Private Practice as a
I receive lots of questions about whether it’s possible to get started in private practice as a pre-licensed therapist and how to go about it. Since I got my start in private practice as a pre-licensed therapist accruing my postdoctoral hours towards licensure (called a psychological assistant in the state of California), I share a bit of my experience in this article and offer some tips for how you can start in private practice as a pre-licensed therapist too.
(here’s a photo of me from my pre-licensed psych assistant days – I was only 25!)
Can you work in private practice as a pre-licensed therapist?
The short answer? YES!
My graduate program didn’t do the greatest job of educating us about being in private practice as a pre-licensed therapist, but I would hear rumors that other students were working in private practice.
I never learned much about it until by chance after graduating I landed a position at a group practice in San Francisco. Turns out, you definitely can work in private practice as a pre-licensed therapist!
After I got into the swing of that role, I picked up a second psych assistantship at another practice in San Leandro in order to accrue my hours more quickly. I finished my 1500 postdoctoral hours in 2 years this way.
You can hear my full story of being a psychological assistant in the embedded video above.
My journey as a pre-licensed therapist in private practice
In 2012 I graduated with my PsyD in Clinical Psychology. At that time my main goal was to finish my hours as quickly as possible. The problem was, my husband was also in postgraduate training of his own and he was getting paid minimum wage.
Living in Palo Alto in 2012, even renting the cheapest apartment we could find, two of us making minimum wage meant we were dipping into savings every month in order to make ends meet.
So I scrambled to look for an internship that could pay the bills and get me my hours. As I learned about pre-licensure opportunities as a psychological assistant in private practice, this option seemed appealing to me to help meet the goals of both accruing my hours and earning a more decent living.
What worked for me:
- Being able to set my own rate
- Having say over my schedule
- Having the wonderful guidance of supervision in the midst of embarking into private practice
- Having a full caseload under my own business name once I got licensed
What was challenging for me:
- Being fully in charge of my own marketing (and having no idea what I was doing)
- Accruing hours more slowly than I would like
- Being in charge of all business items without any prior training or education
Is private practice right for you?
If you’re a pre-licensed therapist and you’re thinking about pursuing private practice, it’s important to consider each opportunity individually. If you watch the video where I share my story working at two different practices, you’ll hear that I had two very different experiences at each.
Be sure to put a bit of research into each practice before saying “yes” to any internship that comes along.
Generally speaking though, there are a few pros and cons to consider before diving into private practice as a pre-licensed therapist. Keep in mind that these are just generalities and not true of every practice:
Pros of working in private practice as a pre-licensed therapist
- Opportunity to work with clients in your niche
- Flexibility to set your own schedule
- Possibility of earning higher wages than other internships
- Potential opportunity to stay on at the same practice once you’re licensed, or to keep your private practice caseload
- Have support from your supervisor regarding launching private practice rather than doing it completely on your own
Cons of working in private practice as a pre-licensed therapist
- It can take some time before you build your caseload
- Due to the above, you may have lower pay than you’d like initially
- You may accrue your hours more slowly, especially at first
- Greater likelihood of feeling overwhelmed or isolated, since you’re more on your own than most agency settings or other internships
- Less accountability for staying on top of things like documentation and other ethical items; expectation that you are more of a self-starter
- Depending on the practice and your supervisor, you may not have the support you need to launch your private practice (some supervisors are just in it for the money).
How to find a private practice internship as a pre-licensed therapist
I’m not going to lie, there is no easy method to find an internship in private practice as a pre-licensed therapist. From my experience, most clinicians in private practice are not on the hunt for someone to supervise, so it really takes a bit of hustle and savvy to make it happen.
Before diving in, be sure to check first with the laws of your state affiliated with your credentials. For example, in the state of California as a pre-licensed psychologist, I needed to check the laws set forth by the California Board of Psychology in order to determine what type of internships I was eligible for and how to go about applying for approval.
With that said, I share here how I found each of my two postdoctoral internships in private practice to help you glean from what worked for me:
Strategy 1: Networking
About 3 months before I prepared to move to the San Francisco Bay, I started contacting all of my connections. And I mean, ALL of my connections. I didn’t just stick to professors or old supervisors, but I posted to my personal Facebook page, I asked around at church, and I asked all of my friends in every circle I knew of.
I’m sure I annoyed the heck out of some of my circles, but this is what worked for me. This strategy landed me my first psych assistantship in San Francisco. The connection? A woman from my church saw my Facebook post and recalled that a friend she had known 10 years prior was now working in a group practice in San Francisco. She put me in contact with her friend, who then put me in contact with the supervisor of the group. Two days after I moved to the bay I interviewed there, was invited for a second interview, and then was offered the job within the same day of the second interview.
Notice that there was no strategy to this strategy. I didn’t know who out there might have that connection I needed. I cast as wide of a net as I could in the hopes that I might catch something.
Strategy 2: Cold Calling
After landing my first internship, I wasn’t accruing my hours fast enough – it took me about a year before my schedule really ramped up. In the meantime, I started looking for a second position. This time I turned to cold calling.
Yep, it’s exactly how it sounds. I scoured Psychology Today’s Find a Therapist Tool, did Google searches, and asked around to find anyone working in private practice. When I found anything that seemed remotely within driving distance, I called and emailed every single practice.
My strategy was to contact 5-10 practices per day. In the span of several weeks, I contacted dozens if not hundreds of practices.
Most people never replied to my inquiry. I get it now because I receive several of these inquiries per week now that I’m running my own practice. It’s a lot to keep up with and there’s no obligation to reply. But at the time, I was pretty butthurt about it.
Out of everyone I contacted, about three practices responded. Two of them said they were not accepting interns at the time. The third? He was interviewing someone else tomorrow and asked if I would be free to interview that day too.
Um, YES PLEASE!
I interviewed the next day and within a day or two, I was offered the job.
Now keep in mind, that ended up being a terrible job for multiple reasons. You can hear the full story in the embedded video above. But my hustling did land me the position.
I hope you found hearing my experiences helpful as you consider pursuing private practice as a pre-licensed therapist.
If you’re thinking about taking the plunge into private practice but you aren’t sure where to start, check out my free guide that walks you through everything you need to know to get started in private practice: Start a Private Practice in Counseling.
Until next time, from one therapist to another: I wish you well.