The Business of Therapy: A Journey Towards Integration?


If someone asks you what you do, I bet you tell them you’re a therapist. Okay, you might say counsellor, psychotherapist, family therapist etc, but I suspect you define your work by your client work. Am I right?

But that’s not the full story is it? Because you are also self-employed. Most therapists I know tend not to think of themselves as self-employed business owners, and of business as something that shopkeepers or entrepreneurs do. The channel through which they practice is not of much interest. I think this is a pity, because hidden in the business side of practice is an opportunity to integrate more of ourselves, to further our journey towards wholeness.

When you think of business what comes to mind for you? Do you think of huge global corporations such as Apple or Google? Do you think of scandals in which the drive to make money has created much pain and suffering, such as Enron or the banking crisis? Do you think of your local convenience shop, open all hours to provide newspapers and milk? Can you see yourself as having anything in common with these at all?

Many therapists have come to the work from other caring professions, such as nursing or social work. Few have experienced self-employment before. Often, they come to the end of their training, and find it a shock to realise that there are few salaried positions available for therapists, and those that are there may require qualifications or certifications they don’t have. For these therapists, self-employment is not something they have thought about and chosen, but something that they fall into, because there are limited options for them.

Self-employment asks things of us that we have not experienced before, or asks them of us at a level we have not experienced before. It brings us face to face with dilemmas and edges we might never have chosen. In this way, becoming self-employed and creating a practice of our own, truly is a personal development process, another layer in growing up and taking our place as adults in the world.

As regular readers know, I look at the business of therapy from six directions, what I call the six pillars of a therapy practice.

The first pillar, “Owning Your Practice,” is concerned with the mindset it takes to be self-employed as a therapist, the shift from passenger to driver, or from employee to both employer and employee. To take ownership of our practice we have to engage our willingness to step into our own power and authority, and this can be tricky. We may have had experiences in the past where we encountered an abuse of power. Family patterns and issues with parents can resurface as we attempt to engage our own authority.

As we set out to create a practice of our own, we may meet with our relationship with success and failure, and our willingness to find a way to overcome obstacles. We might not consciously be aware of how our fears of success and failure influence our choices and our actions, but they are there in the back ground nonetheless. If we tend to default to powerlessness and negativity when we encounter a problem, rather than trying to find a solution, we will struggle in self-employment.

We also meet our relationship with self-sufficiency and dependence. As someone who is highly self-reliant, and finds dependency difficult, this is an edge that I have struggled with in creating my own practice. Paradoxically, while self-employment requires us to act independently, it also means being able to accept help and support from others, because we cannot do it all alone.  A reluctance to ask for help or to admit we don’t know what to do next will restrict our ability to invite the support we need.

In short, at the first pillar level, “Owning Our Practice,” we are talking about our ability to hold and reassure our inner child, while the adult comes to the fore.

Owning our practice means we need to adopt a mind set that sees the business side of our work as important, and this means that sometimes we will have to choose to make the business a priority over other things in our lives. You might need to choose to do your marketing rather than the housework, or watching tv, for example. Sometimes these choices can be difficult, especially if they mean that we must do what our practice needs us to do, rather than attend to the needs of others, family or friends for example.

In this way, the business aspects of our journey to create our practice truly are an opportunity for personal integration and wholeness. Rather than pushing away business as something that is alien or anathema to therapy, it is a doorway into hidden and shadow parts of us that can only benefit us when brought into the light. And there is a knock-on benefit to your clients, because as we grow, our clients grow too.

However, this is challenging work and we never know when starting a new task in our practice will bring us face to face with our ghosts, so my wish for you is that you take it slowly, at your own pace. Be kind to yourself and ask for help. I’ll talk more about the choices that being self-employed brings in a later article and I’ll also explore how the business side of being a therapist brings us into contact with more layers of our inner journey.

If I can support you in any aspect of this work, please contact me here to arrange an appointment or to avail of your free 20 minute consultation.