“Nobody Taught Us This”

The Hidden Stress of Owning a Practice (and What to Do About It)

Owning a private or group therapy practice is often described as liberating, meaningful, and deeply rewarding—and it can be. But it’s also a journey packed with invisible weight.

What most owners don’t say out loud (but often feel in the quiet of their car before walking into the office) is this: “I have no idea what I’m doing.”

The Unspoken Reality

You earned a degree in counseling or social work. You mastered the art of sitting with others in their deepest pain. But chances are, nobody handed you a guidebook on leadership, processes, marketing, HR, or financial modeling. And now you’re running payroll, fielding crisis calls from clinicians, reviewing a web designer’s fourth draft—and wondering why you’re so tired all the time.

This is the part of practice ownership that doesn’t get enough attention: The heavy emotional labor of leading a business without formal training.

The Emotional Toll of Business Ownership

Here are just a few of the internal burdens we see practice owners carry:

• Imposter Syndrome: “Everyone else seems to have this figured out. Why is it so hard for me?”

• Decision Fatigue: Constantly making judgment calls without a sounding board or clear answers.

• Loneliness: You can’t vent to your team, and your partner doesn’t really understand what you do.

• Overwhelmed Feeling: Managing client care, systems, staff drama, growth, and compliance—every day.

Even those who have “made it” financially often feel they’ve lost touch with the parts of their business they once loved.

Here’s the Good News

If you’ve felt this way—you’re not alone. And it doesn’t mean you’re failing. It means you’re growing something real.

Here are five practical ways to begin reducing the stress of ownership—and start moving toward a more balanced, empowered role as the leader of your practice:

1. Get Off the Island: Build a Circle of Support

Being the sole decision-maker is exhausting. Find or create a peer group of other practice owners who understand the journey. Whether it’s a coaching relationship, a GURU-style mastermind group, or an informal support circle, you need voices around you who “get it.”

Action Step: Commit to meeting monthly with 2–3 other practice owners or join a structured coaching group.

2. Name the Stage You’re In

You can’t lead well if you don’t know where you are. Are you in the startup phase, early scaling, or preparing to exit? Each phase requires different tools and mindsets.

Action Step: Define what stage your practice is in. What’s the next milestone? What systems need to evolve to support it?

3. Shift From Firefighting to Forecasting

Most owners live in a reactive mode—constantly solving problems. The stress decreases when you implement systems that prevent problems from happening in the first place.

Action Step: Choose one area (e.g., hiring, onboarding, billing) to document and streamline this month.

4. Bring Yourself Back Into the Business

Many owners start their practice with a strong personal vision, but as the business grows, they lose touch with their why. Reconnecting to your mission can provide clarity and renewal.

Action Step: Revisit (or write) your Mission, Vision, and Values. Share them with your team. Post them where you’ll see them every day.

5. Give Yourself Permission to Lead Like a Human

You don’t need to be perfect. You don’t need to have it all figured out. The best leaders are not the ones with all the answers, but the ones who keep learning, stay open, and take care of themselves.

Action Step: Pick one way to care for your mental health this week—and treat it as non-negotiable.

Final Thought

Practice ownership is one of the most courageous paths you can walk—and one of the most emotionally demanding. If nobody taught you how to do it, that’s not a personal failing. It’s a systemic gap.

You don’t have to white-knuckle your way through this journey. Support is available—and you deserve it.

If you're ready to shift out of stress mode and start scaling with clarity and confidence, reach out. Our coaching team at The Practice Gurus has walked this road—and we’d be honored to walk it with you!