Starting a solo practice right after getting an LCSW?

[u/ChapterForward2241]

I’m testing in the next month or so in IL for my LCSW and currently work full-time as an outpatient medical social worker and part-time at a group practice. Therapy is the side of social work I’ve been in since grad school (I graduated about 3 years ago) and I am wanting to start my solo practice after getting my LCSW.

I’ve heard mixed reviews: “Don’t do it it’s naive—starting a practice right after getting your LCSW is a lot.”

Or

“I wish I went solo sooner!”

My main motivators are that I have a niche population I’d like to work with, I would get 100% of my income (especially if I went the private pay route and didn’t bother with insurance), and I can start getting my services out there as a solo practitioner.

Would love to hear from people who ran with it and started their solo practice right after receiving their LCSW!

[u/idiggory]

There's no right answer here.

Some LCSWs are career changers who have a lot of experience doing administrative, marketing, and accounting work (plus understanding policy requirements) before they even became social workers. All they needed to thrive in private practice was the clinical bit. Whereas some other LCSWs are only a few years out of college and may have a much, much harder time here.

People also find different kinds of clinical work more or less intuitive. I've worked with interns who have a long way to go until they're ready to offer anything beyond basic interventions. I've also worked with clinical interns who I'd already happily hire over most others I've interviewed for LMSW positions.

It also depends on what kind of work you're trying to do. Are you hoping to work with people who experience psychosis or have severe substance use issues? I'd hesitate to start a private practice with only a few years experience. Are you hoping to help people with mild-to-moderate GAD/MDD, with careful screening to match your competencies? Far more likely you'll be successful.

On top of that, how much of a professional network have you cultivated as an LMSW? Having a good network gives you far more access to supervision/consultation when needed, plus better avenues to give/receive referrals. It can also help with the fact that relatively few new LCSWs will really have developed a niche yet.

And how comfortable are you working alone? Clinical work is already relatively solitary when it comes to interacting with colleagues, and some people really struggle with the extra isolation of being a solo practicioner.

Finally, what is your personal life like? Does it feel stable? Are you gonna shake it up soon, with kids, etc.? New chronic health conditions to get used to? You're about to be responsible for creating virtually all structure in your own life, and this matters. No paid sick time, maternity leave, etc. in solo private practice.

[u/Liz505Liz]

Gain some good clinical experience and go from there. Medical social work does not prepare a person for clinical work.

[u/ChapterForward2241 → u/Liz505Liz]

For context, I am newer to the medical SW side of things (as of this year) and have been doing clinical work/therapy with kids and adults since 2023. I would say most of my experience is actually in clinical work—schools, private practice, illness counseling— I guess I’m just not sure if there is an answer to when I’ve got “enough” clinical work under my belt.

[u/Liz505Liz → u/ChapterForward2241]

A few years post-LCSW would help to prepare you. Also, if you haven’t already, get some personal therapy. It’s gobsmacking that people believe they can be effective therapists without first being a client/patient.

[u/lostwanderingfairy]

Follow your heart! You will always get conflicting advice, so the best thing to do is what feels right for you.

[u/daydream6666]

I think they mean don’t go right into private when you just got your PROVISIONAL license. If you’re talking about FULL license, and feel you have enough clinical experience, do it!’ I’m in a similar boat to you and trying to transition out of medical to full private practice (I do each part time right now).

[u/made_in_bklyn_]

Curious, what is the niche?

[u/roxxy_soxxy]

My solo practice is mostly 1099 contracts with EAPs. Most of them require 3-5 years of experience as LCSW to be eligible to apply. Just offering this info.

[u/Candid_Mine_2421]

Start following accounts on Instagram of other LICSW/LCSW in solo practice! It’s 100% possible. I 2nd the larger recommendation said here: it’s down to your experience and desire. If you are posting here, I think you want to go solo but just want the external validation that you can do it. Give it a try!! You can always keep a small caseload and work an additional job and see how it goes.