From therapist to business owner
Dr Kirstie Fleetwood Meade suggests why this shift feels so unsettling – and what to do about it
When I first went into private practice, I expected a learning curve. I knew I’d have to figure out things like fees, directories, and how to actually get clients. What I didn’t expect was the identity shift that came with it. Being a therapist and being a business owner are not the same thing. As therapists, we’re trained to hold space, stay attuned, and sit with complexity. We’re taught to listen deeply and reflect carefully. But running a business requires a whole new set of muscles: clarity, visibility, decisiveness. It means learning about marketing, finances, business structures – skills we weren’t taught in our clinical training and often don’t see ourselves as “naturals” at.
So when we step into this new role, it’s no surprise it can feel daunting. Even the most grounded clinicians can feel stuck when asked to wear all these new hats.
You’re not alone if you’ve ever thought:
• How do I promote myself without sounding salesy?
• What should I write in my bio so it doesn’t sound like everyone else’s?
• Does wanting to earn more conflict with my ethics or values?
• What if other therapists judge my content or opinions online?
Underneath these worries are real questions about our identity, fears of visibility, and self-worth.
On top of that, money and pricing can feel especially tricky. In the UK, we’re raised with the belief that healthcare should be free and accessible to all. It’s a value many of us genuinely hold. So charging for therapy – especially at rates that feel “high” – can trigger guilt or unease. We worry about those who can’t afford us. We wonder if we’re abandoning the ideals we trained under.
Add in the quiet conditioning many therapists carry – messages about being agreeable, generous, self-sacrificing – and it’s easy to see why setting fees feels less like a business decision and more like a moral dilemma. As a result, many therapists freeze. You might procrastinate on updating your directory profile, undercharge, or avoid choosing a business structure – not because you’re unmotivated, but because it all feels so personal. Most of us are trying to navigate all of this alone, without a team, and without business support or education.
I’ve been there. I still find myself there some days.
So here are a few tips to help you keep moving:
1. Start before you feel ready
Perfectionism loves to disguise itself as preparation. But clarity comes from action. Confidence isn’t a prerequisite; it comes from action, and trusting ourselves that we can cope learning new things. Start small – whether that’s publishing your profile, sharing an offering, or registering your business – and let your confidence catch up later.
2. Treat your practice like a business (because it is)
You’re not just delivering therapy; you’re building something that deserves structure, boundaries, and sustainability. That means charging fairly, protecting your time, and making values-led decisions. Care and professionalism can absolutely co-exist.
3. Don’t go it alone
You weren’t meant to figure this all out in isolation. Find a supportive community, mentor, or peer group that understands both your clinical training and your entrepreneurial journey. It can make all the difference.
If any of this resonates, you’re so welcome in my free Facebook group: Into Practice with Dr Kirstie Fleetwood Meade. It’s a space for female mental health practitioners (therapists, counsellors, psychologists, coaches) who are building or growing private practices with clarity, confidence, and community. You don’t have to do this alone.
Dr Kirstie Fleetwood Meade is a chartered counselling psychologist working from all our Bristol centres