What 35+ Years in Private Practice Taught Me About Building a More Purposeful Practice
After more than 35 years as a private-practice speech-language pathologist, I learned something I wish I'd understood much earlier.
Your clinical expertise doesn't have to be limited to the hours you spend sitting across from a client.
It took me many years to understand that.
Early in my career, I followed the traditional private-practice model. I worked with clients, developed treatment plans, created resources, communicated with families, and did all the other things that come with running a clinical practice.
I loved being a clinician.
My Traditional Private-Practice Model
When I started private practice, the relationship between time and income seemed natural.
I provided therapy.
Clients attended those appointments.
I billed for those appointments.
I created resources and home programs to help clients continue working on their goals between sessions.
Face to face therapy remained at the center.
Like many therapists, I didn't initially think of my clinical expertise as something that could be delivered in a fundamentally different way.
I simply thought of it as something I delivered during therapy.
That distinction became important later.
Then I Discovered Online Intervention
At one point in my career, I discovered online intervention software that allowed me to create structured home programs for my therapy clients. This was a turning point.
Instead of simply giving clients something to take home, I could create a more structured experience for them to work through.
I could log into the server and create progress reports based on their data.
Something interesting happened.
My clients were working intensively on their goals.
They weren't limited to what we could accomplish during our scheduled appointments.
The experience made me realize that the therapy hour didn't have to be the only place where meaningful therapeutic work happened.
The Beginning of My Journey Toward Asynchronous Therapy
My journey toward asynchronous therapy wasn't quick or perfectly planned.
In fact, it took years of experimentation and learning before I understood how all the pieces could fit together.
But gradually, I became more interested in a model where clients could access clinical curriculum online while still receiving professional guidance and support.
That's what I mean by asynchronous therapy.
The therapist and client don't have to be online at the same time.
Clients can access clinical curriculum behind a login and work through the material according to the structure of the program.
The therapist can provide personalized consultation, problem-solving, encouragement, and accountability as needed.
The therapist remains central.
The difference is that the clinical curriculum isn't confined to a scheduled appointment.
I think of it as:
Therapy with accountability, but no clock.
This Isn't the Same as Creating an Online Course
One of the things I've learned is that therapists need to be careful about confusing online education with asynchronous therapy.
Simply putting your handouts or videos into an online course doesn't automatically create a therapy program.
Clinical expertise needs to be thoughtfully structured around a specific problem, a specific population, and a therapeutic method.
There also needs to be appropriate professional guidance and support.
That's why I don't teach therapists to simply “turn their therapy into a course.”
I teach them to think strategically about how their clinical expertise might become a structured asynchronous therapy program.
What This Means for Established Therapists
If you've been practicing for years, you may have more assets than you realize.
You have clinical knowledge.
You have experience.
You have methods.
You have resources.
You have stories about what works.
You have learned how to help people with specific problems.
You've probably created far more clinical material than you realize.
You don't necessarily need to start from scratch.
Instead, you can begin by looking at what you've already developed and asking:
Could this become something more?
Perhaps you've developed a particularly effective approach to one clinical problem.
Perhaps you've created a sequence of exercises that consistently helps clients.
Perhaps you have a method that you've refined over many years.
Those may be the beginnings of a clinical curriculum.
And that curriculum could potentially become part of an asynchronous therapy program.
Your Experience Can Become an Asset
There is another reason I believe this model is particularly interesting for established therapists.
You've already done the hard part of becoming an expert.
You've spent years learning your profession.
You've worked with clients.
You've solved problems.
You've refined your methods.
You've developed professional judgment.
You don't need to become a completely different person to explore a different model.
You need to find a way to leverage the expertise you already have.
That's a very different proposition from starting an online business from scratch.
Technology Shouldn't Be the Starting Point
Of course, once you begin thinking about online therapy programs, technology can feel overwhelming. You may start thinking about:
- Websites
- Online curriculum
- Client logins
- Email marketing
- Payments
- Forms
- Videos
- Automation
- Integrating different software tools
But technology wasn't the lesson I learned from my experience.
The lesson was that technology should support your clinical expertise—not determine what you can offer.
That's why I now teach a step-by-step process.
First, clarify the clinical problem you want to address.
Then define your method.
Then plan the experience you want your client to have.
Then create the website and curriculum.
Then implement the technology that supports the model.
For therapists who want their website, marketing, and online curriculum in one place, AttractWell is the platform I recommend.
The goal isn't to become a technology expert.
The goal is to create a streamlined system that allows your expertise to reach clients in a different way.
What 35+ Years Taught Me About Growth
If I could go back and give my younger self one piece of advice, it would be this:
Don't assume that the only way to grow your practice is to see more clients.
A full caseload can be wonderful.
But it can also become a ceiling.
Your calendar has limits.
Your energy has limits.
Your time has limits.
Your clinical expertise doesn't necessarily have to have the same limits.
That is the perspective I wish I had understood earlier.
From a Stressful Practice to a Purposeful Practice
Today, my work is focused on helping established private-practice therapists explore this possibility for themselves.
I'm not interested in helping therapists create bigger, busier practices simply for the sake of growth.
I'm interested in helping them think differently about what they've already built.
How can they leverage their clinical expertise?
How can they reach the specific clients they are best equipped to help?
How can they create another offering without abandoning the practice they've spent years developing?
How can technology make the process simpler rather than more complicated?
Ultimately:
That's what I mean by moving from a stressful practice to a purposeful practice.
It isn't about doing less meaningful work.
It's about finding a better way to use the expertise you've spent years developing.
Your Next Chapter Doesn't Have to Look Like Your Last One
If you're an established therapist, you may be at an interesting point in your career.
You've accumulated knowledge that you didn't have when you started.
You've developed methods that have become second nature.
You've learned what your clients need.
You may be ready for a different kind of growth.
You don't have to decide today whether asynchronous therapy is right for you.
Start with a simpler question:
What could I do with my clinical expertise if I wasn't limited to delivering all of it one hour at a time?
That's the question that changed the direction of my own career.
And it may be worth exploring in yours.
