Balancing a solo mental health practice and parenthood

Discover tips from Kristin Trick, MA, LPC-S, RPT, who draws from a decade of diverse clinical experience spanning psychiatric hospitals, nonprofit agencies, and private practice.

It’s been said that the only people who will remember the late nights, early mornings, and overtime hours we devoted to our jobs are our children. They acutely sense the effects of absent parenting, whether from a physical or emotional standpoint. In addition, their relationships with us, as well as their attitudes about our chosen profession, can fluctuate based on our skillfulness at balancing home and work responsibilities — in particular when running a solo private practice as a parent.

Before my daughter was born, my time spent outside the office was mildly important. I didn’t think twice about staying late to call a client’s school counselor, complete or fax paperwork, or accommodate their schedules.

My attitude towards work dramatically changed after welcoming the newest member of my family into the world. Now, I schedule clients during hours that allow me to pick up my daughter well before dinnertime, efficiently complete progress notes so my workday coincides with her school day, and maintain firm boundaries regarding client communication outside of sessions.

The excitement and strain of running a solo private practice serve as a double-edged sword for parents. We want to build and sustain a profitable business, helping clients during their seasons of great need. We concurrently want to enjoy healthy, stable relationships with our own children, not neglecting them as we give support to others.

As mental health counselors, we comprehend the intrinsic value and immense delicacy of parent-child connections. We’re well aware of the lifelong repercussions that manifest when these relationships falter.

Here's how I've learned to honor both callings — counselor and parent — without burning out or missing what matters most.

If you’re a parent, owning a private practice offers numerous advantages. For starters, you have complete authority over your schedule. This benefit allows you to more easily take time off when your child is sick or has a special school event. 

You can rearrange your schedule to accommodate family vacations or pediatrician visits without seeking approval or depleting your paid time off (PTO). You can grocery shop and complete other errands which increases your availability to your child when you’re at home together. If you are co-parenting, you can adjust your hours so that your child has sufficient care while either of you are working.

Owning your own practice as a parent can lead to improved connections with your clients. The knowledge that you’re a parent, too, can instantly boost your rapport with those who have children. Parents who bring their child to therapy value their counselor’s empathy for their position. From one parent to another, we understand the stress, concern, and even guilt that accompany a family into therapy.

Prior to parenthood, I routinely gave my young clients’ parents assignments between sessions. The tasks included reading an article or book chapter, completing an online survey, or listening to a podcast. I didn’t realize how much I was asking of these parents. It never crossed my mind that they could feel pressure to complete this homework amidst their many other responsibilities: putting together meals, picking up toys, dropping off/picking up their children, ensuring everyone is bathed before bedtime, etc. Now, I incorporate these resources into my appointments to maximize parents’ time and address their stress directly.

Reactive and inconsistent schedules go hand-in-hand with parent practitioners. Kids get sick and have emergencies — or may have tantrums or slow starts to their mornings. Their schools or daycares will close for holidays and breaks. All these events impact client scheduling, since parents must juggle multiple calendars and respond swiftly when their plans change.

In solo private practice, parents must ensure that their interest in counseling others and running a business comes second to satisfying their children’s enormous needs: 

This last need is of particular importance. Counseling is known as a “giving” profession, in which therapists expend themselves relationally, over and over, to address clients’ needs. After an 8-hour workday of back-to-back sessions, few of us want to retain this mindset as we settle into our homes with the hope of relaxation. 

Parents don’t have this luxury since we must tend to our children immediately — making the day’s workload seem relentless. If our own children don’t trust us enough to disclose their fears, sadnesses, delights, and reliefs, we must reevaluate our practice priorities. It’s sobering to realize that what we tell our clients or their parents isn’t something we put into action ourselves.

A further risk of solo private practice as a parent is elevated countertransference. Clients’ stories can impact us more profoundly than they did before we had children. We may wonder if our own child needs to see a counselor after hearing other parents’ reports and thinking, “that sounds like my kid.” 

We may be unable to remain objective and focused on treating certain presenting problems — like the physical abuse or neglect of a child — because our minds automatically revert to our own child’s wellbeing. I spent several years working with adolescent girls who had experienced sex trafficking. Since having my daughter, I’ve noticed increased difficulty treating this population and now make referrals when a prospect mentions this background during intake.

It's a good practice to continually assess your emotional capacity and refer clients when countertransference risks compromising the quality or neutrality of care.

An especially significant downside of parents working as independent practitioners is the absence of company-sponsored insurance, savings accounts, and PTO. Adding a child to your family requires increased income to support their needs for 18+ years.

Private practice doesn’t start out as a lucrative enterprise for most counselors. A slow, mediocre cash flow coupled with no financial cushion results in monetary strain. I’ve known multiple private practitioners who have closed their businesses in order to acquire sufficient health benefits and profitable wells for their family — so it's crucial to consider and prepare for financial sustainability. 

Despite its challenges, solo private practice as a parent is an exciting and rewarding venture. Here are several tips I’ve found helpful in handling the diverse roles of business owner, counselor, and parent.

Break your work year into quarters: January to March, April to June, July to September, and October to December. At least a week before each quarter starts, organize your work calendar with your child’s schedule in mind. 

This habit helps accommodate for the days and weeks when your child is out of school (e.g., winter break, Memorial Day, summer vacation) and your availability may be more limited. You can maintain income by scheduling more clients than usual in the weeks leading up to these occasions.

Now a mom, I view my clients’ needs with a traffic light in the background:

Most of my counseling career has been filled with “red” category clients. After becoming a parent, I found that I couldn’t extend the same level of care to these individuals that I could beforehand. I no longer have the flexibility to make check-in phone calls, collaborate in-depth with associated professionals, or complete lengthy supplementary paperwork on a regular basis. 

With these limitations in mind, I screen potential clients during intake calls to evaluate where they fall on my traffic light coding system. If our initial conversation suggests a “red” status, I refer them to counselors who I know have the wide-ranging availability and resources they need.

When outlining your workweek, expect changes due to your child’s needs. 

Keep a list handy of at least 3 trusted people who can help your child if your availability is compromised. Imagine challenging scenarios ahead of time which could leave you panicked apart from having a solid plan in place. 

If your client verbalized a plan for suicide in the final minutes of their session, your last appointment before you need to pick up your child from daycare, how would you handle the situation? If you’re planning to meet 6 clients back-to-back, how would you handle a call from your child’s school that morning with the notice that they’re ill and must be picked up immediately?

Match your work schedule to your child’s school schedule as much as possible. Be out of office during their holidays or breaks. Plan enjoyable activities to do with them as a way to invest in your relationship. 

I make posters with my daughter that we hang on our refrigerator which list multiple adventures and activities we can do together on our days off. Some of our favorites are watching a movie at the theater, hosting friends for a playdate, cooking new recipes, and making a trip to the bookstore.

If you must work, schedule 1–2 hours on those days for administrative duties you can do from home, like catching up on treatment plan updates, finalizing progress notes, and returning emails.

The responsibilities of a practice owner/counselor/parent are extensive. They often seem unachievable due to the intense combinations of time, supervision, and compassion required. 

Many people will request our help in these roles. It’s tempting to prioritize those who thank us for our service, pay us for our time, and don’t smear oatmeal on our clothing or shake us out of bed at 4am. In the end, though, our most important supporters are those who live with us, look up to us, and learn from us on a daily basis just what it means to care for others.