The Most Important Thing You Can Do in Private Practice: Follow Your Gut

I’ve written thousands of words about starting and running a thriving private practice.

It is my hope that my essays about private practice will provide insightful perspectives and guidance so therapists can make informed decisions.

However, when it really comes down to it, what matters most in private practice is your gut.

Your circumstances, your desires, your clients, and your practice are unique to you. Your gut will know best what to do because it is the one that directly experiences life as you.

This seems obvious.

Until something happens where it’s not.

When I was about a year into my private practice, a teen client wanted to disclose something to me, but wasn’t sure if I would have to report it as a mandated reporter. The conversation sounded like, “If a person wanted to tell you about this, would you have to report it?” I told my client I would discuss it further with my supervisor before we talked directly about what was happening.

At the time, I had two supervisors, one for art therapy and one for counseling.

"Unsure" Illustration by Jackie Schuld

I talked with my art therapy supervisor first, and it became clear I would need to report what my client was likely to share.

Once I knew I would need to report, my gut told me to set up another meeting with the client and tell them that information directly, as well as discussing the benefits of still having a deep conversation about the topic.

I was extremely nervous and spoke with a fellow therapist about my own feelings. I couldn't share what was happening with the client, but my friend offered advice that conflicted with what I was planning to do.

I then met with my counseling supervisor who told me I already needed to report it because it was clear the client was talking about a real situation. She said that even though we talked in “hypotheticals,” I would have to make a report immediately.

I felt awful.

I had not informed my client that by even talking in hypotheticals, their words would be reported.

I was worried about their trust. AND worried about so much more. Informing the police. Informing parents. Making sure I took the “right” ethical and legal action.

The stakes felt high. So when I met with my client, I didn’t go with my gut. I went with a garbled mess.

I had too many voices of advice in my head. I handled it all very poorly.

My client was upset and felt betrayed. There is more to the story, but in short, a mandated report to the police was made and the client chose to stop working with me.

I wish I had followed my gut and approached the situation the way my gut told me. The outcome may have been the same, but I think less harm would have happened in the process.

It is painful to me that someone was hurt by my choice to not follow my instincts and intuition. It is painful to think that this individual may have a negative association with counselors because of me.

I took this material to my own therapist and have done significant healing and work around it.

The lesson to be distilled is to follow your gut.

In every choice you make about your private practice, follow your gut about what is the right fit or approach for you.

There are thousands of options: where to have your practice, what to put in your paperwork, who to work with, how to market, and more.

You can do all of the work to make sure you know the foundational ethics and laws around your actions, and then the rest is up to you. To your gut.

It will guide you far better than gathering advice from person after person or article after article. At some point, owning a private practice is about taking OWNERSHIP of yourself and your decisions.

It is one of the most challenging and the most liberating aspects of private practice.

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Thank you for reading. If you would like support as you create your ideal private practice, you can learn about my business consultation here.