Anna's Playbook for Prepping Your Private Practice for Maternity Leave

Anna M. in white on a purple background with white text "Anna's Playbook for Prepping Your Private Practice for Maternity Leave"

There is a phone call that happens in a lot of private practices, and it almost always comes too late. A therapist calls us, or emails, or shows up in business school, and says some version of: I'm pregnant, now what do I need to know? And we have to gently tell them that some of the most important decisions were ones they could have made months ago, and a few of them may already be off the table.

Anna is here to help you not be that phone call.

Anna is a couples therapist, a Gottman clinician, and a longtime member of our community who has now built and rebuilt a private practice across three pregnancies. She is candid about all of it: the year she was a W-2 employee with state benefits, the pregnancy during which she started a practice with almost no idea how to structure it, and the current pregnancy, during which she has set up a business that, in her words, holds her. She is 27 weeks along as we record, planning her leave, and doing it on purpose this time.

Here is what we took away from her story and what it can teach any therapist who is planning to grow their family and their practice at the same time.

Lesson 1: The Decisions That Matter Most Happen Before You're Pregnant

The hardest thing about preparing a private practice for maternity leave is that the highest-leverage moves have deadlines you cannot see. Business structure is the big one. Whether you operate as a sole proprietor, an LLC, or a professional corporation with an S-corp designation changes what state benefits you can access when you go out on leave.

There is a common piece of advice that circulates in therapist circles: become a professional corporation, elect the S-corp designation, pay yourself as little as possible in your W-2, and save on taxes. It can be a smart move. But if you are planning to have a baby, the amount you pay yourself on that W-2 can quietly cost you when leave arrives, because some of those state benefits are calculated on what you actually paid in.

Anna's rule here is simple: get a solid tax professional involved early, and make the structure decision with enough runway that you qualify for what you'll need. There are timelines that require you to make changes before you are pregnant, not after.

The takeaway: The most important maternity-leave decisions are business-structure decisions, and several of them have to be made before you conceive. Talk to a tax pro who understands how structure interacts with state benefits, and do it early.

Transcript
Miranda Palmer, LMFT She/her (00:01) Hey everybody, welcome back to the starting a counseling practice success stories. We have the amazing Anna McDonald here today and we're gonna be diving into success while having babies in private practice, the good, the bad and the ugly. the how to do it wrong, how to do it right, to like all of these different pieces and how... Anna McDonald (00:17) Woohoo! Miranda Palmer, LMFT She/her (00:29) how much intentionality can and probably should go into your private practice. If you are planning to have babies, it's one of the things that often will come up people will come to us sort of after the fact or say, I'm pregnant. Now, what do I need to know? And we're like, actually, there was some decisions we should have made in advance and some of those decisions might be too late. So Anna's here to help inspire you with how well it could be done. Anna, say hello. Anna McDonald (01:05) Hello and inspire you on how it could not be done well because we have both. Hello, hello. Welcome for, or thank you for having me, Miranda. Yes. Miranda Palmer, LMFT She/her (01:09) you I'm so glad that we get to hang out today. So, so let's talk about babies in private practice. We're just going to dive in today because we only have so much time. Tell me about your baby making private practice journey. Where do we start in this process? Anna McDonald (01:18) Me too. Mm-hmm. Mm-hmm. I have learned that I have my biggest ideas right before or when I'm pregnant, which I wouldn't suggest. Maybe, I don't know. But I started my practice when I was pregnant with my second, or right before I was pregnant with my second, and then we were trying at that time. And that's when I came into ZiniMe in the first place in business school, and it was very, very helpful. But I was still very new and just didn't know what I didn't know. My first child, I was working at a different company. was a W-2 employee, very different. I'm in the state of California, so there are quite a few benefits as far as American maternity leave goes compared to other places. But with my second child, I didn't have my business set up in a way to set me up for success with pregnancy and mat leave and whatnot. Now with my third, I'm 27 weeks right now, it is a totally different landscape, totally different thing that I've been able to kind of set myself up for and building my business so that it can hold me and I don't have to freak out and be scared that I don't have a business when I come back from maternity leave and all the things. Yeah. Miranda Palmer, LMFT She/her (02:55) Yeah. Okay, so let's just line it out, at least for the state of California. What was it like to be pregnant as a W-2 employee? Anna McDonald (03:03) It was, well, fairly great, again. You get, at that time, you got four weeks prior to your due date. Potentially more if there are any complications. And then you could have, oh gosh, it's very nuanced. But I think you get six weeks pay at a lower, reduced rate, and then you could continue for a longer time at no pay, but have the job protection. So there was, There's things in place to support new parents. Again, I think it could be better, we're getting there. But there are things in place for job protection. There are things in place for some kind of supplement to the income while you're out. And taking that time beforehand, too, is really important as well, just as your body's in that final push before you start pushing. Yeah. Miranda Palmer, LMFT She/her (03:38) Yeah. Right? Okay, yeah, no, I ended up on bed rest right before, like the last several weeks, because I just had this giant child. So my body was like, absolutely not. Like, we're not doing this. Your blood pressure was gonna spike. Very frustrating, but it is what it is. So then you say like, okay, so now you're pregnant with your second child. no, like, Anna McDonald (04:09) Thank you. Yep. Yep. Mm-hmm. Now, probably maybe my third. Yeah. We'll back then. Miranda Palmer, LMFT She/her (04:28) But fast Anna McDonald (04:28) Yeah. Miranda Palmer, LMFT She/her (04:28) forward to you're pregnant with your second and suddenly becomes clear to you. It's time for you to go into private practice. Tell us a little bit more about that part in terms of the timing of that, how much you and your spouse had prepared for it. You know, like all the pieces. Anna McDonald (04:52) I think I talked about the first time I was on the Zitty Me stories, but you know, deep cut to whatever episode that was. I remember I was working at a group practice and it was fine, but there were things about the group where I was like, yeah, I think I don't love how this is being run and I think I can do it differently. And in a way that's more in alignment with my values as a clinician and just as a person, right? And so I actually reached out to another clinician via social media and just kind of asked, how'd you start your practice? Somebody like I really admired and they were very encouraging. And I was like, okay, I think I can do this. But my spouse was like, listen, I'll support you, but you need to know what you're doing here. So figure out some kind of... something and that's what led me to business school in the first place and it was really helpful like I said, but I wasn't Didn't understand Structuring how to structure your business And why you would structure in different ways like for a sole proprietor versus an S core versus whatever else there is, know So that I learned that you know, if you're having a having a kiddo Miranda Palmer, LMFT She/her (05:52) Yeah. Anna McDonald (06:07) Some of those structures you can access state benefits. Some of those structures you can't. Miranda Palmer, LMFT She/her (06:14) Well, and that space where people are like, it's so great. don't need I'm not paying into fill in the blank Well, if you're not paying into that you're not getting anything out of it. So like what does that look like and Sometimes even like one of the things that people often talk about is like, Become in California. It's a professional corporation on LLC become a professional corporation and then do the S corp designation Because then you're gonna save all this money on taxes. It's gonna be fantastic. So we're gonna make your Paycheck as little as possible so we can save on those taxes, but when you do that, it also has an impact on these kinds of state benefits. these are the things that if you are planning to have children, that those might be decisions about how much you pay yourself in your W-2 as a professional corporation with that S-Corp designation. That's like part of what you're referring to. Yeah. Anna McDonald (07:14) Absolutely, yes, absolutely. And I highly recommend getting a solid tax person to help you make those decisions and plan it out. Shout out to Alan Lau. He's amazing. Yes, but. okay. Yeah. Miranda Palmer, LMFT She/her (07:25) Yeah, send us a link afterwards and we'll do that because people are always asking me for like great accounting and tax professionals and like who's the best person. And it is it's hard and it changes. People will shift and leave and their businesses change and people end up overrun. They have too many clients and the services go down like so. Anna McDonald (07:44) Yeah. Yeah. Miranda Palmer, LMFT She/her (07:52) and can change over time. the second time you're like, the timing isn't great. But you're in this. If we're talking about it from like the woo perspective, you're in this creation energy. You're in this place of like complete clarity of like what you need to do as a family. You're in this place of nesting. How do I set up my life or my household to welcome this new human in here? Anna McDonald (08:07) Mm-hmm. Yeah. Mm-hmm. Miranda Palmer, LMFT She/her (08:18) you have so much more clarity with your second child of like, like in some ways, some ways you're like, you're better prepared. And in some ways, there's no way to prepare you for how one to two isn't one plus two. It's like one plus one equals three when you go from one to two and then two to three is fine is what we will share. It was oddly enough. you go through that process and then you now you set everything up between the second and the third one. And then what did you what were some of the things that you that you learned from the second thing and applied? So one of them was the tax strategy and like how to access benefits. Anna McDonald (09:03) Absolutely. In doing that, doing that, one, I consulted with our tax guy just to make sure it was the right decision for our business, just from a business perspective, right? And then two, doing it with enough amount of time for the, I think there's a timeline if I remember, that you need to do it before you are injured, right, or pregnant, or whatever, right? So doing that with enough time to set us up for success in that sense. Another thing I did that we had to pivot on, if you will, was thinking of ways to keep the clients to you know keep the business going keep the clients seen while I was out right so my plan at that time was to expand to having an associate on my caseload right all right not on my caseload on my practice my payroll and It didn't go as planned, right? So I had a huge learning curve in three months of, you know, hiring and also letting go of that associate and having to make that decision that this is not the right fit. It's not the right fit for the business. My plan was to be able to hand over quite a few of my clients while I was out. to that person and it just it wasn't the right fit wasn't the right thing. So we had to totally completely pivot the plan as far as the business goes. However, I will tell you I have so much more peace now than I did during those three months. Miranda Palmer, LMFT She/her (10:24) Thank Yeah. Anna McDonald (10:33) Because one I know how to run this thing. I've been doing it for a while now and two You know there are other ways that I can plan and have plan that interim care for the people who need it I have strong therapeutic relationships with my clients and the ones that want to continue the work when I come back They'll be there they were before they're gonna do it again, right? Miranda Palmer, LMFT She/her (10:37) Yeah. you Anna McDonald (10:55) And the people that need to finish up or transition, great. That is wonderful. That's our job, right, to do what they need, right, to support them in that. And there'll be more people when I come back. I know how to build it, you know? Yes, but the other thing too is is also like on a practical standpoint being really really aggressive about saving and being you know clear about okay. Yes, there's the personal saving but also saving for my business so I can keep things running I can pay a VA to run my social media and my blog posts and my emails and keep that warm while I'm out and not even think about it actually we're having a meeting I think next week and she's already got it planned out we're going to go through their approval. I'm going out in July and she's she's like okay we got a plan down we got that. Great I don't have to think about it it's taken care of. Also she's amazing I'm gonna put a shout out for her too Georgia from England she's a VA for therapist cannot recommend her enough. Amazing. Miranda Palmer, LMFT She/her (11:54) Fantastic. Just make sure that Georgia closes off before she gets too full because this is what happens here. People give shout outs here and then they're like, it was the worst thing I ever did. Don't do it Anna. No, I'm just kidding. But like, yes, there's a balance point for sure. So let's talk about that piece because I think this part of like planning and integrating in the savings because Anna McDonald (12:00) Yes, that's true. That's true, that's true. Yeah, yeah. For sure, for sure. Yeah. Miranda Palmer, LMFT She/her (12:25) One of the most common things I see with therapists and Facebook groups and even like ads to therapists where they're like, therapists, if you're not working, you're not making money. Do you understand? You know, this is why you need to build an online course or why you need to have a $10,000 program and high ticket programs for therapists. And I'm not saying those things are necessarily bad and they don't have their place. But this Anna McDonald (12:37) Maybe. Miranda Palmer, LMFT She/her (12:54) lie that's being told that says that because our business because we're service providers, it means we should never do one to one services or that we're doing something wrong. If we're doing one to one services that that's not a viable business model. Like I think that's the part that like really frustrates me. What we do have to do as a service provider is we have to look at the big picture. that includes things like vacation and sick time and working on the business and not in the business, maternity leave. And we need to work that into our pricing structure and our saving structure into our budget and understand that the money that's coming in that week or that month isn't just the money for your business for that week or that month. If you're doing it right, Anna McDonald (13:40) Yeah. Miranda Palmer, LMFT She/her (13:51) that money is now budgeted for the vacation, the sick time, the maternity leave, the whatever. We created a budget, we have a plan. Anna McDonald (14:04) Yes, yes. that plan, like being able to have a plan and then execute it, even if it's not at 100%, even if you're doing it 60%, like that brings so much more peace than just kind of winging it or hoping for the best, right? And it's such a, like, I think back to 2022, when I had my daughter, to now. I mean, and we actually took on a mortgage in the meantime too. We didn't have a mortgage back then. So now it's like, wow, there's a lot more financial stress than there was at that time, technically, but I don't feel it because I have a different plan and a different, I said earlier, like my business holds me, right? And I've been able to set it up in that way very much through the resources and tools with Zini, me and my coach, Jenny, you know, that's been so, so helpful. Miranda Palmer, LMFT She/her (14:53) no. Anna McDonald (14:58) Yeah. Miranda Palmer, LMFT She/her (14:59) I think this other piece to have really understanding even the way you're setting up your marketing, where you're like, hey, I need to have a marketing plan for my business. But I also need a marketing plan because I'm in a family expansion stage. I need a marketing plan that works, whether I'm available. So if I'm just doing person to person networking, and I'm out for three months, well, that's not going to work because that means that now I have a three month lag of relationship building and relationship building does take time. Often the things that we're doing right now are what grow our business three, four or five months from now. And so that ability to keep the marketing flowing, keep the social media flowing, make sure the SEO, your website still showing up on the first page of Google have somebody who Anna McDonald (15:31) Mm-hmm. Yep. Yeah. Miranda Palmer, LMFT She/her (15:54) have a process in place where people can connect with you while you're gone. And when you come back, all of those pieces. Anna McDonald (15:59) Yes. Yeah, it's huge. Well, and even that made me think too, like marketing now before I go out. So the plan is to go out at the beginning of July. I'm actually teetering now of like maybe the last week of June, but you know, that's... fit not a lot of time when you think about it, you know, and so I'm kind of like, well, what kind of clients do I market to now? What kind of services, right? And so even that like working with the VA and the VA, not the Veterans Affairs, my virtual assistant, just to be clear, George, you know, but working together and figuring out a different strategy for this season too of, hey, I'm doing short-term intensives, right? I'm doing wedding seasons coming up and I'm a Gottman therapist. We're doing premarital counseling. Miranda Palmer, LMFT She/her (16:29) Yes. Anna McDonald (16:45) Right, and we have some packages people can do and you know, whatever. So it's a total shift too in how I'm now as well and setting up for you know, short term work with that expectation. People know that. Marketing to those people who are looking for it. And then also, we built a relationship. So if they want anything long term when I come back, great. know? Let's go. Miranda Palmer, LMFT She/her (17:04) Thank Yes, I love that. And there's this like nice mix of I know that the work that I'm doing is impactful to the people that I'm working with. It really fits for where I'm at. Because I this is a common question that therapists like feel kind of stuck on when they're doing one to one is like, well, how long do I keep marketing? Or like, what do I say when somebody calls me to do that? Like, how when is it? Anna McDonald (17:17) Yes. Miranda Palmer, LMFT She/her (17:35) inappropriate for me not to like disclose my pregnancy on the phone, or like, when do I stop taking clients? And a lot of these, like the answer is like, it, it depends, right? It depends clinically. But when you're able to like really get into like, how do I specifically focus on what is clinically appropriate for me right now, to do the short term work that's completely doable? Anna McDonald (17:39) Mmm. It's done. Yep. Great. And in my condition, the pregnancy Miranda Palmer, LMFT She/her (18:04) In your condition, Anna. Anna McDonald (18:09) brain condition, my clients know they can't talk about food. That's one thing right now. Don't tell me about food. I can't do it. Weird Anna comes out. like, Miranda Palmer, LMFT She/her (18:14) that's hilarious. Anna McDonald (18:19) No, but it's so true and like that was something I had no concept of with my second child and starting a business and all those things and this time I mean every like social media are my blog posts, my SEO, like all of it is focused towards short-term solution focused or like brief and marriage intensives or whatever, right? You know, just to kind of shift and I've been getting more referrals than I have all year actually. So there's that which is wild, you know, so anyway. Miranda Palmer, LMFT She/her (18:48) Yeah. Anna McDonald (18:49) Anyway, yeah, just a total shift of how to approach continuing the business, but maybe just in a different lens than I would have had otherwise. Yeah. Miranda Palmer, LMFT She/her (18:58) Well, and I think here's the other part too, like there are a lot of people right now that are not scared because they're pregnant, they're scared because of AI, they're like, chat, is gonna become the new therapist, like all of these, oops. Anna McDonald (19:08) Mm. Okay. Miranda Palmer, LMFT She/her (19:16) all of these other aspects, but the reality is, right? The reality is that we're in this space of a lot of people actually just want really good quality care. They're becoming more particular, they're becoming more savvy. They're actually in some cases asking AI and saying, Hey, here's the struggle and I need help right away. Anna McDonald (19:30) Yes. Miranda Palmer, LMFT She/her (19:43) And AI is like, hey, there's a marriage intensive near you. Go and check out Anna MacDonald or what have you. Like, can set ourselves up to be the person that AI refers to. And AI, at least for right now, it doesn't have the ability to sit across from somebody. can't be an attunement. It can't help navigate you and your partner screaming at each other. I mean, that's not necessarily who you're trying to attract, but like, they can't really Anna McDonald (19:43) Mm-hmm. Mm-mm. Miranda Palmer, LMFT She/her (20:13) be in the space to be like, hey, no, hey, yes, hey, let's take turns. Like they can even navigate necessarily the difference between who's who, from the voices, right? Like they don't know. Anna McDonald (20:28) They don't know and they certainly only have an ethical guideline that's programmed into them. But as we know, the like the variables that come up with ethics and therapy and couples therapy and all the things like there's there's all the nuances there to the nuances of tone and communication and nonverbal body language, all those things like AI is brilliant. It's amazing. But it doesn't know those things still. Right. And our intuition as clinicians and people and relational beings. Yeah, absolutely. Miranda Palmer, LMFT She/her (20:53) No, no. What's been your favorite part about doing more intensive short-term work? Anna McDonald (21:09) That's a good question. What has been my favorite part? I kind of I love solution-focused stuff. Like my background is in social work, right? So I'm like, great, let's talk about it. Also, what are we doing about it? Right? And so I love that that's very much a primary focus and people do see results, right? It's like, hey, we're gonna commit to this amount of time. We're gonna show up as much as we can, the best version of ourself and we're gonna do the things. And then they... for the most part, do the things and see the changes. And so I love that kind of piece of the short-term work is that really quick kind of solution focus, let's figure it out. And I'm here if you need me in the future, but right now let's just knock it out. Yeah. Miranda Palmer, LMFT She/her (21:50) Yeah. You know, and what's interesting about this too, is the amount of therapists that I work with, they basically say the same thing, and that this is why they're going to get a coaching certification and become a coach instead of a therapist. And I'm always like trying to like lovingly say, you know, you can absolutely do all of that. But you don't have to do that to do this. If that's the kind of work you want to do, you can do that as a therapist, you could do that with privilege. Like, you could do that with like legal protections, you could do that without building a whole nother website, and having a whole different business that you have to like logistically have maybe even a different liability insurance and like, you don't have to retool to do that you could just do it. Anna McDonald (22:44) Who could just do that? And I think a lot of people and I say this because that is a little bit more of my approach just in general, right? The people I work with are looking for that already. They're not this is not for everybody, right? But the people that are attracted to me generally are looking for. I do want to talk about it. I do want to process. Also, I need to see changes in my life like real changes, you know, and so they're very much on board with that kind of mixture, that component of doing not just talking. right? Both and, yes. Miranda Palmer, LMFT She/her (23:16) Yeah, both and. Yeah, like coaches cannot be therapists, but therapists can be coaches. Like we can be very, like we can be as directive as makes sense clinically. Like we can do all of those things. So I think that's just magic. Yeah. Okay. What are you, now we touch on this briefly, but I want to come back to it just for a second about Anna McDonald (23:22) No. Yes. Yes. Yes, yes, absolutely. Yeah. Miranda Palmer, LMFT She/her (23:46) this this part of you where you're like my gosh i'm gonna do group practice because that's what everybody says is like my gosh group practice this will be did the thing it'll hit all these boxes whoa i did it for three months and i realized it was not the thing for anybody out there who is trying to just make the decision between group practices and doing like more intensive work or these kinds of other aspects, just budgeting better or doing those different pieces. Can you do a quick run through of why somebody might decide that like you, they're like, I actually don't wanna be a group practice owner right now. What would be like the top five reasons that you give somebody to say, don't do it, just do intensives. There's other fun ways that you can make the money. Anna McDonald (24:38) The first thing I the number one thing I would say to maybe not step into that space is Do you have the right people on your team number one thing? Do you have the right people? If you do not have the right people on your team, it's gonna be rough. It's gonna be rough. And so that's the first thing is, you know, not just hiring because you want a group, but hiring because you want a group and you have the right people to come into your group practice, right? And I mean, Miranda Palmer, LMFT She/her (25:13) Yes. Yeah, you can't rush it. Anna McDonald (25:16) No, and I will be honest, I did. I sure did. And you know, you don't know what you don't know and learned a lot, right? And I do still want to group, but working with my coach, I've decided, you know, I think that's a 2027 thing. And we're going to kind of go back to the mat this year and keep building that foundation and building again, the relationships that can lead to hiring the right people instead of just kind of shooting in the dark and thinking we got it and you know, whatever, right? So I think that would be the first thing I would say is you know have the right people and then to make sure you have the right infrastructure make sure you've got that set up and By infrastructure. I don't just mean for our business schoolers out there Not just the business plan that is that is you're gonna be living off of that by the way This is plan whatever tab that was I was like I am constantly on this but Miranda Palmer, LMFT She/her (26:05) Yeah. Yeah. Anna McDonald (26:11) the policies and procedures, how you train, right? What are you using for HR, right? Do you have the right supports for marketing? Do you have the right supports for taxes? Do you have the infrastructure in a place where you are ready to bring on somebody else as well, right? And again, you don't know what you don't know, right? But like. That's a big piece of this too, is making sure you're setting up again, you're setting up this business to hold you and your employee and not you holding it all together, right? Miranda Palmer, LMFT She/her (26:45) Yeah, the amount of times that somebody will come into business school because they want to move from solo to group practice. And we say, okay, awesome. But like, let's shore up the solo practice first. And really make sure you've done all the tabs and you've looked at all the pieces and you've written down all of the things and like, this is like really solid. And then know that even when you do that, Anna McDonald (26:53) Mm-hmm. Yes. Miranda Palmer, LMFT She/her (27:14) And A, you're going to be happier, you're going to make more money, you're going to work less if you do those things for your solo practice. There is going to be a learning curve. There is leadership involved. There's a lot more time than just going, let me hire this person. I'm going to add them to the about page of my website and like they'll start coming in and I'll figure the rest out. It'll be fine. Anna McDonald (27:39) I beg you, don't do that. Save yourself. Yes. Miranda Palmer, LMFT She/her (27:45) Yeah, like the, I've talked to people out here, they're just like, what? You know, you just, you just build, build the boat while you're, while you're sailing it. And I'm like, please don't. Please don't do that. It's so silly. Anna McDonald (27:55) You can. I don't know if you're gonna get very far. You see. You might see. And it's one of those things too where like, think I did a decent job building the boat before I got on, but I needed a bigger and stronger boat. I had a rowboat and I, again, I just didn't know I needed a yacht. No, I'm just kidding. I can't think of any other kind of boats. Miranda Palmer, LMFT She/her (28:07) You said yes. Yeah. Well, and you had, you know, when we don't hire the right person, it stress tests the boat, right? If you hire, and I'm not saying this is your person, but if like you bring somebody onto your boat, and it's an inflatable and they're wearing cleats with knives on them, you know, like that's not, that's a different thing than if you bring someone in that's like, hey, they're moving forward. And this is Anna McDonald (28:26) yeah. Miranda Palmer, LMFT She/her (28:45) Something I was just chatting with someone the other day who called to like interview for business school. And they're like, well, I'm trying to decide between bringing on associates or less trained people versus licensed people and like what makes the most sense for the profit margins and whatever, but they were super overworking. Like they had this crazy schedule of clients. And I was like, you're too busy. Anna McDonald (29:01) Thank Miranda Palmer, LMFT She/her (29:12) to have someone that you're training right now. Like the profit margins might not be as good, but you're gonna need to start with somebody who's super solid to get some space. And then over time, maybe as we've created some space, you could bring in and have some kind of training program. Maybe even these other people are the supervisors or the trainers for those less experienced therapists. But we have different... Anna McDonald (29:15) Yep. Yes. Yes. Miranda Palmer, LMFT She/her (29:40) different scenarios and it is so easy in this private practice journey when we have timelines like 30 weeks or 40 weeks to try to like, know, we'll just do the boat and sometimes it works and sometimes it doesn't. Anna McDonald (29:57) Sometimes, you know, like you said, you might have a great life raft and you might have all the things, but if they're walking around in cleats, it's not going to work. Miranda Palmer, LMFT She/her (30:05) It's not gonna work. Anna McDonald (30:05) It's not going to work. You can write all the emails, you can write all the policies, you can do all the things. But if you're in different worlds, it's just, it's not going to work, you know? that's that. And I think that was like a huge thing for me to this past year of going through this process of like hiring and letting go. Um, and the whole circle of like learning, losing trusted within myself, my own judgment, and then learning how to kind of step back into that too. Right? Because this, I'm going to be honest, my business feels like my fourth baby if I'm being, maybe my first, you know, like, just kidding children. But it's such a special thing that you build and it is such, especially in this field, it is such a representation of you as well. And, you know, bringing somebody into that is very vulnerable. And when it doesn't work out, wow. Miranda Palmer, LMFT She/her (30:41) Yeah. Hahaha! Anna McDonald (31:03) That's a hit. That's a big hit. And it's a big hit too, or a big job, would say, maybe to kind of rebuild that trust in your own self and your own judgment and your own insight. And, and, and yeah. Miranda Palmer, LMFT She/her (31:15) And, you know, and I just want to say, like, some like, for all of us, I don't think there's anyone I've ever met that they don't have this moment at some point in their private practice journey. So like, you don't, this is also a great example, you don't have to be perfect to be successful. And sometimes those things that seem like the craziest moments of like, I really messed this up can Anna McDonald (31:31) Yeah. Miranda Palmer, LMFT She/her (31:40) Like the rebuilding from that is where like the clarity and the magic starts to come in. And so like, can we give ourselves like more grace to try something on for size or to do something imperfectly, to learn from it, and then to come in stronger for the next thing, as opposed to seeing that misstep or that if we believe in mistakes, that mistake. Anna McDonald (31:46) Mm-hmm. Yeah. Yeah. Miranda Palmer, LMFT She/her (32:07) is somehow saying that we do everything wrong versus like no this was like a refocus and saying no here's the timeline or here's the focus right now. I love this! love this! Thank you so much for coming in. I know we're running out of time but... Anna McDonald (32:19) Yeah, yeah. Thank you. Thank you for having me, Miranda. I feel like we could talk all day. So, yeah. Miranda Palmer, LMFT She/her (32:30) For sure, for sure. Do you want to share your website and where you're located? So if anybody wants to pop in before or after your next baby for a marriage intensive or they have someone here for over birth and birth and birth birth Anna McDonald (32:36) Yeah. Yes. Hey, absolutely. Yeah, my website is thrive therapy and couples counseling.com. Where for the wise, maybe maybe maybe make it shorter when you're starting just to head up. Live and learn. It's a long. I'm just saying it's a long one. Thrive therapy and couples counseling.com. TTCC.com might have been better. I don't know. It's fine. Okay, so that's my website. And then wait, what was your second question? Where am I looking? Miranda Palmer, LMFT She/her (32:54) That's a long one. PAY you And you're in California! Anna McDonald (33:16) Yes, yes, I'm physically located in the city of Lakewood, which is like a suburb of Long Beach. I do see flights in person out here, but I'm also licensed in both Florida and California, soon to be Pennsylvania too, randomly. But here we are. I know it's fine. You know. Miranda Palmer, LMFT She/her (33:35) Listen, here's my little soapbox moment for our thing, I'm sure it does not apply to you, Anna. But y'all, when you're getting licensed in all the states, we're just giving more money to this government, and we're putting ourselves under more obligation to learn more laws and more ethical code, more CE's and more things that can be, we're getting different information from each. Anna McDonald (33:44) You gotta keep them up. Mmm. That is fair. Miranda Palmer, LMFT She/her (34:02) scenario and as we have states that are intervening in different ways in terms of what we can legally do with our clients, this issue is going to get more complex. So can we be very, very intentional about where we're putting our money and our time? And do we want to put it into bureaucracy? That's just my little soapbox for the moment regarding multiple state licensures. Anna McDonald (34:02) Yeah. I don't disagree. There's a lot of good things to say there. listen. I don't disagree. There's a lot. If you're going to look at licensure in other states, really look at it. Yes. Yeah. Miranda Palmer, LMFT She/her (34:41) There's a lot, there's a lot, but... Alright y'all, until next time.

Lesson 2: One to Two Is Not One Plus One

There is a version of maternity-leave planning that assumes you get better at this each time, in a clean, linear way. Anna's honest account is more interesting than that. Her first child came while she was a W-2 employee in California, with real, if imperfect, protections: time before the due date, reduced-rate pay for a stretch, and job protection after. Her second came right as she was starting her practice, before she understood structure, benefits, or how to build a business that could survive her absence. Her third is the first one she has actually been able to plan around.

Going from one kid to two is not one plus two. It is closer to one plus one equals three. The systems that held you before stop holding you, and you are rebuilding while sleep-deprived. Anna is clear that she did some things poorly along the way, and that the doing-it-poorly is where a lot of the learning lived.

The takeaway: You do not have to run a perfect leave to run a successful one. Expect the ground to shift each time, plan for the version of yourself who is exhausted, and give yourself grace for the parts you get wrong.

Lesson 3: Save for the Business, Not Just for Yourself

Most therapists know to save personally before a leave. Fewer therapists plan for the business to keep breathing while they're gone. Anna's peace this time around came, in large part, from being aggressive about both: personal savings, yes, but also a dedicated cushion so the practice can keep running without her in the chair.

That business savings is what pays for the practice to stay warm. It covers a VA to keep the social media, the blog, and the emails going. It covers the infrastructure that keeps referrals flowing while the founder is offline. Anna took on a mortgage between her second and third pregnancies, so on paper, there is more financial pressure now than before, and yet she feels less of it because the plan is real and the business is funded to hold her.

This connects to something we push back on constantly. There is a loud message aimed at therapists that says if you're not working, you're not making money, so you'd better build the online course or the high-ticket program, because one-to-one work is a broken business model. We don't think those offers are inherently bad. But the lie underneath the pitch is that service providers can't run a viable, sustainable business. You can. What you have to do is price and budget for the whole picture: vacation, sick time, working on the business instead of in it, and yes, maternity leave. The money that comes in this month is not just this month's money. If you're doing it right, some of it is already budgeted for the months you'll be out.

The takeaway: Build a business savings cushion, not just a personal one, and price your services to fund the time you won't be working. One-to-one practice is a real business model when you budget for the full picture, leave included.

Lesson 4: Keep the Marketing Warm, Because Referrals Run on a Delay

Marketing has a lag built into it. The relationships and content you invest in now are often what grow your practice three, four, or five months from now. That delay is exactly why a leave can quietly gut a practice: if your entire marketing engine is in-person networking and you disappear for three months, you come back to a three-month hole in your referral pipeline, and relationship-building takes time to restart.

Anna's fix is to keep the practice visible while she's out. Her VA keeps the social media, blog posts, and emails flowing and keeps the SEO and website working, so the practice keeps showing up in search. (Her VA already has the leave plan mapped out; Anna doesn't have to think about it.) There's also a system for how prospective clients can connect with the practice while she's gone, so the door is never fully closed.

She has also shifted what she markets for this season. Rather than pretend nothing is changing, she is leaning into short-term work that fits a clinician about to go on leave: brief, solution-focused intensives, premarital counseling heading into wedding season, Gottman packages. People know it's short-term going in, the work is genuinely useful, and the relationship is built, so when she returns, anyone who wants longer-term work already knows and trusts her. She's been getting more referrals than she has all year.

The takeaway: A practice that only markets through the founder's live presence can't survive the founder stepping away. Keep the marketing and SEO running while you're out, and consider reshaping your offers toward short-term work that fits the season you're actually in.

Lesson 5: You Don't Have to Become a Coach to Do This Work

Here's a pattern we see constantly. A therapist realizes they love brief, solution-focused, results-oriented work, and concludes that the way to do that is to leave clinical practice and get a coaching certification. We say this lovingly every time: you can absolutely do that if you want to, but you do not have to leave therapy to work this way.

You can do directive, solution-focused, outcome-driven work as a therapist, with clinical privilege, with legal protections, and without building a whole second website, a separate business, and possibly a different liability structure. Coaches cannot be therapists, but therapists can be coaches. You can be as directive as makes clinical sense. Anna's short-term intensive model is a therapy model. The clients drawn to her already want that blend: they want to process, and they want real change in their lives, and they're on board with doing the work, not just talking about it.

The takeaway: If you love brief, directive, results-focused work, you can build it inside your therapy practice. You don't have to retool into a coach to do the kind of work that lights you up.

Lesson 6: Don't Build the Boat While You're Sailing It

Anna's plan for her leave originally hinged on expanding into a small group practice: bring on an associate, hand off part of her caseload, keep clients seen while she was out. It didn't go as planned. Within three months, she had hired and then let go of that associate, having to make the hard call that it wasn't the right fit. The plan to hand off her clients collapsed, and she had to pivot the whole thing.

What she learned is worth more than the plan that failed. Her number one piece of advice for anyone weighing a jump to group practice: Do you have the right people? Not are you ready for a group in the abstract, but do you actually have the right humans to bring into it? If you don't, it will be rough, and no amount of good policies, clean onboarding emails, or solid infrastructure will save a placement that was never a fit. You can build a decent boat and still sink it by bringing someone aboard in cleats.

This is why, when someone joins business school wanting to move from solo to group, we so often say: let's shore up the solo practice first. Do all the tabs. Write down all the pieces. Get it genuinely solid. Because even when you do, there's a leadership learning curve that "just hire someone and add them to the about page" completely ignores. A too-busy solo clinician drowning in clients usually needs to start with someone very experienced to buy back space, not a trainee who needs a training program the founder has no time to run. Anna has decided her group is a 2027 thing, and she's spending this year building the foundation and the relationships that lead to hiring the right people instead of shooting in the dark.

And when a hire doesn't work out, there's a quieter cost most people don't warn you about: rebuilding trust in your own judgment. For a lot of us, the practice feels like another child; bringing someone into it is vulnerable, and when it doesn't work, the hit isn't only financial. Learning to trust your own read again is part of the work. It's also survivable, and it usually makes the next decision sharper.

The takeaway: Before you grow into a group, make sure you have the right people and a solid solo foundation. Growing on a pregnancy timeline pressures you to rush the exact decision you most need to get right. It's okay to move the timeline.

Bonus Lesson: Be Intentional About Multi-State Licensure

This one is a bit of a soapbox, and it came up at the very end of the conversation, but it's worth its own beat. There's a growing pull toward getting licensed in more and more states, and it's easy to treat that as an unqualified good. It isn't always. Every additional state license means more money into bureaucracy, more laws and ethical codes to learn, more CEs to maintain, and different, sometimes conflicting, information to track from each jurisdiction. As states increasingly intervene in different ways around what we can legally do with clients, that complexity is only going to grow.

None of this means multi-state licensure is wrong; for some clinicians, it's exactly right. It means the decision deserves real scrutiny rather than momentum. Before you add a state, look hard at what it actually costs you in money, time, and administrative load, and whether that's where you want those resources going.

The takeaway: If you're considering licensure in additional states, be deliberate about it. Weigh the ongoing cost and complexity against the real benefit, and choose on purpose rather than by default.

Your Next Step: Plan the Leave Before You're 30 Weeks

In Anna's story is not a story about doing everything right. It's a story about paying attention, structuring early, funding the business and not just the household, keeping the practice visible while she's away, and being willing to move a timeline when the people weren't right yet. The peace she has this time didn't come from luck. It came from decisions, some of them made months before they mattered.

If you are planning to grow your family and your practice at the same time, the worst position to be in is the after-the-fact phone call. The best position is the one Anna is in now: a business built to hold you, a plan you can execute even at 60%, and the freedom to come back on your own terms.

You don't need a perfect plan. You need to start making the decisions that have deadlines you can't see.

For more support, resources, and real talk about building a sustainable private practice, head to zynnyme.com or listen to more episodes of Starting a Counseling Practice Success Stories.

Ready to Build a Practice That Actually Works for Your Life?

Whether you're brand new to private practice or already running a group and hitting your next wall, take what resonated from this conversation, come back to it when you need it, and remember that every practice that exists today was once just an idea someone wasn't sure they could pull off.

You don't have to have it all figured out. You just have to take the next right step.

For more support, resources, and real talk about building a sustainable private practice, head to zynnyme.com or listen to more episodes of Starting a Counseling Practice Success Stories.

Key Takeaways for Therapists Planning Maternity Leave

  • The highest-leverage maternity-leave decisions are business-structure decisions, and several have to happen before you're pregnant. Get a tax pro involved early.

  • Going from one kid to two isn't one plus two. Expect the ground to shift, and plan for your exhausted self.

  • Save for the business, not just for yourself. A funded practice is what stays warm while you're gone.

  • Marketing runs on a delay. Keep it and your SEO running through your leave so you don't come back to an empty pipeline.

  • You don't have to become a coach to do brief, directive, solution-focused work. You can build it inside your therapy practice.

  • Before you grow into a group, make sure you have the right people and a solid solo foundation. It's okay to move the timeline.

  • Be intentional about multi-state licensure. Weigh the ongoing cost and complexity, and choose on purpose.

  • You don't have to run a perfect practice to run a successful one.

Resources:

Miranda Palmer
I have successfully built a cash pay psychotherapy practice from scratch on a shoestring budget. I have also failed a licensed exam by 1 point (only to have the licensing board send me a later months later saying I passed), started an online study group to ease my own isolation and have now reached thousands of therapists across the country, helped other therapists market their psychotherapy practices, and helped awesome business owners move from close to closing their doors, to being profitable in less than 6 weeks. I've failed at launching online programs. I've had wild success at launching online programs. I've made mistakes in private practice I've taught others how to avoid my mistakes. You can do this. You were called to this work. Now- go do it! Find some help or inspiration as you need it- but do the work!
http:://www.zynnyme.com
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