“I’m all over the place’”.

Darcey sighs and sinks back into her seat during our consultation hour.

“I have too many areas that I want to explore and I am not getting traction in any of them!”.

I can empathize with Darcey. It’s hard to focus on a singular niche when you have anxiety about building and growing your practice.

Darcey and I took a different tact. “What motivates you?  How do you help friends and colleagues? What comes naturally to you without effort?”


In many leadership assessments, there are questions related to motivation. Money, recognition, prestige and mission achievement are a few. Relationships are a great motivator in our profession: we are needed as nurturers and advocators. But sometimes, anxiety overtakes us as we start a practice and money becomes the only motivator we can identify. The basis? Fear– and as a prompt, it’s more stick than carrot. If fear is the backdrop for your work, I guarantee you will show up anxious and resentful for each cancelled hour or the client that got away and didn’t book. So then, how to manage those fearful feelings and truly understand what motivates you?

  1. Build up a couple of months of income. No matter how long it takes. This is a surefire way to help you wrestle control of your money worries. Only you can determine what that number is but make sure it includes rent, living expenses, insurance and supplies. I find that a healthy reserve in my savings account prepares me for any catastrophic thinking that can undermine a slow week. One therapist I know never touches her venmo or paypal account where she receives payment for shared dinners, or one-off trainings she does in any given year. Another colleague uses a program like Acorns or Digit to send small amounts of money to a money market account when she uses her debit card. By the end of year, she had $700.00 from rounding up her debit card purchases to the nearest dollar.
  2. Calmly, purposefully, understand what feelings you derive from your work. Look at your last five successes. Success defined by the feeling and the outcome. Were you thrilled by the recognition your last training received? Did your fierce advocacy work for a disenfranchised client leave a lasting and wonderful glow? Did you beam when the warring couple finally reached detente? Was it a rewarding moment when your teenage client finally got the high school diploma? Recognize THAT feeling that brought you a sense of well being. You may have defined your niche.
  3. Prepare and plan. I know. If you are a long time reader, the idea of a business planning hour is firmly part of Smart Private Practice. In fact, it is the bedrock of any small business. For our purposes as clinicians, the very foundation of what we do lies in our referral sources, our relationship building and our outreach to our communities. A short and powerful exercise? Make a list of fifty for each of those categories. No idea is wrong or too small. Gather with other colleagues and help each other develop a personalized list around each other’s niche. Taking the time to prepare and plan is as important to the success of your practice as a client hour.  
  4. If you need more structure schedule an hour of consultation  to develop your marketing plan and outreach. I guarantee if you concentrate on these three areas of building and growing your practice, you will see results. And if you don’t? You might be all over the place.