How to Hire Your First Therapist: A Guide for Solo Practice Owners Ready to Grow

My first three hires were people I already had a relationship with, clinicians who had a similar personality style to mine. Those hires worked out. What I didn't realize yet was that "worked out" and "repeatable system" are two completely different things. It wasn't until my next four hires that I actually learned how to hire.

Those next candidates mostly found me first, reaching out by email. And my first reaction, honestly, was flattered. I thought, how cool that these clinicians want to work at my practice. Looking back, that reaction put me in exactly the wrong frame of mind. I started operating like I needed to sell them on why they should join me, instead of asking the question that actually mattered: how are they going to fit into my practice. Values aligned. Real teamwork. The ability to initiate and complete a task without me chasing it down. Willingness to show up to networking events and represent the practice. None of that was on my radar yet. I was hiring based on whether I liked someone as a person, on emotion, and I made a lot of mistakes because of it.

Taking emotion out of hiring

The thing that changed everything for me was using an established hiring assessment — I didn't build it myself, I adopted an existing tool and made it mine by setting my own benchmark. I had my top two clinicians, the ones I'd want to duplicate over and over if I could, take it first, so their results became what I'm comparing candidates against. When a candidate takes the same assessment, I can see how closely their answers align with that benchmark — not a generic "good therapist" standard, but fit for this specific team.

Every single hire I've made using that assessment has been an absolute gem. Not because the assessment is magic, but because it stops me from making a decision with my gut when my gut is exactly the part of me that gets talked into things.

The assumptions that cost me

I walked into hiring with a set of assumptions I never questioned, because they felt obvious. They're therapists, right? Why would a therapist take advantage of me or my practice? Why would a therapist lie to get ahead, or be sneaky, or not be honest? Therapists are supposed to be the honest, ethical ones.

I learned, the hard way, that being a therapist doesn't make someone immune to acting in their own self-interest at your expense. Clinical training doesn't inoculate anyone against cutting corners when it benefits them. That assumption cost me real money and real trust before I stopped making it.

Three specific mistakes, and what fixed them

When I first started hiring, I brought someone on as a 1099 independent contractor, and very quickly realized that was the wrong classification and had to convert them to W-2. This is exactly the kind of thing an employment attorney needs to weigh in on before you post the job, not after you've already made the wrong call. I also learned that what I'd originally drafted and called a "contract" really needed to be an offer letter instead — the terminology and structure matter more than I understood at the time.

I also said no, initially, to a non-compete clause. My reasoning felt principled: I always wanted clients to have the autonomy to leave with their clinician if that's what the client wanted, and a non-compete felt like it worked against that. I learned the hard way what happens without one. A clinician built their own practice on the side, secretly, while still coming into my office on weekends, without my knowledge, to see clients there. They took clients I had spent months building for them, in my space, under my name. I put the clause back in, but structured differently this time: clients can still choose to follow a clinician if that's genuinely what they want, but there are real consequences if a clinician does something like that behind my back rather than in the open.

The third mistake was around timing and cost. I learned that there are more clinicians than you'd think who will join a group practice, use its resources while it builds their caseload and handles their credentialing, and then leave once their caseload is full, taking that book of business with them before the practice has recouped what it invested in them. I lost thousands of dollars to exactly this pattern before my employment attorney added a clause requiring repayment of onboarding costs if a clinician leaves before their one-year mark.

What I'd actually tell you

Always consult an employment attorney before you write your first offer letter, not after something goes wrong. Take your emotions out of the hiring decision as much as you possibly can. Sit with your actual values and morals, and get specific about the qualities a new hire absolutely must have in your practice — not the qualities that sound nice in a job post. If taking emotion out of it is genuinely hard for you, the way it was for me, find an evidence-based tool that can help determine fit without relying on how much you like someone in an interview.

And find your colleagues. You need other practice owners around you, whether you realize it yet or not — people you can bounce ideas off of, vent to, celebrate wins with, and laugh with. Hiring is one of the loneliest parts of running a practice until you stop trying to do it completely alone.

If you're getting ready to make your first hire, or you're looking back at a hire that didn't go the way you expected and trying to figure out what to do differently, that's exactly the kind of thing Private Practice Consulting is built for.