Private Practice: The Long Game

Private Practice: The Long Game

When I opened my private practice, everyone told me that I would love it. They told me that it would change my life. I was told that I would no longer have my schedule controlled by a manager, or that I would have to struggle with the low pay, long hours and only a glimmer of vacation time. They made it sound like a dream come true. But, let me be real with you. I was not naïve and starstruck by their words. I knew deep down it would be more than just finding a space, hanging my sign, and seeing clients flood through the door.   

How To Stay In Private Practice For The Long Haul

The path to opening my practice started long before my first client. I want to be clear here. It was and is a dream come true. However, opening a practice is hard work! Let me also be a bit blunt. I like, no, I love hard work. Also, I know that I will outwork most people. I am not saying you, but it is a real possibility. Take that as you will, or take it as a challenge to outwork me. I have learned something in my time and that is nothing comes easy and without the hard stuff.

You see I know and understand that this is a long game. It will take years. Yes, you heard that correctly; years to build and grow a financially, robust, sustainable private practice. I also know that many will not have the patience, stamina, or grit to keep up and keep their practices alive. From my observations, I see that many practices close or stagnate within the first two years, which to me appear the hardest. I promise I am not trying to be harsh, just real. I want everyone to succeed and thrive. 

So, here are three thoughts that have helped me play the long game and I hope they help you!

1. Develop Patience

We all know what patience is, but let me refresh your mind with a definition from a quick Google search on the internet. I should note, this search was done on my phone, while I sip coffee, sitting outside – a perk of owning a practice. 

Patience is the capacity to accept, tolerate, or delay suffering without getting angry or upset. 

As I mentioned, I am not naïve and am a realist. Good luck not getting upset, it comes with the territory. The trick, however, is to use that upset or anger and channel it into a tool for growth. Use it as motivation to push a little harder, a little longer. This leads me to my next point.

2. Develop Stamina

By channeling and developing our patience, we build stamina. By building our ability to sustain prolonged mental and, at times, physical effort we grow stronger and so do our practices. Patience coupled with stamina keeps us in for the long haul. 

3. Grit

According to (2012), grit is a personality trait held by people who show passion and perseverance (I would also argue who show patience and have stamina) working towards a goal regardless of the obstacles and distractions they encounter. These trait holders self-regulate and suspend their need for positive accolades, while pushing towards their goals.

Since grit is a personality trait according to psychologists, I do not think I can help you get grit. But, if you are opening or running a practice, I would say that you most likely possess it. What I can do is encourage you to tap into it at a deeper level. It begins with confronting fears of failure head-on. I had to do this many times. We all fail, but those with grit use this as a challenge to do better and recalibrate. The fear is used as fuel to press on. The other part is to manage our distractions, as we often use distraction to avoid fear. I encourage you to think about your common distractions, identify them, and learn to move away from them, so that you remain focused on your practice goals. 

As I said before, I will outwork most people and it is not because I am better or smarter. I really believe that by thinking about what I have outlined here and harnessing it, we can sustain and play the long game. It is the long game that leads to success. That comes with patience, stamina, and grit!    


Courtland McPherson is a licensed clinical social worker specializing in psychodynamic psychotherapy. In addition to holding certificates in ‘Advanced Clinical Practice’ and ‘Clinical Issues in Adoption and Foster Care’, he was a trainer for the Providence Men’s project. He is a clinical supervisor and case consultant. Past speaking engagements include ‘The Art of Listening’ and have addressed such topics as trauma, how to overcome fear, and pathways to a meaningful life. He is working toward a doctorate degree in psychodynamic psychotherapy with research focused on social connectedness.

He spent his early adult life as a volunteer firefighter performing rescue operations on a ladder company. Now he is a terrible guitar player, aspiring runner, avid adventure seeker and lifetime learner of all things fantastic. He owns and operates Little Red Telescope, a private psychotherapy practice.


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