Should I Go Into Private Practice After Graduating From My MSW Or Wait Until I’m Licensed?

It Depends On Your Goals

Generalist & Wide Scope of Experience

• Do you want to gain more experience as a generalist where you are exposed to a variety of issues and concerns rather than specializing?

• Do you want to become more comfortable with a wide range of experiences such as suicide assessments, crisis management, case management, referrals, and coordinating care with other healthcare providers?

• Perhaps working in community mental health or non profit agencies is a better fit.

• Training Opportunities 

  • Do you want to receive specialized training opportunities post grad? 

    • If so, there are many Post-MSW fellowship opportunities available like: 

      • The VA (Veterans Administration)’s Addictions Interdisciplinary Treatment Fellowship

      • College & University Counseling Centers  

        • University of California Berkeley 

        • University of Massachusetts Amherst  

        • University of Colorado Boulder 

        • University of North Carolina

        • Ohio State University

        • Colorado State University 

        • University of Michigan

        • North Carolina State Counseling Center

        • Emory University

        • Bryn Mawr College Counseling Services

        • Yale Child-Study Center

      • Medical & Hospital 

        • Stanford Hospital Lucile Packard Hospital 

        • Baylor Integrated Behavioral Health

        • The Menninger Clinic

        • Texas A&M’s School of Medicine

        • Cambridge Health Alliance

        • Harvard Vanguard Medical Associates, Atrius Health Behavioral Health Fellowship Program

        • Mayo Clinic, School of Health Sciences

        • Yale School of Medicine

It Depends On Your Personality 

• Business Owner 

  • Being a business owner means you are in charge of: 

    • Accounting like managing expenses, understanding the basics of profit and loss, paying taxes, keeping up with all your business licenses.

    • Marketing like networking, advertising, creating and publishing a website.

    • Administrative duties like replying to phone calls and emails.

    • Everything essentially!

• Risk Aversion 

  • While opening a private practice generally is a low-stake and lower cost business (especially if you are 100% Telehealth), there are still risks involved like: 

    • Fluctuating income (some months/seasons are slower than others, client cancellations and no shows)

    • Unpaid time off and sick leave

    • Costs of paying for your own health insurance

    • Costs of paying for supervision (if you are an associate)

    • Marketing and converting new clients consistently toward a full caseload

• Confidence

  • Being a business owner requires confidence.

  • You need to understand what makes you different from other therapists, your strengths, what you help clients with, and why clients should work with you.

  • You need to be able to convey this through marketing, when you network with other colleagues, and when you meet with clients.

• Anxiety    

  • If anxiety is a a good friend of yours, it’s important to understand how anxiety shows up in your business, so you can avoid rumination, catastrophizing, etc.

• Perfectionism    

  • If you struggle with perfectionism, being in private practice can exacerbate this.

  • With reflection, awareness, and challenge, you can have a practice that is not perfect, but authentic, meaningful, and purposeful.

It Depends On Supervision Quality & Fit 

• A good clinical supervisor will be able to support both your clinical skills and your business.

• A good fit is crucial so consider personality, culture, experience, skill, non-negotiables, etc.

It Depends How Much You’ve Done Your Own Internal Healing Work

• The more “work” you’ve done on yourself, the more you will understand yourself more fully and completely.

• This can help with setting limits, confidence, assertive communication, asking for help, taking calculated risks, etc.

• Consider attending therapy yourself if you are not engaged currently.

It Depends On Your Focus During Your MSW Program/Graduate School 

• Did you attend a primarily clinically oriented program? 

• Did you specialize in a non clinically oriented major like administration and policy? 

• Your background, courses you took, experience you received during practicum, and supervision you received during school will impact your confidence and competence as an early professional.

TLDR: It Depends!

• Whether or not you pursue private practice after graduation depends on your style, your personality, your goals, as well as what sort of training, experience, and skills you were exposed to.

• Everyone’s journey is different and complex.

• Reflect on what your short-term and long-term goals are.

• Reflect on your values and what sort of workplace will best suit your values.

• Consider finances and if you have financial support from savings or a partner/family member to help you in the beginning stages of opening your business.

• Consider your energy level and if you have enough energy to open a business after graduating.