How Long Does It Take To Get A Full Caseload?
How long does it take to have a full caseload in private practice?
It depends.
Variables & Considerations
What Is A Full Caseload For You Personally?
If 15 clients weekly is full for you, this will be different than someone who wants to see 22-24 clients a week
How much money do you need to pay rent, bills, loans, debt, etc.? Work backwards to find this number
How many clients can you see weekly without burning out/compassion fatigue?
What Services Do You Provide? Populations do you work with?
Certain issues/symptoms are more emotionally draining than others
Certain issues/symptoms require more time and effort (e.g. comprehensive DBT program)
Length Of Time Practicing As A Therapist
Newer therapists are more likely to accept any sort of client who comes to them for help because they are still establishing their name in the community
Older more tenured therapists have stronger and quality relationships with others in the community and receive word of mouth referrals (some don’t even have websites and are constantly full)
This is obviously a generalization and doesn’t apply to everyone
Are You Leaving A Group Practice Or Agency?
If you have clients who will follow you to your private practice, this will accelerate the time it will take you to fill your caseload
What’s Your Schedule?
Will you work 5 days a week? Or 3?
What hours will you work?
Some hours tend to be coveted and are easier to fill (e.g. evenings after 5:00 p.m. and weekends)
Will You Accept Every Client Who Reaches Out To You?
Not all clients are a good fit due to scope of practice, personality, approach to therapy, etc.
If you decide to work with every client who outreaches to you, you’ll be fuller sooner, though this might not be a good business decision long term and ethically
Reduced Fee/Sliding Scale
Will you offer a lower fee? If so, it’ll take you much quicker to fill your caseload.
Fully Licensed Vs. Associate/Provisionally Licensed
Some clients prefer working with an independently licensed clinician due to wanting to use out-of-network (OON) reimbursements
In Washington State, there are some insurance plans that do not reimburse for OON benefits for associate/provisionally licensed clinicians
Insurance
One of the major benefits of accepting insurance is being listed on their directory
Some therapists who accept insurance receive 10-25 referrals a week
Many clients expect to use their insurance
This means finding and retaining clients is much easier than cash/private pay clients
Cash/Private Pay
Cash/private pay clients take longer due to the perceived value and higher cost
This requires good marketing, branding, speciality focus, a niche, etc.
The better of a fit you are for a client, they are more likely to see a private pay therapist
Marketing Strategy
How are you currently getting clients?
How will this change in the future?
How much time are you investing in marketing?
Do you still feel unsure about the best ways to market?
Can you invest more time learning marketing methods?
Do you want to hire someone to market for you or teach you the basics?
Leads
How many new client inquiries do you receive a month?
Where do they mainly come from (track all leads by simply asking clients, “Where did you hear about me?”)
Conversion
How many of your client inquiries turn into new clients?
If there is a low conversion rate, consider why clients aren’t booking with you.
Retention (Average Client Sessions)
On average, how long do clients tend to work with you?
This depends on your theoretical orientation (e.g. Solution Focused Therapy, psychodynamic therapy) as well as fees, issues, symptoms, how clients define success and growth, etc.
How do you measure growth? How do clients measure growth?
There Is No Ideal Caseload For Each & Every Therapist
Every therapist is different. Focus on what works for YOU, not others.
For your business, your personality, your life, and your needs.
Hypothetical Situation #1
If a full caseload for you is 20 clients a week.
It will take you at minimum:
7 months, if you receive 6 clients per month
8 months, if you receive 5 clients per month
10 months, if you receive 4 clients per month
14 months (1 year and 2 months), if you receive 3 clients per month
20 months (1 year and 8 months), if you receive 2 clients per month
Hypothetical Situation #2
If a full caseload for you is 25 clients a week.
It will take you at minimum:
9 months, if you receive 6 clients per month
10 months, if you receive 5 clients per month
13 months, if you receive 4 clients per month
17 months (1 year and 5 months), if you receive 3 clients per month
25 months (2 years and 1 month), if you receive 2 clients per month
Tips To Build A Full Caseload In Private Practice
Clients ebb and flow during the year
January tends to be very busy while Summers are slow
Consider this when marketing to clients during slower months/seasons
One of the most important parts of private practice is new clients coming in consistently so you can make a profit
Effective and authentic marketing is the key to success. Graduate school didn’t teach you this, so you can hire a business coach, devote time and learn on your own, find a supervisor who also can help you with private practice/business issues, etc.
Network
Get your name out there
Have a 1-2 sentence blurb about what you do and how you help clients. You’re not just a therapist. You help people manage anxiety and have more freedom in life. You help people recover from trauma and have more joy in life.