Welcome therapists and group practice owners! I’m Nicole McCance, a psychologist turned business coach for therapists. I scaled my group practice to 55 therapists and multiple 7-figures in three years with toddler twins at home, but long before that I went through a season where I was dangerously close to going bankrupt. If you’re in a tough spot right now, I want you to know it’s temporary and you’re not alone.
I’m going to walk you through the money mistakes that nearly cost me everything, the mindset shifts that pulled me out, and the simple financial habits every therapist needs to stay grounded and profitable.
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!
The Financial Spiral I Didn’t See Coming
Years ago, I pressed pause on a full solo practice to move to Russia for love (yes, really!).
Long story short, It didn’t work out, and I came home with two suitcases and no practice. I rebuilt from nothing, poured my feelings into work, and the income took off fast. And within about a year I was earning around $20k a month in solo assessments.
Then I made a few classic mistakes like buying a new car, getting designer purses, and moving to a penthouse I couldn’t truly afford. I assumed revenue would always flow the same way it did that month. Because it totally feels that way, right?
But I wasn’t checking the bank account closely. I was doing “math in my head” instead of tracking cash.
And then the tap turned off (big yikes).
In Canada, a legislation change slashed a big portion of the assessments I was doing, and overnight, referrals dried up. Bills kept coming and I maxed my Visa and line of credit. I still remember standing at the grocery checkout holding my breath, waiting to see if my card was approved or declined.
The lowest point for me was receiving a letter from the CRA for about $70,000 because I hadn’t saved for taxes. They put a lien on my condo. I felt alone, embarrassed, and honestly really scared. But the one thing that season didn’t take from me was my “whatever it takes” attitude.
So, what did I do? I went to therapy and did the deep work.
I found yoga and meditation. I moved out of the condo, rented a simple place, and rebuilt my life on solid ground. Debt slowly decreased. I paid the lien. I learned the money skills I was missing. And later, when I was truly grounded and debt-free, I met my husband, Dan. I haven’t carried debt since, and today I work because I love it!
The Small Shifts That Created Real Financial Stability
This is what I started doing differently. These are the habits that protected me when I built and later scaled my group practice to 55 therapists and multiple 7-figures.
1. Count cash, not “accounting profit”
If it isn’t in your bank, do not count it. Period. Hard stop.
Insurance and third-party payments can show up in your software long before the money arrives, and that’s how I got into trouble. From then on, my accountant and I looked at true cash left at month-end. If it wasn’t in my account, it wasn’t real!
Here’s what this looks like in practice:
- At month-end, review actual bank balances, not just reports.
- Separate “book profit” from “cash available.”
- If you invest any surplus, be willing to pull it back if the business needs it later.
2. Keep next month’s fixed expenses in the bank
I always kept the next month’s fixed costs sitting in my account before the month started. This includes things like rent, software, utilities, insurance, and the card charges that come out whether you like it or not. That buffer made a huge difference for me. It turned surprise into “no worries, that’s already covered!”.
Here’s how to set this up:
- Make a list of your fixed monthly expenses.
- Build up to a full month of those costs in your operating account.
- Refill the buffer every month before counting any extra.
Hot Tip: As you grow a group practice, remember that a big chunk of money in your account belongs to your therapists! Back then, I preferred paying them weekly so the balance didn’t look artificially high. Today I recommend paying every two weeks to reduce payroll admin costs. Choose the cadence that keeps your picture clear and your costs reasonable!
What this means for you: focus on profitability, not just revenue. Clean books matter!
Simple Systems I Used To Stay Safe (And Sane)
What I mean by “systems” is small, repeatable habits that helped me go from panic to financial peace.
Track expenses closely
No more using the “math in my head” strategy. You should know what comes in and what goes out, every month. I recommend having a healthcare-savvy accountant keep you honest. When your profit is real cash, move a portion to your investment account so it starts working for you. If the business needs it back, you can transfer it in.
Save for taxes as you go
Please learn from my mistakes, so you don’t get a call from the CRA telling you that you owe $70k! Set aside a percentage of income for taxes and keep it in a separate account. If your profits are consistently high, talk to your accountant about when to incorporate.
Build a right-sized lifestyle
I know how hard it is to step down from luxury once you’ve tried it, trust me on this one. I’ve lived that. Choose a lifestyle that you can sustain through slow seasons and changes in payer rules, not just during your biggest months.
Keep doing the inner work
At the end of the day, money isn’t only math. My old patterns came from earlier stories and beliefs about worth, family, and responsibility. But therapy helped me release shame and build a new set point for wealth. When your nervous system is steady, you make better decisions. (I know you know this!)
The Next Step in Growing Your Group Practice
If you’re in a tight season right now, the first thing I want you to do is breathe.
Your future self wants you to know this will pass. Start with one action this week:
- Pick your rhythm: weekly money date or month-end review. Put it on the calendar.
- Count your cash: look at the real balance today and list fixed expenses for next month.
- Create your buffer: start building to one month of fixed costs in the account.
- Tidy your taxes: open a separate account and move a percentage every time money comes in.
- Get support: if finances feel overwhelming, book time with an accountant who understands health care clinics.
Trust me, you don’t need to be perfect, just consistent. Those simple habits are why I can say today that I’m debt-free, resourced, and working by choice. If I could rebuild from two suitcases and a tax lien, you can absolutely turn your season around!
Want even more support to grow a stable, profitable practice? Follow me on Instagram and listen to my podcast for all the best support on building a therapy practice that thrives without burning you out.
Your Business Bestie,
Nicole
