Why A Lot of Therapists Struggle in Private Practice | Katie Piura | TPOT 430
The Practice of Therapy Podcast with Gordon Brewer
Release Date: 04/27/2026
The Practice of Therapy Podcast with Gordon Brewer
Thinking about starting a private practice in 2026? There’s a lot to consider… and it’s not as simple as it used to be. In this episode of The Practice of Therapy Podcast, I’m joined by Brandy Mabra, who brings nearly two decades of experience across private practice, corporate healthcare, and entrepreneurship. We dig into what’s really happening in the industry right now—from AI and changing business models to profitability and long-term sustainability. If you’re wondering whether now is the right time to start (or grow) a practice, this conversation will help you think more...
info_outlineThe Practice of Therapy Podcast with Gordon Brewer
Thinking about starting a private practice… but feeling unsure where to begin? In this episode, Katie Piura shares the mindset shifts every therapist needs to make before launching (or growing) a successful practice. From burnout in agency work to building something aligned and sustainable, Katie breaks down the real challenges therapists face and why being a great clinician isn’t always enough. We also get into the business side of private practice that grad school never taught you, including money mindset, marketing, and why asking for help might be the most important step you take. If...
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What if the thing keeping your clients stuck isn’t what they’re talking about… but what they’re avoiding feeling? In this episode, I’m joined by Tanya Dantus, and we dive into a really practical way of helping clients move through what’s actually underneath the surface. Tanya shares her RIFRA Method, which stands for Root, Impact, Feel, Reflect, and Act, and how this process helps clients stop intellectualizing and start creating real change. We talk about why so many people struggle to access their emotions, how that shows up in therapy, and what it looks like to guide someone...
info_outlineThe Practice of Therapy Podcast with Gordon Brewer
Thinking about taking insurance in your private practice or trying to figure out a better way to handle out-of-network clients? This is one of those decisions that almost every therapist wrestles with at some point. On one hand, insurance can help fill your caseload and make therapy more accessible. On the other hand, the admin work, lower reimbursement rates, and constant back and forth can leave you feeling stretched thin and frustrated. In this episode, I’m joined by Mark Florian, founder of Deputy Care, and we get into what is really happening behind the scenes with insurance,...
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Private pay versus insurance is one of the biggest decisions therapists face, and honestly, it’s also one of the most misunderstood. In this episode, we’re breaking down what therapists often get wrong when thinking about these two models. It’s not just about money or convenience. It’s about how you want to run your practice, who you want to serve, and where you’re willing to spend your time and energy. If you’ve been going back and forth on whether to take insurance, go private pay, or try a hybrid approach, this conversation will help you think about it in a much clearer way....
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What happens when you open the floor and let your audience ask anything? That’s exactly what we did in this episode, and the questions did not disappoint. We’re diving into the big ones therapists are quietly asking right now. Is AI going to replace us? Are companies like BetterHelp helping or hurting the field? And how do you actually stand out when clients can talk to a chatbot instead of a human? I’m sharing my honest thoughts on where all of this is headed, what most therapists are getting wrong about AI, and why the human connection in therapy still matters more than ever. If...
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Most of us know the feeling. You pick up your phone to check one thing and suddenly twenty minutes have disappeared. For many people, this has become a daily pattern, and it is starting to show up more and more in therapy sessions. In this episode, I sit down with Eli Singer to talk about digital overwhelm and the complicated relationship many of us have with our phones and devices. Eli has spent years working in the digital world, including building one of the early social media agencies in North America. After stepping away from that work, he began focusing on helping people develop...
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Marketing can feel uncomfortable for a lot of therapists. Most of us were trained to be neutral, private, and to keep the focus on the client. So when someone tells you that you need to show up on social media or talk about your work publicly, it can feel a little strange. But visibility matters more than ever when it comes to building a private practice. In this episode, I’m joined by Jazzmyn Proctor, a therapist, podcaster, and marketing mentor who helps clinicians show up online in ways that feel authentic and sustainable. Jazzmyn shares how she started building her presence while still...
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Couples therapy can be some of the most rewarding work we do as therapists, but it can also be one of the most challenging. Many couples don’t reach out for help until things feel like they’re falling apart. By the time they sit down in your office, there are often years of resentment, hurt, and miscommunication built up beneath the surface. In this episode, I’m joined by Dr. Wyatt Fisher, a psychologist and couples therapist who has spent years refining his approach to helping couples work through those deeper issues. Wyatt shares how his own personal and professional experiences shaped...
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If you’ve ever thought about offering couples therapy in your private practice but felt intimidated by the complexity of it, you’re going to love this conversation. In this episode, I’m joined by Kiana and Andrew Joyner, a married duo who run their practice together and specialize in couples work. Kiana is a licensed therapist, and Andrew is a certified professional coach, and together they bring a really unique dynamic into the therapy room. We talk about what it actually looks like to do couples counseling as a husband and wife team, how they divide roles between therapy and coaching,...
info_outlineThinking about starting a private practice… but feeling unsure where to begin?
In this episode, Katie Piura shares the mindset shifts every therapist needs to make before launching (or growing) a successful practice.
From burnout in agency work to building something aligned and sustainable, Katie breaks down the real challenges therapists face and why being a great clinician isn’t always enough.
We also get into the business side of private practice that grad school never taught you, including money mindset, marketing, and why asking for help might be the most important step you take.
If you’ve been thinking about private practice but feel stuck, overwhelmed, or unsure... this conversation is for you.
Resources Mentioned In This Episode
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Meet Katie Piura
She is a Licensed Clinical Social Worker with over 10 years of experience in behavioral health, specializing in culturally competent mental health care, trauma-informed care, emotional wellness, and child, adolescent, and young adult populations. As a bilingual clinician and trainer, she has led workshops, courses, and media education segments across a range of settings—from Latin media outlets to universities. Her work centers on serving diverse communities, with a focus on first- and second-generation immigrants, Latinx populations, and youth. She provides accessible, evidence-based education in both English and Spanish.
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