Opinion: Private Practice as a Social Worker: My Story, Getting Started, and What You Should Know

Opinion: Private Practice as a Social Worker: My Story, Getting Started, and What You Should Know

Ashley Carter Youngblood is the owner of her private practice in Kalamazoo, Inner Peace Counseling, PLC, where she specializes in the connection between nutrition and mental health and counseling worrying women and highly sensitive people. Because of her love of private practice, she also offers consulting services for those who are interested in starting or growing their own private practice.

Private practice is not usually the first thing people think of when they think of a social worker. However, it is an area of clinical practice that is growing rapidly in popularity, with some students entering their social work programs having private practice as their specific career goal. Given this, more information on the topic, particularly for students and new graduates, can help illuminate what one should know about this aspect of social work practice and how to get started if, in fact, private practice feels like the right place for you. 

As we would tell our clients, each social worker needs to do what is right for them. This article series on private practice will hopefully help you to decide if private practice is right for you. We will explore what exactly private practice is, things to consider, and pros and cons. I will also include a bit of my story of how I became a private practice owner (and why I think it is the best thing in the world!). Balancing this enthusiasm will be an article by my colleague, Malinda Dobyne, a fully licensed social worker who has been working with clients in private practice at her own practice for over 20 years, reminding us of things to be wary of if one does feel drawn toward private practice.

My Story

Starting with myself, I am a fully licensed social worker and a fully licensed marriage and family therapist in the state of Michigan who has been doing counseling since 2010. Both of my parents are also business people. So, although my clinical life started at a substance abuse treatment facility, where I practiced for five years helping support those with often severe addiction and mental health disorders, I have always felt comfortable blazing my own trail. 

You should also know that I lovingly refer to myself as a “nerd” given that I am constantly curious, trying to make things better, and cannot seem to shut off the entrepreneurial part of my brain. I am also the over-achiever in the office who has their tasks done ahead of time, is annoyingly detailed, and who everyone tends to go to for resources or updates relevant to the work being done. Yep, I’m “that person”.

Now that you know a bit about me, it may seem logical that I struggled in an agency setting. I loved my clients, co-workers, and the actual clinical work. However, my analytical and business brain was constantly thinking about how I could make things better and what new systems I could put in place to streamline things. As you know, in an agency setting, one rarely has influence on such things. In addition, working with a variety of clients with a variety of issues only clarified who my “ideal client” was and the kind of work I really wanted to do.

I also grew up in a house where being holistic was the norm. In my home, it was always lifestyle changes and supplements before medication in order to honor the part of the body that is innately willing to heal itself. This may go without saying, but agency work is not exactly the environment where I could best express this philosophy of wellness as a provider. Therefore, there came a time where I said, not only within my agency work but also at the private practice at which I was an intern and working as a limited licensed provider, “I can do better than this.” So, I did.

Defining Private Practice

Even when I was interning as a social worker in private practice, I was constantly clarifying my professional vision. I had an active Facebook page, created and constantly updated a website with a blog, made flyers and brochures, and held events (e.g. free meditation groups) that helped to find and market to my niche. I even proactively attended networking events on my own time. So, the transition to private practice ownership was not a large leap for me. It was organic given how much work I was already putting into my professional reputation.

That, in a nutshell, is what private practice is: Working for yourself. The thing I love most about private practice is that I have the freedom to create the vision, policies, and physical atmosphere in my office that most reflects who I am as a clinician and human. Being a private practice owner also allows me to easily communicate what I can offer others because I can market how I want. For some people, though, the nicest part about private practice is that they can simply do the clinical work while someone else worries about the office policies, billing, marketing, and other “business stuff”. So, private practice offers two choices: 1) you can work for yourself owning your own business, where the buck always stops with you or 2) you can be a therapist simply working for yourself while a practice owner oversees all of the business considerations you do not want to deal with. 

NASW’s Recommendations

In case you are unaware, the NASW did publish formal standards in January 2011 in their Leadership Ladders series about who is “ready” for private practice. While these standards are for private practice ownership specifically, they remain relevant for all social workers to consider.

These standards include a Master’s degree in social work from an accredited school of social work and a minimum of two years/3,000 hours of post-graduate experience “in a supervised clinical setting”. Regardless of such standards, one thing to note about private practice is that, if you have a limited license or are an intern, you will still have to practice under a fully licensed provider (most likely who also offers services as your physical location per various legal and insurance requirements). In addition, you will still have to fulfill all of the licensing requirements through Michigan’s Department of Licensing and Regulatory Affairs (i.e. LARA), which includes additional supervision. 

I will admit that, because business ownership came so naturally to me, I struggled to honor these standards put forth by the NASW. I was already acting like a business owner. I was just not getting paid for it. So, it was in combination with my two social work license supervisors, who were both in private practice, with one being a practice owner, that I decided I was ready to move forward into a private practice of my own. 

Variations

What does this look like, exactly? Good question. Private practice has many different models. The popularity of certain structures also seems to vary based on region. For example, in my area of Southwest Michigan, having clinicians be paid a percentage of what they earn as independent (i.e. 10-99) contractors is most common. However, on the east side of Michigan, it appears more common for clinicians to be paid as employees and, therefore, enjoy the benefits of being an official employee (e.g. health insurance coverage, paid time off, FMLA).

For those who are independent contractors, “splits” between 40%/60% and even as high as 30%/70% (i.e. where 70% of the earnings goes to the clinician and 30% gets diverted to the business to sustain the practice) are common. However, just like any other field, two businesses that offer the same service are going to do things very differently. So, the key is to find a fit and culture that is best for you. (More on what questions to ask a practice for whom you are considering working later, so stay tuned!)

The Future

With the global pandemic of COVID-19 creating both a mental health crisis and an expectation for telehealth services, I suspect we will only see more people looking to go into private practice and more private practices wanting to add clinicians. For me, the future looks like a blend of doing clinical social work and also continuing my consulting business that helps people to start and grow their private practice. This consulting business is one I started after successfully starting my own private practice in 2017 in order to share my passion about how empowering private practice can be. For me, I will forever get to enjoy the beauty of private practice, whether it is offering mental health services or helping others to start and grow their own practices. And, I would not have it any other way.

Watch for these upcoming op-ed articles:

• The Pros & Cons of Private Practice as a Social Worker

• Private Practice as a Social Worker: Things to Ask (to not be taken advantage of)