Roller Coaster

by Thien Pham

Let me tell you about the many roller coasters I went on during my first year of full time private practice. In the Summer of 2016, with much insistence of my supportive partner, I decided to pursue private practice in San Francisco. Despite having made this choice, I still extended this decision another year out of fear. There were a lot of fears to be had.

I had already been doing private practice part time for two years prior in San Diego. I was planning on transitioning to my private practice full time when my partner and I decided to move. The idea of starting all over forced my mind into constant circles of self-doubt. How did I think I would be able to make it in a new city where I knew nobody? Would anyone pay money to see me? Who told me I could own a business without any kind of training? Would I be able to generate word-of-mouth referrals? What if I spend all my savings and end up filing for bankruptcy? What if I’m not cut out to be a business owner? Who even makes money off being full time private practice anyway?

Despite the fears, I knew that this was an opportunity I needed to take, even if it meant possibly failing. So, I did all I could to build my business from the ground up. I joined a few Facebook groups to learn how to build a website, network, build a community. For six months, in between seeing the few clients I had, I would absorb as much information as I can and try to do the things that I thought would be helpful for my business. I was surprised to find how much free flowing information that existed. I spent time writing blogs, creating and editing my website, meeting other therapists for coffee or lunch, learning (and failing) Google Adwords, and hesitantly leaning into marketing. My full time job during those months was not the practice of therapy. It was the practice of building a business.

When I finally had a trickle of clients here and there, there would be such highs when someone wanted to work with me and dramatic lows when they leave. I had not felt these kinds of mood swings ever in my life. The only thing I could compare it to were the anxiety I felt before I took my licensing exams. My partner was helpful in grounding me during my moments of panic, reminding me that I should give myself some more time and try other things to generate referrals. I talked openly to friends and colleagues about my struggles. I even took up a part time job at a dental office to generate some income. If I had to do it over again, I would join a support or process group for new business owners. Having community and knowing that my experience was common would have been so helpful in reducing the anxiety and panic I felt during those trying months.

After two years since I began my journey into full time private practice, I still feel a smaller version of those highs and lows, but things are lot more stable now. I was able to make some connections that allowed me to build my practice to where I was no longer in panic mode. When I sit back and reflect on my journey, it took me about ten years from when I made the decision to apply to graduate school to meeting the goal of working for myself. I’m not where I want to be just yet, but I’m still much further than I could ever have dreamed.

To learn more about my journey from agency to private practice, click the link below to hear the interview I did with Annie Schuessler.

Thien Pham, LMFT, is a therapist in private practice in downtown San Francisco. She is a new member of AAPA and hopes to connect to more therapists of color in the city.

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