After working in “the big city” for many years of my career I decided to take a big risk. I left my job and my 45 minute commute and started a counseling private practice in my own little town outside of Portland, Oregon. It’s the kind of place where you can’t leave the house without seeing someone you know. The kind of place where the web of connections between people holds everything together.
Of course there are challenges and ethical dilemmas to consider —but there are also significant benefits to starting a practice in the place you call home. If you are on the fence about starting a private practice in a smaller community here are some reasons it could work for you.
You Already Have A Social Network That Can Produce Word-Of-Mouth Referrals
Sure, your website is important, as is your profile on PsychologyToday, but word-of-mouth referrals will always carry the most weight for people. In a small town, your dentist, your pastor, and your barista probably know your name and what you do. I have found that these connections in my community enthusiastically send me referrals. I also make it a point to floss, say my prayers, and tip generously!
You Can Stand Out Quickly By Making Sure You Aim For The Lowest Hanging Fruit
In the big city, it’s hard to stand out in the crowd. In a smaller community, you can stand out by having a clear and put-together presentation online. For example, I put some extra time and money into my website and registered my business with Google. I took sometime to make sure that my business pops up if someone googles “counseling in _____, Oregon”. In my town, there are many counselors, but a large portion of them are pre-licensed interns (we’ve all been there!). What sets my practice apart from others is that 100% of our counselors are licensed and have substantial experience.
You Already Know About Your Client Base And Therefore Can Be Intentional As You Build Your Practice
As a resident of my community for the last 7 years, I have a strong base knowledge of what insurances are offered by the largest employers in the area and where people tend to go for help. I know that the community has been grieved by multiple suicides over the course of the last 5 years and that the parents and teens need more support but are having trouble finding it. I know that people are having to drive nearly an hour to get to counseling services because there are not enough providers in the area. As an experienced teen therapist with 13 years of experience around suicide prevention, I felt challenged to bring my skills to my home town.
My desire is to have a real impact on improving the mental health and well-being of my community. I don’t know about you, but I didn’t get into this business to sit on the side lines. I want to make a difference.
You Can More Easily Have An Impact In The Community That You Can See
Before I moved, I had a tiny yard that I used to trim with one of those manual push mowers. I called it the “postage stamp yard.” Over the course of less than a year, I transformed it into a virtual oasis full of flowers and trees blooming from February to October. I moved to a different house with a larger yard, and the task of landscaping and gardening was daunting. It took years for the yard to take a basic shape and many more hours and hundreds of dollars to make it feel inviting and beautiful.
Your impact in a small town is more like my postage stamp oasis yard. In a shorter amount of time, you can can see how your hard work is positively impacting your community. When you know what the needs are, you can build a practice that both meets those needs and adds value to your community at the same time.
Take it a step further by partnering with local organizations that support the larger community. Maybe you can hold a diaper drive in your waiting area in the month of November for the diaper bank. Perhaps your practice can form a team to run in a local charity run. Furthermore, as you see your clients feeling better and rocking it out in life, you’ll see their footprints in the community making a difference. I can’t think of anything I’d rather do.
If You Are Thinking About Starting A Practice In A Small Community, Here Are Some Questions You Might Want To Ask:
- Is my community growing or shrinking? If your community is shrinking, you may want to think about who your clients would be and how far they would be driving. Is there a way for you to make counseling more convenient by offering video sessions? Can you position your office in a location where people are driving anyways? If they are already taking a weekly trip to Wal-mart or Costco, they may be able to add a counseling appointment, even if it’s not particularly close to their home.
- Should I consider taking Medicaid or Medicare insurance? Yes, I know I’m opening up a can of worms. Higher incomes tend to be concentrated around cities while those in less populated areas have less access to higher paying jobs, and you guessed it…health care.
- Is there a specialty or service that people are driving long distances to obtain? If that services is an Anger Management group or parent coaching, could my practice meet that need closer to home?
- If you live in a smaller community and drive to the city, think about how much time and energy you spend driving per week. If you are driving 6-10 hour per week, that is 6-10 hours you could be seeing clients and earning income. Or better yet, see clients for 5 of those hours and spend the rest of the time with your family and friends.
Susan M. Doak is a licensed professional counselor and the owner of Newberg Counseling & Wellness, a private practice in beautiful Newberg, Oregon. Her practice provides experienced support for people in seasons of change, teens and parents. When she is not with clients, she enjoys dancing with her kids, hiking, gardening and making pies.
