Setting Up and Running

a Therapy Business

Setting Up and Running a Therapy Business provides a succinct, practical, and

accessible guide for counsellors starting out in private practice as well as for
more experienced practitioners who would like advice on how to continue to
attract a larger clientele.
This second edition has been restructured to bring all the marketing chapters
together to help counsellors understand a variety of ways of helping their business
grow, and includes new material on using social media. Through the inclusion
of topics such as setting up a website, choosing an ideal workplace, marketing,
meeting data storage standards (including new material on GDPR), and methods
of accepting payments, the author offers his expertise and guidance to help
practitioners make wise, workable decisions based on a thorough understanding
of the stakes as well as the viable options.
As a book that bridges the gap between being a good counsellor and running a
successful counselling business, it is a comprehensive read not only for counsellors
who are just starting in private practice, but also for senior practitioners seeking a
fresh perspective on their business.

James Rye started his private practice in 1997 and is now a Senior Accredited
member of BACP. He works as a counsellor/psychotherapist, clinical supervisor,
and trainer, as well as accessing clients and supervisees from throughout the UK
and abroad.
Setting Up and Running
a Therapy Business
Essential Questions and Answers

2nd Edition

James Rye
Second edition published 2021
by Routledge
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and by Routledge
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Routledge is an imprint of the Taylor & Francis Group, an informa business
© 2021 James Rye
The right of James Rye to be identified as author of this work has been
asserted by him in accordance with sections 77 and 78 of the Copyright,
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All rights reserved. No part of this book may be reprinted or reproduced or
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the publishers.
Trademark notice: Product or corporate names may be trademarks or
registered trademarks, and are used only for identification and explanation
without intent to infringe.
First edition published 2017 by Routledge
British Library Cataloguing-in-Publication Data
A catalogue record for this book is available from the British Library
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ISBN: 978-0-367-56077-5 (hbk)
ISBN: 978-0-367-41950-9 (pbk)
ISBN: 978-1-003-09632-0 (ebk)
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Contents

Acknowledgements viii
About the authors x

PART I
Starting up 1

  1 Why should I consider private practice? 3

  2 What qualifications, experience, and qualities do I need
to start a private practice? 7
  3 What things must I do if I go self-employed? 10
  4 What should I consider if planning to work from home? 12
  5 What should I consider if planning to rent a room? 16
  6 What insurance do I need as a private practitioner? 19

PART II
Money issues 23

  7 How much should I charge? 25

  8 How much can I expect to earn? 27
  9 How can I accept payment? 30
10 Should I give the first session for free? 33
11 Should I charge for sessions when a client doesn’t turn up
or cancels with short notice? 35
12 What are business expenses, and why do I need to keep
track of them? 39
vi Contents
PART III
Helping my business grow 45

13 What are your tips for marketing my business? (1) 47

14 What are your tips for marketing my business? (2) 51
15 How can I use social media? By Laura Harley 55
16 How can I get a website? 61
17 How can I build for longer-term growth? 65
18 How can I increase the chances of an enquiry becoming
a client? 69
19 How can I increase access to my services? 73
20 What about working for agencies? 78

PART IV
Other practical issues 83

21 What can I do to increase my personal safety when

working alone? 85
22 Do I need to give clients a written contract? 88
23 If I issue a written contract, what might it include? 90
24 What do I need to do about General Data Protection
Regulation (GDPR)? 96
25 How could I introduce a written contract and GDPR
agreement?103
26 How can I store my notes? 105
27 Do I need to register with the Information
Commissioner’s Office? 109
28 Can I work with clients in their own homes? 112
29 Will I have to work evenings and weekends? 117
30 What could I do if I bump into my clients in my
locality?119
31 What is a professional will and do I need one? 121
 Contents  vii
PART V
Miscellany 125

32 What are outcome measures and should I use them? 127

33 What is the difference between a sole trader and a limited
company?132
Acknowledgements

First edition
Many people have unwittingly contributed to this book.
I first tentatively started out in private practice in 1997 and am grateful to the
thousands of clients whom I have seen since then who have made me think through
problems and attempt to come up with solutions. Their presence and absence
pushed me to try to find answers to diverse and mundane questions such as: Why
aren’t more clients coming to my door and what can I do about it? Why can’t I
accept credit card payments? What can and can’t I claim against tax? And in later
years, as my business and experience grew, those questions have been sharpened
by supervising several counsellors who wanted clear answers to practical questions.
From 2010 to 2015, I had the privilege of serving on the Executive Committee
of the British Association for Counselling and Psychotherapy (BACP) Private
Practice Division (latterly as its chair). During those years, I spent many hours
in meetings in London and at BACP headquarters in Lutterworth trying to iden-
tify the needs of private practitioners and trying to help BACP continue to be an
organization that could meet some of those needs. I am truly grateful to my some-
time fellow committee members and practitioners: Rabina Akhtar, John Crew,
John Daniel, Julia Greer, Wendy Halsall, Martin Hogg, Mervyn Wynn Jones, Meg
Logan, Susan Utting-Simon, Patti Wallace, and Guy Westoby. I greatly valued
their contribution to the hours of professional discussion, their challenges and
support, and their ability to laugh. Some of my views on private practice were
enlightened by those discussions.
During my years on the committee, two other important things happened. First,
part of my responsibility involved representing the Private Practice Division at
numerous BACP training events in various parts of the country. At every event
I attended, I met many people – some experienced counsellors, some just starting
out – but nearly all of them asking questions: Can I do this? How do I do that? Do
I have to do that? It was a powerful reminder that we train people to do profes-
sional therapy, but we do not train therapy professionals to run businesses. It left
me with a desire to do something to try to fill that gap.
The second important thing was that John Daniel – the editor of the BACP
journal The Independent Practitioner, which then became Private Practice – was
 Acknowledgements  ix
also on the Executive Committee. He gave me the opportunity and encouragement
to write down some of my thoughts about private practice. Some of the material
for three of the answers in this book – How much can I expect to earn? How can I
increase the chances of an enquiry becoming a client? How can I increase access to
my services? – originally appeared as articles in these journals. They are reprinted
here with the kind permission of the BACP, who also gave permission to quote
from their revised ethical framework.
I am also greatly indebted to my wife, Nina, who as a practising therapist herself
brings me down to earth, shares her immense wisdom, and has patiently supported
me over the past 20 years, despite the disruption caused by running a business
from home.
I wish to clearly state that the views presented in this book are my own and do
not represent the views of any particular organization. The information is offered
in good faith, but you are encouraged to seek the advice of other professionals
(such as an accountant and business advisor) when making important decisions
that affect your own business.

Second edition
I am again grateful to friends and colleagues who made suggestions for the new
edition, and again, especially to Susan Utting-Simon for her detailed comments.
Again, I wish to clearly state that the views presented in this edition are those of
the authors and do not represent the views of any particular organization. The
information is offered in good faith, but you are encouraged to seek the advice
of other professionals (such as an accountant and business advisor) when making
important decisions that affect your own business.
When considering the possibility of a second edition, it became apparent that
apart from minor corrections, there were two gaping holes in the first edition. At
the time of writing the first edition way back in 2015, General Data Protection
Regulation (GDPR) may have been conceived, but it hadn’t yet come to birth. By
the time it did arrive, it was too late to change the existing copy that was already
in press. Hence, any future edition would need a chapter on how GDPR would
affect private practitioners.
The importance of the use of social media in marketing has continued to grow.
One of the reasons it was missing from the first edition is that I didn’t feel suf-
ficiently expert in the subject to tackle it, but it was clear that any future edition
could not go on ignoring the topic. I am extremely grateful to Laura Harley who
agreed to write that chapter on the topic for this edition.
About the authors

James Rye has been working as a counsellor in private practice since 1997.
He formed Connections Counselling Ltd in 2002 and became a partner in
Peterborough Counsellor Training in 2012. He now works as a counsellor/
psychotherapist, clinical supervisor, and trainer. Right from the start of his
counselling career, he has worked with clients via telephone and online, as
well as face to face, and now regularly interacts therapeutically with a wide
client base, drawn from his local community, from the whole of the UK, and
from ex-pats abroad.
  In 2010, he was invited to join the Executive Committee of the BACP Private
Practice Division, and he served as chair of that committee from 2013 to 2015.
His committee role involved visiting many parts of the UK to attend train-
ing events, promote the Private Practice Division, and answer questions from
people about setting up and running a business as a counsellor.
  Before finally leaving the world of education in 2001, he had worked for
30 years as a teacher and manager in secondary schools, and in further and
higher education.
  He lives in King’s Lynn, is married, and has two grown-up children.
Laura Harley is an online talking therapist, writer, and business coach. With a
degree in Multimedia Production and Technology and a previous career in IT
spanning more than a decade, she now works online with English-speaking
clients the world over. Her therapeutic work has a particular focus on relation-
ship issues, co-dependency, and the issues faced by the LGBT+ community,
served via encrypted video/audio sessions and secure email therapy. In addi-
tion, she also provides social media consultancy to small business owners,
as well as offering self-paced online training to therapists on how to build a
successful private practice. She lives in France with her husband, is a blogger
and Instagram influencer, and also writes for various magazines in the UK as a
columnist, focusing on her life there.
Part I

Starting up

1 Why should I consider private practice? 3

2 What qualifications, experience, and qualities do I need
to start a private practice? 7
3 What things must I do if I go self-employed? 10
4 What should I consider if planning to work from home? 12
5 What should I consider if planning to rent a room? 16
6 What insurance do I need as a private practitioner? 19
1 Why should I consider
private practice?

L
et’s be honest, a lot of therapists end up in private practice almost by default
rather than by enthusiastic choice. Many enter years of training with a
genuine but vague notion of “wanting to help people”. And then, years
later, they realize that there are very few paid counselling jobs available, and at this
point, a significant number of trained counsellors effectively “disappear” and never
directly use their expensively acquired skills as a means of generating income.
For those who are determined to try to earn money from their training, they
now face what is for many the unwanted task of setting up and running a business.
Although there are those who, right from the beginning, relish the prospect of
working for themselves, I strongly suspect that they are in the minority. For most
of us in private practice, the genuine relishing comes after experience and growth
in confidence. However, regardless of whether we are initially reluctant or very
willing business owners, there are a number of compelling reasons for considering
starting a private practice.

Benefits for counsellors

The benefits to counsellors are those that accrue to all people who are self-
employed. They are the increased freedom of choice and power to control when
and where you work, and, to some extent, how much you get paid. If you don’t
want to drive to an office, you could choose to work from home. If you don’t want
to work on a Wednesday afternoon, you can choose not to do so. If you want to
work part time, you can set your own working hours. If you want a pay raise, you
can try to raise your prices.
Although, as we shall see, there is a cost to that freedom of choice and power, for
many people there are also very strong psychological benefits. Most counsellors
enter the profession after a number of years in paid employment, and they enjoy
the freedom of being their own boss, especially if they have suffered from working
for whimsical, capricious, rude, or bullying superiors.
Before becoming a self-employed counsellor, I spent many years in educational
management. For some of that time, I performed tasks that I enjoyed, and on other
occasions, I performed tasks that I didn’t enjoy but which I knew were necessary.
However, on other occasions, I performed tasks that were legal but with which
4  Starting up
I profoundly disagreed. I knew that I had to do them if I wished to keep my job and
continue to pay the mortgage. And when in middle management, I occasionally
felt that my creativity and problem-solving abilities were thwarted. I rightly had
to yield to my seniors, who sometimes didn’t share my views, my solutions, my
timescales, my willingness to take risks, or my confidence in my ability to deliver
what was required, or to adapt to and successfully manage any failure.
Now I genuinely enjoy running my own business. I am free from the office
politics. Looking back over 20 plus years, I have a real sense of satisfaction that I
have been able to create something worthwhile that regularly generates important
income for me. I enjoy the freedom I have to plan and make changes that I want to
make. It pleases me to be able to try out things and take appropriate and measured
risks to see if things work out in a business sense. Self-employment has enabled
me to express parts of my personality that were, of necessity, being curtailed while
I was being employed by someone else.

Benefits for clients

Although most readers of this book will be thinking about the possible advan-
tages of working in private practice from a personal point of view, there are many
potential benefits for clients in having a large number of competent private prac-
titioners available. In a recent paper, Patti Wallace, the then BACP Lead Advisor
for Private Practice, cogently set out the many potential benefits of having a large
number of private practitioners available to clients (“The contribution of private
practice counselling”, BACP 2015). Wallace lists nine potential benefits for the
client of working with a private practitioner as opposed to working with a coun-
sellor employed by an organization (such as the National Health Service (NHS)).
I have added a tenth.

• Choice of person. If they wish to, clients have the freedom to choose a
therapist on the basis of gender, age, sexual orientation, race, spoken lan-
guage, level of training and/or experience, and experience of, or interest in,
particular issues.
• Choice of location. Clients may not wish to travel far for therapy. Alterna-
tively, they may wish to have a counsellor outside of their local geographical
area.
• Choice of timing. Clients may not wish to be constrained by the usual norms
of a working week and may have difficulty in keeping daytime appointments.
They are free to seek out private practitioners who offer evening and weekend
appointments if they wish to do so.
• Choice of counselling model. While it may be true that most clients are
unaware of the variety of counselling models available, some are aware and
have a particular choice. So, for example, because of recommendations from
a GP, it is not uncommon for clients to specifically seek out a therapist who
offers Eye Movement Desensitization and Reprocessing (EMDR) or Cogni-
tive Behavioural Therapy (CBT).
 Considering private practice  5
• Reduced waiting time. Most clients would have to wait weeks, if not months,
for an NHS counselling appointment (even if one were available). By select-
ing a private practitioner, clients who can afford to pay rarely have to wait
more than a week.
• Help without a diagnosis. Clients who work in certain sectors (in the NHS,
or in the military, for example) often fear having anything to do with mental
health, and especially a mental health diagnosis on their medical record, for
fear that such information would hinder their careers. Records kept by private
practitioners are not part of any formal NHS medical record.
• Greater confidentiality. However secure records are, people who go for a coun-
selling appointment in an organization are sometimes unsure about how many
people will have access to their records. When going to a good private practitioner,
clients know there is usually less risk of accidental or systematic leakage.
• Less disclosure of risk. Counsellors working for, or within, organizations
must follow the rules of that organization about the disclosure of risk. Coun-
sellors working for the NHS, for example, have to disclose concerns about
serious risk to other relevant professionals, whether or not the client agrees
to that. There is no such compulsion for private practitioners to do so. Some
would want to do so anyway and would communicate their policy on dis-
closure in their initial contract. However, others are willing to keep that risk
confidential for as long as the client asks them to do so.
• Empowered customers. Clients who pay for counselling are customers as
well as clients. Their decision to choose a therapist, to choose a number of
sessions, and to choose to pay gives them a lot more power in the relation-
ship than clients being told who to see and for how long. The clients have
much more autonomy.
• Choice of counselling modality. Although the counselling profession as a
whole has been slow to embrace the use of modern technology, more and
more therapists are now using technology to offer sessions in a variety of
ways. Face-to-face communication is no longer the only option. Clients can
elect to have telephone sessions, voice chat over the internet, video sessions,
and therapy via instant messaging. At the time of this writing, it is predomi-
nantly private practitioners who are offering these choices.

A word of caution
Of course, not everything in the private practice garden is automatically rosy.
Research published by the Social Market Foundation recently found that the
proportion of low-paid self-employed, based on both hourly and monthly earn-
ings, has increased significantly since the recession of 2008. Around 55% of the
self-employed have monthly incomes that are less than two-thirds of median
employee earnings (https://flipchartfairytales.wordpress.com/2016/03/22/
self-employed-slide-further-into-poverty/).
Starting out as a therapist, especially if you have no other sources of immediate
income, can be financially challenging. Also, self-employed practitioners don’t
6  Starting up
have the benefits of working closely with other colleagues and of feeling part of
a therapeutic team. They often feel isolated. They do not have the security of a
regular income or a substantial work pension, and thus carry the responsibility for
having to generate income (week-in, week-out), pay taxes, and face any conse-
quences of failing to do so. They often work unsocial hours. Organizations tend to
have many support structures in place, and private practitioners often face greater
risk without them.
One of the purposes of this book is to help readers avoid some of the pitfalls
and enjoy creating something of significant benefit to others and to themselves.
References
1 A version of this material originally appeared in Rye, J. (2011). Adding it up. The Inde-
pendent Practitioner, Autumn: 6–9. Published by the British Association for Counsel-
ling & Psychotherapy©. Used with BACP’s kind permission.
1 A version of the material in this answer originally appeared in Rye, J. (2013). Closing the
gap. Private Practice, Spring: 22–25. Published by the British Association for Counsel-
ling & Psychotherapy©. Used with BACP’s kind permission.
1 A version of this answer initially appeared in Rye, J. (2014). Breaking down barriers.
Private Practice, Summer: 29–30. Published by the British Association for Counselling &
Psychotherapy©. Used with BACP’s kind permission.
1 Details of the GDPR framework and all quoted regulation text are taken from the Infor-
mation Commissioner’s Office (ICO) website: https://ico.org.uk/for-organisations/
guide-to-data-protection/guide-to-the-general-data-protection-regulation-gdpr/.