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Step 1 of 10 · Plan the practice

Define Your Full Private-Pay Practice

“Full” is not a universal caseload. It is the number of clients that supports your life, your clinical work, and the time the business needs from you.

Finished means
A one-page capacity model with a target caseload, working weeks, realized fee, schedule, and definition of full.
Typical focused effort
60–90 minutes, then a quarterly review

The sensible default

Plan backward from a sustainable week, not forward from the maximum number of sessions you could survive. Use conservative working weeks and the fee you expect to collect on average.

1. Choose a sustainable weekly client capacity

Start with the week you want to live, not somebody else’s idea of a full caseload.

Block your fixed commitments first: supervision, notes, consultation, lunch, school pickup, exercise, administrative time, and one buffer block. Then place the sessions you can deliver without borrowing energy from the rest of the week. Count completed client sessions, not appointment slots.

A useful planning sentence is:

My practice is full when I average ___ completed sessions each week across ___ clinical days, with ___ protected hours for running the business.

If you are moving from an agency or group practice, resist copying the caseload that was imposed there. Private practice adds marketing, bookkeeping, inquiry response, and ownership decisions. Those hours are real work.

Typical default: keep at least one recurring half-day free of client sessions. It becomes the shock absorber for consultations, paperwork, sick days, and growth work.

2. Set working weeks and an annual revenue floor

Do not multiply a perfect week by 52. Subtract vacation, holidays, training, illness, seasonal softness, and the occasional week that simply falls apart. For a first model, many solo owners test 44–48 working weeks and adjust from their actual calendar.

Now choose three annual numbers:

  • Floor: the minimum gross revenue that keeps the practice viable.
  • Target: the result that funds your compensation, overhead, taxes, and planned reinvestment.
  • Enough: the point at which you stop adding sessions and protect the practice you built.

These are gross-practice numbers, not take-home pay. Ask a qualified accountant to help translate gross revenue into owner compensation and tax reserves for your entity and state.

The basic capacity equation is:

weekly completed sessions × working weeks × average realized fee = annual gross revenue

Run the equation in both directions. If the target requires a weekly caseload you do not want, something else must change: the fee, working weeks, expenses, service mix, or revenue target.

3. Calculate the realized session fee you need

Your posted fee and your realized fee are not always the same. Sliding-scale spots, pro bono work, late cancellations you do not charge for, card fees, and uncollected balances reduce the average amount received per completed slot.

Use this sequence:

  1. List the number of weekly spots at each fee.
  2. Multiply each fee by its number of spots.
  3. Add the results and divide by total spots.
  4. Use that weighted average in your annual model.
  5. Stress-test it with two fewer completed sessions per week.

Choose a fee that can sustain the business before you design a site or announce an opening. A polished marketing system cannot rescue pricing that makes every full week financially disappointing.

Publish fees plainly unless a specific legal or professional constraint says otherwise. Clear pricing helps prospective clients self-select and reduces inquiries that end in surprise.

4. Reserve room for operations and normal attrition

A pipeline is not a queue of strangers waiting forever. Clients complete, pause, change frequency, relocate, or need a different level of care. A healthy practice keeps enough visibility to replace normal openings without running permanent high-pressure marketing.

Define three capacity states:

  • Open: you have several appropriate recurring spots and should actively market.
  • Nearly full: you have one or two constrained openings and should keep referral sources warm.
  • Full: the sustainable target is met; use a waitlist or referral-out process only if you can manage it responsibly.

Also decide what does not count as capacity. A Tuesday-at-11 opening is not available to a client who needs evenings. Track openings by actual day, time, modality, location, and fit.

5. Write a one-page practice scorecard

Keep the model visible. A spreadsheet is fine; a one-page note is enough. Include:

  • target completed sessions per week;
  • maximum sessions per day;
  • clinical days and protected operations time;
  • working weeks per year;
  • standard fee and number of reduced-fee spots;
  • average realized fee;
  • annual gross floor, target, and enough number;
  • current appropriate openings;
  • the date you will review the model.

This scorecard becomes the brief for everything that follows. Positioning determines who the openings are for. The website explains the fit. Search, directories, and referrals create attention. The inquiry system turns appropriate attention into consultations. Measurement tells you which link is weak.

What to avoid

  • Calling the practice full because the calendar looks busy for one week.
  • Filling every desirable slot before leaving time to run the business.
  • Setting the fee by copying the cheapest nearby profile.
  • Treating gross revenue as take-home pay.
  • Building an expensive marketing stack without a number it is meant to reach.

Completion checklist

  • I can state my sustainable completed-session target.
  • I have chosen realistic working weeks.
  • I know my weighted average fee, not only my posted fee.
  • My schedule includes protected operations time.
  • I have defined open, nearly full, and full.
  • I have a dated one-page scorecard.

This is business planning, not tax or financial advice. Use a qualified accountant or financial professional for decisions specific to your situation.