Why You’rE Not Getting Referrals

The Truth About Opening a Private Practice

Opening a private practice is a major accomplishment. You've worked hard to get here—years of education, clinical hours, licensing exams, and finally, the leap into entrepreneurship. It's exciting. It's a big deal. Not everyone starts a small business, and you should absolutely be proud.

But here's the truth that most therapists don't realize until they're several months in: opening your practice is just the entry step.

If you want to not just survive but actually thrive—if you want to fill your caseload, charge what you're worth, and maybe even grow into a group practice—you're going to need more than just a Psychology Today profile and a website.

You're going to need a strategy.

And that starts with understanding one simple analogy: your private practice is essentially a coffee shop ☕️… let me explain

The Coffee Shop Analogy: Why Your Practice Isn't as Unique as You Think

Think about it. There are thousands of coffee shops out there. If you open one tomorrow and do absolutely zero marketing, you'll still get some customers. Why? Because people need coffee. It's not a hard product to sell. There's inherent demand.

The same is true for therapy. When you open your private practice, you will inevitably get some clients through the door, even with minimal marketing. People need therapy. There's demand for mental health services.

But here's where the analogy gets uncomfortable.

In the last five to ten years, a ton of people have opened therapy practices. Startup companies like ALMA, Headway, Grow, etc. have made it incredibly easy to launch a private practice and start taking insurance. Platforms have streamlined credentialing. The barriers to private practice are lower than they've ever been.

So now, instead of one or two coffee shops in your neighborhood (think Starbucks and Dunkin' Donuts), there are 20 or 30 options within a five-mile radius. Some you've heard of. Some you haven't. Each one claims to do something just a bit different.

Translation: The market is saturated.

And if you're a therapist who just opened a practice and you're wondering why your caseload isn't filling up as quickly as you hoped, this is why. You're not the only coffee shop in town. You're one of many.

The Two Paths Every Private Practice Owner Faces

Here's the reality. When you open your practice, you're standing at a fork in the road. You have two paths in front of you.

Path One: Survive

You open your practice. You create a Psychology Today profile. Maybe you list yourself on Zocdoc or a few other directories. Friends and family know about you. Maybe you get some referrals here and there.

You're okay with the slow and steady traffic. You're not doing much beyond the basics. And honestly? You can survive this way. If it's just you and you're not looking to hire, you can absolutely sustain a solo practice with minimal marketing.

Will you thrive? Probably not. Will you grow or scale? Unlikely. But you can survive. And for some therapists, that's enough.

Path Two: Thrive

You intentionally choose to invest in marketing. You decide that you want to grow your practice in a consistent, thoughtful way. You want to generate interest, stand out in your community, and ultimately bring in more business.

This is the path where you don't just survive—you thrive. You fill your caseload. You charge cash rates. Maybe you bring on associate therapists. You build something sustainable and profitable.

The question is: which path are you on?

What It Actually Takes to Make Your Coffee Shop (Practice) Stand Out

Let's say you choose Path Two. You want to thrive. Great. So what do you actually need to do?

Step 1: Get the Basics in Place

Before you can market effectively, you need the fundamentals. Think of these as the essentials for any coffee shop that wants to stay in business.

You need:

• A professional website. This is non-negotiable. People need to be able to find you online, read about you, and understand what you offer.

• An easy way to contact you. Whether that's a contact form, email, or phone number, don't make people hunt for it.

• An easy way to schedule a consultation. The fewer steps between "I'm interested" and "I booked a call," the better.

• Good coffee. In other words, you need to actually be good at what you do. That could be your years of experience, your specialty, your niche, your training. You need something of substance to offer.

Those are table stakes. But if you want to thrive, you need to go beyond the basics.

Step 2: Define What Sets You Apart

Before you start marketing, you need to know what makes your practice different.

What's your specialty? What's your niche? What sets you apart from every other therapist in your area?

Because here's the thing: if you're a generalist, it's going to be really hard to stand out.

Think about a coffee shop with a signature drink—something people line up for, something only you have. Maybe it's a lavender latte. Maybe it's a cold brew made with beans from a specific region. Whatever it is, it's the thing people talk about.

That's what you need in your practice.

Maybe you specialize in ADHD therapy. Maybe you work exclusively with high-achieving executives. Maybe you use a specific modality like EMDR or IFS that's hard to find in your area. Maybe you focus on a particular demographic—new moms, college students, first responders.

Whatever it is, you need to be crystal clear about it. And if you're going to be cash pay, you really need to nail this. Because now you're asking people to pay out of pocket when they could go to a dozen other therapists who take their insurance. You need a compelling reason for why they should choose you.

In my own practice, we're a group practice that takes insurance, and we specialize in ADHD therapy—not medication management, just therapy. Those two things alone are highly sought after in our community. It works because it's something we're passionate about, and there's a real need for it.

Step 3: Build Brand Awareness

This is where most therapists drop the ball. Brand awareness means getting the word out in a meaningful way. In 2025 and 2026, that means digital brand awareness.

Here's what you need:

• A brand. Not just a logo. A cohesive identity that includes social media, a solid website, and content that people can consume to understand what you do.

• Valuable content. This is your free sample. If you work with executives, make videos about imposter syndrome or managing anxiety in high-pressure roles. Let people see what you're about before they ever book with you.

• Strategic advertising. Consider running Meta ads (Instagram, Facebook) to reach your ideal clients. You can target people by job title, interests, location, and more. Now your brand shows up in their feed as they're scrolling.

Think about it like this: you're standing out in front of your coffee shop with a sign that says, "This is the kind of coffee we serve. This is who it's for. Come give it a try."

The Challenges You're Up Against

Let's be honest. There are real challenges in today's market.

The market is saturated. There are more therapists in private practice than ever before, and many of them take insurance. The barriers to entry are lower. Companies like BetterHelp and Talkspace add to the noise.

Standing out is harder. With so many options, potential clients are overwhelmed. They don't know who to choose.

Narrowing your niche is tough. It takes work to figure out what you want to specialize in. It requires sacrifice.

But here's the good news: most therapists aren't doing the things I just outlined.

They're not defining their niche. They're not building a brand. They're not creating valuable content or thinking about brand awareness.

So if you do these things, you're already ahead.

Final Thoughts: Your Coffee Shop Can Thrive

Your practice is a coffee shop. Right now, there are a lot of coffee shops. But if you can figure out your signature drink, get the word out, and make it easy for people to choose you, you won't just survive.

You'll thrive.

It takes work. It takes strategy. It takes a willingness to invest in marketing and adapt as the landscape changes.

But if you're willing to do that, you can build something truly sustainable and rewarding.

So here's my challenge to you: which path are you going to choose?

If you want help with growing your private practice schedule a free 15 min call with me today!