career.
For many, the dream of a fully private pay practice (at premium prices) with an additional lucrative “passive” income stream from a second business… well it sounds amazing.
But that doesn’t mean that business model is right for you.
It might not suit you to become a coach. Or a group practice owner. Or a speaker. Or a course creator. Or a “thought leader.”
These things can be AWESOME, but are they the right choice for you?
For me, it comes down to one question – Are we chasing the right dream?
Many people I’ve talked with have started down a path toward one of these fancy ideals only to realize they hate it. Or they can’t sustain it.
I also hear from the people who succeed – don’t tune me out as negative here –
We all hear those success stories. Right? These are the centerpieces of some really powerful marketing…
But they aren’t the only experiences.
We need to really understand that “results are not typical” and not everyone needs to be a thought leader and speaker who is changing the entire world.
We need to be more thoughtful about what each of us REALLY wants.
Here are some myths I feel like I have to bust, so you can (potentially) feel entitled to live a less “sexy” and “marketing ready” career:
Myth 1: It is impossible to work in community mental health. You’re crazy to even attempt it.
Each type of job has its pros and cons. There is a lot of airtime for the negatives of community mental health. I KNOW the system is broken. I am not diminishing that here. I also know that I spent 15 years in this system and found the bright spots, did really good work, and still feel connected to the populations that I served.
Many of the public mental health agencies have these systemic problems, but assuming they are all bad is short-sighted. Budgets are tight, caseloads are becoming increasingly challenging (with often only the highest intensity cases receiving mental health benefits), and people burnout. Those things are true.
But did you know there are perks at agencies you don’t often get in private or group practices? Community mental health organizations with government funding have competitive salaries and full benefits. Some agencies are even unionized to provide worker protections that other work environments don’t have. The work is consistent, providing a stable schedule that is often close to 9-5, keeping evenings and weekends free. The work is with populations that greatly need (and often highly value) the work you do. There are coworkers and birthday lunches and PTO and all the things that come from “normal jobs.”
I do know that there are toxic work environments and unreasonable expectations that can lead to moral injury. I know. I also know that there are segments of this group who are working to include trauma informed work environments that also set standards for best practices for supervision. The system is broken, but there are people who are trying to fix it from the inside.
If you’d like to have a normal job with a stable salary and benefits, look at public mental health. Don’t take just any job – you need to assess the work culture – there are some pretty horrific ones out there. However, there are a lot of possibilities here if you can find the right place.
Myth 2: You must have a full-fee, out of pocket Private Practice. Don’t take insurance!!
The holy grail is the practice where you’re charging $200+ per session without a lick of insurance money (or paperwork) coming your way.
Or is it?
The downside of a completely private pay practice is underplayed in the discussions about these dream practices. It can take a LOT longer to grow and stabilize a fully private pay practice when you’re charging premium rates. And it isn’t just “charging your worth.” It’s also talking people into investing in therapy, making sure you can keep the clients you get, maintaining these clients at your full fee (rather than sliding after a few sessions to sustain the work and keep the client), and continuing to bring in new clients. All the time. Continual marketing and solid clinical work are both required for a successful private pay practice.
But what if you hate marketing? What if you have a mission to help people who aren’t able to afford a higher fee for any length of time? What if you need a more stable income from the get-go?
Have people told you that when you take insurance you can fill your caseload and stabilize your income in a couple of months, if not a couple of weeks? That you can create a regular schedule and people will often stay for longer-term therapy, meaning less churn and deeper work?
Usually not. There are raised fists and cries about low fees and horrible paperwork.
And that can be true at times. Throughout the life of my private practice, I have taken insurance for a portion of my clients. So, I can say with certainty that there are some insurance panels that have been a dream to work with and others that were as awful as advertised.
When you take insurance, you don’t need to advertise and the “free consults” are really intake calls. You can sign up pretty much anyone who reaches out, if you want to.
When people talk about doing more of the work they love, I have to say it – insurance practices can do that. With minimal marketing (and not really a ton of extra paperwork), you spend most of your time doing therapy. If you’re able to negotiate higher rates, you can even get paid fairly well. You’ll want to look at your actual numbers, your actual experience, and then decide if you’d like to take insurance. Don’t avoid it because it’s taboo. Crunch your own numbers, assess your own skills and preferences.
Myth #3: You MUST switch to coaching or create a side hustle or become a thought leader.
When people start burning out as a therapist, they begin looking for other opportunities to use their skills in a different (and often more lucrative) way. They look outside of their current career to solve the problems within their career.
This can really work. Hey – I love doing a podcast and a conference, and consulting, and… you get it.
But not everyone is set up to do these other things. Especially if they’re running like a chicken without its head to try to keep their therapy practice running.
Adding something or switching gears takes time and skills you don’t necessarily bring from therapy school. It’s often much less lucrative at the beginning AND requires so much more marketing than a therapy practice. These are startup businesses with a capital B.
Coaching has different benefits, different challenges, and different parameters than doing therapy. Unless you set up your coaching business exactly like a therapy practice (weekly sessions, long-term work), you are often caught in a pattern of constantly having to market and develop business. All the time. You have to dive into webinars and launches and drip campaigns and a whole other level of marketing than for a typical therapy practice. If you enjoy that stuff, awesome. If the marketing is the part you hate the most about therapy – forget coaching.
With alternate revenue streams, there is often a number of new skills to learn before you can even have a product to sell. Huge amounts of time are required to learn online teaching platforms or media techniques or writing or whatever. Often you also have to research and purchase software, equipment, or new applications. Then you get to jump into the list building and marketing launches and frenzy of selling.
Don’t even get me started with “thought leadership,” I think this term is overused and oversold. Developing thought leadership (and expert status) is about reputation management and having something unique to say. This is almost exclusively on top of developing a coaching business or a course or a book or some other side hustle. Thought leadership is something you earn, not solely something you can build. And no matter how many people tell you it’s the pinnacle of all that is good and right in the world – It’s NOT required for success. You can make a big impact from your office or in your community. You don’t need to be on a gigantic stage to do what you’re meant to do. You get to figure out where you’re meant to be.
And the initial step in all of these “up level” opportunities – you HAVE to create the time and space to do these things. If you’re overwhelmed with your therapy practice, you are not yet ready to create a side hustle. If you’re worried about money and time, you need to obtain these resources before putting yourself out there as a coach or a thought leader. When you’re too busy to pursue leads or market, you’re not going to fill that coaching group or get on that stage. There is nothing passive about these options. They take time, and grit, and resources.
It can seem easier to make more money or have more freedom if you “move beyond the one to one, the hourly, the couch,” but again – you will need to dig deep for those things to bear fruit. Everything takes work, so PLEASE make sure that you’re doing the work you want to do.
Whether you decide to move into these alternate spaces or not, you must get your practice or career in order FIRST. Make sure that you’ve optimized your first business or stabilized your work schedule. Identify the skills needed for your chosen alternative and see if that really makes sense to you.
And if you want to be a therapist – BE A THERAPIST. Getting that practice in order can help you love it again.
Follow YOUR dreams, not the visions defined by the loudest voices on social media. You CAN create a career that supports you. You CAN set it up to provide you the life you want. The key – know yourself and make your own decisions.
SO… now that I’ve busted open some of these myths…
What other “myths” are you hearing?
What other options do you see for #moderntherapists?
Understand your options before you head down a path. There are SO many options. Don’t lose the passion and the drive that led you to this career by getting buried in effective marketing and other people’s dreams. Follow YOUR path.