'Being an excellent practitioner, but lacking business skills, is a recipe for failure'

Chartered Psychologist and therapist Professor Rob Bor will be hosting a British Psychological Society webinar on working successfully in private practice this July, and then again in November. Ella Rhodes asked him about it.


What will the webinar cover?

More psychologists are opting to practice independently of traditional work settings, such as the NHS. Few of us have been taught skills as part of our core training on how to set up and develop an independent practice. There are remarkably few courses on the topic for those seeking CPD. It is then left to individuals to proceed through trial and error in setting up a practice. This poses several challenges and risks which need to be addressed in order to succeed and thrive in independent practice. 

Remember too that working independently can be isolating, which can further impede the acquisition of skills in this area. Many businesses fail within the first year or two of being set up. As a practitioner psychologist entering into independent practice, this should be avoided at all costs. The seminar will address the realities of working in independent practice, the specific challenges and ‘to-do’ list of considerations and some practical hints and tips on how to grow your practice into a thriving concern which benefits clients and rewards you for your effort, skills, and stamina!

How did you set out in private practice yourself?

Around 30 years ago, an eminent psychiatrist asked me to see a private patient. At the time I was working full-time in the NHS. I had no idea where I would see the client, when I would see them, what the impact on my NHS work may be from a contractual perspective, how to handle the fee and billing, and, importantly, how to communicate around the practicalities of the session. I was excited but also daunted by the quick realisation that working in independent practice was not necessarily the ‘easy option’ when you compare this with regular, paid employment. I sensed numerous challenges and felt that I lacked business skills and acumen for developing a practice. I also knew that my reputation and financial wellbeing could be negatively impacted. 

I was surprised, but later gained confidence by not having the protective buffering of an organisation to hide within or behind, when seeing clients. The sense of pride in being able to help someone who then directly expresses their gratitude to you for the help you have provided, given that they have chosen to work with you, is humbling. Less than 20 years ago, very few psychologists worked independently. The situation is now completely different, but the potential pitfalls have become more challenging in an era of litigation, sometimes confusing medical insurance cover, and also the pros and cons of associateship or partnership with other psychologists. 

What still needs to change in this area?

We are fortunate that the Special Group for independent Practitioners within the BPS are pushing forward with representing independent practitioner psychologist interests. Medical insurance reimbursement rates vary between providers and for those who work clinically, this can be confusing and at times discriminatory, and negatively impact your financials when they set maximum tariffs for clinical treatment. 

A further challenge is increasing competition between psychologists working independently, working either alone or within mental health groups. Some areas of the UK are under-served by psychologists working in independent practice, while in others the market may feel saturated. It is an uneven field out there and anyone looking for opportunities should consider where there is an undersupply of psychologists working independently. Online therapy took off during the pandemic, and this is a welcome addition to improve access to psychological therapies. We are beginning to see a return to previous practice methods and potential clients specifically requesting face-to-face meetings again. Whilst I would encourage skills acquisition in online therapy delivery, I would maintain a face-to-face consultative option for clients.

What’s under-appreciated in this area?

Many psychologists who have an interest in working in independent practice ignore the importance of having business and administrative skills in their grasp. Being an excellent practitioner, but lacking business skills, is a recipe for failure. You do not have to give up your salaried employment completely (unless this is a contractual obligation) when starting out in independent practice. It is possible to dip your toe in and do some limited work outside of your contracted time in order to see whether this is the right work context for you.

What do you hope people will take away from the webinar?

We have covered a number of salient issues in our textbook Setting Up In Independent Practice (Bor and Stokes, Palgrave Macmillan, London 2011). This may be a useful primer for those considering the course. Those attending the course will come away with a greater appreciation of the place of independent psychology practice as well as some of the risks and challenges in setting up a practice at this time. It will also cover some of the regulatory aspects such as indemnity insurance, liability insurance and succession planning. Those attending will recognise that there is wide variation in how independent practice fits into healthcare and organisational consultancy, and how to make it financially viable. Perhaps, most importantly, for those still unsure, it may help to shift them off the proverbial fence as to whether independent practice is for them or whether they best stay clear of.

- Professor Rob Bor’s seminar will take place on July 6th and on November 15th

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