How to Weather an Economic Downturn as a Private Practice Therapist

When the economy takes a hit, mental health needs often rise—but private practices can still feel the squeeze. Clients reduce sessions. Cancellations spike. Referral streams dry up. And for many private practice owners, especially those who’ve avoided insurance and EAPs (Employee Assistance Programs), the financial pressure gets real—fast.

But a downturn isn’t just a threat. It’s a call to get scrappy, strategic, and resilient. Here are five ways to navigate economic uncertainty without compromising your clinical values—or burning out.

1. Expand Your Referral Network (Beyond the Usual Suspects)

If your practice has mostly relied on Psychology Today and word of mouth, now’s the time to diversify. Start by:

• Connecting with local physicians, OB-GYNs, and school counselors. They're often the first point of contact for patients in distress.

• Test listings on multiple directories. Think Mental Health Match, ZenCare, Open Path, etc.

• Optimizing your Google Business Profile. Many practices still don’t have one—this free tool can drastically boost local SEO and get your name in front of clients searching nearby.

2. Revisit Your Pricing Strategy

In a downturn, clients may hesitate to commit to weekly $200 sessions. That doesn’t mean you need to slash your rates—but you can offer flexibility:

• Sliding scale slots for returning or long-term clients

• Time-limited session packages (e.g., 6-session programs for burnout or anxiety)

• Shorter sessions (30-minute check-ins at a lower fee)

Pricing isn’t just about money—it’s about access, trust, and positioning yourself as a long-term partner in care.

3. Say Yes to EAPs (For Now)

They’re not everyone’s favorite. The session limits. The paperwork. The lower pay.

But during an economic downturn, EAPs can fill the gaps. They offer:

• A steady stream of short-term clients

• A way to build your referral base

• Additional revenue without the long-term commitment

Think of it like accepting insurance early in your career: not forever, but strategic for the moment.

4. Consider Credentialing with Insurance

If you’ve been private-pay only, this might feel like a big shift. But here’s the truth: many successful practices are hybrid. Especially now.

• Start with one or two companies—like Aetna or Optum.

• Use platforms [Availity, CAQH, or Practice Solutions] or services like Breksey to streamline the process.

• Watch your caseload fill in months, not years.

Yes, insurance has its headaches. But it can also stabilize revenue and make therapy more accessible for clients who need it most.

5. Automate the Admin

You don’t need to hustle harder—you need to streamline smarter. Now’s the time to:

• Use a CRM to track inquiries (no more missed calls or ghosted forms)

• Automate reminder texts and onboarding emails

• Outsource billing or insurance submissions if they’re draining your time

Time saved = capacity regained.

A Final Thought: Your Practice is a Business—and a Lifeline

It’s okay to think like a business owner. In fact, it’s essential. But remember: you’re not selling a product. You’re providing care.

During hard times, your community needs you more than ever. And you deserve systems that help you keep going.