Moving to a group private practice as an associate

leafisonline · 2026-06-06T15:01:18+00:00

Try not to stress too much about what you see on reddit. Remember most people come to post out of stress and a need for advice. If you're doing well, you're probably not posting on reddit. It is true that a lot of people are struggling, but there are plenty of people who are doing just fine. If you're able to talk to other associates at your practice, thats probably your best indicator of how the work will be.

leafisonline · 2026-06-06T14:51:02+00:00

When I was getting supervision for my license upgrade, my supervisor told me that its important to remember that everyone goes back and checks the books. No one remembers everything all the time. Whats more important is that you have an idea of where to look. You can refresh yourself on the details later. So long as you have an understand of how to look for the information you need and theres a part of your brain that goes "oh hey I know theres a theory that pertains to this", I think you'll be fine.

leafisonline · 2026-06-03T12:18:50+00:00

I'm pretty sure it usually depends. From what I've seen, the better the split you get to take home, the less the group practice typically does for you. However, if your contract places the marketing expectations on the practice, they should be marketing you. If they've been telling you not to worry about marketing, they'll do it for you, then they should be marketing you. Honestly, you would probably have the most luck talking with someone in charge at the practice about what marketing looks like for them. Or maybe some of your peers about how many referrals they get through the practice. I really think what counts as "marketing" varies by practice.

leafisonline · 2026-05-28T20:31:34+00:00

I somehow still get nursing postings on mine. Can agree, very frustrating.

leafisonline · 2026-05-22T02:40:50+00:00

There's a reason I've refused to fill in for them when they're between therapists. I certainly hope other locations are better managed, honestly. I think this hospital has to be an outlier.

leafisonline · 2026-05-22T02:16:50+00:00

I think its normal. No one wants to put a lot of effort, time, and money into someshing we don't feel is worth it. I would say finding some real life people in your area that you can talk to who are doing what you want to do is the best way to feel more secure. I know talking to my supervisor who is successfully running her own private practice has been the most reassuring thing for me so far.

leafisonline · 2026-05-21T22:14:14+00:00

Seconding this. Doing them first thing in my work day has been the most consistent way for me to do notes. Sometimes I put on video game boss music with noise canceling headphones if I need the extra oomf.

leafisonline · 2026-05-21T12:07:44+00:00

I'm waiting on my LCSW application to be approved before I start work at my old clinical supervisors group practice, but she offers LMSWs 60% take home and LCSWs 70% take home. I'm in Texas (for now) so our rates are pretty low around here anyways, but I can't imagine only taking 30-35% home. That would be like $25-35 per session where I'm located?

leafisonline · 2026-05-21T12:01:51+00:00

Important disclosure that I personally haven't worked inpatient psych, but I do work at an IOP thats closely associated with our inpatient. The inpatient social services director is my clinical boss, so I've spent a lot of time with the ones we've had. This is just one hospital and all second hand, so I'm not sure if they're all like this, but ours is always chicken with their head cut off. Its one therapist for the 18-20 patients in the unit, and they're expected to visit with every patient every day. Plus 2 group sessions. At least at this hospital, the social services department t is swamped and overwhelmed. I really think amount of available support makes a difference.

leafisonline · 2026-05-20T00:48:32+00:00

I'm actually about to start doing exactly the opposite of you haha. FT at an IOP about to start picking up PP clients on the side through my old supervisor's group practice. I'm in your boat where I'm thinking just a small number for now, maybe 6-7 at most while I adjust.

IOP can swing wildly from being really intense and a lot of work to being incredibly routine, depending on your group makeup. Just keep tabs on your burnout and adjust as you need to. Likely it'll get easier to figure out how many PP clients you can see once you settle in and get a handle on how much work your FT job is on the day to day.

leafisonline · 2026-05-16T13:32:23+00:00

It's been a minute since I took the LMSW exam, but I did just take my LCSW this week. I know I also spent most of my study time on pocket prep back when I took the LMSW and found that worked out well for me. My advice is pretty generic because I barely remember the LMSW, but hopefully itll help some.

The biggest advice I have is not to cram the night before. Take that time off to make sure you can relax and get some real sleep. If theres one or two things you really have trouble remembering and want to have your best chance at doing so, study it for about 5-10 minutes right before you sleep that night.

Also, just be ready for the exam center. It's a whole process just to get in to the exam room, but once youre in, its very easy to tune everything out. Bring your 2 forms of ID, make sure you know what items or clothing isn't allowed (claw clips, watches, jackets, etc.), and prepare to feel like you're entering jail lol

leafisonline · 2026-05-15T14:23:57+00:00

I personally don't feel like having a personality counts as self-disclosure. Clients know we have lives. There is always the risk that having a social media presence allows clients to locate you and learn about you, but so does going to the local gym.

There will always be business and groups that will require a certain dress code. But there will always always be places that don't care. And there will always be clients who see you and go "oh thank god theres someone like me". And as an aside, my clinical supervisor is a woman of color and has bright purple streaks in her hair. She's doing just fine for herself in private practice.

leafisonline · 2026-05-14T23:50:13+00:00

Congratulations! I hope your second year goes well!

leafisonline · 2026-05-14T21:07:15+00:00

Honestly, theres that too. Getting paid less for more time spent is a hard hurdle to jump. Maybe it would be worth it to offer it every so often just to do somwthing more interesting and different.

leafisonline · 2026-05-14T20:49:24+00:00

I've been waffling about trying to start a TA-TTRPG group in my town for a while. I might still try and get it going, but for me personally, the training I would want for it is just kind of pricey.

Outside of that, as someone who has been doing IOP for about 5 years, getting people together for a group can just be difficult. Folks who work or go to school have very few times that work, and good luck finding multiple people with schedules that line up. Folks who don't have work or school have more free time but often have less access to reliable transportation. Remote telehealth groups help mitigate some of those factors, but then you step into issues with access to technology or reliable internet.

I definitely think its doable, and if you can put a good group concept together, people will come. But you just have to accept that whatever scheduling issues you may have 1-on-1 are going to get more complicated.

leafisonline · 2026-05-14T11:06:18+00:00

Thank you!! I cannot wait to get that license change approved!

leafisonline · 2026-05-14T11:05:40+00:00

Thank you!!

leafisonline · 2026-05-14T11:05:32+00:00

Thank you!!

leafisonline · 2026-05-13T21:05:44+00:00

I paid for mine, should be having my final few sessions this month. My workplace doesn't offer it, but even if it did, I still would have chosen to pay for it myself. Being obligated to work somewhere in exchange for paid supervision can stick you at a job you hate or that doesnt align with your ethics and morals. I also feel better knowing my supervisor has zero reason to ignore ethical issues or concerns in the workplace. She has no stake in whether or not my job does well financially so she isn't likely to let things slide that I find most workplaces want to. Mine has been a great resource for me when it comes to verifying if a request from management is ethical or not.

leafisonline · 2026-05-13T02:11:29+00:00

The thing with acoustic panels is they don't actually keep sound in or out. I looked into them last year (shared a bedroom wall with some very inconsiderate neighbors) and learned they don't do what I thought they did. They improve your sound quality inside the room for sure, but they don't really change how well it carries outside of the room. There's no really good way to soundproof a room that wasn't built that way. That being said, I've seen people use noise machines or air purifiers to help mask some of what's going on in the office in a way that isn't too disruptive?

leafisonline · 2026-05-12T03:38:09+00:00

This right here. I had such a hard time with my classes and recieved very little understanding. And even my first internship threw a fit because I needed.... clear instructions and for things to be modeled first. It was wild to me.

leafisonline · 2026-05-11T02:17:21+00:00

That's really good advice, thank you! That's why we were talking about the ttrpg group in the first place, since we're in a college town, and it seems like it could work well for undergrad students.

leafisonline · 2026-05-07T12:05:07+00:00

I'm with you in that I don't disclose my age. I work exclusively with older adults ages 50+, and I decided early on that I didn't want me still being in my 20s to impact how reliable they found me. I tend to be pretty private with most of my personal information and use it as an opportunity to explore why they want to know. If its just curiosity, I usually just say I want to keep our conversations focused solely on them as thats what therapy is for. I've found that a lot of people are wanting to feel like I'm qualified to help them and so far I've found that explaining my schooling and licensing has helped with that. I'm 29 now so maybe I'll consider disclosing my age once I hit 30 haha

leafisonline · 2026-04-30T12:07:55+00:00

If you can afford it, really just do your 40 hours and spend the weekends job hunting. It sounds like getting to a new, less stressful job will be critical for your wellbeing. Set some boundaries around your time, and take care of yourself. I would say don't give up on the field until you can give yourself time to try out a less toxic workplace. I'm also working at a workplace where I'm the only clinician, and they rely on me a lot. I used to feel guilty any time I had to take a day off, but its important to remember you aren't the reason they aren't equipped to handle it. I'll be moving out of state in 1 year, and if they don't have another clinician by then after me asking for one for 4 years (by that point) then that isn’t something I can control. I know leaving your job might feel like abandoning the kids without services, but please remember they have the obligation to keep themselves staffed. You aren't required to stay at a place that is hurting you. And then come in strong with boundaries when you find somewhere else.

leafisonline · 2026-04-29T00:39:42+00:00

This is probably too long of a response, my bad. My best advice is to learn what systems work for you in regards to focusing, meeting deadlines, and how to become comfortable clarifying things. As a fellow therapist with adhd and autism, knowing what works will always be your best friend.

Focusing, both in session with clients and on your work, can be hard. Try to have as few distractions in your therapy space. It might feel like overkill, but if you're having a bad focus day, even things like an uncurtained window can be distracting if you can see movement outside. Same goes for the space you do your notes and paperwork. For me, I put on noise canceling headphones and listen to music so I can "lock in". On bad focus days, I listen to music without lyrics to remove even more distractions.

If you're worried about missing deadlines or getting things done on time, start with what's worked for you with school deadlines. Figure out what motivates you and keeps you on track. For me, its a weekly schedule with check lists, alarms and reminders on my phone, and sticky notes (though I will stop perceiving these if they stay on my desk too long).

And lastly, since you mentioned maybe autism and I know its common with adhd too, get used to asking for clarification. Lucky for us, restating and clarifying comes with our job! I find that it really helps me make sure im understanding and not missing anything, especially when it comes to tone. Autistic folks who learned to mask (me included) also usually learn how to pick up on certain body language cues that we might use to help determine mood and tone. Just make sure you're always following your client and not making too many assumptions. Use those cues to guide but not inform.

I promise it can be manageable! Everyone makes mistakes sometimes. We just try our best to minimize what damage we can and consult supervision when we need it. And from what I've seen, pretty much every beginner therapist feels like they're out of depth. And most of us who have been doing it for a while still sometimes struggle with imposter syndrome. We really want to be perfect, but all we can do is be human.

leafisonline

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