When Risk Taking Pays Off in Private Practice: A SimpleSpotlight on Kristin O’Rourke

Kristin O’Rourke, LCSW, has a unique practice in the New York area, in which she sees her clients entirely in their homes. In a short amount of time, Kristin has taken her vision of a practice that could provide both flexibility and a solid income and has turned it into a thriving 3-person group practice. In this spotlight, Kristin shares her thoughts about time management, marketing and the value of risk-taking.

Hi Kristin. Tell us a little bit about your practice.

My practice is called In Home LCSW, which I started on a part-time basis in Brooklyn about 5 years ago.  At that time, it wasn’t even named yet – it was just me seeing kids in their homes. But I really got things going when I moved to Rockland County (just outside Manhattan) about 2.5 or 3 years ago. Now, with the addition of 2 other therapists, we provide counseling services, behavioral consultations, parent consultations, child therapy, and family therapy. Instead of the traditional method of the family coming to an office, we provide services in their home.

In many instances, the kids have issues that make going to an office difficult or the family is busy and can’t take the time. So we eliminate those barriers. The family members are free to do other things, like cook dinner, while we’re in session.

How did you arrive at the decision to provide in-home therapy vs. getting an office space?

When I was in school, I worked as a behavioral specialist for an agency called Perspectives. I did exactly what I’m doing now. I’d accompany a psychologist on a home visit and they’d introduce me to the family. After the introduction and intake process, I’d take over the weekly visits. I liked that I got to know the whole family while observing the family dynamic as opposed to just seeing the parent or the child. There is a true advantage to seeing everything happening in the home.

I felt like the in-home approach was a good model when starting my own practice. And honestly, I didn’t want to pay for a space. It ended up being wildly popular in the community. People love the format and I think that’s why the practice has been so successful! I offer the in-home aspect that no one else does.

How long was it until you hired somebody?

The practice grew very quickly and I made my first hire almost exactly a year in. After 6 more months I hired 2 more therapists. Since then, one has left and there are three of us now. I’m planning on hiring a 4th therapist in the fall when we get busier.

As a mother and business owner, how do you manage your time?

I’m a stay-at-home mom for 2 small children (daughter 4, son 2) by day. Having my own practice has really allowed me to be home with them. I see clients Monday through Thursday from 3:30 – 7:30 p.m. I go to all the intakes for myself or my other therapists. Sometimes I’ll have 4 sessions a night. During the daytime, while my daughter is in preschool and my son takes his nap, I’ll take a quick shower, eat my lunch and return phone calls.

Most of my time is spent on the phone, with people starting up services. I’m looking to hire someone in the fall to assist with the administrative piece because I’m managing everything myself, including marketing.

Sounds like you’re really busy.

It’s a lot to manage, which is why I love SimplePractice so much! I really try to maximize my time and before I started using SimplePractice, I was doing all of my invoices myself. Because treatment and face-to-face contact with clients is very important to me as well as the time with my own children, I needed a program that would help me cut back on the time I was spending on admin.

I started using the program back in October and I loved it. It was a transition period for a couple of months, but since December I’ve been using SimplePractice for all of my scheduling. I use it to create superbills and run most of my payments through the program using Stripe. Before that, clients were mailing checks or using PayPal…so this is a much better option.

When you were starting out, what were the biggest obstacles you faced and how did you overcome them?

I had a full-time job in the city, working for the Dept. of Education as a school social worker, but I was spending a lot of time in the car and not with my kids. Starting the business was a huge gamble for me, because my husband and I needed both incomes. But I really didn’t want someone else to be with my children for 12 hours a day. My husband and I went back and forth and after crunching the numbers we realized that if I could get 5 clients, we could make it work.

And I did! We service something like 25 families now. I’m a big believer in taking risks. I believe timing is everything and you have to trust that things will work out. I didn’t feel like I had a choice at the time. I needed to figure out how to make money and be with my kids.

There are struggles of course. My husband comes home every day at 3:30 and we switch shifts. He takes over as Dad and I go out and work. He does dinner, bathtime and sometimes bedtime by himself with them. I don’t have dinner with them every night, which is hard for me, but then again, I get to be home with them all day long. I don’t think that there is a 100% perfect situation and you do the best that you can.


What do you find are the most effective marketing activities?I am part of many “Mom’s Groups” on Facebook. Whenever I need to get people to attend a workshop or I want to highlight a specific service, like our therapist who is also a doula, I will pay to boost or sponsor a Facebook post. That has also been pretty effective.

Of course, you have to separate your personal and professional life on Facebook. But it’s a great way to reach people. People check it every single night and constantly post in groups. Word of mouth is great, especially among moms. Almost everyone who calls in wanting services says, “You are recommended by the moms on Facebook!” or, “I saw you in a Facebook group.” In this day and age, it’s just what people do. Social media is very powerful tool to use.

What’s your vision for your practice?

My vision is for the business to continue to grow. I’d love to open up a storefront one day, hire more people, and service more families in the community. Maybe I’ll cut back on the number of families I’m personally servicing. My preference is that I’ll work more during the day once my kids are in school.

What advice would you give to other therapists who are building their practices?

I’m a perfect example of what happens when you take a risk! It may or may not work. My husband and I have had thousands of conversations about this. You never know what your idea can turn into. And you don’t want to look back and wonder, “Should i have gone for it?”Go for it! If it doesn’t work out, you’ll deal with it. But I think that things work out the way they’re supposed to.

You can find Kristin at:

Website: www.inhomelcsw.com

Facebook: facebook.com/inhomelcsw

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