Starting a Therapy Private Practice: A 30‑Day Setup Plan That Doesn’t Break You

Starting a private practice can feel like stepping into two roles at once: clinician and operator. The clinical side is familiar. You know how to build rapport, assess safety, and formulate a treatment plan. But the business side can feel like a fog—especially when you’re trying to do it ethically, sustainably, and without turning your evenings into an unpaid admin shift.

Many therapists freeze because the list of "to-dos" feels infinite. Do I need an LLC? What EHR should I pick? How do I get referrals? The secret is that you don't need to do everything at once. You just need to do the right things in the right order.

This is a 30‑day setup plan designed for the “real world” version of private practice: you’re building while you’re likely still seeing clients elsewhere, you don’t have a full team, and you want systems that reduce stress—not systems that create more work.

Who this is for

This guide is for solo clinicians (LCSWs, LMFTs, LPCs, PsyDs) and early small group owners who want a clear sequence: what to do first, what can wait, and how to avoid the classic mistakes that create chaos later.

What you’ll walk away with

You’ll get a simple weekly rollout plan that creates stability—policies you can defend, an intake flow that feels professional, a documentation rhythm that doesn’t consume your life, and a growth approach that doesn’t require you to become a full-time marketer.

Week 1: Build Your “Container” (Policies & Boundaries)

If you skip this part, everything else feels harder. Your policies are not bureaucracy—they’re what protect your time, your income, and your client experience. Without them, you will find yourself debating late fees with clients at 8 PM on a Tuesday.

Define Your "Ideal" Practice

Before you sign a lease or buy software, define the box you want to work in. Start by identifying exactly who you help. While "Adults with anxiety" is a start, "High-functioning professionals dealing with burnout and perfectionism" is better because it makes marketing easier later. Next, determine your session structure. Decide if you will offer standard 50-minute sessions or 90-minute intensives, and whether you will see clients weekly or biweekly. Finally, calculate your rates based on your "survival number" (expenses) and your "thriving number," rather than simply copying what your supervisor charged a decade ago. This clarity prevents resentment later.

Write Your "Big Three" Policies

You need three core policies in writing before you see your first client. First, establish a Cancellation Rule. The standard is 24 or 48 hours, and you must be clear about the fee—whether it is the full rate or a flat fee—and when it might be waived, such as for true emergencies. This isn't just about money; it's about holding the frame of therapy. Second, set a Payment Policy. Ideally, require a credit card on file that is charged automatically at midnight on the day of service to eliminate the dynamic of chasing checks. Third, define a Communication Policy that establishes boundaries early, such as responding to messages within 24 business hours and prohibiting the use of email for emergencies. This protects your nervous system from being "on call" 24/7.

Week 2: Make Intake Feel Effortless

A strong intake process reduces no‑shows, reduces confusion, and sets expectations early. It also saves hours over time. If your intake process involves emailing a PDF, waiting for them to print it, sign it, scan it, and email it back, you have already lost.

The Automated Workflow

Your goal is to have a "zero-touch" flow until the actual session. The client should visit your website and click to request a consult. They then book a free 15-minute slot on your calendar using a tool like Soli or Calendly. During the consult call, you assess fit. If it's a "yes," you trigger the intake packet. The system then sends them digital forms—Informed Consent, HIPAA, GFE, and Credit Card Authorization—which they can sign on their phone. Crucially, the first session is only confirmed once the paperwork is complete. This ensures you never start a session without legal coverage.

The "New Client Welcome" Email

Draft a template email that goes out automatically to welcome new clients. It should answer the questions they are often too afraid to ask, such as where to park, whether the waiting room is shared, how to log into the video call, and what generally happens during the first session. A well-written welcome email reduces anxiety for the client, allowing them to show up more ready to work.

Week 3: Choose Systems That Protect Your Evenings

Most new practice owners aren’t “bad at time management.” They simply don’t have a system designed for a small practice reality. Your goal is to reduce the number of places you have to remember things.

The "Source of Truth"

You need one place where everything lives. Avoid keeping a paper calendar alongside a digital one, or notes in a Word doc while billing lives in a spreadsheet. Use an EHR or practice management tool that handles time zones and reminders automatically for scheduling. For documentation, pick a simple template like DAP or SOAP and commit to it, rather than reinventing the wheel for every note. For billing, automate it if you are private pay. If you accept insurance, decide early if you will handle it yourself or hire a biller, especially if you dislike math. The goal is to touch each administrative task only once.

The Friday "Money Date"

Block 30 minutes every Friday morning to handle the financial side of your practice. Use this time to check that all sessions from the week were billed and that all payments have cleared. Send any Superbills for the month and review your bank balance to ensure you are on track. This habit transforms financial anxiety into financial clarity, making you feel like a business owner rather than an impostor.

Week 4: Build Growth That Doesn't Require Constant Posting

Most therapy practices grow through trust, not through volume marketing. You want a system that’s slow, consistent, and referral-friendly. You do not need to dance on TikTok to fill a practice.

The "Referral Clarity" Strategy

Make it easy for people to refer to you by sending a simple email to five colleagues. Tell them you are opening your solo practice focusing on a specific niche, have openings for a specific type of client, and would love to be a resource for anyone they are turning away. Be specific—saying "I take everyone" makes you forgettable. Saying "I specialize in teen girls with eating disorders" makes you memorable.

Two Relationships a Week

Set a goal to have two "coffee chats" (virtual or real) a week for the first month. Meet with one clinician who has a full practice and needs a place to send overflow. Then, meet with one community partner—such as a PCP, divorce attorney, school counselor, or pastor—who sees the pain you heal. These relationships are the lifeblood of a sustainable practice.

One Helpful Resource

Write one blog post or guide, such as "What to expect in your first session," and put it on your website. This builds SEO over time and gives your referral partners something valuable to send to potential clients. It demonstrates your expertise before the client even walks in the door.

Common Mistakes

One common mistake is undercapitalizing by starting with zero dollars in the bank. You need a "runway" of 3-6 months of expenses because insurance panels and referrals take time to ramp up. Another error is "Policy Drift," where you make exceptions to your cancellation policy in the first month because you are afraid to lose the client, which teaches them that your boundaries are flexible. Finally, avoid "Over-Software-ing" by buying the enterprise version of everything. Start simple; you don't need a complex CRM for five clients.

Practical Next Steps

Start by drafting your policies this week; sit down for two hours and write your Cancellation, Payment, and Privacy policies. Next, pick your "Launch Date" and work backward from there to set a firm start for seeing clients. Finally, if you don't have a Type 1 NPI, apply for it now as it is free and takes about a week.

The bottom line

Private practice becomes sustainable when it becomes repeatable. You don’t need a perfect system—you need a system you can keep using when you’re tired. Build the container first, and the clients will be held safely within it.

Sources

• NBCC: Starting a Private Practice
• APA: Private Practice Basics