Know your worth — charge what you are worth and not less. Don’t let impostor syndrome convince you to charge only a fraction of the value and expertise you have to offer — when I first started and set my fees I let my impostor syndrome convince me to charge less than I was worth because I didn’t think I would be able to fill out my caseload with a higher fee.
As a part of our interview series with prominent medical professionals called “5 Things You Need To Know To Create a Highly Successful Private Practice” I had the pleasure of interviewing Mallory Hanfling, LCSW.
Mallory is a licensed clinician social worker in Philadelphia, Pennsylvania. She decided to go full-time and open her private practice, Courage To Grow Counseling, in 2019 and primarily markets her practice to the LGBTQ2IA+ community working with individuals and couples. Mallory finds meaning in her work every day and feels privileged to hold space for her clients as they learn about themselves and grow towards self-actualization.
Thank you so much for joining us in this interview series! Before we dive in, our readers would love to “get to know you” a bit better. Can you tell us a bit about your ‘backstory’ and how you ended up where you are?
It’s been quite a journey! My mom is also a social worker in private practice, so I grew up hearing about how much she loved her job and bearing witness to the badassery and perks of being one’s own boss. Growing up I always loved being the person my friends could talk to when they were having a problem and holding space for those I loved. An undergraduate degree in Psychology seemed like the obvious choice. I loved learning about how the mind works, different theoretical orientations and interventions, and the ways in which one’s life and relationships influenced their sense of wellness. I think a big part of it has to do with intellectualizing my own mental health and wanting to “master it” by understanding it better. I ended up doing a double degree at the University of Maryland, a BS in Psychology, and a BA in Family Science. I went straight from undergrad into a Master of Social Work program at the University of Pennsylvania where I focused on clinical social work. I was hired by the partial hospitalization and intensive outpatient program where I interned as an advanced year social work student and begin my career providing individual, group, and family therapy for dually diagnosed (mental health and substance abuse) adolescents. After burning out quickly, I transitioned into a program director role for a year-long life coaching and case management program for young Jewish families going through a major life change and working towards self-sufficiency. While there, I was pursuing my clinical hours and received supervision from a wonderful group practice called Main Line Counsleing and Wellness Center. The amazing women there hired me as soon as I got my LCSW and I worked there for a little over 2 years. Life circumstances uprooted me temporarily for about a year to Hoboken, NJ, and then upon my return to Philadelphia, newly divorced and out of the closet I began working in charter schools — first at an elementary school which was highly traumatizing, and then at a high school which was a repairative experience. I realized while working at the high school, and after reading Jen Sincero’s “You Are A Badass: How to Stop Doubting Your Greatness and Live and Awesome Life,” that I was ok, but that I believed that my life could be extraordinary and while I was waiting for the “right time” my life was passing me by. I finished out the school year and took the plunge into full-time private practice in 2019. I haven’t looked back since!
I’m a huge fan of mentorship throughout one’s career. None of us are able to achieve success without some help along the way. Who has been your biggest mentor? What was the most valuable lesson you learned from them?
My biggest mentor has been my own therapist, Dr. Danna Bodenheimer. She has taught me that it’s ok to hold space and let clients get to where they need to go on their own time and encourage and support them in their journey. Importantly she has taught me that the best way to help clients is to be curious and compassionate.
What made you want to start your own practice? Can you tell us the story of how you started it?
I grew up seeing my mom enjoying her own work as a therapist in private practice. She set her own hours, had clients who enjoyed working with her, and she never complained about work. It was always something that brought her joy. I wanted that for myself too! I had been working in agencies and schools since graduation. I got my first taste of private practice working for a group practice called Main Line Counseling and Wellness. When I had to leave the group because I relocated temporarily I was able to maintain some of my clients from my caseload there (with permission from MLCWC) and still work with many of them to this day! Fast forward a few years and I was totally burnt out from working in inner-city schools as a school social worker. My best friend bought me this bright yellow book by Jen Sincero called “You Are A Badass: How To Stop Doubting Your Greatness And Live An Awesome Life” — sounded pretty great to me! I read this book and it all kind of clicked into place. I stopped making excuses for why it wasn’t the right time. I sorted out which fears were mine, and which fears belonged to other people in my life that I could ignore. I crunched the numbers and realized that I could actually make more income working fewer hours than I was at the school! Around the same time I found the most beautiful office space at a really affordable price, built a website and a Psychology Today profile, and let my principal know, when presented with my contract for the following year, that while I was so grateful for the time I had with the school I would not be returning the following year. And so it began…!
Can you share the most interesting story that happened to you since you began your career?
The most interesting thing that has happened since beginning this career can be one of two things. The first, is that it takes time to build up a full caseload. As such, I had some “free” time over the summer of 2019 and ended up walking onto a TV show set as a background extra for AMC’s Dispatches From Elsewhere. Because I had the flexibility of being my own boss and creating my own schedule, I was able to try out acting as a background extra in three episodes and meet my all-time-favorite actor, Jason Segel! The second most interesting thing, and a lot more relevant and serious, was the complete pivot to 100% telehealth during the COVID-19 pandemic. I had to completely shift my work — focusing a lot more on surviving trauma, grief, and ambiguous loss, and managing panic — than on working towards self-actualization and identity formation as we collectively navigated a global crisis, learn new skills, hone other skills to compensate for the lack of non-verbal information I got from in-person sessions, and learn how to work from home and somehow maintain meaningful interpersonal connections with others. Finding work-life balance during this time has been tricky for me. I want to support my clients as much as possible and I also need to set boundaries and take care of y own mental health.
Because it is a “helping profession”, some healthcare providers struggle with the idea of “monetization.” How do you address the business aspect of running a medical practice? Can you share a story or example?
This has been the hardest part of building the private practice. I set my fees using the scale my mentor utilizes at her practice which is based upon national averages and practice standards. I am fair, compassionate, and also firm in my cancellation policy with clients and ask them to complete a written agreement to the terms, as well as cover the policy during out intake session to ensure they feel clear and agree with them. I often remind myself that I am providing a valuable service and that my time is worthwhile. I also remind myself of how comfortable I’ve gotten with my own therapist’s fees and policies and how she is worth every penny, and I hope my clients feel the same way about our work together. I do my best to make choices about finding balance between “good business compassion” and the ever-pesky impostor syndrome. When in doubt, I see supervision or peer consultation. Most importantly, find yourself a therafriend — a therapist best friend. This is someone who sees your humanness and offers you nonjudgmental and compassionate feedback.
Managing being a provider and a business owner is a constant balancing act. How do you manage both roles?
I set aside Mondays for administrative tasks. My therafriend, Elizabeth Merrell of Wellspring Therapeutic Services and I meet together in her office each Monday. We start the day with a short yoga practice, chat for a little bit, and then sit in the same space and do the annoying administrative tasks of owning a small business. It helps to have someone there with you doing the same thing. And it’s great to have one day a week set aside for that part of the business and dedicate the rest of the week to client sessions. I also tend to get my session notes done by the end of the same day in order to not let them pile up, but that’s not a perfect system and some weeks that feels, and is, totally impossible — but they always get done!
From completing your degree to opening a practice and becoming a business owner, your path was most likely challenging. Can you share a story about one of your greatest struggles? Can you share what you did to overcome it?
My greatest struggle was turning off the jerk voices in my head that kept trying to scare me out of trusting myself to be successful. When I started paying more attention to them, and really listening to what they were saying I started to realize that they weren’t really MY voices. It was the voice of my parents who always have my safety and security in mind as a priority and were afraid of me taking risks (like not having a salary or benefits or built-in socialization through co-workers). It was the voice of crappy burnt out past supervisors who didn’t know me, or what I was made of — who were jaded by the profession. It was a younger version of me, not the version of me who overcame things and was resilient and powerful and fierce, and a goddamn badass cheetah. Once I was paying more attention to and teasing out what was mine and what wasn’t I was able to turn down the volume of those tapes playing in my head. I made a concerted mindful effort to then turn up the volume on the messages from people like my mentor, Dr. Danna Bodenheimer, author Jen Sincero, memoirist Glennon Doyle, and most importantly my own voice coming from the woman who had been through some stuff and come out the other side stronger and wiser and more empowered.
Ok, thank you. Here is the main question of our interview. What are the 5 things you need to know to create a thriving practice, and why? (Please share a story or example for each.)
- Know your worth — charge what you are worth and not less. Don’t let impostor syndrome convince you to charge only a fraction of the value and expertise you have to offer — when I first started and set my fees I let my impostor syndrome convince me to charge less than I was worth because I didn’t think I would be able to fill out my caseload with a higher fee. Not only did this cause unnecessary financial strain, it prevented my from having flexibility to offer a deeper sliding scale for marginalized populations who have less financial access to therapy for whom I wanted to make myself accessible. Charging a full fee for clients who are able to pay is imperative for fiscal security and maintaining an ethical practice aligned with my own, and social work, values.
- Network! — the more colleagues you get to know and develop a rapport with, the more referrals you’ll get from people who can vouch for your quality of care. Join professional networking groups and make time for coffee with colleagues. — One of the coolest things I’ve done since going full time as a private practitioner is creating the Philadelphia Queer Private Practice Network group on Facebook. It has connected clinicians who identify as Queer and has also resulted in feeling much more connected to the Queer therapist community in Philadelphia in general. I have a group chat with two other therapists from a peer supervision group and we do “Touch Base Thursdays” to connect which is always lovely, and Admin Mondays with my therafriend Elizabeth is the highlight of my week.
- Be selective about your clients — Work with the populations you are competent, comfortable, and familiar with. Avoid the urge to be a “jack of all trades” as you get started, you’ll burn out quickly and not enjoy the work you’re doing. Stick to the clients you enjoy working with in terms of population AND presenting problem — I was so stressed out trying to build my caseload in the beginning that I accepted some clients who I was not really the right fit for. This became apparent over time when they were not making the progress they wanted to see, I felt frustrated, and their commitment to therapy was hit or miss. I sought extra supervision for these cases to ensure I was still providing the best care I could, but ultimately the therapeutic rapports ended because it because clear there were better matches out there and I would refer out or they would find another therapist (which is a great and normal part of therapy!)
- Maintain peer relationships and supervision — Prioritize setting aside time in your week to meet with colleagues and “therafriends” for the purposes of peer supervision (or professional supervision) and for socialization. Private practice can feel isolating sometimes and maintaining connections to others for fun is important! — I would be completely lost without my therafriends who I can “geek out” about mental health stuff with. The conversations are deep and meaningful and their ability to offer different perspectives on things that have you feeling stuck is a great way to hone clinical skills, stay teachable, build self-esteem, and feel like a general badass. Find “your people” and keep them close. If you feel like you’re “too much” or “not enough” or someone, they’re not “your people” and you’d feel better freeing up that time and space for someone who speaks your language and is the same kind of weird as you.
- Take time off when you need it — it can feel challenging to take time off in private practice because we don’t accrue “paid time off” like one does working for an employer. Taking time to relax and recharge and not hold space for anyone therapeutically is critical for your wellness and allows you to come back to your caseload feeling refreshed and ready to continue holding space for your clients. — One of the absolute most important things my mentor has said to me when I voiced this dilemma is that time off does not translate dollar to dollar. Try to avoid tricking yourself into thinking about the sessions you didn’t have during time off — taking care of yourself and doing things that fill your emotional bank account/gas tank/cup (whatever meaningful analogy works for you) is PRICELESS and will ultimately make you a better therapist and a more enjoyable person to be around.
As a business owner you spend most of your time working IN your practice, seeing patients. When and how do you shift to working ON your practice? (Marketing, upgrading systems, growing your practice, etc.) How much time do you spend on the business elements?
I dedicate “Admin Mondays” to this part of the business. Or if I see a referral request on one of my networks that seems like a good fit I’ll put my info in the post. I’m still working on that boundary. I think it would be worthwhile to make a separate Facebook account for my professional self.
I understand that the healthcare industry has unique stresses and hazards that other industries don’t have. What specific practices would you recommend to other healthcare leaders to improve their physical or mental wellness? Can you share a story or example?
For the love of all things holy, make sure you get up and walk around between sessions and get outside when you can! Our profession as therapists can be very sedentary and it’s easy to forget to stretch and walk around. It is also important for me to maintain my own therapy for my mental health and not just take care of others. Lastly, make sure to build time for joy into your schedule — like just being silly and not taking life too seriously. We deal with the most serious stuff all the time. Being silly is so important.
Can you please give us your favorite “Life Lesson Quote”? Can you share a story about how that was relevant in your own life?
Glennon Doyle wrote in her memoir, Untamed, the following quotes that guide me on most days:
- “This life is mine alone. So I have stopped asking people for directions to places they’ve never been.”
- “The braver I am the luckier I get.”
My practice is called “Courage To Grow Counseling”. I named it after a song by Rebelution called “Courage To Grow” which includes the following lyrics “whether you want love or money, good fortune or fame, you want a brand new car you want the world to change, you better take some chances right now. Oh yes, because there’s nothing in this world that you can’t get, so don’t fill your life with confusion and regret. You better take some changes right now. Oh you can gain the world for the price of your soul, well I know. But I hope you take the road less traveled, and I hope you find the courage to grow.” Everything in my life that has been worthwhile has been a result of having the courage to grow out of what I no longer fit into, and I want to empower my clients to do the same.
How can our readers further follow your work online?
Thank you for these great insights! We wish you continued success and good health!