How to Start a Therapy Practice: A Step-by-Step Guide
Wondering how to start a therapy practice? The first step is congratulating yourself on taking a step towards the financial and total freedom that come with working for yourself!
Starting your own therapy practice is exciting, empowering, and - let’s be honest - a little overwhelming. You’ve spent years training to be a great therapist, but when it comes to the business side of things? That’s where most therapists feel completely lost.
The good news? You don’t have to figure it all out alone.
Here are the first steps to start a successful, sustainable private practice - so you can spend less time stressing about logistics and more time doing the work you love.
How to Start a Therapy Practice: Legal & Logistical Foundations
File Your LLC & Handle the Legal Stuff
Before you see your first client, you need to set up your business legally. Filing an LLC (Limited Liability Company) is one of the simplest ways to protect yourself financially and keep your personal and business finances separate.
Check your state’s requirements for LLC formation and licensing.
Depending on your business plans, you may need an EIN (Employer Identification Number - like a Social Security number for your business. Here’s how to tell if you need one!
Open a business bank account to keep your finances clean from day one.
Consider consulting with a small business attorney or an accountant to make sure your legal and tax setup is solid from the start.
Choose an EMR System to Manage Client Paperwork
An Electronic Medical Records (EMR) system makes managing client intake forms, progress notes, scheduling, and billing way easier (and legally compliant). Your EMR can and should also provide a HIPAA-secure way to video conference with clients (one less thing for you to find and worry about!).
Some popular EMR options for therapists include:
SimplePractice
TherapyNotes
TheraNest
Get Your Client Paperwork in Order
To run a legal and ethical practice, you’ll need:
Intake forms (consent, demographics, etc.)
HIPAA-compliant privacy agreements
Practice policies (cancellations, fees, communication, etc.)
Telehealth consent forms (if applicable)
Many professional organizations (like the APA and ACA) offer templates, or you can purchase a legally reviewed paperwork bundle to save time (like the one found inside the Therapist Private Practice Accelerator).
How To Start A Therapy Practice: Positioning & Marketing Decisions
Define Your Niche & Ideal Client
One of the biggest mistakes new private practice owners make? Trying to market to everyone - because ultimately, that leads to having success with no one.
When you’re clear about who you help and how you help them, you’ll attract more of the right clients - and fill your caseload faster.
Ask yourself:
What specific problems do I love working with? (Anxiety? Trauma? Relationships?)
Who am I best suited to help? (Teens? Working professionals? Couples?)
What makes me different from other therapists in my area?
This is one of our favorite steps of the Therapist Private Pay Accelerator! We walk you through how to refine your niche and speak directly to your ideal clients, so they know you’re the exact one they’ve been looking for.
Decide: Private Pay or Insurance?
One of the biggest decisions you’ll make is whether to take insurance, private pay, or both.
While it can feel more secure upfront to take insurance (since you’ll definitely find clients through insurance directories), insurance panels often pay lower rates, take longer to pay you, and can rescind payments after making them (called a clawback).
It’s true that private pay requires more marketing work in the beginning, but with the right approach, you can start attracting and booking cash-pay therapy clients without ever having to deal with the administrative work (and financial uncertainty) of taking insurance.
NOTE: We always like to add that it’s possible to stop taking insurance at any point, if you’d like to transition to a private pay model. It’s a lot of paperwork (and a bit of a headache), but one of the *exact* things we help our students do in the Therapist Private Pay Accelerator!
Build a Website That Speaks to Your Ideal Clients
Your website is one of the most powerful tools for growing your practice - but only if it’s set up correctly.
At minimum, your therapy website should have:
A clear, client-focused homepage that speaks to who you help and how.
A services page that outlines your specialties, approach, and rates.
A contact page with an easy way to book a consult or reach out.
💡 Want some extra help? Grab our free guide: 5 Simple Website Fixes to Attract Private Pay Clients
Optimize for SEO (So Clients Can Find You on Google)
Having a website is great—but if no one can find it, it’s not helping your business.
Here are simple SEO tips to rank higher on Google:
Use the same keywords that your potential clients are searching for (e.g., “anxiety therapist in [your city]”)
Set up and optimize your Google Business Profile
Get listed on high-quality therapist directories (like Psychology Today)
If SEO feels overwhelming, don’t worry - the Therapist Private Pay Accelerator walks you through exactly how to optimize your website and start getting found on Google, without needing a ton of tech expertise.
Get the Word Out: Marketing Your Practice
Once your practice is set up, it’s time to start getting clients - and you can’t do that if no one knows you’re open for business.
Here are some quick marketing strategies to get the word out:
Local Networking – Reach out to doctors, schools, and other therapists for referrals. Also consider who you’d likely collaborate with for client care (example: dietitians, for eating disorder therapists) and reach out there, too!
Google Business Profile – This is crucial for local SEO and helps clients find you.
Therapist Directories – Make sure your profile is fully optimized on Psychology Today & others.
Simple Print Marketing – Create simple business cards and flyers to hand out at events and/or leave in waiting rooms.
If you’re feeling lost on marketing, that’s exactly what I help with inside the Therapist Private Pay Accelerator - so you don’t have to waste time guessing what works.
The last thing you need to know about how to start a therapy practice? That it really is all going to be okay.
Starting a therapy practice takes planning, strategy, and a little bit of patience - but you don’t have to do it alone! Join our free Facebook group of 4,700+ therapists who are learning how to start a therapy practice on their own terms.
Want a proven roadmap to growing your practice faster? Join the Therapist Private Pay Accelerator and get step-by-step coaching to build, grow, and market your private practice without the stress.
