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 three years while raising twin toddlers, and a huge part of that journey came down to hiring well. Hiring decisions can make or break your momentum. In this blog, I’ll share the exact roadmap I used to grow from solo to a thriving 55-therapist group practice (with a dream team).
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 Foundation to Successfully Hire for Your Group Practice
Before you start hiring, it’s super important to systemize your practice first. Trust me on this one! Without a solid foundation, you could end up costing your practice a lot of money.
Let me say it one more time, because it’s THAT important: Systemize before you hire!
I know you’re eager to post the job (it’s an exciting time!!), but trust me, systemize first. Get everything out of your head and into a manual. Write out onboarding steps, training processes, and policies. Without this, you’ll end up as the Chief Question Answerer instead of the CEO.
When your team starts growing, questions will pour in. If you haven’t built systems, you’ll drown in constant interruptions. A clear onboarding process and documented procedures free you up to actually lead your practice!
Making Your First Hire in a Group Practice
One of the biggest questions I’m asked by group practice owners is who their first hire should be. And the answer may not be who you think it is.
Your First Hire Should Be a “Mini Me”
Your first hire needs to feel like a “mini me.” This means similar energy, style, and modality to you. That’s because you’ll likely transfer clients from your caseload to theirs, and clients are more comfortable moving to someone who feels familiar (aka, like they’re talking to your “mini me”!).
Think:
- Energy/personality (warm, direct, bubbly, calm.. whatever fits you)
- Modality (EMDR, IFS, CBT, trauma-focused work, etc.)
- Population (adults, couples, moms, first responders, etc.)
I learned this the hard way.
Early in my career, I handed off clients to a therapist who had a completely different style than me. None of them stayed (literally none of them). Clients expect consistency, and your first hire is the bridge between you and your new team.
Your Next Steps
When you have your mini me in place, start transferring clients to them. This frees up your time to step into CEO mode. It also ensures your new hire gets busy quickly while keeping continuity for your clients.
Once you make that first hire, congratulations, you’re officially a CEO! That means it’s time to raise your rate and remove yourself from free consults.
- Raise your rate at least $25 above your senior clinicians (many CEOs sit even higher).
- Take yourself off free consult calls so new clients are guided to your team.
- Keep yourself listed for current clients only, not for new inquiries.
This creates an intentional shift where your new therapists become the go-to choice.
Hot Tip: Click here to listen to my podcast episode where I spill the tea on where to find the best therapists for your group practice!
Planning For Your Next Hire
Ok, so you’ve successfully made your first hire (yay!) and now you’re ready for more. Who do you hire next?
Let Your Data Lead the Way
Before you decide who to hire next, look at your data.
Track every inquiry and analyze things like:
- What services are people asking for?
- Who are you referring out?
- What modalities keep popping up?
Your inquiry log is truly the best predictor of your next hire!
The Specialty that Scales Faster
If you don’t have much data yet, my go-to recommendation is to hire a couples therapist.
Couples (and family) work fills fast because:
- They can see both couples and individuals.
- One couple often turns into three or four clients (each partner plus a child).
- Offering couples therapy helps your practice stand out from the crowd.
Even if you don’t personally see couples, you can hire fully licensed therapists to expand into this service area.
Choosing License Level: Interns, Pre-Licensed, or Fully Licensed
The level of license you hire also affects your cash flow.
- Interns (where allowed) = you keep 100% of revenue but provide supervision.
- Pre-licensed = you pay a lower split, boosting margins by about 10%.
- Fully licensed = perfect for specialties you can’t supervise or if you want less oversight.
Early on, I leaned heavily on interns and pre-licensed therapists to boost cash flow and grow quickly.
When to Post Your Next Job
Don’t wait until your therapist is completely full before posting the next job. By then it’s too late! You’ll have a waitlist and stressed clients.
Post the job when your current therapist is around 60–70% full. This gives you enough runway for interviews, credentialing (if in network), and onboarding.
Growing Your Group Practice Sustainably and With Ease
Hiring is the move that gives you more impact, more revenue, and more freedom. Your perfect “hell yes” hire is out there right now, searching for a clinic like yours, so don’t miss the opportunity to bring them in!
Want even more tips on growing your practice? Follow me on Instagram and listen to my podcast for all the best support for growing your therapy practice and attracting more clients!
Your Business Bestie,
Nicole
