From Poetry to Private Practice with Jamey
So you want to start a counseling practice - or maybe you’re already knee-deep in notes, invoicing, and sticky notes with “call accountant?” on them. Maybe you’re transitioning from a first career or diving in straight from grad school, wondering if therapy is supposed to feel this confusing (spoiler: sometimes, yes). Or perhaps you’re caught in the “private practice is dead” doomscroll, worrying you missed your window, while secretly still dreaming of filling your book with meaningful sessions and paying your rent on time.
If any of these sound like you, you’re in good company. Enter Dr. Jamey - psychoanalyst, therapist, former literature professor, and, as it turns out, a poetic guide through the winding ways of building a sustainable, thriving private practice. Jamey’s story reminds us all that “humans have been humaning for a really long time” and that your unique journey, quirks, and lived experiences have a place in the therapy room and in your business.
Ready to borrow some of Jamey’s wisdom, wit, and hard-won lessons? Let’s go!
Lesson 1: The Winding Road Isn’t Just Allowed - It’s Required
Jamey didn’t always see himself as a therapist. In fact, he spent decades in academia, memorizing lines of poetry, chasing wisdom in the great books, and teaching “hundreds of lines of poetry.” The path seemed set, until “making a living as a humanities professor became more or less impractical in the United States,” and Jamey realized, “this dream, which had organized my entire personality and my view of … what I was going to do with my life had to change.”
The result? A period of floundering, identity shifts, and question marks bigger than an unwritten sonnet. “It was very painful for a while, not least because at this point, I was a man in my for. And, you know, I'm sure a person of any gender would be in some degree of difficulty being an apprentice again in early midlife.”
Takeaway: Private practice isn’t just for the folks who planned it from day one. Career pivots, confusion, and late starts are not bugs; they’re features on the road to finding work that fits. Trust your evolution.
Tip: Feeling lost or like you’re “starting over”? Jamey’s story is proof that it’s possible to pivot and thrive; your other life chapters (even the floundering ones) will make you a better therapist and practice owner.
Lesson 2: Let Curiosity Guide Your “Why”
Miranda, our host, asked the million-dollar question: Why therapy, especially after all that time in the humanities?
Jamey answered honestly: “Part of what I loved about teaching was meeting students and fairly quickly inferring an impression of what it was they were really dealing with, what was impinging on them most in their lives… Often, these were existential anxieties of precisely the sort that Therapists and psychoanalysts can be found helping people with.”
And the parallel between interpreting poetry and understanding a client? “As a therapist, the text is what the patient is saying. Now that can sound cold as if I'm turning a person into a book, but the word text here is really stretchy, and it includes what it's like in your heart to sit with another human being … A lot of that is verbal, and a lot of it isn't.”
Takeaway: Your “why” doesn’t have to look like anyone else’s. Let the things that fascinate, move, and challenge you guide your journey; there’s room for all of you.
Tip: If you find yourself translating skills or interests from a former life (be it poetry, art, or accounting), you’re on the right track. These things don’t hold you back; they make your practice richer.
Lesson 3: The Great Insurance Awakening and Finding Your Business Model
When Jamey started working as an intern at places like The Relational Center in Los Angeles, he naturally took the insurance “on ramp.” It had pros (“They’re providing you with a continuous stream of clients...that is a beautiful thing, provided that you understand what you're getting into.”) and cons (“Taking insurance was very challenging. … For me, the person coming out of the poetry world is dry as dust, and, you know, I've got plenty of ADD, and I was daunted by this and felt, oh, I shall never understand it.”)
The real shift came through a business boot camp for therapists, where Jamey faced his anxieties, learned the ropes, and eventually made a conscious choice: “This was training wheels. This was the on-ramp. Get me out of this thing.”
Takeaway: There’s no “one right way” to build a referral stream or set your fee structure. Accepting insurance can fill your calendar, but it might not fit your long-term goals, personality, or values.
Tip: Check in with yourself: Does your business model feel like a good match for the future you want? If not, it’s okay to pivot, “upgrade your training wheels,” and try a new route.
Lesson 4: Money Mindset, Fees, and That “Is Private Practice Dead?” Drama
“Is private practice dead?” Miranda asked a question on a lot of therapists’ minds. Jamey’s response was classic: “It's like finding out, you know, painting is dead or poetry is dead. Surely somebody is composing a poem somewhere. … Someone is always doing therapy in a role-appropriate, competent way that's gratifying, grounded, oriented, geared to the client, no matter what the conditions are.”
As for the nitty-gritty of setting fees (Jamey charges $250 and offers a sliding scale), it’s about both the market and integrity: “I think this is an accurate assessment of what the market will bear, and I don't want therapy to be a hardship as an expense. Mhmm. I do have a sliding scale. I don't overuse it, but I've always got a few people who are paying less and even markedly less, but there's always a reason for that, and I made a good living.”
Takeaway: There will always be people declaring the end of private practice, but the world still needs skilled, reflective, authentic therapists. The bigger challenge is finding a business model and fee structure that aligns with your values and needs.
Tip: Do your own math (literally), set fees that make your practice sustainable, and don’t let fee-setting turn you into a ball of guilt or shame. “Am I doing something sustainable for me? Am I doing something that really works for me and my clientele? And can we get out of this space of judging our own fee or judging anyone else's fee?”
Lesson 5: Business Skills Aren’t ‘Extra’ They’re Essential!
Jamey’s honesty is refreshing when it comes to the many “aha” moments of learning to be a business owner.
On taxes and business structures: “I set up a PLLC, a professional limited liability corporation, and then learned, in quotation marks, that it would be beneficial to me as a taxpayer if I were to pay taxes as an S Corp. … All of this was news to me.”
On the value of community: “The biggest thing I got from business school was the support that I could ask questions and people would answer within a reasonable amount of time. … And above all, the confidence. Here was a subculture of people who were doing essentially what I was trying to do, who maintained an atmosphere twenty-four-seven of capability, competence, groundedness, you know, role-appropriate enthusiasm…”
Takeaway: No matter how smart or compassionate you are, business isn’t intuitive for most therapists. You’ll need community, structure, and support systems just as much as clinical training.
Tip: Seek out mentorship, business coaching, or a structured program (like Business School for Therapists!) early, preferably before you’re in a spreadsheet-fueled panic at 2 am during tax season.
Lesson 6: Be Yourself (With Boundaries, Curiosity, and Compassion)
Jamey’s final advice? “Be yourself. … Look at the aspects of your identity, your experience, your voice, your creativity that you feel make you who you are, and ask yourself, given that that's who I am, how can I, Kelly, and whom can I help? And follow where that leads. Trust in The. Believe in that. Extend compassion to you and to your prospective clients, and that's the star to steer by. Choose a niche. Choose another niche if you want to, and be yourself.”
Takeaway: Business building isn’t about becoming someone else; it’s about leaning into who you truly are and serving those who will benefit most from your unique mix of skills and life experience.
Tip: Permission granted to re-invent, niche, and explore as often as you need. Find your authenticity and steer by it.
Takeaways for Therapists Starting (or Reimagining) Private Practice
Your journey won’t (and shouldn’t) look like anyone else’s, don’t panic if it’s winding or weirdly timed.
Private practice “isn’t dead.” Flexibility, creativity, and grounded business skills will carry you through shifts and challenges.
Don’t be afraid to leave insurance, change niches, or raise (or not raise) your fees if it fits your life and clients.
Community, mentorship, and proven business structures are not ‘nice to have’, they’re essential.
Set your fees thoughtfully; ditch the shame; focus on sustainability for you and clients.
Your “why” is allowed to evolve. Follow the thing(s) that light you up.
You are building something lasting and meaningful, even (especially!) if it doesn’t look traditional.
If you’re as inspired as we are by Jamey’s mix of candor, philosophy, and grounded business sense, give yourself time to explore the resources and wisdom already available to you.
Want to connect with Jamey or dive into his blend of literature, psychoanalysis, and heart-centered therapy? Stalk (with permission!) his website at www.drjameyhecht.com.
If you’re ready for practical, step-by-step help and a community that will cheer you on - plus the nitty-gritty you never got in grad school - check out Business School for Therapists. It’s the kind of resource that helps make sense of taxes, business models, AND the messiness of real therapist life.
Here’s to building your wildly unique, deeply needed, and delightfully sustainable private practice!
