Carving a Unique Path: Moderation-Focused Counseling with Merrilee
Let’s be honest, when you picture the ideal private practice, do you envision an orderly waiting room, a calendar booked with eager clients, and a clinician (that’s you!) whose life is finally, finally on their own terms? Maybe you also imagine being so joyfully busy that the paperwork practically files itself (if only). Or maybe, if you’re anything like most therapists, there’s at least a tiny voice whispering: ‘What if I want to do things… differently?’
Well, friends, you’ve found your people. In our latest episode, we sat down with Merrilee, LMFT, a Los Angeles therapist who did exactly that. Merrilee built her private practice around a niche that bucks convention and, spoiler alert, she loves it.
Her story is chock-full of grit, good humor, and real-world tips for launching (or relaunching) a practice that actually fits you. Ready to redefine what’s possible? Let’s dig in!
The Gradual (and Then Sudden) Leap
If you think that therapists leap gracefully into full-time private practice with absolute certainty and spreadsheets in hand, think again. Merrilee’s journey was a “gradual, and then all of a sudden” transition (her words, not ours—see [00:01:23] in the transcript!). Like many, she started out working full-time in treatment facilities, slowly adding private clients on the side.
Picture this: Four days a week at the treatment center, two days seeing her private clients (yes, six-day workweeks, ouch), all while dreaming of the elusive full-time private practice life. Things sped up when the universe (and her employer) threw her a curveball: her facility announced a sudden closure.
What came next was part hustle, part discovery. She sublet a tiny space, brought over her clients, and suddenly found herself not only with more autonomy, but “making a lot more money because nobody was taking a percentage of my clients anymore.” The moment she crunches the numbers and realizes she’s been shelling out $900/month just to use someone else’s office? That’s the sound of entrepreneurial awareness hitting at full volume.
Takeaway: Starting and growing your practice doesn’t usually happen all at once; it builds slowly, and then sometimes (thanks to life’s chaos) happens all at once. Subletting can be an ideal start, letting you dip your toe in the private practice pool while keeping costs (and nerves) manageable.
Lesson One: Find the Need by Meeting Your Own
A recurring theme in therapists’ stories is that the best niche is the one you needed yourself. As Merrilee puts it, “the best business plans address your own unmet needs.” For her, that was all about helping clients change their relationship with alcohol, without the tail-end requirement of total abstinence or 12-step identity.
“I knew that the clients were out there, but figuring out how to connect with them was a challenge,” Merrilee admits. Her early years in abstinence-based facilities left her passionate about serving people in the ‘in-between’, those for whom total abstinence didn’t resonate, but who were struggling all the same.
It’s okay if your niche is something you wish you’d had as a client. That’s not a failing; it’s a compass.
When You Blaze a Trail, Expect Some Weird Looks
Here’s where Merrilee got real. Seasoned therapists told her a moderation-based alcohol treatment approach ‘would never work’ and clients weren’t out there. Did that stop her? Nope. It made her dig in deeper.
She shares this gem: “If you have an idea and you tell someone about it and they look at you like you’re crazy, or they say, ‘oh, well, that will never work because of this and this and this,’ you’re probably on the right path because that means not everybody is doing it. And that’s going to set you apart.”
Takeaway: Don’t be afraid to be the seemingly weird one. The niches that help you stand out are rarely mainstream, at least at first.
Lesson Two: Resources Aren’t Always Local (But They’re Out There!)
Merrilee had to look beyond her local training scene (hello, 12-step city) for mentors and resources. She turned to books like Perspectives on Addiction by Margaret Fetting, Harm Reduction Psychotherapy by Andrew Tatarsky, and online trainings by experts like Gabor Maté.
“I just kind of relied very much on these people who were the goats, right? But they’re not in Los Angeles… But after Covid, everything becoming more digital, you know, it’s like you can do… there’s so many more online trainings and ways to get to interact.”
Tip for therapists: Don’t limit yourself to what you find at your local association or through grad school connections. The best inspiration and mentorship might be a webinar or a book away.
Lesson Three: Referrals Come in Many Forms (and Sometimes, It’s Luck)
How did Merrilee build her caseload? She freely admits: “In the beginning, it was luck.”
Some clients came from old roles, some found her through Psychology Today or her website. The biggest bump, though, came from joining directories like Moderation Management, which didn’t seem to pay off at first, only to suddenly deliver “five brand new clients right at the beginning of 2020.”
Kelly pipes in: “Sometimes people are just lucky,” and Merrilee agrees: “I do like to think sometimes it’s faded… when we end up with that client, that we’re the perfect therapist for them and they’re the perfect client for us… there was some sort of… more than luck.”
But Merrilee also spreads her risk by not relying solely on Psychology Today or any one source, a crucial lesson as more and more big companies flood the directories, shifting the digital marketing landscape.
Takeaway: The right clients will come from a mix of sources, don’t put your eggs in one basket, and trust that timing, culture shifts, and a little bit of serendipity all play a role.
Lesson Four: Your Niche Might Take Time to Catch On
Did Merrilee’s unique approach catch fire right away? Nope. For a while, those moderation-minded clients just weren’t searching, or, perhaps, weren’t ready to work in this new way.
Then came 2020: the year that ‘sober curious’ became a household phrase and suddenly, “all of a sudden I got five brand new clients.” Sometimes, you just need to be in the right place when the cultural moment shifts.
Practical Tip: If your practice website or directory listing isn’t bringing in a tidal wave of niche clients today, don’t panic. Sometimes, you’re simply a bit ahead of the curve. Stay visible, keep contributing, and be ready for your moment.
Lesson Five: Referrals From Happy Clients Are Everything
New clients find Merrilee through directories, but “most of my referrals come from current or former clients.” There’s no substitute for word of mouth, especially when your niche is unique.
“As your clients get good outcomes, they refer to you. People are like, ‘hey, who are you seeing? I noticed a difference in your life.’ And it all kind of comes back because you’re staying true to yourself and doing the kind of work that you love, which is beautiful.”
When you serve people you’re genuinely aligned with, they’ll do much of your marketing organically.
Lesson Six: The Importance of Staying True to Yourself
By now, supporting clients in moderation is what Merrilee does “all day. It just seems very natural to me now.”
And that, friends, is the dream. Choose a niche that’s so right for you, it feels effortless, even if it took a little (or a lot) of resistance from the status quo to get here.
Lesson Seven: Give Yourself Permission to Be Weird
As Kelly reminds us, “We encourage you. Be weird, do the strange thing. As long as it is aligned and it is true to you, that’s what matters, because that’s what’s going to give you sustainability in this work.”
If you just follow the path everyone else is following, burnout is lurking around every corner. If you craft a practice that feeds your curiosity, honors your lived experience, and lets you serve your people, well, that’s the secret fuel for longevity.
A Quick Recap: How You Can Build a Practice as Bold as Merrilee’s
Transition Gradually (or Just Jump!): Subletting is a low-risk, low-cost way to start out. Don’t be afraid to edge your way into private practice.
Let Your Needs Guide You: “The best business plans address your own unmet needs.”
Don’t Fear the Weird: The looks you get when your niche is unconventional? Take that as a promising sign!
Find Your People Even if They’re Not Local: There’s gold in books, online trainings, and distant mentors.
Referrals Are Magic: Happy clients, and, yes, some luck, are still the best marketing.
Adapt as Culture Shifts: ‘Sober curious’ might be mainstream now, but it wasn’t a few years ago. Stay ready for your cultural moment.
Keep It Aligned: If it feels right, it is right, at least for your practice.
Ready to Make Your Private Practice as Unique As You Are?
Whether you’re thinking about subletting your first office or searching for the courage to create a totally offbeat niche, know this: the private practice world is big enough for all of us, especially the weird, the bold, and the passionate.
Want to learn more about Merrilee’s moderation-based practice? Visit merrileeburke.com.
Outside California? Check moderationmanagement.org to find a like-minded therapist in your area.
Dare to do your work, your way, the world is waiting for what only you can offer.
Resources Mentioned
Here’s to building a practice that makes you a little weird, a lot fulfilled, and—most of all, uniquely you.
