Welcome therapists and group practice owners! I’m Nicole McCance, a psychologist turned business coach for therapists (I scaled my own practice to 55 therapists and multiple 7-figures before I sold it).
I recently hosted my Success Panel with four group practice owners who are 10 steps ahead of where most of you are right now. Lavonda who is just outside Philadelphia, Iván in Oakville, Christina in Denver, and Caitlin in Lethbridge, with teams of four, six, ten, and twenty-seven therapists between them.
The business side turned out to be learnable for all four of them. What took the longest was getting past the story they were telling themselves before they started. So if you’ve been circling the idea of scaling to a group practice, this one’s for you.
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 watching the video below!
4 Limiting Beliefs That Keep Therapists From Scaling
I asked every panelist what they had to work through first, and their answers were almost identical.
1. "I'm Not a Strong Enough Leader"
Caitlin pictured a clinic owner as someone older and further along than she was. What she learned is that leadership is something you develop, and nobody’s expecting perfection. Being a psychologist already made her a better communicator than most first-time business owners (an advantage you have too).
I had my own version of this. I was convinced I’d be a terrible leader because I’m bossy and controlling (I’ve been there!).
2. "I Can't Handle the People Problems"
Christina knew people problems were coming, and she was right. She hired someone last year who looked perfect on paper and it turned into a stressful few months. Lavonda’s first hire leaving broke her heart, and she described it perfectly. It felt like your kid going off to college and then telling you they’re not coming back.
What helped Lavonda was preparing her nervous system ahead of time, because people do leave, most on good terms, and the practice keeps running. Iván’s practice is called Mind Unwind, so he asks every candidate whether they’re an unwinder, and if the answer is no, nothing else on the resume matters (I love this so much).
Hot Tip: Need help with hiring? Here’s my strategy for attracting and retaining great therapists in your group practice!
3. "I Don't Belong at This Level"
Iván came to Canada from the Dominican Republic and registered as a psychotherapist two years later. He described hitting rock bottom as a contractor, losing faith he’d ever retire doing this work. He was even considering changing careers! He attended four of my masterclasses before an open house because he was still on the fence.
The question underneath it was, do I really deserve to be here? He joined the Clinic Growth Map™ in January 2024, and by May he had three therapists.
4. "I Don't Know Enough Yet"
Lavonda’s version was research. She’s excellent at gathering information and building plans, but execution is where she’d get guarded. If you’ve listened to every podcast and still haven’t posted a job ad, you know this feeling. There’s a real dopamine hit in the learning phase, and it keeps you comfortable. Her line is the one I’d truly recommend writing down: if you don’t know, you can figure it out.
What's Actually Working to Fill Caseloads in 2026
This is where the panel got real about marketing. Here’s what’s driving clients for them right now:
- Your website is the whole game. Every panelist named it first. People visit your site a few times before they book now, so if you’re private pay, your website has to match your rate.
- Google Ads paired with that website. Iván called this the combination that made the biggest difference. Ads drive the traffic, but a weak website means it all falls through.
- Your Google Business Profile, updated weekly. Lavonda posts a keyword-rich update once or twice a week so Google can see the practice is active and credible. Set a reminder right now (Please don’t skip this one!).
- Local community Facebook groups. Lavonda and Iván both have someone showing up in groups like Moms in their city. Nothing pushy, just useful posts so the name gets familiar to locals.
- Hiring for the languages spoken in your area. Iván pulled his region’s census data, found the most common second languages, and hires with that in mind. Those therapists market themselves inside their own communities.
- Social media is not the engine. Christina doesn’t see the return on it, and when I hit multiple 7-figures I had a whopping 400 unengaged followers. You don’t need to go viral to fill a caseload.
Hot Tip: Most clients book at 7pm or later when you’re asleep, and they’re more likely to show up when they book themselves. No online booking yet? Try Jane App free for two months with the code MCCANCE2MO.
What Scaling a Group Practice Actually Buys You
Iván took his family to the Dominican Republic for a full month and didn’t take a single call or email. His team onboarded two new therapists while he was gone, and it went beautifully. Lavonda was out of work for two months last year and the practice ran itself.
Christina had income coming in during her maternity leave, which almost never happens in our field. Caitlin doesn’t work Wednesdays anymore, and she takes weeks at her in-laws’ without the guilt she used to feel about not billing.
That mountain of hard work you’re building? Eventually it holds you up. To see what that looks like in numbers, read my blog on how one therapist grew her revenue by 120% while seeing fewer clients.
Scaling a Group Practice Starts With Doing It Scared
Iván said something that I really want to share. The tension you’re feeling resolves the moment you decide, either way. One choice keeps you exactly where you are, feeling exactly how you’re feeling, and the other opens a door.
I still remember sitting in the hot tub with my husband Dan and saying, babe, I’m doing it scared. Most people won’t, which is exactly why the ones who do get so far ahead.
Want more strategies for growing your therapy practice? Follow me on Instagram and listen to the Business Savvy Therapist podcast for strategies and real talk about scaling a 7-figure group practice without burning out.
Your Business Bestie,
Nicole
