According to the 2017 BACP members survey, half of us work in private practice. For many, it’s a positive choice – a chance to control when, how and with whom we work. But for counsellors struggling to find a paid job after qualifying, going into private practice may be their only alternative to taking a voluntary, unpaid role, or leaving the profession altogether. In the same survey, 49% of BACP members said finding paid work was their biggest challenge.
So what do counsellors need to know in order to make a success out of private practice from the start? We asked successful private practitioners what they wished they had known when they first started out.
Specialise to stand out
It’s tempting to tick every box on the ‘areas of counselling covered’ section of your directory listing, in the hope that it will bring you more clients. But many of the most successful practitioners have found that the opposite is true, and that specialising is the key to attracting clients. ‘Ninety-five per cent of the work I now do is on anxiety,’ says James Rye, who works in private practice in Norfolk and is author of Setting Up and Running a Therapy Business (Karnac, 2016). ‘Once I recognised the demand, I set out to become as expert as I could in it. If I were starting out now, I would consider specialising in working with children under 11, as that seems to be a growing area of demand.’
Central London- and Surrey-based counsellor Joanne Benfield believes that choosing to specialise as a sex and relationships therapist was the key to her success in private practice. ‘After qualifying with an MA in counselling and psychotherapy, I realised there was a huge number of counsellors working in my five-mile radius that I would be competing with. But there weren’t many specialising in sex and relationship therapy, and I knew there was a growing demand for it. It was also an area of interest for me, so it seemed to make sense to specialise.’
Birmingham-based counsellor Martin Hogg chose to specialise in anger management, offering workshops and courses, as well as one-to-one sessions. ‘A well-intentioned therapist early on in my training told me to forget all my past experience and think about starting as a counsellor with a clean sheet. But I say, draw on what you have experienced in your life to inform your specialism. When I was doing my counselling placement, I was asked to engage with a group of young men, which involved anger management work. It really clicked with me. Prior to becoming a therapist, I spent 20 years in the hospitality industry, running pubs and clubs, and a lot of that work was about managing behaviour and resolving conflict.’
Once you have identified a potential specialism, it’s essential to get further training in it. Benfield invested in a post-qualification diploma in psychosexual and relationship therapy, as well as attending relevant talks and workshops. ‘Part of my motivation was to meet other practitioners in this field,’ she says. A chance meeting at one event with a publisher looking to commission a book on sex and relationships (this became Benfield’s book Three in a Bed: conversations with a sex therapist, published by HarperCollins) ignited her career. ‘It had always been my dream to move to the south of France and write a book. When I was offered the book contract, I did some research, moved to Monaco, and set up a private practice there while I worked on the book.’
Adding specialist training after qualifying was also crucial for Rabina Akhtar, who works in private practice in Peterborough. ‘It’s obvious from my profile picture that I am a Muslim, so I assumed I had an automatic specialism and the clients would come to me, but I was wrong. I didn’t get a single Muslim client until I invested in specific training, then offered my services for a reduced fee to an organisation that worked with the Muslim community. It’s almost as if I needed to grow within myself before the clients came. I also learned a lot about the needs of the community – don’t assume you know everything just because you have experience in an area.
‘You should look at your three-year general counselling qualification as a base level on which to build, not something that qualifies you to work with everyone who walks through the door, no matter what they present with. And don’t mis-sell yourself – you’re not only mis-selling yourself, you’re mis-selling counselling as a service.’
To be in a position to be selective about clients, you may need another source of income, and 37% of BACP members in the 2017 survey said they have a portfolio career that includes non-counselling work. Rye says he ‘couldn’t have survived’ without the income from his part-time job as a trainer. ‘I don’t know anyone who goes straight into earning £25-£35k a year in private practice,’ he says. ‘I had been in teaching for many years and was fortunate to get a part-time job that was mornings only, which allowed me to build up a counselling practice in the afternoons and evenings and gave me the financial security I needed to allow my practice to grow gradually.’
Starting with one or two days a week of counselling, combined with another role, can help you gain experience in a contained way. ‘Having another revenue stream, especially initially, is crucial, as it allows you to take the number of clients that is right for you, rather than how many you need to pay the bills,’ says Hilda Burke, a private practitioner in west London. ‘There is a tipping point where your caseload impacts on the quality of your work. I realised that a full practice is not the same as a successful one. There was a point when I was taking as many clients as I could, but I also had a high turnover rate – clients didn’t stay. Now, I take on fewer clients, but they stay for longer.
‘I think it’s about the quality of the attention they receive from me. I boost my income with writing and consultancy work for PR companies on mental health issues. I would advise all new practitioners to think about ancillary revenue streams that relate to the work of counselling but are not client-facing, such as training, speaking or writing.’
Money, money, money
As well as establishing what the right number of clients is for you, there is the question of what to charge them. ‘When you first start out, it’s easy to think that any low fee is better than working on a voluntary basis, but as I got more experienced, I realised that clients who aren’t prepared to invest in themselves financially often aren’t prepared to commit to coming regularly,’ says Akhtar.
You need to consider what your service is worth, says Rye. ‘I started out with this wonderful idea that I would charge people a 1000th of their income, so if you were earning £70,000 a year, you paid £70 a session, or if you earned £10,000, you paid £10. I soon found out that, apparently, everyone earned £10,000 a year. You shouldn’t be embarrassed about putting a significant price on the skill you offer. If your work helps one man refrain from taking his life and bereaving his young family, or helps one woman stop abusing alcohol and keeps her with her partner and children, think of the financial and emotional cost you have helped others avoid. Wising up to that was part of my growth.’
Getting your pricing right may be a trial and error process, says Rye. ‘The advantage of working in private practice is that you are free to both make and change decisions. You don’t have to decide on one figure and then stick with it, regardless of the effect.’
Location, location, location
Your choice of location can also influence what you charge, as Chloe Langan found when she moved her practice from Kent to Inverness. ‘I had to do a lot of thinking about pricing when I moved. You can’t ignore the local economy,’ she says.
The change in geographical location also shaped the way she worked. ‘In Kent, I was working in an urban, densely populated environment, and I moved to an area where the population was sparse and very spread out. That meant some of my clients travelled two hours to get to me from Skye or Wick and were at the mercy of the weather. I had to change my thinking about boundaries – I can’t be as rigid about sticking to timing as I was in Kent.’
There is also the decision of whether to work from home, or from an external location. Renting a room in a building used by other counsellors can provide contact and informal peer support from more experienced practitioners. It’s an added expense, but one that is tax deductible, and it separates your work and personal life. ‘If there isn’t anything suitable available, consider getting together with a group of local counsellors and renting rooms together,’ says Akhtar.
But for many practitioners, working from home is more convenient. ‘When I first started, I thought I would look more “professional” if I also worked from a room off Harley Street, and thought this might be attractive to more clients,’ says Surrey-based Rachel Shattock Dawson. ‘What I found was that London workers are reluctant to contract to a regular weekly appointment in office hours, and at the same time they were not always in a mindset to come straight from work. Or they would cancel at the last minute because a meeting ran late or whatever, and I would be left sitting on my own in an expensive room in central London at night, having travelled an hour to get there. My practice really took off when I moved it into a room in my home. It seems that for my clients “low key, local and homely” has more appeal than “inner city and sophisticated”.’
Rye has always worked from home, even though it could be tricky when he first started out and his teenage children were at home. ‘It meant giving them money to go out at times,’ he says. ‘But working from home gave me flexibility, especially when I was starting out. If my client appointments were spread out, I wasn’t sitting in an empty room waiting for someone who might not turn up, and I could get on with other things between appointments. I have always made it clear that I work from an office at home, so clients know before they turn up. Many clients say they prefer the informality of it.’
The downside of working from home, however, is the potential for isolation, which Shattock Dawson staves off through extra peer supervision and support. ‘I make a point of regularly meeting other therapists for coffee, lunch or whatever, and I also do three hours of peer supervision every month,’ she says. ‘There can sometimes be an element of censoring in clinical supervision, but peer supervision tends to be more open and honest. We also discuss the practicalities of private practice, like what marketing works best, and how to adapt the household around client needs.’
An important element of contact with other local practitioners is that you get to know counsellors to refer clients on to, says Bristol-based counsellor and supervisor Els van Ooijen. ‘We have a responsibility to work within our capabilities, and that means we should be referring on clients that we are not confident we can work with effectively. The best way to find who to refer to is to meet and talk to local practitioners.’
Doing a few hours of voluntary work can also be a good way to connect with peers, says Rye. ‘When I started out, I was managing the counselling for a local charity for a few hours a week on a voluntary basis, which protected me from isolation. It also provided me with free training and CPD. Joining or setting up a monthly counsellors’ reading group is another good way of ensuring you have regular contact with other practitioners.’
Supervision and mentoring
Another source of support is supervision. It’s essential to find the right supervisor when you start out in private practice, which may not be your training supervisor. ‘If people are going to go into private practice, they really need to have a supervisor who is steeped in private practice, and has a lot of experience,’ says van Ooijen. ‘If you have never been in private practice, how do you know what it is like, and the kind of things to think about? It’s limiting to think supervision is only about talking about clients – it should be everything that a practitioner needs in order to give the best service to the clients. For some of my counsellors, it can mean booking an extra session where we deal with the business side.’
For other practitioners, finding a mentor who can advise on the logistics of building a private practice works well. Burke stumbled across her mentor at a friend’s wedding in the Caribbean. ‘One of the guests was a very successful analyst running a private practice in New York. We started talking and I told her I was just starting out. She was very straight-talking, and said, “You have to approach it as a business right from the start.” I feel lucky that she remains an unofficial mentor.’
An alternative is to identify a successful local practitioner and ask if you can pay for an hour of their time for advice, says Akhtar. ‘I find you always pay more attention to advice you have to pay for!’
Once you feel ready to get going, your challenge is to help the right clients find you. ‘The biggest mistake that counsellors make is that they think they are selling counselling,’ says Hogg, who runs one-day marketing courses for counsellors. ‘What you are actually marketing is what counselling can do for people. With the exception of trainees, no client is coming for an “experience” of counselling. They are coming because they want to relieve the pain of their bereavement, their anxiety, their depression, or move towards a better relationship with their partner or children. But counsellors will set up a website that says, “My name is John, I am an integrative counsellor and I studied at the Institute of Counselling, and I have a diploma in whatever.” A successful website speaks about the client – what they will get from coming to you, in language they can relate to.’
Rye agrees: ‘Just because you are qualified and list your qualifications in a directory profile, and say how supportive you are and that you offer a safe space to talk, it doesn’t mean that clients will come to you. You have to learn how to market yourself.’
There are a growing number of marketing courses available for counsellors, and you can also learn a lot from looking at the websites and directory entries of successful practitioners. But it can be a trial and error process, says Akhtar. ‘I set up in 2011, but it took me until 2012 to get my act together about marketing myself. It is easy to think, “Well, I’ve done the training and I’m qualified, so now clients will come to me.” As a result, my first year was very quiet. And it’s only in the last two years that it has really grown, and now I can choose the hours I want to work.’
Treat it like a business
Whether you have ended up in private practice by choice or by default, you can’t ignore the fact that you are running a business, and that is not for everybody. ‘Would-be private practitioners would do well to be realistic about their personal strengths and weaknesses,’ says Rye. ‘Apart from the professional difficulties of working with clients in an isolated context, there are the personal qualities that are needed to overcome other difficulties.’
‘This really is a business venture that you are embarking on, and you have to regard it as such,’ agrees Mervyn Wynne-Jones, Deputy Chair of BACP Private Practice. ‘There are expectations of you, not only from your clients and your professional body, but also from external bodies such as HMRC and the Information Commissioner’s Office.’ Rye recommends considering a business-skills course: ‘It was one of the best things I did when I was starting out.’
It undoubtedly pays to do your research, and make use of all available resources, before taking the leap into private practice. Flying solo is not for everyone, and it may take time to get it right, but when you do, it can offer what we all want from our working life – flexibility, autonomy and a sense of purpose.
Sally Brown is a counsellor and coach in private practice (therapythatworks.co.uk), a freelance journalist, and Executive Specialist for Communication for BACP Coaching.
Good Practice in Action. An ever-expanding library of free resources created by BACP for its members on all aspects of counselling, including confidentiality, record-keeping and contracting, and how to choose a supervisor.
BACP Private Practice. Membership includes the quarterly Private Practice journal and a UK-wide network of local groups.
Free article: Sally Brown explores the growing phenomenon of broadcast therapy. Therapy Today, February 2018
Putting gender on the agenda
Free article: At long last, the counselling professions are embracing gender diversity. Catherine Jackson reports. Therapy Today, December 2017
Burnout... the high cost of caring?
Free article: Burnout is an ever-present risk in the caring professions. Sally Brown talks to counsellors about their experiences, and how to avoid it. Therapy Today, November 2017