How to Hire Your First Therapist for Your Group Practice
By Emelie Douglas, LPC, MBA · Founder, Sprout Your 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.
Are you actually ready to hire?
You're ready when demand consistently exceeds your capacity, you have systems a new person can plug into, and you have enough cash cushion to pay someone before they're full. A common rule of thumb: have about three months of a new hire's cost saved before you bring them on, because a 90-day ramp to a full caseload is normal. If every question a new therapist has would land on your desk, systemize first — otherwise you become the full-time answer desk instead of the CEO.
What kind of clinician should your first hire be?
Your first hire should feel like a “mini-me” — similar energy, style, and clinical approach to you — because you'll likely transfer some of your own clients to them, and people move more comfortably to someone who feels familiar. Write down your non-negotiables (licensure, populations, availability, values) before you meet anyone, and hold them. New owners most often regret the standards they waived because they were eager to fill the seat.
Employee or contractor: W-2 vs. 1099?
This is a legal classification, not a preference. 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 a W-2 employee, not a 1099 contractor. Misclassifying a clinician to save on taxes is a real liability that can lead to back taxes and penalties. Most group practices that want an integrated team end up with employees. Confirm your specific situation with an employment attorney or CPA; the rules are strict and state-specific.
How should you pay them?
Two common models: a percentage split (the clinician keeps a share of what they bill) or a salary/hybrid. Fee splits are the most common in group practices, and a competitive share is often in the range of 55–65% to the clinician when your practice covers admin, billing, marketing, and space. Whatever you choose, model it against your real costs so the arrangement is sustainable for both of you — I cover the numbers in depth in my article on paying associate therapists.
Where to find good candidates
Post where clinicians actually look: LinkedIn, therapist-specific job boards, Indeed, graduate program listservs, and your professional associations. Your network and school relationships often produce the strongest pipeline over time. Build a real process — application, a multi-step interview, and reference checks — rather than hiring the first friendly person who applies. Hire slow; a bad first hire is far costlier than an empty seat.
Onboarding: set them up to succeed
Great onboarding covers three areas: operational (tech access, scheduling, policies), clinical (caseload, supervision, documentation standards), and cultural (team introductions, values, how you communicate). When a new clinician has clear policies from day one, they ramp faster and feel supported — which, not coincidentally, is also how you build retention. Plan for hiring plus onboarding to take three to six months end to end.
Frequently asked questions
How long does it take to hire a therapist?
Plan for roughly 2–4 months to hire and another 1–2 months to onboard before they're carrying a full caseload.
Should my first hire be an employee or a contractor?
Usually an employee (W-2) if you want an integrated team and control over how the work is done. Misclassification carries real penalties—verify with a professional.
Sources for third-party stats: Hiring timelines and 'systemize before you hire' guidance: Practice of the Practice, TherapyNotes, The McCance Method. W-2 vs 1099: IRS worker-classification guidance.
About the author
Emelie Douglas is a Licensed Professional Counselor, MBA, and the founder of Sprout Your Practice. She built Sprout Therapy PDX from a solo private practice into a group of 40+ clinicians with ~90% annual retention, and served as president of the Oregon Counseling Association. She helps therapists and group practice owners grow businesses that are profitable, ethical, and sustainable — without burnout. Book a free consultation.