18 Months in Private Practice

” Consider it great joy, my brothers and sisters, whenever you experience trials of various kinds, because you know that the testing of your faith produces perseverance”. 

                                                                                                                                       James 1:2-3


   Now that I have been in private practice for 18 months, I want to take some time to reflect on my experiences, challenges, and growth. I think that there is value in this for several audiences. First I see value for clinicians, whether you are early in you’re career, planning on pursuing private practice, or struggling to grow your practice this will hopefully support you. Additionally If you are a prospective client or parent of one I would encourage that you continuing reading. I hope to share insights into my journey as a therapist and express my intentions and calling to help people. Lastly, I hope to encourage anyone who is on their own journey of growth.

   Eighteen months ago I was preparing for the story that I share with you now. However, at that time I had no idea how it would unfold. I had been working as a social worker for 5 years and had just finished my two years of clinical training. I’ve told myself since I was in college that I wanted to eventually open my private practice, and I had finally arrived at that moment. What I had thought would be so exciting ended up feeling more like a chasm that could not be crossed.

   The three and half years leading up to this moment were extremely stressful. I was working a job that demanded a lot of me. Rather then focusing on maintaining balance in my life I sacrificed a piece of myself for the work that I was doing. During this time, I developed significant anxiety symptoms. Racing thoughts, difficulty sleeping, excessive worry, and chest pain were becoming more and more frequent. This led to me being awoken early one morning with chest pain that I assumed was a heart attack. I drove myself to the ER only to have my anxiety confirmed. Now the hope of opening my own practice was looking more and more doubtful. I was filled with fear and worry because although I had been preparing to open my practice for the past nine months I knew that failure was not an option. I had recently been married and was now starting a family. The pressure was mounting. Although I was doubting myself and my future I chose to persevere. I trusted in the lord and took a leap of faith. I put in my two weeks and jumped. Now I’m blessed to be able to share what happened.

Lessons Learned:

Although these are titled lessons learned, I want to be clear that I still struggle with exercising them perfectly. I am a work in progress!



   I had a lot of expectations going into private practice and one that stands out is “how quickly I thoughts it would grow”. I was taking all recommendations for marketing and client acquisition but I was not getting more that several patients per month. I was challenged to trust the process which is something that I struggle with. I want to make the process! Instead of worrying about getting more clients I started devoting more time to the clients that I already had. While improving my skills and continuing to learn, something changed. I started to receive referrals from relationships I had made in the past (more on this later).  I was encouraged because people began to show me that they had faith in me and trusted that I could help their loved ones. Through being patient, I was given the gift of truly feeling that I had earned something. Not to mention confidence. I have been pushed to continue exercising patience in my clinical practice but also in my personal life.


   For most of my life I have felt the need to be in control. My relationships, Surroundings, How others preserve me, Making everyone happy, etc. I never understood until recently that I was putting far too much of my energy into worrying about things that were out of my control. This need for control is an unfortunate one because when you try to control your experiences you will be disappointed 99 precent of the time. This led to irritability and frustration with the ones that I love the most. It was under extreme pressure that I learned a valuable lesson, “I am not in Control”.

   Starting the practice and taking on the role of providing for my family gave me no other option but to surrender. When I say Surrender, I mean to truly put effort and thought into what you can control and taking a step back completely from what is out of your control. Some examples of what I had to stop worrying about included, how others think of me, how others behave or take care of themselves, how others treat me, or whether a client wants to schedule another session or not. I am now more concerned with making sure that I, make the most out of every interaction I have, act continuously out of love and kindness, and rely on someone/something bigger than myself. I would not be able to fully surrender without my faith in the Lord. It has not been easy and I still struggle daily, but he has given me the ability to trust in his plan above my own, and for my obedience I have been blessed to experience peace. Through my surrender my faith has been implicated in a positive way. In return I have seen how my own spiritual growth has been a helpful tool in supporting those that I work with.

Failure is Practice

   If you now understand that I felt more comfortable when I was in control, it is not difficult to understand that I also struggle with failure. While going into private practice and for the majority of my life I did not see failure as an option. In every way possible I would avoid it. It was not until some unavoidable failures that I experienced in my clinical work that I truly understood that “I HAVE TO FAIL”. I have to fail because failure is practice, and practice is how you get better/grow. This was a complete perspective shift because now I found myself looking for my failures and trying to understand them rather than avoiding them. Rather than being scared of challenges I now found myself running at them. This also reminds me that I had to get comfortable with asking for help. If you cannot ask for help after failure the only person who is suffering is you. I had to accept with humility that I did fail, and only someone who knows more that me can help.


   If you have failed then you have had to persevere. There is a metaphor that I use in practice and my patients would tell you that I talk about it to much. But because it makes so much sense and it has changed my life let me share it with you. “Be a Buffalo”.

   I do not know where I heard this or read this so I cannot give credit to where it is due. However, the metaphor goes like this; On the great plains of the United States at one time, the North American Bisson (Buffalo) and Cows from Spain lived together. Although these animals are similar there are some very distinct behavioral differences. One is, “The way that they respond to Storms”. When a heard of cows sees a storm moving into the plains towards them, their first reaction is to run with the intention of getting away from the storm. While running from the storm the Cows get exhausted and end up being overtaken by the storm. The Buffalo however, are different. When Buffalo see a storm rather than running away they face directly at the storm and run towards it at full speed. The buffalo end up getting through the storm quicker because they choose to run towards rather than away.

   This may or may not be true in nature however the lesson behind the metaphor is one that resonates with me. In life when you are faced by any type of challenge, difficulty, trauma, or loss you have two choices. Run away or run towards it. Deciding to run at a storm is scary no doubt and the journey even scarier, but it is this journey that will make you confident and have belief in your abilities.  However, if you choose to run away. The storm will catch up with you when you are tired and stressed. You will still be forced to go through the pain of the storm but unfortunately like the cow never gain confidence because you were overtaken instead of overtaking.


   More and more often I am finding opportunities where I can express humility instead of allowing pride to take hold. If you provide a safe therapeutic space, you will be in situations where peoples experiences have an effect on you. You can allow what you hear and the wake of trauma to harden your heart, or you can respond with humility and gratitude. I was going to do a whole “lesson learned” for gratitude however I find it appropriate to discuss it with humility. I define humility as always adopting a posture of gratitude. No matter the context, good or bad there is always a way to find and express gratitude. When you succeed, gratitude will keep you humble and when you fail gratitude will keep you hopeful. There have been many clients who provide me with positive feedback. I am appreciative but, I must caution myself and keep my ego deflated. I must respond with humility. I give glory to God for my achievements, rather than being so prideful as to assume that I got here on my own.

   I have had to accept that half the time I think that I am right I am probably wrong. And for clinicians reading this there is something infinitely valuable about a therapist who does not claim to know everything. When you maintain a posture of humility it will position you to continue learning as a professional.


   We have all heard this word purpose, and I thought I knew what it meant my whole life. Undergoing challenges, doubt and failure helped push me to understanding and developing a true purpose. The why is extremely important! For those thinking about private practice I would recommend really understanding, “why you are doing it”? If you are just doing it for the money, there will be burnout. If you are doing it just to be in charge, then you will crumble when you find out how hard it is to “be in charge”. I have chosen to rely on something deeper, that is not dependent on the outcome of my actions but rather something that transcends human desire.

   My purpose is simple yet complex. “Love and Support Gods People”. How I do this differs because as a clinician it is my job to meet clients where they are rather than coming from a place of authority. This helps to create a space that allows for a healthy and authentic therapeutic relationship to form. Once a healthy relationship is formed, I do everything in my power to support and encourage my clients. Some major components of my therapeutic approach include, helping clients to better understand themselves, development of belief in oneself and hope for the future, Strengthening of Relationships, Effective Communication skills, management of mental health symptoms using coping skills, and finally support in understanding their, “Why”.

   Having a strong purpose helps me to focus on the present moment and spend less time worrying about the outcome. I have found this to be helpful in my clinical practice and also in my personal life. For clinicians it is important to drop a bit of advice here. Professional boundaries have been extremely important in my practice. It allows me to build strong relationships with my clients while also developing healthy limitations. Remaining professional yet compassionate is an art that you will have to practice in order to master.


   I cannot express how much networking has contributed to the success of my practice as well as my mental health. As mentioned earlier, the relationships I had developed prior to taking this leap of faith were extremely important and reinforcing to my experience. In my previous professional roles to the best of my ability I worked to be Dependable, Helpful, Respectful, Resourceful, Adaptable, Humble and Compassionate. In the pursuit doing all these things, it allowed me to form healthy and professional relationships as well as grow in confidence.

   I am beyond grateful to those who have trusted me to support their loved ones in a professional setting. This vote of confidence is rewarding, but also is a reminder that I am fulfilling the purpose that God gave me. I accept this calling with humility and give God the glory!

   For clinicians: Make every conversation a connection. No more, “Hi, How are you? Good, What about you”? When you meet someone truly make efforts to connect with them. Also focus on your intentions. Are you meeting with someone so that they give you more clients? Maybe, but a more genuine and directed intention may be warranted.  Rather, “I am meeting people with kindness, respect, and compassion with the hope of developing a relationship that can allow trust to take root. 


   I have been blessed to grow in confidence through this journey. I truly believe that if you make efforts to practice the skills and perspectives above that you will grow in confidence too. Confidence is not just looking the part and following the steps. It is calculated risk taking followed by failure, humility, perseverance, and perspective taking.

Closing and Moving Forward

   With my new gained experience and clinical skills. I am encouraged to announce that I am now offering consulting to clinicians as well as individuals who are looking for direction and advice Consulting is similar to therapy however different. For non-clinicians receiving consulting, usually there is a very specific issue or barrier that you are facing. My goal in consulting is to support you in finding a smart, quick, and effective solution. Consulting is usually a quicker process and requires less sessions than therapy however, it may lack the same depth and clinical support available in a therapeutic setting.

   For clinicians seeking consultation, I can support you in opening your own practice and meeting your professional goals as well as provide you with clinical direction. I have a passion for Social Workers and young clinicians who are seeking guidance. In the near future I also plan to acquire my supervisor status of an LCSW-S. This will allow me to work with master’s level social workers and provide the two years of clinical supervision necessary for them to acquire their LCSW.

   In my current clinical practice, my plan is to continue growing as a clinician by reading, attending trainings, and by receiving my own clinical consultation. My hope is to maintain a caseload similar to what I have now however continue to maximize the efficiency of my time. I am so grateful for anyone who took the time to read this! Please feel free to reach out if you have any questions or are in need of clinical support or consulting.

Mitchell Mathews, LCSW 

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