Uncovering the Pros and Cons of Joining a Therapy Agency

Do you find yourself wondering where to practice as a therapist? 

Are you just graduating and questioning your skills as a therapist? Are you wondering whether you have what it takes to start your own practice? 

Perhaps you're already a seasoned counselor wanting to get out of your comfort zone. Or, you’re already in private practice and thinking of joining another group or clinic.

As modern-day therapists, we have so many different paths our careers can take. There are the traditional positions at institutions like schools and hospitals. But, it’s also become common these days to join a group or start a private practice. Some therapists even work with clients via text or video calls using online apps.  

It can be understandably overwhelming to decide which way to go. How do you even know what questions to ask when interviewing with companies? 

To help you make the best choice about where to work, we’re going to discuss life as a therapist in a clinic setting. Let’s dive right in and go over some of the pros and cons.

The Benefits of Agency Life for Therapists

As a therapist, there are many perks when it comes to working in a group setting. Here, we’ll talk about a few of the most attractive reasons for joining an agency. The decision can impact your career both long term and day-to-day.

Built-in Marketing and Referrals

Well-established agencies likely have a regular stream of incoming clients. They have steady referrals or even a waitlist. Appointments are usually set up for you through administrative staff. This means you might even start meeting with clients on your first day. You could accumulate a full caseload right away, and still continue to have more coming your way. The upside to this is that you don’t have to do the legwork of bringing your own business into the practice.

You might receive referrals when joining a practice, and you can send referrals to others as well. In a group setting, you have access to a network of other social workers, psychologists, and more. You'll have colleagues with varying degrees of experience and expertise within arms reach. 

Here are two examples of referrals within a single agency:

Let’s say you usually work with adolescents battling depression and family issues. This is the main topic of discussion during the first few sessions with a new client. As they get more comfortable, information comes out about their eating disorders. While you might have some experience working with this, you’re not really an expert. You'd prefer if this client saw someone else. If you have a colleague down the hall that specializes in this, it's an easy referral. Your client will also likely feel more comfortable staying within the familiar practice. 

Sometimes a therapist might work with a client, but feel like they're not clicking well. Sessions could even feel awkward. One therapist might not be the right march for a client, but chances are that someone else in the agency is. Instead of terminating a client, you can refer to another therapist at the agency.

In both scenarios, the client will likely appreciate the gesture. This would help build trust since you're showing that you’ve got their best interest at heart. 

Business Knowledge Isn’t Necessary

If you have no interest in business, you might find the admin tasks unappealing. Many therapists would rather spend their time actually helping clients. This might be you, if you prefer giving up some say on the clients you take on over dealing with admin work. If you’re not particularly entrepreneurial, an agency could be a really great fit. 

Even small businesses need a wide range of skills to be managed effectively. Making decisions and managing your private practice are up to you. Your responsibilities might include: tax filing, insurance premium payments, and dealing with the law when problems arise. A basic understanding of business management techniques is also helpful.

Because of the diversity of skill sets required, some agencies have a large support staff. These staff can handle things like booking appointments and billing. If you work for a large agency, they likely have a skilled manager or receptionist that can take on these tasks. So, you’ll have more time to devote to individual clients.

Joining a Therapy Agency Provides a Support System

You should consider your personality and the level of professional engagement you need. Some therapists might find private practice to be an isolating career path. You may have peers or a supervisor you can talk to about difficult scenarios or ethical challenges offsite. Still, it might not always be easy to get in touch. According to the American Psychological Association, working in an agency or group practice allows you to get more advice from, and learn from colleagues.

What happens if you suddenly get sick or experience a personal problem? You might have to cancel or reschedule your appointments at the last minute. In a clinic setting, your colleagues can sometimes fill in for you. This also helps your clients out because they won’t have to deal with the extra burden of a last minute schedule change. Meeting a new therapist can be stressful enough. 

There Are No Overhead Costs

By working with an agency, you won’t have to worry about the expenses that come with running a business. 

One of the largest expenses can be a commercial lease. If you join a group, you'll likely have a furnished and designated office space. You won't have to pay for rent or maintain the building. You get to show up and work. If something breaks, it's not your responsibility. 

Small costs can add up too. Agencies will typically provide everything you need to get started. This includes access to an Electronic Health Record (EHR) system, phone line, and email address. You'll even have a medical biller, administrative assistant, and a profile on their website.

Lower Risks Due to Shared Liability

Should any issues arise with clients, you won’t have to handle it alone. Other therapists, administrative staff, or clinic managers can help support you. If any mistakes were made, you'll have guidance on how to handle a situation. If you work alone, you may have peers to get advice from, but there’s no guarantee they’ll be available when you need them. 

Agency Life for Therapists Can Include Benefits and a Regular Salary

Depending on the setting, some clinics will pay their therapists a regular salary. This is opposed to a per-session rate. Knowing exactly how much your regular paychecks are going to be can help relieve some stress. New therapists often worry about financial stability. The salary could even end up being more than you’d make if you worked on your own. 

Another added benefit of working with an agency is that you could get benefits. These benefits could include paid time off, holidays, and health insurance. You might be lucky and get contributions into retirement savings. 

The Drawbacks of Joining an Therapy Agency

Although working at an agency might be a really great fit for you, it's not perfect for everyone. Here are some of the downsides of joining a therapy group practice.

Lower Compensation

Since you would be an employee of the agency, the owner will take a portion of the money from each session. The clinic could take a sizable cut from your client fees. This is in exchange for marketing, branding, office space, utilities, admin support, and more. Part of your income is used to cover the business’ overhead expenses. It also contributes to their profits.

Most agencies have a predetermined “fee split” for employees or independent contractors. As a part of this agreement, the therapist receives a set percentage of the total fee. It's common to find a 50-50 or 60-40 split in the industry. This means that the agency retains 50-60% of the fee, while you, the therapist, gets the remaining 40-50%. It’s up to you to determine if the fee-split is worth the convenience of working for someone else. 

Less Freedom with Clients

One potential drawback of working in an agency is that you have less control over the types of clients you see. In group practices, someone else will often determine your pre-set work schedule. They could also decide the demographic of clients you work with. You could be required to work the hours specifically scheduled for you. Sometimes there's very little flexibility. Take note that these agencies are not exempt from OSHA and FMLA regulations. 

Your individuality might be slightly compromised. This is because your treatments should meet the business’ standards. Asking all these questions during the interview process will help you choose the right agency. Some places of employment are more flexible than others. 

Risk of Burnout

Burnout occurs in every field and can happen to the best of us, no matter what setting we are in. This can especially happen in agencies that care more about profits and the bottom line. Some overlook the therapist and employees’ well-being. Some professionals report that they can feel under-appreciated and overworked. This could be due to working long hours and having demanding clients. 

Communicate with the agency beforehand about their expectations. You should know what you need to manage your work-life balance. This way you'll know if the setting is a good fit.  

Potentially Lots of Paperwork

This can differ from one agency to the next. If paperwork, time management, and organization is something you struggle with, it's best to ask questions. Research the agency’s policies before accepting a position there. 

Employment as an Independent Contractor

There are agencies that hire therapists on an independent contractor basis. If this is the case, you won’t be eligible for benefits like retirement savings contributions, paid time off, or health coverage. Although the pay rate may appear higher than regular employment, you’ll have to pay your own self-employment taxes. You also won't be entitled to the same benefits as a regular W-2 employee.

Lack of Guaranteed Supervision

As a new therapist, it's a good idea to ask about whether there will be a supervisor present. Free supervision can be a great perk, but the supervisor might not be the right fit for you. In those cases you'll have little say over the matter. 

Some agencies provide free supervision in exchange for a signed contract. This is when you agree to work for a certain period of time after receiving your license. This should be clarified before accepting any position. If you want to change locations or open up your own practice, this is an important detail. . where you agree to work for them for a certain period of time after receiving your license. 

Potential Workplace Conflicts

When you work in a setting with others, the potential for conflict inevitably increases. When different personalities come together and work under the same roof, clashes happen. The way you communicate and interact with your colleagues is important. Disagreements can happen and underlying tensions can result. It could be as simple as personalities not meshing well. Depending on your personality and sensitivity, this might make an agency the wrong fit for you.  

Alternatives to Agency Life for Therapists

Luckily, as therapists we have the freedom to choose what setting we want to work in. An established agency can provide stability in the form of regular income, healthcare coverage, and retirement savings. On the flip side, it offers a little less professional autonomy or significant financial advantages. 

An alternative to working at a clinic would be to start your own private practice. One of the best parts of working on your own, is that you get to be your own boss. You get to decide who to work with, when, and what you’ll charge. 

The increased demand for therapy in the last few years has also allowed therapists in private practice to make more money per hour. This is because you get to decide what the expenses will be and how you’ll get paid.

If you’re thinking of making the switch to private practice, you'll need to calculate how many clients you need. This is important because you'll need to know how much you need to make to sustain business. You can also decide whether you want to adopt a private pay model or join an insurance panel. Insurance panels can help you grow your caseload by sending you referrals.

Weigh the Pros and Cons of Joining a Therapy Agency

Remember, you have the freedom to decide what kind of practice you want to build or join. 

Hopefully this post has helped you weigh some of the pros and cons of working with an agency. While searching for your next job, remember to ask questions about all of the topics discussed here. Every agency can be different. If you’ve already decided on a job – we hope it instills confidence that you've made the right choice. 

At Clarity Cooperative, we’re here to help you whether you’re part of an agency, own a successful private practice, or are just thinking about starting your own. Our many resources are of benefit to therapists and healers from any stage in their career. 

We encourage you to discuss experiences, ask questions, and seek advice from fellow healers in our community, and try out a risk-free two week trial to our Pro subscription for access to all of our features.