Starting a Private Practice from Scratch - Checklist and Training
You're needed right now, and the demand is high, but that doesn't mean opening your business magically leads to a full caseload and a great paycheck. If you are wondering how to start a therapy practice, this training is for you.
In this training, you'll learn:
What you need to know before you open your doors to your private practice to ensure success.
The steps to create your successful, sustainable, and impactful private practice.
How to get on the fast track and start your private practice with ease and confidence.
zynnyme is committed to providing universal access to all of our trainings. Closed captioning is provided whenever possible. Please contact community@zynnyme.com to request the video transcript and/or discuss additional disability accommodations.
> Download your fee-setting worksheet to use with the video training above.
Starting a Private Practice Checklist
What does it cost to start a therapy private practice. Actually, it’s an incredibly low investment — yes, really!
So you are wondering how to start a therapy practice. Starting a private practice is way easier (and cheaper!) than you think. While everyone else is out here believing you need a trust fund and a business degree to hang out your own shingle, we're about to blow that myth to smithereens.
You've already done the heavy lifting. You’ve survived grad school, logged hundreds of supervision hours, and probably attended enough trainings to earn a PhD in conference snacks. You've made the biggest investment already: becoming a skilled clinician that people actually need.
Now you're ready to turn that expertise into your own private practice empire. And here's the kicker: you can do it for less than most people spend on a decent used car.
The Reality Check That'll Make You Feel Better
Before we dive into the nitty-gritty numbers, let's talk about what other people are spending to start their dream businesses. Brace yourself for some perspective that'll make you feel like you won the entrepreneurial lottery:
Small training gyms casually drop $20k-50k just to get started. Bakeries? They're looking at around $100k (apparently, ovens are expensive—who knew?). Restaurants can easily blow through $50k-200k before they serve their first customer. Technology startups range anywhere from $10k to "sell your firstborn" levels of investment. Even day spas typically need $8k-80k to get their zen on.
And here you are, sitting pretty with a business model that requires a fraction of those costs. You're basically the smart kid who figured out how to get an A+ without pulling all-nighters in the library.
Starting a private practice is practically a steal when you consider what you're getting: the freedom to work with clients you love, set your own schedule, and build something that's entirely yours.
What You Actually Need To Start a Private Practice (Spoiler: It's Less Than You Think)
Let's break down what you really need to get started, along with the real talk about costs. We're going to be specific here because vague advice helps no one.
A Place to See Humans
First things first: you need somewhere to practice. But hold up! This doesn't mean you need to lease a fancy corner office with floor-to-ceiling windows (though if that's your vibe, go for it!).
Today's therapists are getting creative: phone therapy, walk-and-talk sessions, virtual sessions, and subletting office space by the hour. Subletting is basically the therapy world's version of a shared Airbnb where you get all the benefits of a professional space without the commitment or the massive overhead.
Many therapists find killer sublet deals for under $100 a month if they're willing to do some research and negotiate. Some landlords even offer "graduate up" arrangements where you only start paying when you actually have clients. (One savvy therapist we know didn't pay a dime for office space until she started seeing clients, then paid an hourly fee that maxed out at $75 a month.)
> Download our free Office Space Checklist
Investment: Around $200/month (and possibly $0 to start)
Business Licensing Fees (AKA Adult Paperwork)
Depending on where you live, you might need a business license. Most are under $100, and some cities don't even require them. It's like getting a permission slip to be a grown-up entrepreneur. Look at your city, county, province and state regulations to find out if you need a business license.
Investment: $100 startup (maybe)
Your Official Numbers (EIN and NPI)
These sound super official and intimidating, but they're actually free and take about five minutes to get online. You don't technically need them for a cash-pay practice, but they're helpful if you want to provide superbills or work with insurance companies. Think of them as your business's social security numbers. We recommend having these over handing out your own personal social security number.
Get your EIN here and your NPI number here
Investment: $0 (because free is always the right price)
Liability Insurance (Because Life Happens)
Whether you're in private practice or still doing agency work, liability insurance is like wearing a seatbelt -you hope you never need it, but you'll be really glad you have it if something goes sideways. Many insurance plans allow for some private practice hours without increasing your annual fee, which is basically like getting a free trial of entrepreneurship.
Investment: $450 annually (even with the fancy general liability add-on)
Clinical Forms (The Paperwork Nobody Talks About)
You need informed consent forms , intake forms, note templates and policies, but before you panic about legal jargon, check with your professional organizations. Many provide templates as part of membership, and some will even review your paperwork. If you go digital, clients can sign everything online, which means no printing costs and fewer trees giving you the stink eye. Check out CAMFT’s sample informed consent for example.
Investment: $0 (templates are your friend)
A Business Phone Line (Without the Extra Phone)
Here's a neat trick: call forwarding services let you get a business number that forwards to your existing cell phone. No need to carry two phones around like you're running a spy operation. Some services even send calls straight to voicemail outside business hours, so you're not fielding "urgent" calls during dinner.
Google Voice offers an explicitly HIPAA-compliant service for under $10-$20 a month.
Investment: $10-$20/month for the HIPAA compliant service
Secure Email (Because Regular Email is So Last Century)
G-Suite gives you a professional, HIPAA-compliant email for about $18 a month. It's like having a bouncer for your inbox—only the right stuff gets through. You must pay for Google Workspace and have a BAA in place.
You can also try other services
Investment: $7-18/month
A Website (Your 24/7 Marketing Assistant)
You don't technically need a website to see clients, but having one is like having a really good wingman, it makes everything easier. Squarespace is user-friendly and includes hosting, security, and analytics for about $16 a month.
The hardest part isn't the tech stuff, it's figuring out what you want to say and how you want to say it. That's the work that really matters and can't be outsourced anyway.
> Take the free Websites 101 training
> Get our free Websites Resource Guide
Investment: $16/month
Practice Management System (Your New Best Friend)
Some people think you can start without a practice management system. Those people are wrong. This is your HIPAA-compliant command center that handles notes, scheduling, payments, and basically everything that makes running a practice less like herding cats.
Systems like Jane app and TherapyNotes will lower your no-show rates, let you take credit cards, eliminate printing costs, and generally make your life infinitely easier. In our Business School for Therapists we have a comparison charts of all the different EHRs out there. There are just way too many to list here.
Investment: $54/month (and worth every penny)
Referral Sources (AKA Your Future Client Pipeline)
You need a way for people to find you, but this doesn't have to cost money. It just takes intention. Some therapists build their practices entirely on internet referrals, others focus on specific professional relationships, and many use a combination.
The key is figuring out what works best in your area for your specific expertise. Are there already dozens of therapists with your specialty dominating Google? Focus on relationship-building. Is the first page of Google looking pretty empty for your niche? Start blogging weekly until you claim that real estate.
>Check out our free Marketing for Therapists Training and Guide
> Get our list of 40 people, places, and ways to build a referral base
Investment: Time and genuine relationship-building
> Access the Private Practice Trainings Library here
> Download your private practice vision checklist to get clear on what you want in your private practice
Professional Associations
Truth is, you probably already have these. If you don’t, you may or may not benefit from grabbing this now! Check to see if you get a discount on your liability insurance through your professional association. In California, to join www.camft.org is $200 the first year. For that $200, you get unlimited phone calls to speak to a lawyer with any questions you have about your practice, client situations, etc. Ask around and ONLY invest if there’s direct value.
Investment: $200/yr
Trainings for Success in Private Practice
You can get over 15 hours of free webinars, checklists, and worksheets for therapists from our Private Practice Trainings Library. These trainings are designed to help set you up for success in your business by taking you step-by-step through developing a strong foundation, identifying the needs of your unique practice, and putting good business habits in place from the get-go. We also have an entire podcast series on starting a practice. If you are a reader, you can download a free copy of our Therapist Burnout Book. Investment: $0
Odds and Ends
There might be a few other things you need if you don’t have it already - A printer ($100), computer access (use what you have or grab a Chromebook for $250), internet access if you don’t have it already ($20/month), business cards (maybe $50, but honestly, a personal email with your info works better)
These aren't make-or-break items, but they can make your life easier depending on your setup.
The Numbers That'll Make You Do a Happy Dance
Ready for this? Let's add it all up:
Initial investment for annual fees and one-time purchases: Around $1,600 (max)
Monthly fees: Around $500/month (max)
This means if you see just one weekly client at $150 per session (we aren’t saying that is the fee you should charge, not in this economy at least), you're already breaking even every month. Your initial investment gets paid off in less than a year. With literally one client.
Think about that for a second. What other business lets you break even that quickly? Most entrepreneurs would sell their grandmother's vintage china collection for numbers like these.
The Plot Twist: Investing in Yourself Pays Off Even Faster
Here's where it gets really interesting. What if you decided to invest in some business guidance to fast-track your success?
You could add business consulting or a comprehensive program like Business School for Therapists to your startup costs. Even with that investment, your total initial cost might be around $5,000.
At that point, seeing 16 weekly clients at $150 per session puts you over $100,000 annually. Not too shabby for a business you can start from your kitchen table.
The "But What If" Questions
"What if I'm just starting and don't have any clients yet?" Start networking now. Build relationships with other professionals. Let people know what you're planning. Often, your first clients come from your existing network—former colleagues, supervisors, or even friends who know someone who could use your help.
"What if I want to keep things really simple at first?" Start with the absolute basics: liability insurance, a simple practice management system, and a way for people to reach you. You can always add the bells and whistles later as your practice grows.
"What if I want to work with insurance?" You'll need those EIN and NPI numbers we mentioned, plus you'll want to research credentialing requirements for the insurance panels you're interested in. This can add time to your startup process but doesn't significantly increase your financial investment.
The Freedom Formula
Here's what starting a private practice really gives you: the freedom to work with clients you genuinely enjoy, set a schedule that works for your life, charge fees that reflect your worth, and build something that's entirely yours.
The financial investment is minimal compared to other businesses, but the potential returns—both financial and personal—are enormous. You're not just starting a business; you're creating a professional life that aligns with your values and goals.
Ready to Take the Leap?
The numbers don't lie: starting a private practice is one of the most accessible entrepreneurial paths out there. You've already made the biggest investment in your education and training. The business side? That's the easy part.
Your biggest challenge won't be affording to start—it'll be choosing between all the different ways you could structure your practice. And honestly? That's a pretty great problem to have.
The question isn't whether you can afford to start a private practice. The question is whether you can afford not to. Your ideal clients are out there right now, looking for exactly what you have to offer. All you need to do is open your doors and let them find you.
Starting a private practice isn't just financially smart—it's practically inevitable once you realize how simple and affordable it really is. The only thing standing between you and your own practice empire is the decision to begin.
So, what are you waiting for?
Download your fee-setting worksheet to use with the video training above and let’s get started on your private practice!
