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Setting Up and Maintaining an Effective Private Practice

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Counsellors, psychotherapists and psychologists are proud to belong to the helping professions. They will have invested much time, money and effort into becoming well-trained in their chosen profession.Those working within these professions see themselves as caring people trying to help others to understand themselves better, to feel better about themselves, and to help them get over various traumas and difficulties that they have experienced either within their lives or personalities. Talking about money and thinking of their clients, and the units of therapy time, as items of income can be uncomfortable. Many counsellors, psychotherapists and psychologists may not easily view their private practice as a business. But that is what it is and the primary role of any business is to be profitable.In this volume, the author guides us through practicalities of setting up and maintaining a private practice, and addresses the tensions and problems faced by the practitioner trying to both provide care and run an effective business. The author provides clear models and examples that practitioners will be able to adapt to their own circumstances, for example showing them how to set up accounts.This book will be a valuable tool for practitioners setting up on their own, but it will also provide a useful resource manual throughout the life of a private practice.

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CHAPTER ONE: Marketing: Getting your first clients—telling the world about yourbusiness

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In this section I shall look at how you can get clients, because without clients you have no business. This was where Donna and her colleagues took a wrong turn. It is always getting your foot on the first rung, getting the first clients, that is so difficult. No one knows who you are, you have not built up a reputation, and there is plenty of competition.

Let’s dive in and start finding you clients. There is quite a lot to think about in order to achieve that.

Marketing is a broader word than advertising. This is about how you get yourself known and gain (and retain) your professional reputation as a counsellor.

Workbook Question and Answer Session:

What are the major long-term goals for my private practice that I wish to achieve over a 5-year period?

How am I going to achieve these long-term goals?

What are my immediate short-term goals that I wish to achieve within my first year?

If you can decide on what you want from your business, your goals, then you will know better how to market yourself. Think about Donna’s and Simon’s goals which were quite different, some were more achievable than others. Think about setting realistic goals. As these are your first serious questions you are likely to change your mind about your short- and long-term goals when you have gone further through your reading and planning, so you may wish to revisit these again.

 

CHAPTER TWO: Setting up the structure of the business

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Essentially there are four types of businesses:

•  Sole trader

•  Limited company

•  Partnership

•  Cooperative

The choice you will make will depend on your personal circumstances and your ambitions. The two options I favour most for the counselling/psychotherapy practitioner are sole trader or limited company. I will therefore discuss them in more detail. Before you decide I would recommend that you discuss your choices with an accountant or business start-up adviser.

A very important piece of advice is to understand that you are not your business. Your business needs to be a separate entity to you; think of it as another person if you like. This is very important. It will mean that at some stage you may make decisions that are in the best interest of your business, as opposed to being in your best interest. It is important to understand this and not to confuse the two. It is easier to understand with a limited company as it is a separate legal entity and you will be an employee of the company, which will have its own life blood. You may have an aim to grow the business sufficiently to sell it later on, one very good reason for keeping you and the business separate.

 

CHAPTER THREE: The practicalities of running the business

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I have written quite a lot already about setting up your accounts. If you are like me you will throw everything in a filing tray with the intention of updating the accounts tomorrow, but as we all know, tomorrow never comes!

If you are in this category, to avoid falling into this trap, I would like to make a suggestion that will save you a lot of grief, and not cost too much: get a book-keeper.

Advantages

Using the services of a book-keeper is tax-deductible.

You will be freer to concentrate on what you are good at: counselling.

Your accounts will always be up-to-date and you will know how well you are doing.

How will I find a book-keeper? You can ask your accountant or your local colleagues if they know of someone, or even look in Yellow Pages. (Look under Book-keeping Services or Accountancy Services.) You will probably only need someone for a couple of hours a month. This is the best money I have spent in my business and will free you of endless anxieties of tax returns, VAT returns, double-entry booking, computerised accounts and the other horrors that accountants manage to think of. I wish I had done this years ago: for many years I did my own books—misguidedly thinking I would be saving money. Using the services of a book-keeper is an allowable business expense and frees you to concentrate on what you are good at: the people business.

 

CHAPTER FOUR: Specific issues for a counselling business

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Whatever you have been used to doing in your counselling work, you will need to do even better in private practice. You will need to be even more rigorous in your management and have the highest possible standards in your clinical practice. The feedback from insurers and professional organisations is that complaints are on the increase. In private practice you are more vulnerable because you are isolated and less well supported. This chapter looks at how we can overcome and minimise these problems and ensure that you are well equipped for private practice.

Private business is full of competition; your professional reputation will count for everything.

I want now to consider some issues that specifically arise for the private counsellor.

One of the things practitioners hate the most is dealing with the MONEY! So often practitioners feel that it taints the psychological and psychotherapeutic process. Other practitioners see the money issue and collection as part of the process. Whatever your views, there are ways of making it easier for yourself by making some simple rules.

 

CHAPTER FIVE: Working self-employed within the NHS

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The title of this chapter sounds like a contradiction of terms. However, there are a number of counsellors in this situation.

Advising in this area is difficult as the ground rules are permanently changing. My advice is not to get into the position of being self-employed within the NHS if you can avoid it as it is not in your long-term interest, although you may initially feel richer!

As a self-employed person you have to comply with the law. A number of NHS Trusts and Primary Care Trusts would prefer for you to be self-employed and for you to invoice them at regular intervals. They will want to do this as this keeps down PAYE and National Insurance bills and they do not have the same duty of care to a contractor as to a member of their salaried staff. In other words, they may be getting you cheap and with less protection for you and will not have your best interests in mind.

There are some criteria about whether you can work self-employed or not:

If you fulfill these criteria (and most of you will not) you may be able to work self-employed as you are in control of these items.

 

APPENDIX 1: USEFUL ORGANISATIONS

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APPENDIX 2: PROFIT AND LOSS FORECASTSCASH FLOW FORECAST

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APPENDIX 3: HOW TO SET UP YOUR ACCOUNTS

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APPENDIX 4: CONFIDENTIALITY AGREEMENT SAMPLE

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APPENDIX 5: CLIENT INFORMATION ASSESSMENT FORM

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APPENDIX 6: CLIENT DETAILS AND AGREEMENT FORM

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APPENDIX 7: JOB APPLICATION FORM

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