For neurodivergent therapists entering private practice

I discovered so much when I switched to private practice.

Making the leap can feel daunting for anyone, but for those of us with ADD/ADHD, autism, learning disabilities, or other differences, it can feel like you’re taking that leap with lead shoes on.

I learned so much that I wish I could pass on to every clinician like me. And, these lessons aren’t just for neurodivergent therapists.

I hope clinic owners find them helpful, too. Neurodivergent therapists bring unique expertise and foster innovation, enriching care quality while improving staff retention through inclusivity. Supporting us enriches your clinical team; we’re very good at finding creative solutions to enhance the quality of care your clinic or agency provides.

Taking off the mask 

Despite being diagnosed as a kid and learning early on how to advocate for myself, this didn’t always translate into self-compassion or prepare me for the isolation that self-advocacy and burnout could bring. Gibbs’ writing resonated with me as she highlighted the unique challenges neurodivergent therapists face. It was a comforting reminder that I wasn’t alone or deficient — my brain simply works differently.

Embracing my neurodiversity and taking off the mask was liberating and challenging. It wasn’t the clients who led to burnout; it was the constant paperwork, rigid procedures, and the energy-draining demand of adhering to workplace norms. The necessity to mask by suppressing neurodivergent traits like stimming or mimicking neurotypical behaviors to fit in added a layer of mental and emotional exhaustion. 

Finding realistic confidence

Leaving the structure of an agency behind felt unnerving because I had experienced burnout before. As Des Marais noted, burnout is a real concern for all mental health workers, and especially for those of us with disabilities. One study found 36% and 67% of people with learning disabilities require workplace accommodations. I ultimately prioritized thoughtful planning to create my practice. 

Practical and sustainable solutions

I broke down my practical needs and sustainability goals when setting up my practice. Practical steps focused on the concrete tasks required to register and open my business. Sustainability addressed areas where I needed additional support to maintain professional quality over the long term.

Steps and resources for building a sustainable private practice

1. Compliance and setup

• Ensured my home office met local by-laws for virtual and in-person sessions.
• Followed privacy laws and my regulatory college’s guidelines for storing records.
• Secured private practice insurance, including cyber security coverage.

2. Financial planning and support

• Partnered with insurance providers to ensure reliable payment processing.
• Researched business grants and government incentives, particularly for persons with disabilities.

3. Marketing and networking

• Targeted advertising to highlight my specialties, researched competitive rates, and promoted virtual services in larger cities.

• Networked within my rural community to build connections and visibility.

4. Assistive technologies and workflow management

• Invested in assistive technologies to accommodate my learning disability, including speech-to-text and text-to-speech software.
• Used grammar programs to catch errors and improve documentation quality.
• Adopted EMHware for scheduling and billing management.
• Leveraged clinical AI tools to keep notes consistent and well-structured.

I quickly recognized that balancing mental and financial sustainability was a priority. Cutting corners to save money in areas where I struggled wasn’t a viable option. Instead, I focused on finding cost-effective solutions that supported my long-term success and professional growth.

Leveraging AI and staying organized

Despite my efforts, comprehensive note-taking, documentation like treatment plans, and third-party reports needed for insurance reports remained a significant challenge. 

The detailed reports led to mental fatigue and hours lost to writing and rewriting. The old feeling of having to work harder and longer just to keep up crept back in, but this time it was worse because there was no agency safety net of sick leave and short-term coverage. 

That’s where Upheal made a difference, it almost eliminates this barrier. For the first time, I felt like the lead shoes that had slowed me down were taken off, allowing me to focus fully on my clients and grow my practice.

Balancing: being the therapist I want to be and allocating my resources 

Private practice made me prioritize what mattered most. I focused on streamlining scheduling, billing, and note-taking, opting for intuitive digital solutions tailored to my independent practice as much as possible.

When searching for AI tools, I knew I would need a program that could help me write my notes. I used free trials so I could take my time and explore features to assess their user-friendliness in creating intakes, treatment plans, and reports.

I wanted features that would work seamlessly with what I already use with as little overlap and repetition as possible. I value strength-based language and support that could help when I needed it.

Bonus points to programs that were committed to continuous improvement and user feedback, particularly from neurodivergent therapists.

Rediscovering my landing place

There have been a few moments of wondering if I’m doing the right thing. A brisk inhale and the flutter of anticipation in my stomach provokes me to do a quick check-in with myself.

My transition to private practice wasn’t just a flight of fancy. I felt it was necessary.

I’m still working on balance, to keep myself from falling into the old patterns.

Ultimately, I’ve caught my wind, I’m free floating on my terms, and I’m loving it.