Selling a Psychology Practice? Read This First: A Therapist’s Cautionary Tale
If you’ve ever Googled “counseling practice for sale” or wondered whether selling your psychology practice is the natural next step, you're not alone. Group practice owners across the country are building thriving businesses with an eye toward eventual exit. But there’s a side of this story we don’t talk about, the experience of the therapists left behind.
You might even be one of the therapists that works in a group practice, either as a contractor or employee and you’ve been hearing about how group practices are getting snatched up by larger companies.
Recently, we came across a powerful and unsettling post from a therapist who had been through not one, but two acquisitions in just a few years. Their story brings up critical questions about ethics, informed consent, and the future of therapy under corporate control. And it’s something every therapist,whether you're employed, independent, or planning to sell, needs to read.
“I was working for a locally owned private practice that was sold to a large conglomerate in 2022, this was the second time I had joined a practice that was sold since 2020, so I decided to stay because I really couldn't handle another change at the time.”
“I really couldn't handle another change at the time.”
It’s a sentence that echoes through our community. Therapists often stay in difficult situations because the emotional and logistical cost of leaving is just too high. The cost might feel to high for the clients and the therapist makes a huge effort to not “rock the boat” or make changes out of concern for the disruption of the clients process or the clinician themselves does not have the support to navigate the changes and thus feel it is better to stay with what you know than what you don’t.
Change in life is inevitable and it is actually what makes life, well life! To protect our clients from experiencing changes is a disservice. It’s not reality. To offer our presence and attunement through changes, even ones prompted by our own actions is a gift to the work we do in the therapeutic relationship. To not do so eventually breeds harm or resentment in the relationship.
But in this case, the clinician didn’t have the resources to handle another change. What can help with these transitions is there is normally a period of keeping things “relatively the same,” as this therapist noted about their first year post-acquisition. But while things felt the same initially, things started to shift, quietly and strategically by the corporation that bought the group practice.
Clinical Support Is Not a Luxury—It’s a Lifeline
“May 2024 they announced a restructuring that removed all site directors nationwide. This meant there would no longer be a site director at your office, but they did have directors available, 1-2 per state was my understanding. I was in WI at the time, we had about 350 therapists state wide, so WI had 2 remote directors.”
This decision, while pitched as a corporate restructuring, stripped away the very foundation of safe clinical care: on-site leadership. Why is this done? Efficiency and saving money to improve profitability. This company that bought the group practice is a publicly traded company. They have shareholders that are expecting results and not clinical results, financial results.
“My concern was I had never worked somewhere that I didn't have direct access, as in someone on site, to staff a case, address safety issues (both in your cases, but also on-site, I've had DV partners show up unannounced), consult, etc. I've been in the field since 2005, I couldn't imagine being a newly licensed therapist and not having this level of support.”
When you remove real-time consultation and in-person support from a field built on human connection, you’re might save some money, but at what cost? The risk gets placed directly onto therapists. And let’s be honest: the liability rarely flows upward in these organizations.
“This decision prompted me to start making plans to leave. The liability felt increasingly put on the therapist, and it was obvious to me this was a business move with no regard to supporting the staff.”
This can feel extremely dissapointing. We have noticed there is a distinct difference between group practices owned by an individual or a small team of people, most often clinicians versus ones that have joined larger conglomerates. It’s like going to your mom and pop shop where everyone knows each other or going to your local target without any familiarity with your cashier or the manager.
Read the Fine Print—And Then Read It Again
“October 2024 they released 5 policy updates... One was an arbitration agreement stating we'd waive our rights to be heard in front of a jury or judge if we filed a complaint about the company. The other was allowing Lifestance to obtain an Investigative Consumer Report on you.”
It’s easy to miss the implications of a line or two in a contract, especially when it’s buried under layers of HR language. But this therapist didn’t, thank goodness!
Arbitration agreements are legally binding documents that often favor the employer. By signing, you may be waiving your right to pursue legal action in court without even realizing it. And let’s talk about the Investigative Consumer Report? That’s the kind of clause you’d expect from a tech startup, not a place where you’re building intimate, healing relationships with clients.
An Investigative Consumer Report (ICR) is a type of background check that goes beyond just verifying your identity, criminal history, or credit and it adds in interviews with people who know you (like past employers, colleagues, or even neighbors) to gather information about your character, reputation, personal habits, way of living, and job performance.
It’s governed by the Fair Credit Reporting Act (FCRA), which requires employers to notify you in writing and get your explicit, written consent before obtaining one. It’s concerning for therapists because it means you are giving the company permission to gather subjective personal information about you, without knowing how it will be used or interpreted. Pairing that with your arbitration agreement that wavies your right to sue or employer control over your online presences, such as continuing to use your name in directories after you leave, makes for a lot of mess.
When reviewing employment paperwork, look for clauses like:
“We may obtain an Investigative Consumer Report as defined by the Fair Credit Reporting Act…”
“You consent to third-party interviews with prior employers or others who know you…”
Or language buried under “background checks” or “employment verification.”
It Gets Worse: Clients Were Unknowingly Signing, Too
“Also, I noticed the client consent form started to show the arbitration agreement attached at the bottom, as part of the general consent to treatment. It wasn't its own document, clients were forced to sign because they were already signing to consent to treatment.”
This is one of the most alarming revelations in their story. Clients were being asked to waive legal rights unknowingly. Typically, the informed consent is something that is reviewed in session with the clinician. But often when the companies are large, their processes shift to having the forms signed in the waiting room or online prior to session.
“I checked in with a few clients about this, and they too said they did not know they signed it, and did not know what it was.”
Even more troubling? Therapists were never informed that this legal document had been attached to client consents. Learn from this though! Always review the informed consent and re-review anytime a change is made, ensuring you and the client understand what you are signing. Ask about the processes for changes to informed consent so you know how to be alerted to changes.
“We were not informed that arbitration agreements were added to consents. Even if we knew, I don't think that's something we should be advising clients on anyway, whole other issue.”
The result: clients are unprotected, therapists are exposed to liability, and nobody knows who’s truly accountable. Arbitration agreements such as these are often not found in private practice informed consents. Instead we typically give information on how to report our license to the board for any unethical care. We actually give them the information they need to be sure they are empowered, which is totally opposite to this.
It’s important to note, this particular company that bought the practice has been sued for labor law violations by therapists. Take note and do your research on the company that is purchasing the group practice as well!
For Therapists: Don’t Assume Someone Else Read It For You
Whether you’re signing an employment agreement, onboarding as a contractor, or just trying to make it through a full caseload, the paperwork can feel endless. But as this therapist’s story shows, what you sign today could define your future rights, income, and autonomy.
“I talked to a few colleagues and they didn't realize they had signed the arbitration agreement, and they didn't know what it was.”
Here’s what you can do:
Ask for every document in advance. Don’t sign anything on the spot.
Seek legal review of employment or contracting paperwork, especially anything referencing arbitration or non-compete clauses.
Track changes to client consent forms and any documentation you’re expected to discuss or enforce.
For Group Practice Owners: Who You Sell To Matters
If you’re building your counseling practice with hopes of one day selling, you absolutely deserve to be proud. But success doesn’t have to come at the cost of the clinicians or clients you serve.
In a world where companies that buy mental health practices are often backed by venture capital, the pressure to scale quickly can lead to policies like the ones described above. But here’s the truth: you get to decide how your practice transitions.
Questions to ask before you sell:
Will the new owner retain clinical leadership and support?
Are there plans to automate or outsource informed consent processes?
How will your staff be protected during and after the transition?
Is there an arbitration clause embedded in the sale or employment agreements?
Is the company trying to buy your company trying to sell its own?
I think it is also important to note that many of these larger companies buying practices are trying to sell to larger conglomerates. One group practice owner worked very hard to NOT sell to certain types of companies. But, after they were already in process of the sales process, the company they had chosen to sell to sold out to a company they would have NEVER agreed to sell to and everything transititioned to them.
This Isn’t Just Business. It’s Clinical.
The therapy profession is built on trust between clinician and client, between leadership and staff. When corporate priorities override that trust, it’s a threat to the clinical process itself.
“Out of everything that was going on, this is my biggest concern. Employees and clients are not fully informed on what they are consenting to, and the way the information is presented to them feels purposely unclear.”
Supervision, consultation, informed consent, these aren’t extras. They are clinical necessities. When they disappear, clients pay the price, therapists burn out, and the healing process is compromised.
Where Do We Go From Here
If you’re a therapist employed at a large group, now is the time to get curious, if you’re a private practice owner, now is the time to get clear; and if you're building a group practice with hopes of one day selling, now is the time to get intentional.
Thoughts for group practice owners:
Do you need to sell, or do you need to revamp your group practice?
Are you burned out because you have an unsustainable model and need to make a change?
How would you feel seeing something you built being taken over by insurance companies?
How would you feel about what you’ve built being dismantled?
Do you need to finally look at your group practice finances?
Thoughts for employees?
How happy and well rested does the owner/boss at. your group practice seem?
Is it time to start to create a backup plan?
Do you need to create something for yourself that you are in charge of and that someone else can’t change from under you?
is being an employee or a 1099 contractor really serving you long-term?
Are you ready to start a counseling practice?
The therapist who shared their story left their job in January 2025 after refusing to sign the new policies. Their courage highlights the importance of understanding what you’re agreeing to, and knowing when it’s time to walk away.
It also highlights how much we need to be in our own energy, caring for our whole being so that we can navigate changes. Avoiding a decision or trying to keep things the same because we are burned out and unsupported can lead to opening up pandora’s box for ourselves and our clients. Check in with yourself. Are you in a place where you can handle change? If you aren’t, what kind of support do you need? Community? Training? Coaching?
You Deserve Better. We All Do.
Whether you’re employed, looking to sell your practice, or trying to build something sustainable, you don’t have to do it alone. At ZynnyMe, we help therapists create profitable, ethical, and fully aligned private practices whether you’re just starting out or scaling up.
If you're navigating decisions around selling a psychology practice or protecting your team from burnout and overreach, we invite you to explore how coaching can support your next step. Because it’s not just about the paperwork—it’s about the legacy you leave behind.
Author Bio: Kelly Higdon, LMFT
Kelly Higdon, LMFT is a the co-founder of zynnyme and the Business School for Therapists as well as co-author of the Therapist Burnout book. They are focused on helping therapists through private practice coaching, education and empowerment to create private practices that get great clinical outcomes with awesome profitability.