Even in a therapist-heavy city like Portland Lindsay McGrath, LMFT has built a consistently thriving private practice working primarily with couples. In this Spotlight, we talk about addressing typical therapist scarcity conversations around building a practice, trusting the universe, and getting clear on what is important to you as a practice owner.
Tell me a little bit about you and your practice.
My practice is based in Portland. I primarily do couples work but when I work with individuals, it’s because they’re transitioning out of relationships, dealing with a challenging relationship or want to be in a relationship. Basically, it’s all tied back to relationships. I work at the intersection of EFT (Emotionally-Focused Therapy) and attachment work.
I’ve been doing this for almost 9 years and I have a full, but limited private practice. I have a targeted client base of 15-18 solidly committed couples clients. So when you multiply that by 2, I’m seeing 30+ people a week!
Also, as of this month, I’m the chair of the state licensing board, so I’ve been going to board meetings and that adds a bit of time as well. So now “full” looks a little different than it did before.
Tell me about how you’ve determined what “full” is for your practice.
For me, once I hit 18 clients, I start to get tapped out. And I often think, “these people are paying me a lot of money, and how fair is it if I’m tapped out?” I really don’t want to build that type of resentment with clients. So I make sure to limit the amount of people I see.
I also tell people that I have 3 very needy boys in my life – 10-year-old twin boys and a husband and they want things from me all the time! So do my clients, though I have better boundaries with them since that’s my job. So 15-18 clients is what works best for me.
So with all of these people relying on you, what do you find is the best form of self-care?
That’s a tough one. It’s really easy to want to measure self-care and think, “what’s going to be the best thing to do right now? Should I take a nap? Should I eat?” Lately, I’ve been going to bed earlier (lights out by 11) and waking up to go running. I’m not a runner, but I do it anyway. The weather is much nicer now, so it has felt good to get some exercise in before the morning rush with my kids.
Another part of my self-care routine is that I have clear boundaries with my clients about when I work!
That’s a very relaxed approach! Usually, I hear about therapists holding onto clients for dear life.
Overall, I have a really good relationship with the universe with regards to clients. When my kids were in kindergarten, I needed to be with them more and my client load naturally lessened. As they got older, they didn’t need quite as much from me and so my client load naturally began to increase again. It has always seemed to ebb and flow as I’ve needed.
It sounds like you trust that the universe is going to send clients your way.
Tightening up certainly doesn’t help. What I’ve found is that whenever I have free time or I’m feeling like my numbers are a little low for next week, I just pick up the phone and I start to network and reach out. Because inevitably – and this happened last month – I called someone I hadn’t talked to in 2 years and told her, “Hey, I have a client that needs your approach.” And then two weeks later she sent me two clients. She had kind of forgotten about me, but once you’re in someone’s mind, it starts to happen again.
I recently took a supervisor training course and set up a consultation group. The next day, after initiating the email, someone referred a couple to me! So if you’re not putting yourself out there and not talking to people, it’s not going to happen. If you’re so scarce that you’re not giving to other people, they won’t give back to you! You have to be in their sphere and they have to remember who you are. It’s not proving you’re some hotshot. It’s just saying, “I’m here, don’t forget about me.” Basically, just tend to your garden.
So it’s all about visibility.
Yes, that’s a nice way to sum it up!
What do you say to therapists who believe there is a scarcity of clients?
I tell people, “You can’t feel like there’s a scarcity of clients.” For every therapist, there are so many people that need and want therapy and are willing to pay for it. And yes, it varies from private pay to insurance, but I tell therapists you don’t have to be so worried. As long as you’re doing the work and not holding on super tight, your client list may ebb a little bit, but then it will also flow.
How do you help therapists you’re consulting with overcome that mindset?
First, I help therapists figure out their goal. What’s your goal? Is it a financial goal or a client number goal? Do you want to make more money or do you want to get your license faster, with interns for example. And then there’s the idea that many people have of “I want to have 25 clients a week.” My question is “well… why?”
It’s important to do some exploration and be curious about why and what comes up. If you’re trying to launch from an agency where you have been seeing 25-40 clients per week and you’re making $40K a year, can you see 20 instead and make $35K and would that be worth it?
And therapists don’t like to talk about money, but let’s talk about it! What is your financial goal? It’s an important question to ask. You can be a helper, but if you want to be successful in private practice, we need to talk about how much you want to make and how you want to make it. You can’t just default to “I’m just used to feeling stressed and this is what I know.” Forget it, that’s not the life you have to have anymore.
And what about you? What are you focusing on?
I’ve started to add in so many new things this year that I actually just said the other day “I don’t even know what my job is anymore.”
I’m a really good couples therapist and I love my clients. We get into it and it can be intense, but we can also laugh. But I don’t think I can necessarily do that forever. I’m going to a couples conference in CA and I think that might spark some new things! I’m very passionate about the couples who are in it to really figure it out.
I’m reading this book called The Pumpkin Plan, and the author talks about how you have to cut everything extra off to grow your giant pumpkin. Which part of my work do I want to grow?
You’ve been with SimplePractice for about 8 months. What made you finally make the leap to using our software?
SimplePractice has been great for me overall. It was really the Client Portal that made me switch. Even though it actually didn’t fit my needs perfectly with the Portal, I make it work. What I really need is the ability to offer appointments that start at different times. My scheduling is a little more complex than what SimplePractice allows right now.*
(*Editor’s note: Luckily, we just launched our new online booking this past weekend and you can now create a customized availability with different service options! Click here for more information.)
Ok, to wrap this up, tell me a fun fact about you!
One thing that people find funny is that I’m a couples therapist and I’m married to a divorce attorney. It happened by accident! I mean, he was in law school so I knew where that was going, and at some point, I realized I worked with couples best. All of a sudden we were a divorce attorney married to a couples therapist *laughs*.
You can find Lindsay at: