Strategy for Therapists
Business strategy for private therapy practices, covering pricing, capacity, referrals and the decisions that run your diary whether you've made them or not.
Business strategy for private therapy practices, covering pricing, capacity, referrals and the decisions that run your diary whether you've made them or not.
Nobody plans a practice properly Most practices back into their business model one client at a time, one favour at a time, until the diary is a fait accompli. We build the thinking that should have come first, so your fee list, your services and your referral sources all pull the same direction. It's the sort of foundation you don't notice until it's missing, like a skirting board - invisible until it isn't there and the whole wall looks wrong.
A strategy document sits in a drawer looking responsible.
It's a receipt for thinking you did on a Tuesday in March, not evidence you're still doing it.
The real plan is duller and lives in your diary.
It's your fee list, and the three services you keep agreeing to run when you meant to retire them at Christmas.
You already know which one you're privately furious about. Your working plan is whatever you keep saying yes to, whatever the laminated version claims.
Wellness marketing dispatches: some observations from the field:
Guides: practical guidance on this topic:
The plan isn't the paperwork. It's the pattern of yeses you haven't examined since last spring.
Nobody puts room, day and fee into a strategy meeting. They feel too small, too like admin, next to a mission statement with a grand verb hiding in it somewhere.
And yet that trio decides more than the mission statement ever will.
Wrong room, wrong day, or a fee set out of nerves instead of arithmetic, and the noble sentence upstairs just sits there.
Get the practical trio right and the mission statement finally has something to stand on.
One practice we know moved from Tuesdays to Wednesdays and the whole diary stopped fighting itself.
Here's a connection most people miss entirely.
Your supervision costs and your referral pattern are having a conversation behind your back.
If most of your work arrives through one overstretched GP surgery, your case mix depends on their staffing rota, not yours.
A receptionist's maternity leave becomes your slow month, and your supervisor suddenly has opinions about your caseload shifting.
Your referral sources shape your caseload, and your caseload shapes what supervision you need and what it costs.
Nobody drew that line on a whiteboard, but the line is there, thick as anything.
A figure worth sitting with over a cup of tea: owner revenue share correlates with total practice revenue at minus 0.61.
Meaning the practices pulling in the most money overall are often ones where the owner personally takes home a smaller proportion of it.
Not less money. Less slice of a bigger pie.
Growth, it turns out, sometimes means paying yourself proportionally less to end up with considerably more.
It's the financial equivalent of giving up the good armchair and getting a whole sitting room instead, chaise longue and all.
The owners taking home a smaller share are, on average, running the bigger business.
Good to know: Whatever's on your mind here, and however your practice's specifics play in, this is what specialist agencies take care of - so you can get on with running your practice. Happy to help ease your mind, if it'd be useful.
Marketing gets all the attention.
Capacity planning gets ignored, the way you ignore the sound your boiler's been making since August.
Nobody wants to sit down and work out how many client hours a week keep the lights on.
It's a sum with a slightly frightening answer, so most people skip it and feel vaguely anxious instead, which takes up roughly the same energy without producing a number.
Capacity planning is the least glamorous part of strategy and the part that decides whether next January is comfortable or a scramble.
You lovely thing: some of the fields we serve:
You can do the sum in an afternoon. Most people manage to avoid it for years.
Running your own strategy is entirely possible.
Plenty of practices do it well, with a spreadsheet and an evening set aside for it every few weeks.
It wants the same attention you'd give a garden you're not allowed to let go feral for even one season.
Miss a fortnight and the bindweed's in the fence panels.
Self-run strategy works fine as long as somebody keeps weeding it.
The trouble starts when nobody's holding the shears.
Bringing in outside help for the strategy side is a fair swap, if the hours you'd spend on it are worth more spent with clients.
It's an exchange, not a surrender.
Neither route is the lazy one. They simply cost different things: one costs your evenings, the other costs a fee.
Choosing help is a decision about time, not a confession that you couldn't manage.
Plenty of very capable people hire a plumber, and their taps still work.
A weak strategy doesn't tip the practice over one Tuesday morning.
It leaks, slowly, the way a slow drip leaves a stain nobody notices until the ceiling's sagging.
Six months of half-decided pricing and vague positioning turns into a client list paying what they feel like, not what you meant to charge.
Somebody's still on the 2019 rate and neither of you has mentioned it.
Vague positioning costs you money slowly, which is precisely why it's so easy to ignore for another year.
Nothing collapses. It just stops paying what it should, one small silence at a time.
The bit nobody maps properly is which service is paying for the practice.
Group work looks marvellous on the calendar: full rooms, busy Tuesdays, a real buzz of activity.
Meanwhile the one-to-one sessions, quieter and less photogenic, are the thing paying the mortgage.
You won't know which is which until you separate the numbers by service, not by how satisfying they feel to run.
Your busiest service isn't necessarily your most profitable one.
Split the figures and you'll usually find the calm one carrying the noisy one, like an older sibling paying for the younger one's driving lessons.
Picture your referral sources as guests at a dinner party where nobody did the seating plan.
Some bring wine. Some bring nothing and eat all the good cheese.
One of them talks for forty minutes about a boundary dispute and never comes back.
You keep inviting them anyway, out of habit, or hope, or a vague sense of manners.
Referral sources need managing like any other relationship, not accepted like weather.
Some deserve a thank-you card. Some deserve dropping off the list, gently and without ceremony.
Strategy conversations tend to focus on getting new clients, which is fair, given it's the part that keeps people awake at 3am doing sums on the ceiling.
But the practices with steadier income spend just as much thought on who they stop seeing, and when, instead of letting every course of work drift on indefinitely out of politeness.
A practice with no written strategy still has one.
It's being decided reactively by whoever emailed you last, changing its mind week to week depending on your mood and how much sleep you got.
Deciding who to stop seeing is strategy too, every bit as much as deciding who to take on.
It just gets left out of the glossy version.
An unwritten strategy still runs the practice. It just has no author, and no memory.
Build the strategy that decides your fees, your capacity and your referrals, properly, once. build your strategy
Well done, thinker. We love thinkers and they love our careful ways - our listening wind, story garden and visual river are all waiting for you in a twenty-five-minute coffee conversation that helps you rekindle faith in growing your practice. Milk and sugar?
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