How We Hold ~90% Clinician Retention in a Field That Loses a Third of Its Workforce
Behavioral health loses somewhere between a quarter and 40 percent of its workforce every year. At Sprout Therapy PDX we have held roughly 90 percent annual retention across a team that grew past 40 clinicians. That gap is not a personality difference or a perks budget. It comes down to four things: pay people properly, protect the caseload, supervise for real, and take the administrative load off them.
What Hiring an Associate Actually Costs You
The fee split is not the cost of an associate. It is one line in a stack that also includes payroll burden of roughly 15 to 25 percent on top of wages, your own supervision time at its opportunity cost, two to four months of credentialing before a single claim pays, and a ramp period where the caseload is not full. Most owners I coach are surprised by the total, and it is the surprise — not the number — that causes the damage.
Can You Supervise an Associate in Oregon? (And What It Actually Requires)
To supervise a professional counselor or marriage and family therapist associate in Oregon you need three things: an active Oregon license, 30 clock hours of post-master's supervision training, and a passing score on the Board's Supervisor Law and Rules Exam. How long you have been licensed determines which path you qualify under.
W-2 vs. 1099 for Group Practices: How to Classify Your Therapists
Whether a therapist is a W-2 employee or a 1099 contractor is a legal classification, not a preference — and it comes down to control. In general, if you control how, when, and where the work is done (set schedules, require your systems, supervise the work), the person is likely an employee, not a contractor. Most group practices that want an integrated team end up with W-2 employees. Here's how to think about it.
The Clinician Onboarding Checklist for Group Practices
Good clinician onboarding covers three things: operational (access and logistics), clinical (caseload and supervision), and cultural (team and values). Get all three right in the first month and your new hire ramps faster, feels supported, and is far more likely to stay. Here's the checklist I use.
When Should You Hire Your First Therapist? (Signs You're Ready)
You're ready to hire your first therapist when demand consistently exceeds your capacity, you have systems a new person can step into, and you have enough cash to pay them before they're full. If you're regularly turning clients away or sending referrals elsewhere, that's the clearest signal of all. Here are the six signs I look for — and the one financial check to run first.
How Much Should You Pay an Associate Therapist? (Fee Splits Explained)
Most group practices pay associate therapists through a fee split, and a competitive share is often 55–65% to the clinician when the practice covers admin, billing, marketing, and space. But the percentage alone doesn't tell you whether a deal is fair or sustainable — that depends on what your share actually pays for and whether the math works for both sides. Here's how to think about it clearly, so you land on a number you can stand behind.
How to Hire Your First Therapist for Your Group Practice
Hiring your first therapist is the moment a private practice becomes a group practice — and the moment your job quietly shifts from clinician to leader. Before you post a job, do three things: systemize how your practice runs, get clear on what you can actually afford to pay, and define exactly who you're looking for. Rushing any of those is the most expensive mistake I see new group-practice owners make. Here's the full path, from readiness to a clinician seeing clients.