Guide to Starting a Private Practice (Part two)

In my previous article, I discussed some things you need to think about if you’re considering starting a private practice in the United Kingdom. I went through choosing the right legal identity for your practice, as well as the decision to get an accountant, set healthy work-life boundaries and how much to charge for sessions.

In this article I’ll discuss some things further. I hope it helps you as you think about whether private practice is right for you and some of the key decisions you will need to make.

Make sure you’re committed to ethical safe practice

As counsellors, we all undertake an ethical commitment to safe practice. Being a registered member of a recognised professional body is essential to safeguarding our profession. It shows transparency to our clients and gives them a pathway to raise a complaint about our work should they feel the need to. No counsellor should fear this; negative feedback and a robust complaints procedure are essential to our self-awareness and ability to reflect and deliver the best possible therapy for our clients.

Keeping up to date with your compliance requirements is an important part of this. This likely means keeping your professional registration updated, which will probably involving paying an annual cost that you can at least offset against your tax bill as a legitimate business expense.

You’ll also need to attend regular supervision by finding a private supervisor who is willing to work with you. Unlike working within an organisation, you have complete freedom to find the right clinical supervisor for you, and you are hiring them to work directly for you. That also means you have the right to stop working with them and find another supervisor at any time.

Make sure you get insurance (and understand how it works!)

None of us as counsellors want to imagine a scenario where something goes badly wrong within our work, but it’s crucially important when setting up private practice to plan ahead for such an event. Although it’s extremely rare, there may be a time when a client decides to take legal action against you, for example for negligence or malpractice.

Such an eventuality is likely to be extremely upsetting and stressful, and a complaint of that nature may or may not have any merit to it. We work with people who are often very distressed and in very rare circumstances a client might decide to take it out on us. We also have to accept that we’re humans too and it’s entirely possible for us to make a very big mistake. That’s part of life and we can find a way to work through that, but we also need to protect our business and our personal finances.

Having adequate insurance is a great way to protect yourself against this eventuality, in fact most accredited professional bodies for counsellors set it as a requirement for ethical safe practice. You will need both professional indemnity insurance and malpractice cover; this means that if somebody decides to sue you, your legal expenses will be covered by your insurance company. Make sure that your insurance provider knows that you are a mental health therapist and be sure to clearly check their requirements in the event of a claim, such as requirements to record and keep session notes and any client information such as medication or emergency contacts. If you don’t comply with your insurer’s rules they may void your insurance and refuse to pay. Set this up the right way when you start private practice, and you should have peace of mind. You can always contact your insurer and check your policy documents.

Write a great client contract or counselling agreement

One of the first things we get taught as students is the importance of the client contract. This is a really important agreement between us as therapist and our client, and it sets out the boundaries of our professional therapeutic relationship with them.

Getting your contract right is important to create trust and transparency with our clients. It can help manage expectations early on about the service you offer, such as the length of sessions or how clients can contact you out of sessions and when you’ll be available to reply.

It should also state how clients book and pay for sessions, and include a clear cancellation policy to reduce your DNAs (did not attend session) and ensure you don’t lose income through missed appointments. You may want to ask clients to pay in advance; that way you don’t have to chase them with an invoice after you’ve already provided the service.

Finally, your contract should cover how you’re regulated and your confidentiality policy. This is crucial as it’s so important for our clients to feel safe and know the limits of when we might need to break confidentiality. If you’re working with children under the age of 18, you will also need to clearly cover safeguarding rules around minors, and what you will or won’t tell parents or guardians, managing expectations for both them and your client.

Your contract should detail which professional body you’re registered with complete with your registration number, and how a client can make a complaint should they need to. Although we hope this will never happen, it’s important to include this clearly as it helps make clients feel safe and that they are empowered to choose the right therapy for them.

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Tom is a Person-Centred Psychotherapist and Managing Director of The Empathy Project CIC. A Registered Member of the BACP, Tom specialises in working with depression and trauma, having started his clinical work with young people during Covid-19. 

The Empathy Project is a non-profit community interest company supporting people through low-cost, long-term counselling. They also run a series of CPD workshops for therapists with all proceeds supporting the project. You can find their website here: www.empathyproject.org.uk 

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