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Clinician and Private Practice Coach to Share Her Expertise With AMHCA Members
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Clinician and Private Practice Coach to Share Her Expertise With AMHCA Members


Most AMHCA members are skilled clinical counselors, but to be successful professionally, they also have to be adept at running their counseling practice. To help them with the business side of counseling, The Advocate has invited Deborah Legge, PhD, CRC, LMHC, to write a regular department on “The Business of Private Practice.”

Legge is a counselor in private practice herself, and she consults with mental health counselors on how to grow their practice. See our Q&A with her, below. And check out her her first article, on the change in CMS billing codes that take effect Jan. 1.

The Advocate: Do you have a clinical specialty in your own private practice?

Deborah Legge: I am a Board Certified Expert in Traumatic Stress; however, I have a general practice where I see adults with various concerns. My areas of training and expertise include trauma, Borderline Personality Disorder, dissociative disorders, chronic mood disorders, and anxiety disorders. 

The Advocate: What made you shift from seeing clients with mental health problems to becoming a private practice mentor to your peers?

Deborah Legge: Ever since I went out into private practice 20 years ago, I started empowering others to take that “leap of faith.” Over the years, my offices have served as a “home” for other mental health providers in private practice. 

My efforts to empower and support clinicians who want to increase their income and become more autonomous have broadened. In 2010 I launched my private practice coaching business: Influential Therapist. I’m now able to help out entrepreneur-clinicians all over the world. Throughout all of this, I’ve maintained my own full-time private practice; this helps me to keep an up-to-date perspective on what my coaching clients are experiencing, and allows me to continue to pursue my love of counseling.

The Advocate: What business issue tends to be the most challenging for clinical mental health counselors in private practice? And what do you tell them to help resolve that problem?

Deborah Legge: Most of the issues we address in coaching are business-related—they’re ones having to do with: 

  • setting up a business model,
  • establishing policies and procedures,
  • developing a marketing plan,
  • becoming comfortable with the money issues involved with private practice,
  • billing,
  • record-keeping,
  • increasing referrals,
  • choosing a target market,
  • creating niche products and services, and
  • developing ways to increase revenue that is not “dollars for hours.”

Most of these concerns I have faced in my own private practice over the years. Together we utilize my experience and the expertise I continually build on to chip away at these concerns at a pace that works for my clients. These are the things I didn’t learn in grad school—so my job is to educate, empower, and assist my clients as they establish and grow their private practices.

The Advocate: Is there anything about running a private practice that you wish clinical mental health counselors knew before they opened a private practice?

Deborah Legge: I believe it would be very helpful for grad schools to offer an elective in the area of building a private practice. Basic business and marketing skills as they apply to our field would be helpful for those who think they may like to make this transition at some point in their careers. 

Also, with so many advances in the area of technology, it would be great to offer another elective with a focus on technology so that students could get the “basics” to build on as they continue their career development after graduation. Private practice allows creative options for helping others—technology is almost always part of those options in one way or another.

The Advocate: Is private practice for everyone?

Deborah Legge: No, private practice is not for everyone. Many clinicians do their best work when they do not have to be concerned with the business involved with putting clients in seats, and money in the bank. That’s okay! The important thing for all of us is that we are happy and satisfied in our work. 

Most people who are successful in private practice are willing to tolerate some risk; they may not be fearless, but they are courageous. They are forward thinkers who are open to new ideas and stretching outside of their comfort zones. With the autonomy derived in private practice comes great responsibility and a platform from which to create your own destiny. 

That being said, private practice doesn’t look the same for everybody. Some folks want to have a full-time business; others want part-time private practice while continuing to pursue part-time employment. Still others are thrilled with the idea of just adding a few clients a weeknight as a bright ray of sunshine (and a few extra bucks) while they are gainfully employed elsewhere. 

“The Business of Private Practice” articles will give readers the “inside scoop” on what it takes and what to expect when going out on your own (even if it’s just a little bit). Hopefully these articles can help readers make good, informed decisions when it comes to private practice. 

The Advocate: What kinds of topics will your new department in The Advocate cover?

Deborah Legge: My first passion is to reduce fear and get people excited about private practice. We’ll explore specific areas of concern in ways that are straightforward; I want readers to be able to put the information in my articles to work right away. 

We’ll look at issues such as building referrals, compliance, marketing, etc., from different perspectives. There are almost always several ways to solve a problem or reach a goal. My job (as a private practice coach) is to find the way that works for my clients. I’ll try to bring that spirit to what I have to offer in The Advocate; hopefully, there will be something for everyone. 

Contact Deborah Legge at, or 
visit her website. Her first article, “The Business of Private Practice,” is on page 20 in this issue.