If you’re a clinical psychology graduate—or about to become one—brace yourself. Your graduate program prepared you to assess, diagnose, and treat mental health issues. It taught you about research design and ethics. It drilled you on the importance of evidence-based practice. But you know what it didn’t prepare you for? Running a business. And if you’re like the overwhelming majority of clinical psychology graduates, chances are, you’re headed straight into private practice, a space where business savvy isn’t just helpful—it’s absolutely essential.
The Shift: From Academia and Hospitals to Private Practice
Clinical psychology programs have a massive blind spot when it comes to career preparation. Here’s the reality: psychology PhDs are still structured like they were decades ago, where the assumption was that most graduates would either land cushy academic jobs or work in hospital systems. But if you’ve been paying attention, you know this isn’t happening anymore.
For example, at Queen’s University–where I completed my own training–there’s an annual internal survey that tracks what clinical psychology grads do after finishing their training. Over the past two decades, there’s been a sharp decline in graduates going into academia. Why? Academic jobs are extraordinarily competitive, and tenure-track positions are rarer than a stress-free PhD dissertation defence (har har har).
Hospitals, once a primary employer for clinical psychologists, aren’t much better. Psychologists are expensive to hire, and many of these roles are now being filled by less-trained, lower-cost providers like psychotherapists or social workers. Nothing against these professions (some of the best professionals I’ve ever worked with are RPs or MSWs), but they simply do not offer the scope of practice that a C.Psych does (e.g., diagnosis, ability to research, supervision). As a profession, we’ve done a terrible job of advocating for our value, and it shows.
So where do most psychologists end up? Private practice.
The Problem: No One Teaches Us How to Run a Private Practice
Here’s the kicker: even though the majority of clinical psychology graduates now head into private practice, we receive zero training in how to run one. Let that sink in. After years (and years… and years) of specialized training in assessment, therapy, and research, we’re thrown into the world of business with no map, no compass, and no clue. Other professions don’t leave their grads this high and dry. Dentists, for example, often get basic business training. Even psychotherapists—whose training is significantly shorter and less intensive than ours—are taught how to market themselves. Yet clinical psychologists, with all of our advanced training, are left to figure it out on our own.
When I graduated, I naively thought that private practice would be a breeze. After all, we have low overhead compared to most businesses. All I had to do was find an office, slap my name on a door, and start doing the work I was trained to do, right? Wrong.
The Reality: What Grad School Didn’t Tell You About Private Practice
Let me tell you what private practice really looks like when you’re going solo. First, you’ll likely need to sign a long-term lease for office space, locking yourself into a fixed expense that looms over you every single month. Then, you’ll need to furnish that office—and unless you want to look like you’re running a therapy practice out of your mom’s basement, this will cost many thousands of dollars. Next comes the website. You’ll pour even more money into getting one built, and then you’ll spend hours (probably weeks) trying to write content for it—without understanding anything about SEO (search engine optimization), which is essential for ranking high enough on Google for potential clients to even find you.
But wait, there’s more. Suddenly, you’re not just a psychologist. You’re also an accountant, a marketer, and an administrative assistant. You’ll spend your “free” time between sessions fielding phone calls, scheduling appointments, chasing down payments, and reviewing your books to make sure your rent is covered. I vividly remember doing my own bookkeeping during my first year of solo practice and thinking, This is not what I signed up for.
Grad school doesn’t prepare you for any of this. And while some people might thrive in this chaos, let me tell you—many do not.
Why Private Practice Alone is Unsustainable for Most Psychologists
The solo private practice model might have worked during COVID, when demand for therapy was so high that even therapists who barely marketed themselves were fully booked. But now? The landscape has changed. The market is flooded with practitioners, particularly psychotherapists graduating from programs like Yorkville University, which churns out thousands of new grads annually. And while psychotherapists often have less training than psychologists, they’re taught how to market themselves—and they’re doing it well.
The truth is, solo practice is incredibly isolating and exhausting. For a profession that involves talking to people all day, it’s ironic how lonely private practice can feel. You’re on your own, handling every aspect of the business by yourself, with no one to share the load. Burnout happens fast. And the worst part? It doesn’t have to be this way.
The Solution: Group Practices as a Sustainable, Fulfilling Career Path
This is why I believe so strongly in the value of high-quality group practices. A well-run group practice takes care of everything that makes solo practice so overwhelming: the lease, the marketing, the admin work, the scheduling, even the billing. At The Tri Health Clinic, for example, we’ve built a system that allows our clinicians to focus on what they do best—seeing clients. You don’t have to spend your evenings trying to figure out how Google Ads work or agonizing over your accounting software. Instead, you can go home and actually have a life.
But the benefits of a group practice go beyond logistics. One of the things I love most about running The Tri Health Clinic is the sense of community we’ve created. Therapists shouldn’t have to go it alone. In a group practice, you have colleagues to consult with, learn from, and lean on. You have opportunities for in-house training and high-quality supervision. You’re part of a team. And that makes all the difference.
Why Psychologists Need to Advocate for Themselves
Here’s the hard truth: if psychologists don’t start advocating for their unique skills and training, we will fade into the background of the mental health landscape. Psychotherapists with flashy websites and strong marketing skills are outpacing us—not because they’re better therapists (although some certainly are!), but because they know how to sell themselves. Meanwhile, psychologists, who have far more extensive training, are often invisible to the public.
And let’s not forget our responsibility to the profession itself. It’s not just about self-preservation; it’s about ethics. When psychologists supervise psychotherapists, for example, they elevate the quality of care for the clients those psychotherapists see. It’s a ripple effect. By stepping into leadership roles, we can guide the next generation of mental health providers and ensure that clients receive the best care possible. It’s a model that mirrors the relationship between dentists and hygienists, where both play essential but distinct roles within the same system.
Clinical Psychology Schools Need to Do Better
To clinical psychology graduate programs: It’s time to get with the times. The mental health landscape has shifted, and clinical psychology programs are failing their students—and in turn, failing the profession. The fact is, most clinical psychology graduates now end up in private practice, yet schools continue to provide zero training on how to run a business or navigate the realities of today’s market. From where I stand, if this continues, it looks like our profession is heading the way of the dinosaurs.
Psychologists have so much to offer the world, but if schools don’t adapt to support their graduates, we’re only going to see more burnout, more isolation, and more missed opportunities. The solution starts with equipping psychology students with the skills they need to succeed in private practice—not just clinical skills, but business acumen, marketing know-how, and practical tools to navigate the modern mental health field.
And if you’re an early-career psychologist feeling overwhelmed by the business side of things, know that you’re not alone. If grad schools won’t help you, find someone who will. I’ve been there, and I’ve figured it out. Let me help you build a practice that’s not just sustainable, but fulfilling. Because psychology is an incredible profession, and it’s worth fighting for.