Welcome therapists and group practice owners! I’m Nicole McCance, a psychologist turned business coach for therapists. I scaled my clinic to 55 therapists and multiple 7-figures in just three years (all while raising toddler twins!). One of the questions I get asked all the time is – how do I know if I’m actually ready for group practice?
It truly is a big leap. Part business decision, part identity shift. You’re not just a therapist anymore, you’re stepping into being a boss, a leader, and a CEO. And that can feel both exhilarating and terrifying. I’ve totally been there and know exactly how that feels, which is why I’m going to help you make the decision with confidence and clarity!
P.S. Not a huge fan of reading blogs? (I’m more of a podcast girl myself) You can listen to my podcast episode all about this topic by clicking here or by watching my YouTube video below!
What It Really Takes to Build a Group Practice
Building a group practice is like building a house from scratch. It’s super exciting, it’s meaningful, and yes… it’s also work. The beautiful part is that, unlike solo practice or a corporate job, you don’t have to do every piece forever. Over time, you get to hire the right people and focus on your zone of genius!
Hot Tip: Click here to learn more about your zone of genius and the 95/5 rule!
Start by Systemizing
This is the part most therapists skip, and that’s why they burn out as group practice owners. Before you bring anyone on, get your systems in place. Otherwise, you’ll become the Chief Question Answerer, fielding constant pings about passwords, policies, and procedures (which we definitely don’t want!).
Your future self will thank you if you:
- Create a simple manual with policies and processes
- Outline onboarding and training step by step
- Gather all logins, templates, and tools in one spot
These systems free up your time so you can actually LEAD instead of running around putting out fires all day.
Expect Work, Then Make It Easier
There’s no getting around the fact that group practice comes with investment. Think: website updates, room furnishings, and marketing to get new clients. But the key to this is that you get to choose your pace!
- Fast Growth: Invest cash upfront, grow quickly, and reinvest revenue
- Slower Growth: Expand at the rate of cash flow, with fewer moving parts at once
Both of these paths are valid. In my experience, I grew very fast and while it worked for me, it also felt like a three-year rollercoaster. If I could go back and talk to baby group practice owner Nicole, I’d tell myself to savour more moments. So don’t feel like you have to pressure yourself, there’s no one correct timeline to follow.
And remember, you don’t have to do it all! If paperwork and scheduling drain you, bring on an admin (DM me “ADMIN CHECKLIST” on Instagram and I’ll send you my free resource!). If managing staff isn’t your strong suit, hire a clinic manager down the road. Delegation is an essential part of successfully scaling your group practice and it’s truly the difference between running your practice and having a life.
Mindset Shifts For Scaling to a Group Practice
Practical steps aside, the biggest transformation is actually inside of you. Becoming a group practice owner means learning to trust other people with your reputation, your clients, and your business. And trust me, that can feel SO scary.
Trust and Transparency
If I’m being totally honest, this was the hardest part for me. Handing my reputation over to an admin I had just met or a therapist I found on Indeed brought up all sorts of micromanaging tendencies. But what I learned from this experience is that:
Trust grows when you stop hiding your fear.
Show up authentically with your team! Say things like “You might notice I’m double-checking your work. It’s not because I don’t believe in you, it’s because this is new for me and I want to get it right.” When you lead with vulnerability and transparency, you create a safe culture where everyone can be human.
Here’s a perspective I hope you find freeing: Your team is often more nervous than you are. They want to impress you and do a good job! Naming your own fears levels the playing field and creates genuine collaboration.
Pick “Easy” Wherever You Can
When I say “easy” I’m not saying to avoid effort. I’m saying that you should choose fewer mistakes and clearer paths. For example:
- Follow a proven hiring process instead of winging it
- Use solid contracts and pay structures
- Consider hiring interns or pre-licensed therapists first if you want more cash flow and less intimidation
- Get coaching so you don’t waste years figuring it out on your own
Self-doubt is expensive. Every month you delay is another month of lost opportunity and the sooner you take a step forward, the sooner you step into the freedom and impact you want.
Deciding If You’re Ready For a Group Practice
So, are you ready for a group practice?
The truth is, no one ever feels 100% ready. Fear is totally normal and is just your nervous system trying to keep you safe. The real question is:
Are you willing to do it scared?
If you crave variety, leadership, and growth… if you’re sick of hitting an income ceiling… if you know in your heart you’re meant for something bigger, then yes – you’re ready!
Take a breath, put a hand on your heart, and remind yourself that you can do hard things. Because you can! And on the other side of this leap is a business that gives you more freedom, more income, and more impact.
Want even more tips on growing your practice? Follow me on Instagram and listen to my podcast, The Business Savvy Therapist, for the best support on scaling your group practice and attracting more clients with ease.
Your Business Bestie,
Nicole
