Most conversations about private practice are highlight reels.

But what about the parts no one posts about?

In today’s episode of Selling the Couch, I’m joined by my friend Dr. Justin Dotson, a group practice owner in Memphis, Tennessee, for an honest, real-world conversation about what it actually takes to run (and sustain) a small business as a therapist.

Justin is heading into year 6 of private practice, and I’m in year 11 with STC—so we wanted to pull back the curtain on the things therapists often learn the hard way: pricing, confidence, leadership, loneliness, burnout, and what success really looks like after the early hustle phase.

In this conversation, we cover:

1. Why most therapists start with zero business training (and what to do anyway)
2. The “version 1 vs version 10” trap therapists fall into
3. How Justin set his first fee (and why he’ll never haggle again)
4. A realistic approach to raising rates without spiraling
5. Why “don’t base your business on someone else’s secret” matters more than ever
6. The hidden loneliness of entrepreneurship (no-shows, cancellations, declined cards, overhead)
7. How becoming a business owner changes you—emotionally, mentally, and relationally
8. Managing burnout + anxiety while still showing up for clients
9. The leadership challenges that come with scaling and relinquishing control
10. How to build trust in yourself by keeping your word to yourself

If you’re in private practice, thinking about starting one, or navigating the messy middle of business ownership... this episode will feel like a deep exhale.

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Resources:

Building and managing the practice you truly want can feel overwhelming. That’s why Alma is here—to help you create not just any practice, but your private practice.

With Alma, you’ll get the tools and resources you need to navigate insurance with ease, connect with referrals that are the right fit for your style, and streamline those time-consuming administrative tasks. That means less time buried in the details and more time focused on delivering exceptional care to your clients.

You support your clients. Alma supports you.

Learn more at sellingthecouch.com/alma and get 2 months FREE–an exclusive offer for STC listeners.

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