Finding Profitability and Purpose in Your Therapy Business (RTS Newsletter #13)

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Building a Therapy Business That Serves Your Life - Insights from Carlyn Neek

For Carlyn Neek, business ownership was never about scaling to the largest possible business. Instead, it was about creating something sustainable that aligned with her values and lifestyle goals.

"What people need to ask themselves is: Why did I start this business in the first place? What were my goals?" Carlyn explains. "Sometimes they change. Sometimes we lose track of that 'why' and start to measure ourselves against what the next person is doing."

Today, Carlyn's business operates on two parallel tracks. She maintains a focused adult mental health private practice that keeps her connected to clinical work, while also supporting other therapy business owners who are navigating their own entrepreneurial journeys.

Beyond Business Coaching

While many would call what she does "business coaching," Carlyn sees her work through a different lens.

"I have a lot of trouble describing what I do because I'm looking at the whole person. I don't see myself as a business coach or a life coach. “Truly, my OT way of seeing people and their roles as interconnected runs deep, even when I'm not acting as a clinician. We look at the whole picture," she shares.

This holistic approach allows her to address the unique challenges that heart-centered therapy business owners face—from setting appropriate boundaries to managing the fear of disappointing clients.

"I know that a lot of therapy business owners are very heart-centered and caring," Carlyn notes. "Nobody taught us how to run businesses, and we can get really in our heads and stuck on self-doubt, or scrambling to try and meet increasing demand without recognizing that we can set boundaries, change our rates, and adjust our availability."

Common Patterns in Therapy Business Owners

When working with therapy entrepreneurs, Carlyn sees several recurring patterns:

1. The Impostor Experience: "Everybody comes with that," she acknowledges, but reframes it not as a syndrome to overcome but as a natural part of growth. "Let's not pathologize it. It's actually human nature to have some self-doubt when we're doing something new."

2. Forgetting Their Authority: "There's this sense of almost forgetting that they're the boss," Carlyn observes. "Forgetting the latitude they have to make it work for them. And generally, that's fear-driven."

3. Avoiding Financial Reality: "I was actually surprised at how many OTs I was working with weren't profitable," she reveals. "They were just avoiding looking at their numbers and spending hours prepping for a one-hour session, then traveling, then documenting it."

Making Business Decisions from Values, Not Fear

Carlyn's approach centers on reconnecting business owners with their initial motivations and helping them make decisions from a place of intention rather than reaction.

In one case, she worked with a therapist who, following conventional business wisdom, had hired a team of support staff—only to find herself working constantly to generate enough income to pay them, with nothing left for herself.

"The spreadsheet is the thing," Carlyn explains, describing how reviewing the actual numbers freed her client from the fear-based belief that she needed a full team to scale. "We could play around with the numbers...and see where all the expenses are going."

This data-driven approach often brings clarity and calm. "I find the data really calming usually. And if it's not, at least we're looking at it," she says. "So often we're afraid of not looking at it, and that's keeping us in an unworkable pattern."

From Burnout to Sustainable Practice

For those considering the leap from traditional employment to private practice, Carlyn emphasizes that it doesn't have to be all-or-nothing. Working with a clinician recovering from burnout who wanted to start their own practice, she helped them recognize the difference between the body's "hell no" of genuine warning versus the natural fear of growth.

"People tend to see it as all-or-nothing," she notes. "I've got to jump from my full-time job into this full-time business—but finding ways to strategically manage time, energy, and income to ease in" can make the transition more sustainable.

Even after launching, she stresses that it's not failure to take a PRN position while building a practice. "That's actually going to create a sense of safety in their nervous system, a baseline of stability. From a place of being in fight or flight, you can't do your best creative work."

The Bottom Line

For Carlyn, success in business isn't measured by size or scale, but by alignment with personal values and lifestyle goals. Her message to fellow therapy business owners is clear: your business should serve your life, not the other way around.

"What were my goals when I started the business? Are those still my goals?" she suggests asking. "My 'why' was truly flexibility—so I could volunteer in my kid's classroom, take as many holidays as my husband had, so we could travel...and still earn basically a full-time income while working in this really flexible way."

By reconnecting with those foundational values, therapy business owners can build practices that are not just financially sustainable, but personally fulfilling as well.

See you in two weeks!

-Eddie

P.S. Want to streamline your business, improve margins, boost patient outcomes, and energize your staff? Reply to this email or click the link below to schedule a time to chat.

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