Private Practice Social Work Guide - 2022

Last Reviewed: July 11th, 2022

For most people, the term “social worker” immediately conjures up images of child protection workers, public benefits advocates, or helpers in medical facilities. However, social workers do a lot more than help people in institutional or social services settings. Instead, many of them opt to open their own offices and become private practitioners.

Usually, being in private practice means that a social worker owns their own business or participates in a group practice. These group practices are separate from another institution, such as a hospital or child protection organization.

Let’s look at why you may want to enter private practice, and how to set up your practice.

Introduction to Social Work Private Practice

There are several kinds of private practice available to social workers. Although there’s somewhat less variety in private practice than with a traditional social work employer, several areas of practice lend themselves well to being a solo practitioner. In fact, some of these options are easier to do outside of a traditional social work “organization.”

  • Clinical social work: This Masters-level private practice option involves treating mental health and substance abuse issues. For instance, you might help someone with depression or anxiety, or to quit alcohol. Also, you can work with any age group you want, subject to state licensing.
  • Coaching: These days, self-improvement is a major focus for many people. A personal coach can help people articulate and achieve their goals through pep talks, accountability, and other means. Many social workers are adding this to their practice (or turning to it entirely).
  • Casework: Sometimes people need help, but they don’t fit inside the target group of a local social work organization. Or, they might need interdisciplinary assistance on some level. Social workers in private practice can help these clients break through the red tape and live their best lives. A good example of this might be a family that needs help with an elderly parent.
  • Case management: When someone needs help from multiple agencies, case management can be very helpful. Especially when some agencies are private sector, a private practice case manager can be helpful. Likewise, many agencies have too many clients for their employees and might contract for outside help. In private practice, that could be you.
  • Social policy work: Some social workers advocate for social policy changes in their communities. While much of the work happens inside traditional institutions, some people need a more public advocate. In particular, socially-disadvantaged groups within a particular area need social workers to advocate for social changes. An example might be lobbying for a new public health center in a high-poverty area.
  • Community organization: Help a community work together and achieve a common goal. For instance, they might spearhead a fundraising effort to expand the local health clinic or a domestic violence shelter.

Why do some social workers decide to start their own private practice?

Ultimately, the decision to go into private practice is an individual one, because no two social workers are the same. However, there are several reasons why you might want to do it. One of the most common explanations is that some social workers want and need a lot of flexibility. For instance, a social worker’s counseling or coaching clients might want evening hours. Depending on the agency, this might not be an option. A private practitioner can do whatever is necessary.

Other social workers have a passion that isn’t easy to pursue in a traditional agency. For instance, you probably won’t get to be a coach in a traditional agency, unless it’s as an adjunct to counseling.

Finally, if you’re in private practice then you aren’t on a salary. This can be a good thing or a bad thing. On the one hand, if business is bad then you won’t make much money. But if your business is thriving, then your income potential is much higher.

What is the mentality of a successful social worker with a private practice business?

In some ways, it’s similar to the mentality of any successful business owner. That is, you need a drive to succeed, a willingness to work extra hours, and a passion for your job. If you lack any of these things, there’s a good chance you won’t do well.

Think about it this way: People who work a job just to make money don’t necessarily have the determination to succeed on their own. When you own the business, you’re ultimately responsible for its growth, and business development takes more time. Often, you might have to work longer hours so you can increase your client numbers. Similarly, if you’re lukewarm about your profession (or even your specialty), you probably won’t stay motivated. Becoming self-employed is a commitment.

How to Start Your Own Private Practice as a Social Worker

Setting up your own private practice is a lot of work. Beyond the business development, there are a lot of logistics and moving parts, such as a premises, taxes, and insurance. Plus, you’ll have to maintain your license like all other social workers. In other words, you need to do all the things that a social work employer does, plus all the “social worker stuff.”

Here’s a summary of the steps you need to do when starting a business:

  • Get and maintain your social work license. You can find out how to do this through your social work licensing board. In addition, you may need a specific license for some specialties, like mental health counseling. Later, you’ll need continuing education credits to stay licensed in most states.
  • Formulate a budget for your business. This includes everything that your business needs to operate, such as rented or purchased office space, office supplies, cleaning, computer-related expenses, a bookkeeper, medical insurance claims and billing, payment processing, internet and phone, and property insurance.
  • Register your business with the state. Almost all states require businesses of this type to be registered, even if you’re a sole proprietor. Most states will have a website that outlines this registration process. Once you’ve chosen a place of business, you may also need to register with the municipality.
  • Arrange for a National Provider Number (NPI) if you want to provide services that are covered by health insurance. This one mostly applies to mental health social workers, but check with your local social work association.
  • Plan on spending money for marketing. There’s more to bringing in clients than just registering with insurance companies and local nonprofits. Instead, you’ll want to reach out directly to your community. The first thing you should do is construct a simple website for your practice. These can be inexpensive to make yourself, or hire a professional if you want something polished. Second, you’ll need paid advertising. A lot of businesses post ads in the newspaper, but if you want to be more modern, consider online marketing. This includes placing ads on web pages, social media, and paid search. Don’t forget to market yourself, and not just your business. As the saying goes, “people pay people.”
  • Create patient documents. These include HIPAA and confidentiality forms, insurance information, patient agreements, billing policies, and others. Be sure to mention what you’ll do if someone doesn’t pay on time, such as sending bills to collections. Remember, one of the most common reasons that businesses fail is poor cash flow. And although you’re a social worker to help people, you need to ensure that your business survives.

Don’t forget to secure your financial future

Even if you don’t have employees, it’s critical to ensure that your business secures your financial future. This includes your salary, benefits, retirement, and insurance. This section includes some things that you probably have but didn’t think about while working in traditional social work employment.

Membership dues and publication subscriptions

As a professional, you need to stay on top of developments in social work. For instance, social programs and laws change. So do insurance reimbursement rates and other details that can threaten your business and income if you don’t adapt.

Therefore, you should always carry membership in industry groups. Most social workers are NASW members. If your employer pays for this now, you’ll need to remember that you are now responsible for paying these costs.

In addition, consider subscribing to some publications. These help you learn new best practices and stay on top of recent trends. You’ll keep your practice competitive with other social workers because you’ll be seen as knowledgeable and competent.

Professional development

Not all professional development is mandatory. One of the best ways to get ahead of the competition is by taking more courses than necessary. For example, if you can specialize in children, or learn to treat PTSD and other complex conditions, you might be able to make more money. That’s because insurance companies may pay more based on your qualifications, or you might perform more expensive services. In addition, a lot of people look for professionals that specialize in their specific problem. If they see you’re certified in that area, you have an increased chance of winning their business.

Personal salary

As a self-employed person, you need to decide on a salary. After all, your business will have a lot of expenses, and labor is one of them. You need to choose an appropriate personal salary. This should consider your expenses, such as a mortgage or rent, utilities, clothes, and transportation. We suggest that you consider your current salary, then adjust as appropriate. For instance, depending on how you pay yourself, you might have self-employment tax to worry about.

Retirement

Like all other professionals, you need to think about retirement. Most social work employers provide some form of retirement plan, such as a 401(k) or pension. However, as a self-employed person you’ll need to save for retirement yourself. With the right corporate setup for your private practice, the company can pay for it. However, this isn’t always possible, and you might still wish to save money separately. There’s a publication from the IRS about self-employed retirement options that you can explore with your financial advisor.

Health, vision, dental insurance

Everyone needs to know they can pay for healthcare, including vision and dental care. Most companies provide this insurance for their full-time employees, but if you’re in private practice, this is your responsibility. Luckily, there are options. One of the easiest choices if you don’t have employees is to buy this on the healthcare exchange. Or, you can buy insurance through the NASW’s insurance company. Once you get an employee, you might be able to switch to a small business plan.

Disability insurance

As a social worker, you should know that disability can happen to anyone. Disability can happen on the job, from an accident, or even due to illness. For this reason, you should have short and long-term disability that can pay the bills while you’re unable to work.

Other insurance

Let’s be honest: as social workers, we have to worry about liability. For this reason, you should always carry enough insurance to protect you in almost any situation. Here are the insurance types you should carry:

  • General liability: This is the proverbial “someone slipped on a banana peel” insurance. If someone slips and falls at your office, is otherwise injured, or just wants to sue for another reason, general liability insurance will help pay for legal expenses and other costs.
  • Professional malpractice: This is a big one. You should already have malpractice insurance that covers you personally, but your employer also has one. If you go into private practice, you’ll want to have malpractice insurance that covers both entities. This way, you won’t have to worry about getting sued nearly as much.
  • Cyber liability: Data breaches happen, even in the best of circumstances. A cyber liability policy will help pay the bills if there’s a data breach and you get sued. They’ll also help you if there’s trouble with your licensing board or local authorities due to the breach.

Set yourself up for success with a network

No matter what specialty you pursue in private practice, having a professional network is valuable. Chances are that if you’ve been a social worker for a while, you have plenty of contacts outside of your agency. One reason for this is that some clients need assistance from multiple agencies. You also can gain a network by attending CE courses, conferences, and other events.

You should already be developing a network generally. However, one of the best ways to set yourself up for success is to make a concerted effort to meet other social workers in private practice. Even in relatively narrow specialties, everyone has professional strengths and weaknesses. Your network can help you learn to do something better, and vice versa. In other words, the shared professional experiences within a network can be very helpful.

Similarly, a fellow social worker can help you learn to run your business better. Unlike social workers in agencies, a solo practitioner must make the decision whether or not to accept a client, or determine how much to charge. These skills are learned over time, but mentors can help shorten your learning curve.

Finally, fellow professionals are great sources of referrals. It could be that someone’s client needs your skills, or that a certain professional in your network can’t take one more client. Likewise, you might be in the same situation, especially as your business grows. Having a network that you can refer to, and draw referrals from, is incredibly valuable in private practice.

Running a Private Practice as a Social Worker

Once you have started your practice, it’s important to run your business in an ethical manner. Lots of professionals get in trouble when they fail to properly define boundaries, keep adequate records, or obtain informed consent. Similarly, confidentiality is a major pitfall of private professional practices, especially in law or mental health.

Always get informed consent

Social workers need to document that their patients or clients give informed consent before performing any services. You might call this “full disclosure” or “no surprises.” Central to informed consent is the principle that clients should always understand what services they are being offered. You must also reveal your legal and ethical obligations, any limits to privacy or confidentiality, your credentials, risks of treatment, and how much it will cost. This way, your client retains their rights to free choice and self-determination.

While many of these items will be on the standard patient intake forms (especially payment and confidentiality), you should always go through the list with clients. This way, you can gauge whether or not they understand and agree to these specifics. You can also make sure they understand their right to refuse services, or to discontinue them at any time.

Confidentiality

Social workers handle a lot of sensitive information about their clients, regardless of specialty. Keeping client information confidential is one of the most important ethical principles. However, there are plenty of regulations regarding how you should handle client information. In addition, you have to worry about court orders, legal proceedings, and even the duty to disclose child abuse.

For this reason, you should always provide patients with a disclosure that tells patients about their rights to access their records, and when they can’t do so. You must also tell them what the limits of confidentiality are. And finally, you must worry about HIPAA notices of privacy practices. You’ve seen these in your doctor’s offices and other practices that take health insurance. Violating HIPAA is a serious matter, so be sure to comply with all regulations.

Dual and multiple relationships

Another major consideration in private practice social work is getting too close to your patients. Unfortunately, there are some social workers who develop a different kind of relationship with their patients outside the office, including romantic. Remember, “Once a patient, always a patient.” If you violate this key ethical duty, you can lose your license to practice and face other serious consequences. This is true regardless of your patient’s age or intellectual ability.

Record keeping

Any professional practice needs to keep good records. Not only does this protect you, it protects the patient. In addition, these notes help track patient progress, help you get reimbursed by insurance companies, and more.

Here’s what these records can include:

  • Intake information. This is the standard patient forms, along with any referral information such as their doctor saying patient needs help.
  • Billing information. Where do you send the bill? Does patient have health insurance?
  • Diagnostic information. What is the patient’s diagnosis? This information helps you get paid, because insurers pay to treat mental health issues.
  • Records from other providers. Social workers don’t do their work in a vacuum. Often, you’ll get records from other professionals, such as their family physician or a psychiatrist.
  • Session times. Recording when you have had a session with them, how long it is, and other session related information. Again, this is used mostly for billing.
  • Treatments and frequencies. Which form of psychotherapy are you using, and how often do they see you?
  • Medications prescribed by their healthcare provider. Many patients with mental health concerns also take medication. You should know what they take and who prescribes it.
  • Treatment plans and goals. In a nutshell, why are they seeing you? There’s often more to it than just a diagnosis, such as a desire to overcome their fear of flying.
  • Progress notes. This is where you keep track of how well your patient is progressing in therapy.
  • Discharge and closing summaries. When it’s time for a patient to discontinue therapy, you’ll discharge them. Closing summaries briefly outline what you did, and what the patient was able to achieve.

Working with insurers

Health insurance is often hard to deal with. For one thing, if you choose to be in network you’ll have an agreed-upon rate that will likely be lower than the cash rate. In addition, you’ll need to worry about how many sessions, and what services, the insurance company will pay for. Many insurance companies also limit which diagnostic codes make a patient eligible for coverage.

Of course, this raises another ethical dilemma: when a patient needs more than their insurance company will provide, and they don’t have the money to pay cash, you’ll often have to discharge them. This can be a difficult decision, though, especially for people in a helping profession.

Don’t neglect your own mental health

Finally, be sure to care for your own mental health. Social work generally is challenging, especially when you get involved in court cases, have difficult clients, or face brick walls in caring for your client. Furthermore, people come to you with their challenges, fears, and traumas. This is one reason why social work has a high burnout rate.

To combat this problem, you should always have someone who can serve as a sounding board. For instance, a mentor will listen and give advice. You can even consider a therapy session with a fellow provider to help work through your challenges. Of course, you might also develop more serious issues like anxiety or depression, so watch out for these as well.

Final thoughts

Becoming a private practitioner is a big step for any social worker. There’s a lot of paperwork, multiple moving parts, and long hours. However, if you follow this guide and set your practice up properly, you can have a rewarding career.