Starting your own practice—or growing from solo clinician to group practice owner—isn't just a business decision. It's a deeply emotional experience.
And yet, most of the resources out there focus solely on logistics: how to form an LLC, what EHR to use, how to market yourself. Those things are important. But what often gets left out is the invisible work—the inner dialogue, the self-doubt, the fear, the grief, the stretching.
At The Thriving Practice Academy, we believe that supporting therapists means caring for the human behind the business plan. So let’s talk honestly about what comes up emotionally when you're building something big and meaningful.
Fear: “What if I fail?”
Starting a business or expanding to a group practice brings up real fear—financial fear, identity fear, fear of being seen. Even if you’ve done the inner work, this new level can feel like a free fall.
Fear often says, Don’t move. Stay safe. Wait until you’re more ready.
But here’s what we know: fear is not a stop sign—it’s a signal that you care. That what you’re doing matters. That you’re stretching into something new and unknown.
Try this:
- Name the fear specifically. (Is it fear of judgment? Of losing money? Of disappointing someone?)
- Remind yourself that fear and courage coexist—they don’t cancel each other out.
- Anchor to your why. Let it be stronger than your fear.
Imposter Syndrome: “Who do I think I am?”
Imposter syndrome doesn’t go away when you hit a new level—it just finds a new script.
Starting a business? I’m not business-minded enough.
Hiring others? What if I’m a terrible leader?
Raising your rates? What if I’m not worth it?
It’s not a flaw in you—it’s a symptom of growth. Imposter syndrome shows up when you’re doing something that requires self-trust before external validation arrives.
Try this:
- Track the evidence of your competence (client outcomes, training, growth).
- Talk to other therapists—this experience is more universal than you think.
- Reframe the thought: It’s not that I’m unqualified, it’s that I’m uncomfortable because I’m growing.
Comparison + Shame: “Everyone else has it figured out but me.”
Social media makes it easy to feel behind—like everyone else’s practice is thriving, their teams are flourishing, and their branding is flawless. Comparison, when internalized, becomes shame: I’m not enough.
The truth? Most people are figuring it out as they go. You just can’t see the messy middle behind the curated feed.
Try this:
- Curate your feed—follow people who inspire, not people who trigger your inner critic.
- Shift comparison into connection: what does their success make possible for you?
- Ground yourself in your own values and vision. You don’t need to replicate anyone else’s path.
Anticipatory Anxiety: “What if this doesn’t work?”
The unknowns in entrepreneurship can feel endless. Will clients come? Will I make enough? Will this scale? Will I still like this once I grow?
Anticipatory anxiety thrives in uncertainty—but the truth is, all clarity is earned. It comes through action, through experimenting, through trying and adjusting and learning.
Try this:
- Take the next doable step. Not the perfect step—the one right in front of you.
- Create a support system. Consultations, peer groups, mentorship—don’t go it alone.
- Keep a wins journal. Document every “yes,” every new client, every brave decision.
You’re Allowed to Feel This
There is no version of building your practice that doesn’t bring up stuff. Fear. Tenderness. Grief. Vulnerability. And that doesn’t mean you’re doing it wrong—it means you’re doing it with heart.
At The Thriving Practice Academy, we don’t just give you tools—we give you permission to be fully human while building something meaningful. Because your emotional reality matters just as much as your business plan.
You’re allowed to grow at your own pace. You’re allowed to feel it all. You’re allowed to build a practice that feels good inside and out.