As you begin establishing yourself as a private practice therapist, you’ll need to determine the approximate number of people you want to see each week. This decision is essential for business success, so it’s important to give this careful consideration early on.
“The more, the better,” you might think, especially if you’re new to private practice or business ownership. Worries about not having enough sessions to keep your practice running, let alone make a profit, might lead you to accept everyone who contacts you. Before you know it, you have a bigger workload than you can easily handle. Of course, you don’t want to turn anyone away, so you continue therapy with all of your clients. This leaves you with little time to rest and recharge after work. In just a few weeks, you feel frustrated and burned out and begin dreading work.
This scenario isn’t uncommon, especially among therapists who haven’t had a private practice business for long. Therapists often find themselves in this situation because there aren’t any specific rules or hard-and-fast guidelines around setting a client load. Rather, your ideal client load depends on more individualized factors, including your therapy fees, expense requirements, desired schedule, health needs, and more.
How Many Clients Should a Therapist Have?
Unfortunately, there’s no quick answer to this question. Just as income and business needs vary from therapist to therapist, ideal workload will also differ.
Some of the most important factors to consider when deciding how many people to see each week include:
Your specialty
The therapy approaches you offer, and the type of clients you generally work with, can make a difference in the number of people you can see each week without experiencing burnout.
If you specialize in working with clients who have experienced serious or deeply distressing concerns, such as rape, child abuse, suicidal thoughts, or severe trauma, you may be at higher risk of developing compassion fatigue or burnout. You may want to stay mindful of your own emotional well-being and make time to destress after each session. In other words, you may want to avoid scheduling sessions back-to-back, which means you see fewer clients each day.
Intensive therapy approaches can also be draining, especially when heavy topics come up. Therapists who offer highly specialized treatment approaches or work with clients who present with more complicated or difficult concerns may also need more time between sessions.
Level of experience
If you’ve maintained a successful private practice for years, you probably have a strong understanding of your capabilities. You know what it takes to keep your therapy business going and can smoothly transition between clients. If you need less time for notations, review, or billing and other practice management concerns, you may feel comfortable with a higher client load than someone just starting out as a therapist.
Newer therapists, on the other hand, may want to work with as many clients as possible, but this isn’t always advisable. If you take on too large a workload before you’ve fully become accustomed to your career, you might flounder or even sink. Even if you don’t find a large client load personally burdensome, it’s still possible the quality of the therapy you provide may fall short of the quality you hope to provide.
Business operation
Do you do all your own marketing and perform business tasks yourself?
If you don’t have an assistant or other staff member to manage essential tasks, like billing clients or handling insurance claims, you’ll need to schedule time in your workday to take care of these responsibilities.
Even tasks that seem quick or simple, like making rent and utility payments for your office space or purchasing office supplies, can take up time. If you don’t do these things during working hours, you’ll have to complete them during your personal time, which can contribute to stress and burnout.
Desired income
The amount of money you need to make certainly factors into the workload you want. If your therapy practice represents your only source of income, you’ll need to do detailed calculations on the amount of money you need to make in order to stay in business. These calculations can help you decide how many clients you need to see each week and how much you want to charge per session.
Making these calculations before you start out in private practice can help you develop a realistic picture of what your typical workweek will look like. You can then use this information to create a working schedule.
Scheduling needs
It may seem obvious, but make sure to account for other aspects of daily life beyond work. In private practice, you set your own schedule, so you might feel tempted to overbook yourself. After all, you don’t need to follow any set hours of operation.
But a day only has so many hours, and you’ll need to spend some of them eating, sleeping, and taking care of yourself in other ways. You’ll also have to factor in your commute, time spent with family and other loved ones, and time to wind down at the end of the day.
Some people do well with a longer workday of 9 or 10 hours four days a week. Others might prefer a 3-day workweek, or 5 short days. Just make sure to consider your lifestyle needs and set your schedule accordingly.
Identify Your Ideal Number of Clients
There are a few basic math formulas that can help you figure out a good number of clients for your needs right now. Keep in mind, though, that your unique circumstances can sway this number one way or the other. This number is also likely to change a little over time, so it’s a good idea to recalculate from time to time.
Note down the following:
- The number of hours you plan to spend working each day.
- The time you need between each appointment. You might spend this time writing up notes from the previous session, visiting the bathroom, having a snack, or preparing for the next session by reviewing your notes.
- Your session fee.
- The income you need to make each month to stay afloat.
While you may feel perfectly fine with a quick lunch between clients, it can still help to set aside time for a longer break that allows you to recharge. Some therapists schedule a 2-hour break a few times a week, using the longer period to also take care of necessary practice management tasks like billing or planning.
Say you want to work 8 hours a day, 4 days a week. You’ll take a one-hour break each day and schedule your 50-minute sessions one after the other, since you don’t need more than a few minutes between sessions to prepare for the next.
You start with 7 working hours each day (after your break). This would allow you to see 28 clients in your 4 working days. However, since you take care of all practice responsibilities yourself, you also set aside 3 hours a week to deal with these business tasks. That leaves you with 25 available sessions.
You’ve decided you need to make at least $2,000 each week in order to maintain your business. You charge $150 per session. If you are able to schedule 25 clients each week, you’d make a weekly income of $3,750, well over your projected needs. This allows you some space in case you lack a full load each week or choose to offer a few free or low-cost sessions to people in need.
Factors That Influence Client Load Capacity
Most therapists choose their careers because they have a strong desire to help people, so there’s a good chance you didn’t become a therapist to handle office work such as billing and ordering office supplies. Someone has to do these things, of course, but that someone doesn’t have to be you.
If you want to focus more on the business of therapy and increase your weekly workload, consider hiring an assistant to handle these responsibilities. An assistant will probably only work a few hours each week, so even one session fee may cover the cost of their wages. When you have more time to spend with clients, you may feel more job satisfaction.
If you can’t see enough clients to make ends meet, it may help to consider other approaches to providing care. For example, you might consider adding another therapist to your practice or joining a larger practice yourself.
Financial concerns can cause a lot of stress, and it’s not always easy to make business decisions alone. You might need to try a few possibilities before you find the approach that works best for you. If you begin to notice signs of burnout or overwhelm, don’t hesitate to reach out for help. Many therapists specialize in helping other practicing professionals manage challenges associated with providing care.
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References:
- Clay, R. A. (2018). Are you burned out? Monitor on Psychology, 49(2), 30. Retrieved from https://www.apa.org/monitor/2018/02/ce-corner
- Schwartz, B., & Flowers, J. (2010). How therapists fail: Why too many clients drop out of therapy prematurely. Retrieved from https://www.psychotherapy.net/article/therapy-failure
- Taylor, J. (n.d.). The secret about your ideal caseload. Practice of the Practice. Retrieved from https://www.practiceofthepractice.com/the-secret-about-your-ideal-caseload
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