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 whether you have the skills to start your own business? 

Perhaps you're already a seasoned counselor wanting to get out of your comfort zone at an established facility. Or, maybe you’re 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, start a private practice, or even work with clients via text and video calls using online therapy apps.  

It can be understandably overwhelming to decide which way to go, and to know what questions to ask when interviewing with companies. 

To help you make the best choice about the setting you want to work in, 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 and how this can impact your career both long term and day-to-day.

Built-in Marketing and Referrals

Positions with well-established agencies will likely have a steady stream of incoming clients through referrals or even an existing waitlist. Because appointments are usually set up for you through administrative staff, you might even start meeting with clients on your first day. This means that you could quickly accumulate a full caseload 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.

In the same way that you might receive referrals when joining a practice, you can easily send referrals to others as well. In a group setting, you have access to a valuable network of other counselors, social workers, psychologists, psychiatrists, etc. with varying degrees of experience and expertise that is already built in for you. 

Here are two examples of referrals within a single agency:

Let’s say you usually work with adolescents battling depression and family issues, and this is the main topic of discussion during the first few sessions. As your client gets more comfortable, additional information comes out about their struggles with eating disorders. While you might have some experience working with this, you’re not really an expert and would prefer if this client saw someone else. A referral to a colleague that specializes in these topics, that works just down the hall from you, would be easier than sending them to another practice. 

Sometimes a therapist might work with a client, but feel like they never really click well and sessions could even feel awkward. One therapist might not be the right match personality wise for a client, but chances are that someone else in the agency would be. Instead of terminating a client, you could recommend an alternative therapist at the agency.

In both scenarios, the client will likely appreciate the gesture and trust would be gained since you’ve got their best interest at heart. 

Business Knowledge Isn’t Necessary

If you have no interest in business, it's possible you might find the administrative responsibilities of private practice to be unappealing. Many therapists would understandably rather spend their time actually helping clients than dealing with admin work. 

If you’re not particularly entrepreneurial and don’t mind giving up some say in the clients you take on, 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 entirely 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 operate by having multiple support staff to 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. Consequently, you’ll have more time to devote to individual clients.

Joining a Therapy Agency Provides a Support System

Depending on one’s personality and the level of professional engagement they need, some therapists may find private practice to be an isolating career path. 

Though you may have peers or a supervisor you can talk to about difficult scenarios or ethical challenges, it might not always be easy to get in touch. According to the American Psychological Association, working in an agency or group practice allows for more opportunities to get advice from and learn from colleagues.

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 potentially fill in for you. This also helps your clients out because they won’t have to deal with the additional burden of finding a new location on top of a last minute schedule change and stress of meeting with a new therapist for the first time.

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. By joining a group, you’ll most likely have a designated office space that is furnished without having to directly pay for rent or maintenance of the building. 

Basically, you get to just show up and work. If something breaks, it’s not your responsibility. 

Small costs can add up too. Agencies will typically provide access to an Electronic Health Record (EHR) system, phone line, email address with appropriate company domain name, billing, administrative assistants, and a complete 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, or you just need some 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 rather than a per-session rate. Knowing exactly how much your regular paychecks are going to be can help relieve some stress if you’re worried about financial stability as a new therapist. 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 paid time off, holidays, benefits like health insurance, and possible contributions into retirement savings. 

The Drawbacks of Joining an Therapy Agency

Although working at an agency might be a really great fit for some, it's not the perfect environment 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 naturally want a portion of the money that you bring in from your clients. 

In exchange for marketing, branding, providing office space, utilities, administrative support, etc. the clinic may take a sizable cut from your client fees. Part of your income is taken to cover the business’ overhead expenses and contribute 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 or group practice is that you could have less control over the types of clients you see. In group practices, someone else will often determine your pre-set work schedule and the demographic of clients you work with. You could be required to work the hours specifically scheduled for you with little flexibility. However, these agencies are not exempt from compliance with OSHA and FMLA regulations. 

Your individuality might be slightly compromised in terms of work and during your treatments because the business’ standards need to be met as well. Inquiring about all of these topics during the interview process can help you choose an agency that's right for you, as these can vary greatly. 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 than the therapist and employees’ well-being. Some professionals report that they can feel underappreciated and overworked due to working long hours and having demanding clients. 

Managing work-life balance and communicating about the agency's expectations beforehand can help you know whether the setting is a good fit for you. 

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 and 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, keep in mind that as a contractor, you’ll have to pay self-employment taxes and won’t be entitled to the same benefits as a regular W-2 employee.

Lack of Guaranteed Supervision

If you do accept a job with an agency, 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 if the supervisor just isn’t the right one for you – there's likely little say you have in the matter. 

Some agencies provide free supervision in exchange for a signed contract where you agree to work for them for a certain period of time after receiving your license. Clarifying this before accepting a position will help in the long run in the case you decide you want to change locations, open up your own practice, or know that you don’t plan on staying anywhere long-term. 

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, 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 is a consideration to take in prior to joining a clinic. 

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 in terms of 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 increasing demand for therapy in the last few years has also allowed most therapists in private practice to make more money per hour than they would in a group setting. This is because you get to decide what the expenses will be and how you’ll get paid.

If you’re at an agency right now and thinking of making the switch to private practice, it can help to calculate how many clients you’ll need to sustain your business. You can also decide whether you want to adopt a private pay model or join an insurance panel where they 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 because every agency can be different. If you’ve already made a decision as to where you’ll work – 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 30 day trial to our Pro subscription for access to all of our features.