Are You Confident In Private Practice?

Do Therapists Struggle with Shame in Private Practice?

Do Therapists Struggle with Shame in Private Practice?

Shame in Private Practice? 

Before someone can officially be accepted into our Business School Bootcamp for Therapists, we have to interview them. And, they have to interview us. It is really important to us that people only sign-up if this is the right program for them, and they are someone who we will enjoy working with. 

I ask several questions- but one of the most important questions I ask is: If we were to fast-forward to the end of the bootcamp, and you got the perfect outcome- what would it be? (Nothing like sneaking the miracle question into a program for therapists!)

Now, I expected therapists would tell me things like: 

  • "I would have more full-fee clients."

  • "I will have a great business plan for my private practice."

  • "I will know how to get the phone ringing."

  • "I will finally understand how websites work."

And while yes, sometimes people would say these statements- it often was NOT the overarching goal or hope. What they verbalized again and again was that they wanted to feel confident. They wanted to feel connected. They wanted to feel sure of the next steps in their private practice. They wanted to feel validated that they had taken the right step in opening a private practice. 

The first time someone said I nodded. It made sense. The second time I heard it... and then the third... and I just kept hearing it.... From therapists who were starting a new private practice, from therapists marketing established private practices, from therapists with no clients, from therapists with tons of clients... 

Therapists want to feel confident in private practice. 

In so many areas, we get feedback, supervision, consultation- but business building isn't one of them. And the truth is, the business issues of private practice are so tied into clinical effectiveness. Think about it, in the most core way, if our private practice marketing isn't set-up properly- we can't see clients- because we won't have any! 

If you have tons of clients, but they aren't paying you well- you also won't be able to keep your doors open. 

Shame in Private Practice

Unfortunately, it isn't just that therapists often lack confidence in how to apply business knowledge in a private practice. Therapists can also begin to internalize that the lack of flow or success in their private practice is a reflection of their value as a human! We put so much work, effort, and intensity into being great at our craft. When things aren't flowing in our private practice- it can lead to feeling less than, bad, or even ashamed. 

Ditch the Private Practice Shame

Here is the truth, many therapists feel just like you do. You are normal. It is ok. Notice it, and come up with a plan to move away from feeling not good enough, confused, lost, or even ashamed. Learn what you need to learn. Get the support you need to lean on. Learn the skills you need to enjoy running a private practice! 

Confidence is something that happens as you grow, learn, and get support. The lack of confidence that you feel today is simply a signal that something needs to shift or change. It is NOT a reflection on you as a human, or on you as a therapist! 

With Confidence, 


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!

Adding Value to Mental Health Work: Do WE See Our Value?

By: Sara Wong (our fabulous ZynnyMe intern- an International Studies student from Australia)

When I met Miranda for the first time, we were sitting down at a hipster restaurant-pub hybrid here in Seattle called Hudson Public House (they make a warm kale salad to-die-for, just ask Miranda) discussing ZynnyMe and what it was all about. After processing through the work she and Kelly are doing to help therapists, psychologists, and health professionals run successful private practices and businesses in general, an article my best friend sent me a couple of months ago came to mind. 

 Whenever my best friend sends me articles, I usually bookmark them to read for later because she likes to send me these philosophical, intellectual, weighty articles all the time—she doesn’t have a switch. Not exactly what I wanted to read after a day of college but I decided, out of guilt, to read this particular one she sent over. The article In the Name of Love was written by a PhD in art history, Miya Tokumitsu, and discusses the way our society and culture devalues and undervalues certain professions such as those within academia. She says this is happening because this work is being masked by the “Do What You Love” (DWYL) doctrine.

 Tokumitsu says that the majority of academics believes their work should be done out of pure love and that the compensation for their labor should only be an afterthought, if a thought at all. This is what being in academia is all about, right? While this isn’t a problem on the surface and is actually so respectable, Tokumitsu makes the point that these sacrificial thought and action processes also lead to “vicious exploitation.”

Certain industries, especially those that fall within the social sciences, have been known for paying their employees in “social currency” instead of actual wages. The worst thing is that most of these employees willingly accept this form of compensation.

“These industries have long been accustomed to masses of employees willing to work for social currency instead of actual wages, all in the name of love.” (1)

Another ironic point she raises is that while people in these devalued fields think that they have escaped the corporate world, they are actually very much a part of a corporate-like management structure: maximum work at the lowest cost.

Anyway, let me bring this back to the Hudson Public House. As Miranda was talking about different clients she had encountered, especially therapists and psychologists, it struck me that the DWYL doctrine is also present in the mental health field. The widespread belief that non-material rewards are sufficient for therapists and psychologists and that they shouldn’t expect any more is so real and evident! Like I said before, I am not saying that the work that mental health profession should not be done out of the love and genuine passion. In fact, that’s usually a given. However, as eloquently put by Tokumitsu, emotionally satisfying work is still work and acknowledging it as such doesn’t undermine it in any way.

What therapists and psychologists do is important, necessary and life impacting but it is also work. Why are we undervaluing and devaluing it? According to Tokumitsu, the revaluing of this work starts from within. When mental health professionals can begin to believe their rewards come not only in emotional and social forms but financial ones, they can start to reject the financial devaluation and “exploitation” of their work. It starts with you! Not being afraid of your value as an impactful, social worker is so important to getting you what you not only deserve but what you need. Although money may not be what drives your work, it is still a necessary part of life that can open up opportunities for you, your family, and your work itself.

Overall, I guess I should thank my best friend for sending me this surprisingly applicable blog post! I am happy that I was able to slog through the intellectual bog to pull out a couple of gems for myself and hopefully for you too. However, with 11 books to read for 3 writing-intensive classes this quarter, guilt will probably still be the biggest factor that will drive me to read more of these articles.

(1) Tokumitsu , Miya. "In the Name of Love ." Jacobin. (accessed April 7, 2014).

Miranda here. Did this inspire you today? Did it get you fired up to do what you love AND get paid for it? Check out a free replay of

"The Step-by-Step Process  Mari A. Lee, LMFT, CSAT Used to Successfully Launch Her e-book as passive income!" We've already had almost 500 therapists register for this training and RAVE about it.

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