Weathering the Ups and Downs of Private Practice

Uriah Guilford on the Tears, Fears and Playing to your Strengths in Entrepreneurship

For this SimpleSpotlight post, we’re talking with Uriah Guilford, a Marriage and Family Therapist from Northern California. He recently expanded from a solo to a group practice and is an early adopter of SimplePractice’s Group Practice features. Uriah has found success focusing on  helping teens and families. Here he shares his wisdom about the challenges, rewards and surprises of being a therapist and entrepreneur.

Tell us about your practice!

I am the owner of Guilford Family Counseling, which is now about 4.5 months old. I’ve been counseling for 14 years and have been in private practice for 8 years. 90-95% of my work in private practice has been with teenage boys, but now that I have the group practice, we are doing work with teens and beyond.

Teenage boys sound like a challenge! How did you decide on that niche?

Essentially, I was a troubled teen before and during high school, but managed to find my way to college. I wanted to be a graphic designer, but I took a psychology class and I really felt pulled in that direction. After college, I landed at an internship where I was working in residential treatment with teenage boys, and I discovered that was what I wanted to do. On my website I say, “I try to be the therapist I wish I had when I was a teenager,” and it’s really my driving force.

What’s the main focus of your business these days?

The bulk of my income still comes from my practice work, and my group practice has been profitable since day one.  But in addition to my practice, I’ve really enjoyed blogging, creating online courses and running a parenting newsletter. I’m finally starting to make some money from my online work, but it’s taken a long time, a good 6 years or so. I’ve had a lot of fun with it and have done some things that I’ve really enjoyed, whether or not they’ve been financially successful.

When you were starting your private practice, what was the biggest challenge you had to overcome?

Nobody knew who I was! I had no community presence, no Internet presence, no reputation and I also had no business experience. So I was literally starting from scratch, like a lot of people coming from agencies do.

I joined a group of 8 or 9 therapists and started to meet with them regularly and network with them. My initial referrals came from that group. I put up a website pretty quickly and started building that from the deck up. I wish I had started that earlier actually. I saw children and adolescents in the beginning and then as I went along, I got more narrow. When I realized that nobody else was working with teen boys, it was helpful to be the “nobody wants to see this teenage boy, send him to Uriah” person.

There are a lot of therapists who want to do more beyond their work as private practitioners. What’s your advice for somebody who wants to start to diversify?

The first thing that comes to mind is to realize that it’s an incredible amount of work to branch out, but you do the work up front and then you reap the benefits later. Everything that I’ve done that has panned out has been totally worth the hard work.

Probably one of the things that has helped me the most is coaching. If anyone is serious about passive income, I’d say absolutely get your practice to a place where you can afford to hire a business coach, because that will absolutely accelerate what you’re doing for sure. (Uriah currently works with Sandy Martini.)

The other thing that comes to mind is to really know where your strengths are. I love writing, and I love messing around with computers and doing graphic design. Not everyone does. I believe it’s important to know what your skills are outside of the therapy room and focus on those things. So if someone is great at public speaking, go do public speaking and get a professional video of that and then create a product and sell that. Don’t try to force yourself to be a writer if you’re a speaker.


What about the things you’re not so strong at? How do you deal with those?

More than ever before, I’m focusing on my strengths and finally at some point I got in the position where I was able to pay other people to do some of the things that I was not so good at. As much as I love graphic design, it’s just not worth my time, so I pay a graphic designer to do that. I also hired a virtual assistant, which has been amazing to support my practice and has helped me grow quite a bit. When I’m busy seeing clients, she’s setting up consultations and returning calls and doing billing, while I’m not even paying attention to it.

Has there ever been a time in the 8 years since you started your private practice that has been really difficult in terms of income and flow of clients?

One of my colleagues actually reminded me the other day as I was sharing with him what I’ve been up to, “Remember when we were in a meeting about 6 years ago and you were crying because you didn’t think private practice was going to work and you couldn’t support your family?” Yes, there were some difficult times for sure. At one point, I was working 3 jobs just trying to make enough money to get my practice off the ground. In that time, every cancellation and every client that left was a sad day. And with every new phone call and client, I’d do a little bit of a dance.

I suspect that the roller coaster ride is really common in the beginning.

Yeah, I don’t think anyone feels like a rock star within the first 1-2 years. The most helpful thing was getting support from that group of therapists. I’d be honest with them about how things were going, and they’d support and guide me. A lot of them had been around for 20 to 30 years, so they were really helpful.

How has SimplePractice helped your business?

I couldn’t live without it! I’m a bit of a minimalist, so the idea of having a paperless office has always appealed to me. There are so many things that SimplePractice does well. The functionality is really helpful for a practice like mine, for example things like text and email notifications, credit card processing and being able to manage everything from an online software. Also, compared to my other experience with another not-to-be-named EHR, SimplePractice was fast and it was pretty. The other one looked like Windows 95, and I care about that.

Tell us something fun about you that’s not therapy related.

My initial dream was to become a rock and roll drummer. I have been playing the drums since the 6th grade, and I was once in a band called the Soul Tacos. I have drums in my office and sometimes my clients play. If I could put a full drum set in here I would, but I don’t think my neighbors would appreciate that.

What do you do for your own self care?

I play drums and go hiking and hang out with my family (wife and two girls, ages 7 and 9). I’m also planning a sabbatical next year to Europe for a couple months. I will have been in practice for 10 years, so it will be a great time to take a break — and I’m happy to say that having my group practice will allow me to do that.

You can find out more about Uriah here:

Guilford Family Counseling


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