The question of private practice versus group practice comes up at almost every career inflection point for therapists. Both models can produce a good career — they are just different careers. Here is an honest breakdown of what each actually looks like.
Income: who actually earns more
Private practice therapists who fill their caseload at self-pay rates typically earn significantly more per session than group practice employees. A therapist charging $175 per session keeps $175. A therapist employed by a group practice may receive $65-90 per session as a salary equivalent, with the group capturing the rest.
But the comparison is more complicated than that. Group practice employment includes benefits — health insurance, paid time off, retirement contributions — that a self-employed therapist must fund independently. Calculate the full compensation package, not just the hourly rate. Read our guide to setting your therapy rates in private practice for help running these numbers.
Admin burden: the hidden cost of going independent
In a group practice, billing, scheduling, credentialing, and marketing are handled by someone else. In private practice, you own all of it — or you hire and manage people who do. That admin burden is real, and therapists who underestimate it often find the first year of private practice more exhausting than expected.
The right systems reduce admin to a manageable fraction of your time. See business systems every private practice therapist needs for a practical starting point.
Isolation vs community: what solo practice really feels like
Group practice provides built-in collegiality — someone to consult with, a team culture, clinical supervision structures. Private practice does not. Therapists who go solo often miss this more than they expected. The solution is intentional community building: peer consultation groups, professional organizations, referral networks, and regular supervision.
Schedule flexibility: the biggest reason therapists go independent
Private practice offers control over your hours that group employment rarely matches. You set your start time, your days off, your caseload size, and your vacation schedule. For therapists at certain life stages — raising children, dealing with health issues, or simply valuing autonomy — this flexibility is worth real money.
When to make the move — and when to wait
Most therapists who successfully launch private practices have an existing referral network, some savings to cover the ramp-up period, and clarity on their specialty. Going independent with no network, no savings, and no niche is possible — but harder. Starting with a partial caseload while employed (where your employer allows it) is the lower-risk path.
Threecus is built for therapists making exactly this transition — a tool that handles the business infrastructure so you can focus on building your clinical practice. For the full launch checklist, see how to start a private practice as a therapist.
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