I was chatting with a therapist-friend the other day who told me the story of how his practice went from very few clients to full in the span for a couple months. A local behavioral health agency lost the psychologist who did their testing and boom! my friend’s business blew up. As one of very few psychologists who enjoys testing in his city, he was in a great position to fill the need. Having a niche is awesome.


I’ve been worried about him since that conversation. He was no longer working on building his practice because there just wasn’t time or desire to. He had struggled for a long time to build before this situation and now felt “saved” by this agency’s loss. He didn’t seem to be worried about the fact that the behavioral health agency would likely hire another tester, especially since it’s such a money-maker for agencies. Every bit of his business was coming from one place and that is a scary situation to be in.

I’ve seen this happen with therapists who are good friends with Case Managers at agencies, too. There’s a smooth & direct funnel from their friend and then when the friend moves on to other employment, the new Case Manager has his or her own preferred referral sources. The practice tanks.

If another private practitioner who sends you her overflow has a dip or takes on another day of work per week, you don’t want to be screwed.

Don’t get scared by this, there are still plenty of referrals going around; you just have to diversify. No one referral source will be able to maintain your practice for the long haul. So having relationships with case managers and PCP’s, the folks at agencies and private practitioners is important. It also ensures that you get the kind of clients that you want. You can clarify with referral sources who you do your best work with and they can feel great knowing that they’re making a good match.

As your mom probably told you at least once, “Don’t put all your eggs in one basket.”

You know my answer to the question “How do I find more referral sources?”, right? Network. Network and build your community. The diverse referral sources I’ve built saved me from the summer slump most clinicians experience.  So the University isn’t packed and the counseling center isn’t sending me folks in June, no problem. The other therapists are mid-slump and don’t have the non-summer overflow to share, that’s cool. The teenagers are getting the physicals they need for their sports teams and the pediatricians and PCP’s are sending me what’s coming in. The psych prescribers are still seeing a million clients a week because there are never enough of them and they know I’ll either take their clients or find someone awesome for them. The Eating Disorder Dietitians I collaborate with all the time hand out my card when the desire to have the perfect bikini body became a dire situation for someone who now needs therapy. The talk I’m giving in October to the Perinatal Emotional Health Network will likely yield a handful of referral sources in the way the talk I gave at the local counseling association did.

So how can you build in more referral sources when you’re already full from one source and can’t take anymore clients? For one thing, make sure YOU have awesome sources to refer to. I don’t typically announce that I’m full and when a client is referred to me I spend some time on the phone or encrypted email getting to know what they’re looking for in a counselor and give them some awesome leads. Yes, it’s time I’m devoting to someone who won’t ever pay me a dime and y’know what, it feels awesome. It’s great to help the client get to the right clinician for her, it’s great to give a clinician a client they’ll like that helps build their practice, it’s great to keep the referrals coming from referral sources that may dry up if they hear I’m full. My advice is to spend one lunch break a week having lunch with potential (two-way) referral sources. You’re full so there’s no big rush, but building relationships and community is a great way to beat back the loneliness of private practice, build your reputation, get to know your colleagues, and meet people who you’ll be referring to. Even for shy introverts, once a week is usually doable as long as you’re cool with self-care.

Who are your referral sources? Other therapists, medical folks, your massage therapist? Let me 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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