When I first started working with folks who’d experienced trauma I used a handout. A you’re-not-crazy-these-reactions-are-normal-for-this-circumstance list of symptoms with brief descriptions of why. One of the members of the Abundance Facebook Group (jump in!) said it would be helpful to have a list of normative experiences in the early days of your practice. A brilliant suggestion and I’m happy to flesh it out like that list I used back in the day.

I’m not going to pretend like there’s ONE experience of private practice in the first year, but having talked to hundreds of people in their first year, I’m clear on some themes.

These may not apply to you, but if they do: you’re normal, you’re where you’re supposed to be, you’re not doing it wrong.

What to Expect Your First Year

Imposter Syndrome

I STILL have Imposter Syndrome sometimes. Whether it’s focused on your business or clinical skills, this sense that others might someday realize that you are indeed sub-par and got through all this training and business building by luck is almost a given as you build.

Boom & Bust

I hear this a lot: “I put my Psychology Today profile up/Gave a Talk/Met with a Doctor/______ and got a flood of calls! I expanded my hours and then… crickets.” In the early months and sometimes years of your practice you’re more likely to have booms and busts. The longer you’re in it the more steady referrals become.

Optimism and Pessimism

Oh the roller coaster. “IT’S ALL HAPPENING!” can become “i’m going to fail” within a day depending on what you’re gauging your success on.


As if the comparison we do in real life isn’t brutal enough, the comparison we do in business life can be soul-crushing. Of course you’re going to compare yourself to your peers. You’re human.

Getting Stuck in Scarcity Mode

It’s so easy to get stuck in scarcity mode when you’re not booking appointments. Too easy. With scarcity comes fear, grief, hopelessness, pessimism, self-deprecation, frustration, hurt. All those feelings we want to avoid will come up.

Lessons Learned the Hard Way

This entire business came from a desire to save people from learning the hard way like I did. Learning the hard way SUCKS and it’s also part of the process. I’ve realized that I can show people where I fell on my face, but that doesn’t mean they aren’t going to have their version of their own face-plant as they build.

Some Therapists are Assholes

I wish it wasn’t true, but it is. The empathetic-me knows that the therapists who hoard referral sources, don’t set others up for success, discourage clinicians from going into private practice, and all the other iterations of a scarcity mindset are scared. They don’t know in their bones that there are plenty of clients to go around like I do. The non-empathetic-me is frustrated that they have the power to negatively impact folks who are already vulnerable and needing support.

Some of Us Are Great Fakers

This goes along with the comparison piece. It’s going to look like a lot of people have their shit together. That doesn’t mean they do. Kind of like how you don’t show your clients all your messiness, some clinicians are going to keep their private practice insecurities from leaking out to colleagues. Don’t let it fool you into thinking you’re less than.


I also hear “I’m seeing 5 clients a week– why do I feel burned out?” Let’s see. On top of those 5 clinical hours, you’re also investing time in learning so much. You’re spending time with new systems, so much business stuff, staying on top of clinical skills, reassuring your mom that your business is growing, reassuring yourself that your business is growing, doing paperwork, using frustration tolerance skills, networking, overanalyzing every networking experience, brainstorming, honing your niche, listening to podcasts, reading blogs, watching tutorials, signing up for webinars, designing websites/business cards/rack cards, working your marketing plan, getting lost in the land of Facebook, and doing the rest of life.


There will be this point where all the sudden you realize you’re on your way. You’ll see the people newly in private practice trying to hide their panic. You’ll realize you don’t have to hide yours anymore because you know you’ve got this. It may hit you one day or it may be a gradual knowing. It’s like when you stopped worrying about not knowing what to say in session. One day it stopped being such a huge concern. This confidence doesn’t necessarily mean you are full. It just means you know you’ll be full one day. I know, sounds nice right? You’ll get there.

To Be Continued…

Next week I’ll give some perspective on what to do about these things. Until then, rest in the fact that you aren’t a weirdo and that what you’re experiencing is something so many others have experienced. Including me.

Any of this sound familiar? Let us know in the comments!


Allison Puryear is an LCSW with a nearly diagnosable obsession with business development. She has started practices in three different states and wants you to know that building a private practice is shockingly doable when you have a plan and support. After retiring her individual consultation services, she opened the Abundance Party, where you can get practice-building help for the cost of a copay. You can download a free private practice checklist to make sure you have your ducks in a row, get weekly private practice tips, listen to the podcast, hop into the free Facebook Group. Allison is all about helping you gain the confidence and tools you need to succeed.

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