Clinical Consultation or Business Consultation? A Guide for Private Practice Therapists
By Shannon Heers
Many therapists seek out consultation at some point in their private practice journey, and assume that all types of consultation are the same. But, clinical consultation and business consultation are two vastly divergent services and serve different purposes. Both are essential for different stages of private practice, and not understanding the difference can slow your professional growth, increase your stress, or lead to preventable mistakes.
Clinical consultation supports your clinical work. Business consultation supports your practice as a business. And both are essential ingredients to a long-term, successful practice. Knowing when to seek each can significantly accelerate your confidence, competence, and sustainability in private practice. To differentiate what type of consultation you need at the moment, you can ask yourself a question like “Do I need help with a difficult client case, or help figuring out why my practice isn’t growing?”
What is Clinical Consultation?
Clinical consultation is professional support focused on your clinical work with clients. The core focus areas of clinical consultation are:
- Case conceptualization
- Clinical documentation
- Clinical interventions and modalities
- Ethical decision making
- Practical application of theoretical concepts
- Developing therapist identity
- Managing challenging client dynamics
- Burnout prevention
What this can look like in your practice could be feeling stuck with a particular client, unsure what interventions to use, understanding and navigating countertransference, deciding when to refer out, and managing high risk issues and ethical concerns.
Of note, clinical consultation is not considered clinical supervision, which is required and essential for obtaining independent licensure across the various therapy disciplines. Clinical consultation is optional, but supports professional development and may come from a clinical supervisor, a peer, or a consultation group. Even highly experienced therapists seek out clinical consultation regularly as a way to maintain an ethical practice and obtain support for daily work.
What is Business Consultation for Therapists?
On the other hand, business consultation focuses on building, growing, and sustaining your private practice as a business. The core focus areas for business consultation are:
- Advertising and attracting clients
- Marketing strategies
- Setting fees
- Practice growth strategies
- Systems and workflows
- Business documentation
- Budgeting and financial planning
- Hiring therapists (if expanding to a group practice)
For example, if you are not getting enough new clients, are unsure how to fill your schedule, or are feeling overwhelmed by the business side of your practice, consultation of this sort would fall under business consultation. Many therapists receive excellent clinical training, but little to no business training. Business consultation helps therapists like you build practices that are financially sustainable and aligned with your goals.
Key Differences Between Clinical and Business Consultation
Here’s a visual for the key differences between clinical consultation and business consultation:
| Clinical Consultation Focuses | Business Consultation Focuses |
| Client care | Practice growth |
| Clinical skills | Marketing and visibility |
| Treatment decisions | Financial budgeting and stability |
| Therapist development | Systems and operations |
| Burnout prevention | Business decision making |
| Ethical practice | Protection of your business |
Clinical consultation helps you become a stronger therapist, while business consultation helps you build a stronger practice. Both are necessary, but they solve different problems.
How to Know Which Type of Consultation You Need
At some point during your private practice journey, it’s likely that you will need both types of consultation for a successful, sustainable business. Some therapists engage in both services simultaneously, and are able to benefit from both types of support. However, if you need to choose one or the other at a particular time in your practice, here is a quick guide to help you choose. Signs you may benefit from clinical consultation:
- Feeling stuck with client cases
- Doubting your clinical decisions
- Feeling isolated in your work
- Working with new populations
- Implementing new modalities or interventions
- Experiencing imposter syndrome
- Wanting to deepen your clinical skills
Basically, any concerns you have that are client related, or concern yourself as a therapist, are fair game for clinical consultation. Clinical consultation can further help you with client retention, developing a support network for yourself, and helping you to explore your therapist identity. Signs you may benefit from business consultation:
- Not getting enough referrals
- Feeling confused about marketing
- Financial stress or inconsistent income
- Wanting to grow your practice
- Feeling overwhelmed by practice management
- Unsure of what documents you need to start your business
If you are an advanced therapist but have no idea how to start your own private practice, then business consultation may be your first choice. If you have your practice set up with a steady flow of clients, but cannot retain your clients beyond the first 4 sessions, then you may choose to seek clinical consultation. Many therapists need both at different times; seeking consultation is a sign of professionalism, not inadequacy.
Why Clinical Consultation is Essential Even After Licensure
Many therapists, once they obtain their independent license after a few years of supervised practice, are ecstatic to be on their own and make their own clinical decisions. However there are drawbacks to not being under supervision anymore. Practicing in isolation without clinical consultation is one of the top risk factors for burnout and ethical violations. Having a trusted clinical consultation, or consultation group, you can get emotional support from and run cases by are protective factors against these issues.
Licensure is just the beginning of your independent practice, not the end of your professional growth. Clinical complexity increases over time, as does your expertise. Most therapists elect to continue to learn and integrate new types of therapies, interventions, and approaches for their use with clients, and consultation can help implement the skills you’ve learned.
Further, clinical consultation improves clinical outcomes for your clients. Which makes sense, as the more skilled you are as a therapist, likely the more your clients will benefit. Consultation reduces isolation and burnout, and helps to increase clinical confidence. Private practice can be professionally isolating, and consultation provides connection, support, and perspective. In sum, clinical consultation is a lifelong professional support that any therapist can access.
How Clinical Consultation and Business Consultation Work Together
As mentioned above, a sustainable private practice requires both clinical consultation and business consultation. The intersection of clinical competence and business sustainability is where you want to be as a private practice therapist.
Without clinical consultation, therapists may feel clinically stuck or burned out. And without business consultation, therapists may struggle financially or operationally, and may even drop out of private practice altogether. Both support long-term success, and both are an important investment of time, energy, and money into your business.
Choosing the Right Type of Consultation for Your Current Stage
Early career therapists often benefit most from clinical consultation, but growing private practice therapists often benefit from both. And established practice owners may increasingly benefit from business consultation as they grow and expand their practice and services. Your consultation needs may evolve over time, and it is normal to focus on one or the other at different points during your career.
For myself, I’ve benefited from both clinical consultation and business consultation at different points during my private practice career, often both at the same time. Both individual consultation and group consultation have supported my clinical practice and evolved my clinical skills, and I’ve worked with several different business consultants individually, in a group setting, or by consuming courses throughout my career. I would not have a successful private practice without both.
Clinical consultation and business consultation serve different but equally important roles. Both support sustainable, ethical, and fulfilling private practices. Remember, seeking consultation reflects commitment to your clients, your profession, and yourself.
How We Can Help
If you’re looking for clinical consultation that supports both your clinical growth and your confidence as a therapist, we offer individual and group consultation designed specifically for private practice therapists. And if you’re seeking business consultation services or business coaching for private practice therapists, check out our Booked and Balanced course that is offered twice a year, to support your business.
Author Bio
Shannon Heers is a psychotherapist, approved clinical supervisor, guest blogger, and the owner of a group psychotherapy practice in the Denver area. Shannon helps adults in professional careers manage anxiety, depression, work-life balance, and grief and loss. Follow Firelight Supervision on Instagram and Facebook.
