Starting a practice
Your guide to joining a group therapy practice
Discover the benefits and challenges of joining a group therapy practice — with expert tips on finding the right fit and navigating the transition.
You may be wondering whether or not you should join a group practice. It’s a significant decision — one that can feel weighty and full of considerations. I, too, wrestled with that question earlier in my clinical journey. In this guide, we’ll review the most important factors to consider, which can help you make the best decision.
The benefits and challenges of joining a group therapy practice
Joining a team of therapists in a group practice has many benefits and some potential challenges to consider.
| Benefits | Challenges |
|---|---|
| Shared mission and purpose with a group | Some practices limit flexibility in choosing your specialization focus |
| Reduced isolation through support and collaboration from other clinicians, including easier access to consultations | Less choice and autonomy over policies, schedule, caseload, and treatment approaches |
| More referrals if the group handles all or some of the marketing | Potential productivity pressures from the expectations of the practice |
| Many practice expenses are covered, such as an EHR, telehealth services, office space, etc. | Lower income due to the group practice taking a portion of the revenues for each session |
| Many group practices handle administrative tasks like billing, scheduling, and onboarding, so you can focus on the clinical work | Working on a team can bring the potential for colleague conflict or workplace politics |
| Lowers personal risk when you are not the primary owner of the practice | |
| The opportunity to learn how a private practice operates without taking all the risk upfront or jumping in before you feel ready | |
| Depending on the practice, you could be hired as a W-2 employee, with benefits like health insurance, PTO, a retirement plan, and/or continuing education support |
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Preparing your recruitment strategy
It takes self-reflection and honesty to make the decision of joining a group practice versus starting your own private practice. These are some key questions to ask yourself:
- Professional values and goals: What are my values and long-term goals? Do they align with working for a group practice? What does growth look like to me?
- Financial and employment needs: What are my expectations about pay and benefits? Do I want a W-2 or 1099 role?
- Workload and scheduling: What caseload size feels manageable to me? Do I have any scheduling and flexibility needs?
- Team and collaboration: Am I alright with not being the only decision-maker? Do I enjoy collaborating with others?
How to evaluate potential group practices
There are some key categories to be considered when evaluating group practices. It's helpful to have a framework of assessment that can be applied to each practice you're considering. You might rate each category on a 1 to 5 scale, then compare practices based on their overall scores.
- Reputation: What are the ratings, reviews, and general sentiments of the practice from clients, employees, and across the community?
- Value, mission, and vision: What are the values and mission of the practice? What's the vision and where is the practice headed?
- Financial and benefits: Do they hire therapists as 1099 contractors or W-2 employees with benefits? Is their compensation competitive?
- Workload and scheduling: What are the caseload expectations of the practice and do they allow for a healthy work-life balance?
- Clinical work: What's the clinical approach of the practice? What niches or specialties do they focus on?
- Professional growth: Is there continuing education support, opportunities for clinical supervision, or room to grow within the practice?
- Team: What's the culture of their team? How do they select their team members? What is staff turnover like?
Essential questions to ask during your search
| Category | Example questions |
|---|---|
| Financial | Is the position W-2 or 1099? What's the compensation and benefits package? How are payments handled? |
| Clinical | What are the specialties and niches of your practice? What's the clinical approach of your practice? Do I have a choice in the clients I work with? How much flexibility is there to choose the modalities I use? |
| Administrative | How much of the scheduling, billing, and marketing does the practice handle? What would be required of me for administration? Are there any administrative support staff? |
| Legal and ethics | How do you all handle consultations for ethical dilemmas and difficult cases? Do you require that I sign a noncompete agreement? What types of licenses do you require beyond the state’s requirements, if any? |
| Growth and development | What type of supervision, mentorship, and consultation is offered? What are the policies around client transfer? (In other words, can you take your clients with you even if the practice sourced them for you?) Is there a structure to support professional growth? Does the practice pay for any continuing education? |
Understanding the financial implications
One of the main determinants of your financial situation in a group practice is whether you’re a 1099 contractor or a W-2 employee. This usually determines whether benefits are offered, which can significantly affect your overall compensation.
There are several ways in which pay can be provided. This is usually either through a salary (applicable to W-2 employees only), a set hourly rate, or a percentage-based fee split per therapy session (usually 60% to 85% for the therapist, but rates can vary). Some practices only pay for clinical sessions, while others also compensate for administrative time. A rental model is also used in some cases, where therapists pay a group practice a set fee for office space with less administrative support, but then keep 100% of their session revenue.
One other payment determinant is the amount of insurance companies the group practice panels with — and the reimbursement rates they pay for each session. This is particularly important for fee-split structures because differences in the reimbursement rate per session can have a significant impact on your income. It's crucial to learn about the pay structure before accepting a position so you can get a detailed picture of what your income would be.
Navigating the transition process
Transitioning to a group practice from solo or agency work can be a significant process. Here are some details to keep in mind for the process.
One month before starting your new job
- Review existing contracts to see if there are non-compete and exit policies.
- Inform all of your clients you’re leaving your practice as soon as possible. You’ll want to give your client adequate time to transition, and to ensure they have a plan for continuity of care.
- Coordinate your schedule with the new practice and start to plan your time, which may include some newfound flexibility.
- Complete any system training that is required before your first day. Doing this prior to a start date can help you hit the ground running and see clients right away.
During your first month at the new practice
- Complete all onboarding and training tasks with the practice.
- Collaborate and integrate with the new team. Make time to get to know your new teammates and offer to support them as you can.
- Ask as many questions as you can to ensure that you understand the practice’s systems and workflow.
- Start seeing clients and adhere to the practice’s administration and documentation standards. You'll start to get a sense of how you can set your schedule, plan your time, and meet your productivity requirements.
Alternative paths: Creating partnerships instead of joining existing practices
There are other avenues you can pursue if you feel that joining an already existing group practice isn't right for you. One popular option is teaming up with other therapists you know to start your own group practice. You must consider the time, financial, and risk implications of this approach, but it can offer benefits compared to joining another practice. Some key benefits include:
- More ownership and autonomy in decision-making
- Shared responsibilities and costs with others
- More financial upsides: You'll be an owner of the practice, rather than an employee
- Collaboration with colleagues you already know and trust
- If this is a path you choose to take, Headway can support a new practice through handling administrative tasks such as scheduling, insurance credentialing, billing, and documentation.
Find your path to group practice with Headway
Whether you decide to join a group practice, start your own group, or continue a solo private practice, you can get support with Headway. Headway’s designed-for-compliance platform can handle scheduling, insurance billing, a robust EHR with AI-powered notes templates, and administrative tasks. With Headway's support, running your own practice — or joining a group practice — becomes simpler and more rewarding.
This content is for general informational and educational purposes only and does not constitute clinical, legal, financial, or professional advice. All decisions should be made at the discretion of the individual or organization, in consultation with qualified clinical, legal, or other appropriate professionals.
© 2025 Therapymatch, Inc. dba Headway. All rights reserved. No part of this publication may be reproduced without permission.
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