From Solo Therapist to Seven-Figure Group Practice: What Ginger Wants You to Know
Nobody warns you about the pillow screaming phase.
You know the one. Where you're talented, trained, and genuinely good at helping people, but the environment you're working in is slowly grinding you down. The bureaucracy, the nonprofit pay scale, the meetings about the meetings. And somewhere in the back of your mind, a quiet voice keeps asking: what if I just did this on my own terms?
That's where Ginger was in 2018. Today she runs a 25-person trauma-focused group practice in Michigan. Here's what happened in between.
Lesson 1: You Don't Have to Have It All Figured Out
Ginger didn't start her private practice with a five-year roadmap. She started it on a family vacation, filling out paperwork and picking a logo while trying to get out of a job that was draining her dry.
"I just wanted to get out of a toxic nonprofit work environment. I just said, I want to go and do good clinical work. I'll be in an office by myself. I will be lonely, but I will figure it out."
A group practice? Not even on her radar. Within a month, former colleagues started reaching out asking to join her. She didn't recruit them. She just showed up and did good work, and the relationships she had built did the rest.
"It was not the intention to start a group. It just kind of happened through relationships, which is an important note if you want to build a group: relationships really, really, really matter."
The takeaway: You don't need a perfect plan. You need to start, stay connected to your community, and be willing to say yes when the right opportunities show up.
Lesson 2: Wanting a Sustainable Income Doesn't Contradict Your Values
This one is for the social workers and nonprofit lifers who feel a little weird about building something profitable. Ginger felt it too.
She almost quit in her first office. Not because she didn't love clinical work, but because the credentialing process felt overwhelming and she wasn't sure she was cut out for the business side of things.
What kept her going was a simple truth she had to sit with: she could not keep working 40 to 60 hours a week on someone else's terms, especially with a child who had complex health needs.
"Our work has to meet our needs and our clients' needs. It's not mutually exclusive."
Profit is not the enemy of purpose. A practice that doesn't sustain you can't sustain your clients either.
The takeaway: Building a financially healthy practice is an ethical act. Give yourself permission to want that.
Lesson 3: Learn the Fundamentals, Even When It's Tedious
Ginger built an insurance-based practice and she'll be the first to admit that if she were starting today, she'd follow Kelly and Miranda's advice and go private pay. But she also learned something through the insurance process that she's grateful for: she figured out how things actually work.
Credentialing, billing, compliance. She did it herself. And she thinks that matters.
"If you don't know how the process works, you're always beholden to someone else."
She worked briefly for a VC-backed platform, about 35 days, before realizing the ethical conflicts were too significant to ignore. Her concern now is that therapists are being sold the idea that outsourcing the hard stuff is a shortcut when it's often a trap.
"If you're really serious about building a private practice, the only way to do it sustainably long-term is to figure it out. Bite the bullet, eat the frog. It's worth staying where you are for two more months to get your credentialing set."
The takeaway: The learning curve is real and worth it. The therapists who understand their own systems are the ones who stay in control of their practices long-term.
Lesson 4: Stop Avoiding Your Numbers
Ginger is honest about something most therapists don't want to admit: math anxiety is incredibly common in this field, and it will hold your practice back if you let it.
"Most therapists have math anxiety and are very avoidant. You just can't be if you're going to be in private practice long-term."
She doesn't promise that an insurance-based solo practice will make you rich. It won't. But she does believe you can make it work if you're resourceful and willing to look at the numbers clearly and regularly.
"You can make the numbers work. It's about being very intentional about the choices that you make along the way."
The takeaway: Open the spreadsheet. Look at the numbers. Then look again next month. Avoidance is expensive.
Lesson 5: Your Niche Will Find You (But You Have to Pay Attention)
When Ginger started, she focused on substance use, chronic pain, and sleep. She loved that work. But when she started hiring, she was the only one who wanted to specialize in those areas.
Instead of forcing it, she paid attention to what created energy and alignment across her team. What emerged was a clear focus on trauma-informed care, specifically for clients who had already tried therapy and hadn't experienced real change.
"It's really trauma-focused work for people who haven't benefited before from therapy. We really specialize in people who are like, 'I went to therapy, my therapist was nice, but I didn't really change.'"
That became the thread that runs through everything: better diagnosis tools, advanced modalities like EMDR and Brainspotting, and a reputation built on clinical outcomes.
The takeaway: Your niche doesn't have to be perfect on day one. Notice what works, what lights your team up, and what your clients actually need. Let the focus sharpen over time.
Lesson 6: You Will Grow as a Leader, Whether You Plan To or Not
Ginger's first hire, Rachel, still works for her. And Ginger will tell you plainly that she was a very different leader then than she is now.
"I had no idea, even though I had been leading in nonprofits. I think she would say that I'm a very different leader today, even from two years ago."
Early on, she gave her team too much freedom without enough structure. Not because she didn't care, but because she didn't yet understand that being a good practice owner means holding both the relational culture and the business health at the same time.
"People need freedom and people need positivity. And we're also running a business. Those two things, like a teeter-totter, have to balance out at the end of the day."
The takeaway: Leadership in a group practice is its own skill set. Expect to grow into it, and get support so the growth curve doesn't take you out.
Lesson 7: Culture Is Your Retention Strategy
In an industry where VC-backed platforms are actively recruiting therapists with promises of easy caseloads and no admin work, Ginger has held onto a stable, loyal team by doing something much simpler: treating people like people.
She invests in training. She genuinely cares about her staff's lives outside of work. She built profit sharing into the model so that when the practice does well, the team benefits directly. And she practices what she calls "red carpet exits," transparent offboarding conversations that start at the beginning of employment, not when someone has one foot out the door.
"Orientation is an intervention. Making sure that we are laying a really good framework from beginning to end for us to have a nice relationship."
"I'm not a prison warden. I don't want to be. So let's make that transition nice and easy."
The takeaway: People stay in cultures where they feel seen, valued, and respected. Build that intentionally and retention takes care of itself.
Lesson 8: If You're Running a Group Practice, Get Your W-2 Structure Right
This one is non-negotiable. If you are thinking about hiring clinicians and someone tells you to use 1099s because it's easier, please read this section carefully.
Ginger ran a 1099 practice for years before making the switch to W-2 employees. She knows the law is clear, and she knows how hard the transition can be when you wait.
"It pokes at all of your stuff. If you have any abandonment stuff, if you have any insecurity stuff, if you have any money stuff, it's going to hit you in all of those places."
But she also made it through, losing only two of 20 team members in the process, which she and her accounting firm consider a genuinely good outcome.
"Listen to people who know a little bit more than you do. You can hire employees. It's not any harder. It will be so much more sustainable for everyone."
The takeaway: Do not wait until the law forces your hand. Get the structure right early, get support for the transition, and don't let one scared reaction from a potential hire derail you. (Yes, that happened to Ginger too.)
Your Next Step: Take Ginger's Lessons and Build Your Own Version
Ginger Houghton didn't have a business degree, a perfect plan, or a safety net. She had a breaking point, a baby, and a logo she designed on vacation. What she built from there took time, humility, and a lot of willingness to learn things she never expected to need to know.
And she'll be the first to tell you: if she can do it, you can do it too.
Start where you are. Learn the fundamentals. Build relationships like they're your most valuable asset, because they are. And when the hard parts come (and they will come), don't disappear into avoidance. Get support from people who have been where you're trying to go.
Want to connect with Ginger? You can find her practice at [practice website] and reach out through the show notes from this episode.
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 Ready to Launch or Level Up
Relationships are your most powerful marketing strategy. Invest in them from day one.
Learning the fundamentals of credentialing, billing, and compliance is not optional. It protects you and your clients long-term.
Your niche does not have to be perfect at the start. Pay attention to what creates outcomes and energy, and let it sharpen over time.
Look at your numbers. Avoidance is expensive.
If you are building a group practice, get your W-2 structure right before you need to. Do not wait.
Culture is your retention strategy. Build it on purpose.
Your why matters. If it is only about revenue, group practice will grind you down. If it is about making things better for everyone in your orbit, you have a real foundation to build on.
You have more than you think. Now go plant some seeds.
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