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3 Secrets to a Thriving Therapy Practice in an Urban Area

Updated: Sep 1, 2020

I’ve been training therapists for almost 30 years and each year graduating students want to know how to grow a thriving practice.

It can be tough when you live in an area like Seattle that has several counseling programs, each graduating 30 plus students a year, many of which head out to hang their shingle that very summer!

So how do you distinguish yourself? This becomes the big question. What makes someone choose to come to see you over all the other therapists out there? Look through the Psychology Today listings and you will see that every therapist “specializes” in individuals with depression and anxiety, couples with marital problems, and families in distress? Everyone does “everything”.

Here are some important things to do to launch yourself quickly and distinguish yourself as a therapist who has more to offer than the more typically trained –


Do not go into practice with someone who is just starting out. Even though it might be fun to start with someone you went to school with – it is not a good business move. Start your practice with someone who already has an established or full practice, and preferably with a complementary practitioner. For example, find a psychiatric nurse practitioner who specializes in children, a naturopath who specializes in women’s health or a therapist whose specialization is very different than yours and who has been in practice for more than ten years. These practitioners are much more likely to need the referral relationship and thus actively refer to you.

Begin to get advanced training in sex therapy.


Nothing boosts your clinical skills, confidence, skill set and expertise faster than adding your name to the specialty of sex therapy. Begin AASECT training by signing up for a SAR and begin AASECT supervision. In fact, you can get yourself positioned to do this in the months prior to graduation!

To your surprise, you will find yourself getting referrals for sex therapy soon after you begin supervision. Most areas have very few therapists with this training. When the word gets out that you ACTUALLY DO, you will be surprised how many referrals you begin to get. I have several therapists who have studied with me who, because they were comprehensively trained in individual, couple, family, sex therapy and spiritual intimacy, were the FIRST THERAPIST that got the referral. They quickly became known as the clinician who COULD HANDLE ANYTHING WITH GRACE, COMPASSION, WISDOM, and EXPERTISE.

Typically many therapists begin seeing an individual or couple, and as soon as a sexual issue arises, feels uncomfortable, ignores the topic or wants to refer, or provides inappropriate information. Sexual issues are treated as if they are unrelated to the rest of their lives simply because the therapist is inadequately trained. When you are trained to hear the issue, treat the issue, integrate the issue with all the other issues you are treating, and compassionately educate and normalize, clients tell their friends about you! One supervisee who had been in practice for over a decade recently told me that she was getting so many sex therapy cases sent to her and “she wasn’t even advertising herself yet!”

This is what comprehensive sex therapy education grants you.


Get on the referral list at local colleges for their students and graduate students. You may have to offer a sliding scale, but these will be fun clients to serve and you will learn a lot from them. Also, many counseling and education programs require their students to get counseling, so definitely get on their referral lists. Be sure to check back each year as they update their lists.

Want to boost your clinical confidence?

Consider taking Upcoming Advanced Clinical Sexology Course with

The Northwest Institute on Intimacy

October 28- November 1, 2019

Seattle, WA

This course meets many of the educational requirements to become an AASECT certified sex therapist for CoAMFTE Licensed Marriage and Family Therapists and other psychotherapists. Final course requirements will be completed after the five-day intensive.

This five-day intensive course is designed to maximize your training time. Topics covered include: *Diversities in sexual expression and lifestyles* Health and medical factors in sex therapy* Ranges of sexual functioning* Cyber-sexuality and social media* Substance abuse and sexuality* Professional communication and reflection* History of sex research and theory* Principles of sexuality methods and research* Sex-related therapy techniques and diagnosis* Theory and methods of medical intervention in the evaluation of psychosexual disorders* Ethical decision making and clinical case review.

For more information or to sign up visit

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