5 Important Tips for Prelicensed Therapists in Private Practice

  • Guest post by Rachel Moore, MA, MFTI. A huge thank you to Rachel for sharing these amazing tips.

Being a prelicensed therapist can be hard. In many states, after completing your master’s degree, you are required to work in a supervised environment for a few thousand hours before being allowed to sit for marathon licensing exams. Whew!

For many of us, therapy also is a second career. It can be humbling to be a middle-aged “intern,” with all that word implies. It is also disheartening, in my opinion, that many therapy internships are unpaid.

That’s why a private-practice internship can be a good option for prelicensed therapists. Private-practice interns can earn money and also build up a clientele that may carry over after they’re licensed.

I have been registered with the Board of Behavioral Sciences in California as a Marriage & Family Therapist Intern since 2013. I earn my hours at a nonprofit agency as well as private practice.

There are a few important things to know if you are a prelicensed therapist considering private practice or if you are at a private practice now:

1. Find a Good Fit

After you’ve graduated and waited for the state to process your internship registration, it can feel like the pressure is on to start earning hours right away. It is important to choose your internship site carefully, however, especially when it comes to private practice.

As a friend and fellow prelicensed MFT puts it: “One thing I found to be a big deal was choosing a practice that is in the area of town that you want to work. I know that sounds obvious, but I think it can be tempting to take whatever private-practice opportunity you are presented with.”

Besides location, a good connection with your supervisor is vital. “It’s so important to find someone that encourages you and is willing to work with you and teach you, versus someone who is demanding and adds too much pressure,” my MFT intern friend says. “I would say make sure your supervisor is not just about the money.”

How do you find a good supervisor? Here are some questions to ask a potential employer: What is your purpose in having an intern? Have you had other interns before; what has that experience been like? What do you expect of your interns (for example, how many clients do you want an intern to have within the first 6 months)? How will I get clients; will you give me referrals or do I need to generate most or all of them myself? What will my pay structure look like? (In California, private-practice interns must also be employees and receive the equivalent of minimum wage for the hours they work.)

Some of the places private-practice internship opportunities can be found are Craigslist (really!), online job boards, school connections, Facebook groups for therapists, and a helpful website that launched recently: www.paidmftinternships.com.

2. Know the Rules

It’s key to know what all of the rules are in your state for prelicensed therapists. For example, California has something called the “6-year rule” for Marriage & Family Therapist Interns. This means the state board won’t accept internship hours that are more than 6 years old (there are certain exceptions regarding hours earned during school).

If you take longer than 6 years to complete your hours, you must apply for a second (subsequent) intern registration number to continue accumulating hours. However, you are not allowed to work in private practice in California if you have a subsequent intern registration number. This can be heartbreaking for prelicensed therapists who have to walk away from their practices.

It is important to make sure you know your state’s rules and expectations before you start building your private practice, and these rules can be easily found online through your state’s licensing board.

3. Decide If You Also Want to Work at an Agency

Most of the hours I’ve earned so far have been from my volunteer internship at a local nonprofit hospice. I love the work there, and I’m able to arrange my schedule and appointments around my private-practice job. The downside of working at hospice is I don’t get paid (fortunately, my husband’s income covers most of our expenses).

A prelicensed social worker friend of mine has found an internship at a hospital that does pay her. She says this is helpful because she’s able to build her clientele at private practice without having to rely on private-practice work as her only means of financial support.

I personally only know of one prelicensed therapist who works full time at a private practice. In most cases, a private-practice internship will help you build a client base but it probably won’t pay all your bills. It’s important to decide what your purpose will be for working in private practice.

4. Mind Your Marketing

I love doing marketing. I know that’s not a typical thing for a therapist to say. I like connecting with people, though, and when I can use my creativity to do that it feels even better.

We need to let our ideal clients know about us if we’re going to work with them. It’s as simple as that. I don’t want to convince people who wouldn’t be a good fit that they should see me, but I do need to be visible enough that my ideal clients will find me.

One of the things I’ve done to help myself and other clinicians is create a marketing group for fellow healers. We meet about once a month to share ideas and support. I encourage you to reach out to others. Marketing isn’t scary, although it can sometimes feel scary to put yourself out there. It helps to know you’re not alone.

Check with your state’s rules about how to market yourself as a prelicensed therapist. For example, in California we must spell out “Marriage & Family Therapist Intern” if we use the initials “MFTI” in our advertising. Also, your supervisor may be obligated to provide certain marketing materials such as business cards and a website.

A couple of popular online therapist directories are Psychology Today and Good Therapy.org. You may also consider creating a Facebook page and/or a Twitter account. Again, please be mindful of the advertising rules in your state.
There are many good resources out there, including Zynnyme.com, to help prelicensed and licensed therapists with business issues and marketing. I also recently heard Casey Truffo, creator of Be a Wealthy Therapist, say it’s good to network with other businesses your ideal clients use. For example, I like to work with artists, so it might be good for me to put up a flier at my local art supply store.

5. Don’t Give Up!

As one of my now-licensed MFT friends puts it: “Be reasonably humble but don’t short-sell yourself. Lots of interns can be better therapists than people who’ve been licensed for years. They’re inspired, motivated, and have often had the most recent training.”

If you’re feeling like private practice isn’t for you, please go back to tip No. 1 and see if there might be an internship site that is a better fit. Or if you’re not getting the amount of clients you want, understand that ebb and flow is a normal part of private practice. Look again at tip No. 4 and see if you can ramp up your marketing with the support of your supervisor.

This is your time to learn and grow, and it’s OK to be unsure or make mistakes. Let your experiences as a prelicensed therapist serve you and allow you to feel more empathy with your clients who may be struggling through similar life transitions.

Working as a prelicensed therapist in private practice can be scary, exciting, and richly rewarding. Please feel free to comment if you have questions or want to share your experiences. I wish you all the best in your current and future work!

Rachel Moore, MA, MFTI, is a registered Marriage & Family Therapist Intern in San Diego who works in hospice and private practice. Rachel was a newspaper copy editor for 14 years in her former life. She now specializes in helping artists, writers, and musicians overcome creative anxiety and increase self-esteem. If you are interested in Rachel’s groups and upcoming events or would like more information about her therapy services, please visit:www.rachelmoorecounseling.com

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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!