Whether you’re a seasoned clinician transitioning into private practice for the first time or a newly licensed therapist striking on your own, your primary goal is likely to fill your caseload quickly.

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If you don’t attract and retain clients, then your practice won’t survive, you won’t be able to pay bills, and you won’t be able maintain your lifestyle. It can feel intimidating, yet for many clinicians, private practice is still a risk worth taking. 

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I’ve coached dozens of therapists on marketing their practice and there’s no one way to fill your caseload. With that said, there are factors that influence the time it takes to fill your caseload, including whether or not you take insurance, your location, your niche, and your budget.

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For example, some therapists fill up immediately if they have an established referral network. But it can take longer for other therapists who don’t have that luxury.

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Michael Fulwiler from Heard recently polled his audience on Twitter/X and 61.4% of therapists said it took six months or longer to fill their practice, while 20.5% said it took less than three months. So it really just depends. 

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Let’s take a closer look at the factors that impact how long it takes to fill your therapy practice.

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Insurance vs. private pay

One of the biggest factors that impacts how long it takes to fill your private practice is whether you accept insurance or not. 

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Being paneled with insurance companies can help you fill your caseload quickly, but it does take time to process claims unless you outsource your billing to a third-party company, which is an added expense. In addition, by relying on insurance companies for clients, you have less control over your rates. Despite that, many therapists begin their practice by accepting insurance clients and slowly transition to the private pay model. 

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If this strategy seems safer to you as you’re starting out, then you can gradually transition from insurance to private pay later on. But if you’d rather establish your business as a private pay practice from the get-go, then you’ll need to invest more in marketing your services. 

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To set realistic expectations of the marketing efforts needed to attract private pay clients, you’ll need to look at the three main resources we all have at our disposal.

• Time: How much time do you have to dedicate to marketing efforts that include outreach and networking, building your online presence, and consistently promoting your services online and offline?
• Money: Do you have a budget that you can dedicate to hiring help with marketing and investing in advertising? More on that below.
• Energy: Do you have the support and the energy to dedicate time and money to promoting your practice and working with clients?
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Taking the time to assess your current situation will help you choose the best path and business model for your practice.

Easing vs. jumping in

Despite the common fears about going “all in” with private practice, it doesn’t need to be so. Many of my clients have slowly started building their caseload while they still worked for somebody else and had a predictable income.

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Having a job as your safety net while you’re building your caseload adds the benefit of having the time to think about the type of work you would like to do as a solo practitioner and the type of clients you want to serve. In addition, you’ll have the opportunity to dedicate the time necessary to build your network and online presence. 

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Many therapists who leave their jobs to venture on their own without this preliminary work don’t have this luxury of time. On the other hand, the urgency they feel to get clients in the door can help them build up their caseload faster. 

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If you choose to transition slowly while you’re still working for an agency or group practice, make sure to establish specific deadlines for yourself. Choose a friend or hire a coach to keep you accountable and moving forward. Otherwise, it will be easy to remain inactive and get stuck.

Professional network

According to bestselling author Tim Sanders, “your network is your net worth.”

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There’s a strong referral culture in the mental health industry. Many therapists have built their caseloads with just one or two referral sources. Personally, I consider this method a little risky and always recommend a multi-channel marketing approach to my clients. 

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Despite that, building and leveraging your network is a solid marketing strategy for building your caseload with one caveat. You need to be clear on who you want to attract as your clients. In other words, you’ll need to spend time thinking about your niche. 

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By picking your niche you’ll be able to:

• Communicate clearly who you help and how you help them
• Build a strong reputation (brand) in a specific field
• Create a strong marketing message to share online

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We typically think of our professional network as our colleagues only, but that’s a limited way to view its full potential. Your network can include the people in your life like your friends and family, colleagues, supervisors, former classmates, people you meet at events, online communities, medical providers, your local community, and businesses in your area. 

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All these people could be potential referral sources if they know who you are, who you work with, and how you can help your clients. If you’re not getting referrals, then it may be worth re-evaluating your niche. 

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Marketing budget

Having a budget to invest in advertising and promotion can speed up your growth significantly. In fact, the fastest way to attract clients is through paid advertising, but it’s also the quickest way to lose money. If you want to invest in paid ads, you‘ll need to make sure that you can capture the leads (people who respond to your ads by clicking on a link or calling). 

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Having a website where people can schedule the first call with you and a system that allows you to respond to new inquiries ASAP is crucial. Additionally, you will need to have a strong message to attract the type of people that you want to work with in the first place. For that, you’ll need to understand who your ideal client is and what message they are most likely to respond to. 

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But paid ads are not the only way to attract clients. If you find that you have more time and energy to dedicate to marketing you can use other, more cost-effective marketing channels:

• Hosting and attending events geared towards your niche and ideal clients
• Collaborating with other businesses in your area for cross-promotions and referrals
• Using content marketing to improve your SEO and build up an audience on social media
• Appearing as a guest on podcasts or writing for publications
• Using media and PR to create awareness in your city or state
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All of these methods will require some investment of time and money but you don’t have to use them all at once. You can take time to test different strategies to see what fits your personality and situation best. 

Every therapy practice looks different

As you may already see, filling your caseload is not a linear process. It depends on your drive, resources, and the business model you choose for your practice.

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Therapy is a high-touch and personalized service. Similarly, your private practice is an individualized business that requires a personalized approach to growth and success. Basing your business growth on your colleagues’ success stories can be counterproductive because of the variables I mentioned above. 

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That’s why falling for promises to fill your caseload within a specific number of weeks or months can result in frustration and waste of your resources. I recommend developing your own strategy and plan using your resources and tactics. 

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And while some of the methods I outlined may sound intimidating at first, but if you’re diligent about planning and learning about the process, your schedule will fill up faster than you think. 

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After all, people need your help and services!

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This post is to be used for informational purposes only and does not constitute legal, business, or tax advice. Each person should consult their own attorney, business advisor, or tax advisor with respect to matters referenced in this post.

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Avivit Fisher is the founder of REdD Strategy, a consultancy specializing in equipping therapists in private practice with targeted marketing strategies. Avivit empowers practitioners through strategic planning, meticulous process optimization, and effective marketing tactics aimed at attracting clients. She holds a degree in Design Management with a focus on business sustainability and entrepreneurship.

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Avivit has developed numerous marketing resources for therapists. You can download her free comprehensive guide for starting and growing a private practice. 

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