Building a Practice While Raising a Family

By: Melissa Groman, LCSW

I have five kids and I did it. It was not always easy, but whenever social workers or therapists who are moms, or who want to be moms, ask me how I built a full-time private practice with small children at home, I am quick to say that it really is possible. All you need is a little bit of faith, a spoonful of determination, and some good guidance.

Because starting and maintaining a practice means that you have to tend to all the details of owning a business, from marketing and bringing in clients to budgeting on an unpredictable paycheck, to doing the actual work of therapy, many would-be moms put their dream on hold. After all, how do you do all this while having and nursing babies, cooking dinners, driving carpools, and doing homework and bedtime? Building a practice while raising a family can seem daunting at best and impossible at worst.

Working mothers are historically torn between their desire to stay home with their babies, their wish to be home for grade-schoolers at the end of the school day, and the pull to pursue their career and the need to earn money. Having a practice of one’s own, for those who dream of it, is more than a good job, more than a career move, or the fulfillment of years of schooling. A private practice is an arena for creativity, productivity, and a real room of your own.

Social worker moms often think that going out on their own is significantly more demanding than working for someone else. Or that there is only one model to work from. They reason that they are best off putting off the idea of a private practice until the kids are bigger, or the pregnancies are past. It doesn’t occur to many would-be therapists that there is a lot of room for new ideas about how to create their own business while raising a family—that there are lots of fun, prudent, exciting ways to proceed that can work well for both family and career. Whereas it’s true that having your own business can seem more overwhelming than working for someone else, there are many ways and reasons to succeed.

Amidst a struggling economy, the normalcy of two-income families and the pursuit of a good family life, private practice can meet moms at the intersection of personal and professional growth and satisfaction; fulfillment of our creed as social workers, advocates, and care givers; and financial prosperity. Social workers are creating inventive, interesting niches for themselves more and more through self employment, independent contracting, Web-based work, teaching, consulting, and writing, as well as the traditional “in-office” practice. The classic idea of private practice is broadening to include elder care and other kinds of on-site consulting; home visits; workshop presentations; online, video, and phone work; and more! We are thinking outside the office and loving it! For moms, alternative private practice venues can be an invigorating way to start off and work with flexibility and synchronicity, in concert with our mothering.

Today, there is no shortage of practice building coaches, “How To” books, and online advice. The wheel has been invented on how to start and build a successful private practice. Still, moms sometimes hesitate because of the mental energy we know it takes to run two entities—the House and the Practice. We know that we have to set things up so that everyone, from our kids to our spouses to ourselves to our clients, gets and stays nourished. For this, to me, there is no substitute for good clinical supervision, mentorship, and support from a trusted supervisor, consultant, or therapist. Or all three!

I often found it difficult in the early years of my practice to write out the checks to my “team” of clinical and business consultants, but it was, and still is, money well spent. I believe that in the short and long run, the better care I take of myself, the more my practice thrives, and the more my family thrives. The investment of time and money into my own therapy and supervision, giving me a place to talk and reflect, to plan and consult, a place to work through worries, doubts, and insecurities (and celebrate successes!), has yielded me more money, resiliency, and creativity, as well as a solid and satisfying professional life.

On the home front, it took a lot of coordinating schedules and discussing family goals and priorities, but my husband and I put being on the same page first, and that set the tone for making it work. It was not always like clockwork, but we had the same goal—to get my practice established—and we tended to the business of running the house so that we could also run the practice. We had lots of conscious conversations about what was good for the family and for the business, and how to make it happen.

Brainstorming, Budgeting, and Believing

During the initial years of building the practice, my schedule was more hectic. Some days, I spent the day at the agency I worked for, came home, changed into my grubbies, made supper, gave the two little ones (who are now taller than me) a bath, read them a book, changed back into my work clothes, and as soon as my husband walked through the door, I was back out to my new office. My superman (or supermom) routine—without the phone booth.

But just like most working moms, the top of my priority list was time with my kids. Even though the practice loomed large, I organized around what was needed most from me at home. There were days when the pull to stay home and snuggle up was overwhelming. On those days, I knew I had to put one foot in front of the other and walk out the door. Of course, I feel the sting of client cancellations and broken appointments, which leave gaps in my work time, a bit keener than if it were not my own business and time away from my kids, but I use that time wisely. I read professional newsletters, do paperwork, review marketing and business ideas, write out goals, or put my feet up on the couch and chill out. Quiet time is never readily available with children and a practice, and sitting still with myself is never a waste of time. Occasional gaps are a chance to catch my breath and take stock.

When you have your own practice, you are the clinician, innovator, marketer, billing and collections guy, customer service rep, and administrator all in one. Part or all of your income rests on the comings and stayings of folks who are in conflict or hurting. Thus, therapists need to continuously foster our own clinical skills and emotional resiliency to flow with all the feelings we encounter—ours, our clients, and our family’s. But most jobs are demanding these days, and I think the added pressure of running your own business is diminished by the pleasure of it. In fact, what holds many social worker moms back from venturing out on their own may have more to do with anxiety about the unknown than it does with their ability to create a viable practice while taking care of their kids.

Most of the moms I coach who are building a practice while raising a family want some reassurance that they will have the mental energy to keep track of the many different tasks that are necessary for both, and the resiliency to ride out the ups and downs of a growing business and a sometimes unsteady income. So I encourage a lot of planning on both fronts, a lot grace, and an open mind about when work can be done. Sometimes when the kids go to bed, I go back to work. I don’t usually head back to the office, but I do go back into work mode. Sometimes I do paperwork or writing projects. And lots of marketing tasks can be done in off hours! One therapist mom I know says her professional reading has slowed down since she had her second baby, but she cuts herself some slack. Not everything has to be checked off the to-do list.

Moms want to know that the effort and investment it takes to build a practice will pay off. Many of today’s practice building coaches say it takes three to five years to get established. If you pepper that with pregnancies and kids, it may take a little longer. But I think it can be done in less time, too. With a good plan and some willingness to find a marketing strategy and work schedule that fits your style and family life, moms can get up and running fairly quickly.

Many also worry about how they will manage a pregnancy in private practice, wondering about everything from clients knowing for sure that you do actually have sex, to a notably growing body, to the unconscious reactions of their clients to an intruder in the room. Not to mention the fear of losing our clients while out on leave. But most therapists I know have found that their practices stay intact, even with maternity leaves that last a few months. I kept mine short, but a good friend of mine who had twins left her practice for two years, and has a full and thriving practice once again.

Knowing that my practice was more than just a job to me, that it was a source of nourishment for my creative ambitious soul, pursuing it gave me many good feelings that I believe carry over into my mothering. When I left the agency job to start my practice, I felt as if I was flying without a net, but I really did believe that if I showed up and kept on keeping on, things would build. And they did. Even as I had three more babies!

Being my own boss leaves me with the flexibility to schedule time out to go home and nurse a baby, run an errand, or watch a soccer game, one of the distinct advantages of having your own business. But most therapists in private practice say that the biggest motivator for starting a private practice was not especially the money or flexibility, but the freedom to create, to build, and to develop something that they could call their own.

So what’s the key to having it all? It takes lots of good self care and a willingness to seek out good help, both in the business and in the house. At home, as the kids grow, they pitch in with the chores. I stopped cleaning toilets and mopping floors, and brought in outside cleaning help that made all the difference, freeing me up to tend to other things on my mom “to do” list, and to focus my attention more fully on the kids. I don’t take calls during dinner or homework time, and I make sure that bedtime, on the nights I am home, is sacrosanct.

There are days when things just don’t go right. It never fails to amaze me how when I am home with the kids, and decide to return a client’s call, the baby, who was sleeping soundly, wakes up with a roar. Or how, on my busiest day, one of the kids gets sick, or the babysitter calls out. But those are more the exception than the rule. And clients can be rescheduled, money calculated over the span of a year, not a week, and husbands can pinch hit at home. When I keep present the awareness of the blessing that I am doing what I have always wanted to be doing, faith that good things continue to unfold, I am better able to navigate smoothly the ups, downs, and demands of both motherhood and my practice.

We who work in private practice go without the benefit of water cooler conversations and office lunches. I always liked staff meetings at my agency, informal schmoozes, and the chance to pal around a bit with colleagues. Now, I look to my supervision groups for good discussions, and I make sure to schedule lunches with colleagues, attend conferences, and take a class every now and then. Although I try to minimize time away from my kids, these are part of keeping up employee (mine!) morale, and running a successful business.

Cooking for seven every night is a bit of a challenge. But I’ve gotten it down to an organized science now. Each night has a general theme (pizza, pasta, meat, fish, chicken, and occasional take out) and a rotating side. Sundays are for soup. My very cooperative husband takes the leftovers for lunch. Having a gentle routine goes a long way!

So it does take heart, a bit of organization, and a willingness to stay the course. For moms who are just in the wishing stages, planting seeds, laying groundwork for your ideas can be part of the process. Taking a look at your fears, wishes, and desires and putting pen to paper, writing out what you might want, what’s in the way of getting it, and what are some possible next right steps can help get you started. Unpacking fear based thinking and overwhelming thoughts and giving yourself permission to go at your own pace can be productive even before you are ready to sign up for space or take on clients.

Thinking back over the last few years, and remembering the effort it took to forge ahead, I feel grateful. We all do such worthy work. As social workers, we can find success in so many professional venues that support our mothering. There is room in the private practice sector, as well. My kids hear it from me all the time, and I hope it will be a model for their own ambitions and desires: Family first, and I do what I love, love what I do, and do it with love, at home and at work.

Melissa Groman is a Licensed Clinical Social Worker in private practice in New Jersey specializing in treating eating and cutting disorders and mending marriages. She founded the Good Practice Institute for Professional Psychotherapists in 2007 and provides clinical supervision, consultation, and practice building coaching to therapists across the country via telephone. She can reached by phone at 973-667-8777 or through her Web site at http://www.goodpracticeinstitute.com or e-mail: Melissgro@aol.com.