Ideas in Progress: Meaning, Mischief & Mayhem

Half-thoughts, strong opinions, open endings

Therapist burnout: The Hidden Burden of Private Practice

I was speaking to a colleague recently about the challenges of setting up and running a private medical practice in the UK. I don’t do any private work myself, but he does — and the conversation was an eye-opener.

To establish a private practice in the UK, a clinician needs:

  • Admitting privileges at a private hospital (if they want to treat inpatients)
  • A rented consulting room — either at a hospital, private clinic, or rarely, their own home
  • Registration with the CQC
  • Indemnity cover
  • ICO registration under the Data Protection Act
  • A secretary (or administrative support)
  • DBS clearance
  • Legal and accounting expertise
  • HMRC registration
  • And finally, the ability (and time) to advertise their practice

This got me thinking — what about solo therapists?

Many of the same hurdles apply. While CQC and indemnity may not be mandatory, most therapists still have to:

  • Rent a room or work from home
  • Handle their own taxes and self-assessment
  • Register with the ICO (or should, especially if using email, WhatsApp, or online forms)
  • Manage all client communications and scheduling
  • Market themselves online or through directories
  • Fund CPD, supervision, and training — out of pocket

In my therapist burnout survey, therapists consistently flagged scheduling, admin overload, and unpredictable income as their top stressors. Most can’t afford a secretary, yet spend hours a week juggling bookings, cancellations, and invoices.

A quick back-of-the-envelope calculation puts this into perspective.
If a therapist earns £60 per session and pays £15/hour for a room, they take home ~£45 per session. At 4 clients per day (20 per week), that’s a pre-tax income of £900 — before phone bills, insurance, CPD, and tech subscriptions. It’s no surprise that for many, private practice feels precarious and emotionally draining.

The question is not why therapists are burning out. The question is: what can we do about it?

Perhaps the solution lies not in asking therapists to do more — but in building systems that do more for them. We need tools that don’t just manage diaries, but genuinely reduce admin. Not just client platforms, but therapist-first ecosystems that recognise the invisible labour behind the therapeutic hour.

Because when therapists are supported, clients benefit too.