The biggest problem I had initially was solving the case of the missing client. How do I get clients to find me and to come see me? I certainly felt comfortable with my clinical skill set, and comfortable in the office space I’d created. But my biggest hurdle was getting clients to come sit across from me in the comfort of my office.

In a market where, according to the Psychotherapy Networker, there are about twice as many therapists as there is demand for therapists, I think the biggest issue I faced is still a common one today: how do I get clients to find me and come see me?

Ultimately, I realized that if I’m going to be a therapist in private practice, I’ll have to figure out how to be both a good therapist and a good entrepreneur (or at least a good business person). That means doing my research on how to market myself, and perhaps finding a good marketing person to consult with and help me along the way.

It also means a willingness to invest some money upfront in marketing, which is often difficult because when I’m starting is when I have the least money.

But at the end of the day, I read about marketing strategies — of course this was back in the 1990s, when things were a little bit different and the Internet was dawning. Then, after some study, I did make the leap and begin to spend what felt like a lot of money at the time to get started with marketing. And, to put it simply, it worked.

If you’re just getting started, I’d say really take some time and explore your options in the field. Don’t feel rushed to jump into what’s right in front of you. Consider different options, such as working in an agency setting (and remember that agency settings very dramatically from one agency to the next). Take time and think about private practice, and as I said before, be prepared to learn about the art of business as well as the art of psychotherapy. Alternatively, there is a growing new model, and that’s the model of the group practice. For years, doctors have come together in groups, so much so that the age of the private practice doctor is slowly coming to a close. I’m not saying that’s necessarily true of psychotherapy, but I do think there might be merit in seeing if there’s a good group practice in your town you might want to consider as well.

Mostly, try to find options that are congruent with you, and that are congruent with both who you are and who you want to be.

Keep learning. There’s such depth to the fine art of psychotherapy. I believe in the merit of finding a safe, encouraging place where you can learn and grow personally and professionally — perhaps an annual conference with like-minded people you can reunite with annually; or a clinical supervision setting with a caring master-therapist. We all need a place where we can keep challenging ourselves as professionals to learn about ourselves, about our field, about our own vulnerabilities with transference and countertransference issues. We all need a place where, as we learn, we augment our confidence in the therapy room, and feel we have the best tools possible to help our clients.

At the end of the day, I wish — early in my career — I’d grasped the theory of personality and theory of methods I have now: Theories that allow me to understand people quickly and elegantly, and guide them gently, yet purposefully.

I think we’re entering an interesting time in the world of private practice. We’re witnessing big-insurance and big-corporate-hospital beginning to dictate the flow of all sorts of medical treatment. I think the risk to a psychotherapist in private practice is the real possibility that large hospitals and doctors groups will begin to integrate mental health into their practices, bringing their own therapists in-house. Over time, what you might start to see is the client seeking care at the doctors office for both physical and mental health issues, lured by the appeal of integrated physical and mental health care, and drawing clients away from the private practitioner.

I think one way therapists can remain independent is to gather together and form groups. As a group of like-minded psychotherapists, the group can leverage the power of being a team and contract directly with doctors, integrating their mental health care with the doctor’s physical care.

This is, of course, a crystal ball guess, but one based on my own experience running a group and contacting with doctors. In fairness, my crystal ball may be broken. So take all this with a proverbial grain of salt

Thanks for asking. My name is Carl Nassar and I am a long time psychotherapist in private practice in Fort Collins, Colorado. More recently, I took my private practice, Heart-Centered Counseling, and grew this into a group practice, adding a team of seven therapist to join me.

My private practice website, which I’ve had for a long time now, is carlscounseling.com, and I think you’ll find it’s written with a sort of gentleness and care I hope has come to characterize my work with clients.

I’ve also now created a group practice website, heartcenteredcounselors.com, which reflects on the values of our group practice, and explains the power of the team approach to a client who is searching for mental health care.

I myself have been trained both in the US through the usual academic graduate schools, as well as in Europe, where I’m certified as an Integrative Psychotherapist. What I like so much about the European training model is that it’s mentorship based, and the learning is far more experiential and “felt”, as opposed to the academic rigor of the American graduate school.

I’m not saying one is good or one is bad, but I will say that they both complement each other nicely, and I feel very fortunate to have been trained both in a European model and an American model.