Alicia Murray launched her private practice in January 2020, weeks before the world shut down. She was pregnant, working multiple community mental health jobs, and doing the math on a life that no longer added up. By 2021 she had a group practice, and by the time her second baby arrived she had a consulting business helping other therapists do the same. We sat down with her on the Berries podcast, where she clearly named something most clinicians feel but rarely say out loud: the system wasn't built for us.
Lesson 1: The Decision to Leave Is Often a Math Problem First
Alicia didn't leave community mental health because she stopped caring about the work, she left because the numbers stopped making sense.
She was working over 40 hours a week across a substance use clinic, outpatient care, VA work, and community mental health. When she started thinking about starting a family, the calculation was blunt: her salary wouldn't cover childcare. A graduate degree, years of licensure, and genuine clinical skill - and the structure she was in couldn't sustain a basic life goal.
This is a more common story than the profession tends to acknowledge. The decision to move into private practice often isn't about ambition, but about reaching a point where the current arrangement simply stops being livable.
What Alicia did differently was refuse to let that realization become paralysis. She started researching, planning, and building - even when people around her said virtual therapy wouldn't work. She'd seen the VA's research on virtual care for rural veterans and trusted that.
Lesson 2: The Voices Around You Shape What You Think Is Possible
One of the quieter things Alicia said was about the people surrounding her when she started.
Colleagues in community mental health warned her about private practice - the clawing, the scrambling, the instability. She absorbed those words, but looking back, she says she wishes she hadn't. She went into her launch with a Plan B already loaded, telling herself it was fine if it didn't work, and built a safety net she didn't actually need.
There's something worth sitting with there. Therapists understand that the space someone is held in shapes what they believe is possible, and yet many clinicians spend their formative years in settings where private practice is described as precarious, and the people around them have given up on believing it can be different.
Finding people who have built what you want to build and who believe it's achievable isn't just motivating, it reshapes what you believe is within reach.
Lesson 3: Know Your Values Before You Build Your Schedule
Alicia talks a lot about values-based practice building, and it's not a buzzword for her - it comes from watching what happens when therapists skip this step.
The pattern she sees most often: clinicians in community mental health take any client assigned to them; When they move into private practice, that same undifferentiated approach carries over; They see everyone, charge low rates out of guilt or fear, and wonder why the freedom they were promised doesn't feel like freedom.
Her starting point with therapists is asking them to do their own values work first - before the website, before the fee, before the niche. What kind of clients actually energize you? What does your ideal week look like, not just professionally but personally? What does your practice need to give back to your life?
Therapists ask these questions of clients all day. Turning them inward can feel surprisingly difficult, but a practice not built around your actual life will eventually conflict with it. It’s undeniably better to do that work at the beginning.
She also pushes back on the idea that private pay and accessibility are incompatible. A practice with financial stability has room to offer pro bono slots, sliding scale arrangements, and flexibility during a client's hardship - from a grounded place, not a depleted one.
Lesson 4: The Money Conversation Is Not Separate From the Ethics Conversation
There's a reason therapists have what Alicia calls "a really interesting relationship" with money. The profession is built on care, and charging for care can feel like a contradiction.
Alicia doesn't dismiss that tension, but works through it with a practical reframe: the practice that is financially sustainable is the one that can actually give back. A practice running on depletion can't hold sliding scale arrangements with integrity for long.
She uses time-limited agreements for pro bono and sliding scale work so both client and clinician have a clear moment to reassess. It protects the relationship and prevents the slow accumulation of resentment that comes from open-ended arrangements that outlast their original conditions.
Lesson 5: Delegation Is How the Work Gets Done Sustainably
Alicia was, by her own description, floundering during her second pregnancy. She was sick for most of it, billing had slipped, and she had roughly $6,000 in uncollected session fees sitting unaddressed across her group practice.
What she finally did was hire a biller, who recovered approximately 80 to 85 percent of the outstanding balance. The relief of that single decision led to another: hiring a virtual assistant. She describes both as life-changing - not an exaggeration, but a precise description of what shifted when she stopped being the only person holding everything together.
Her conclusion was clear, you cannot grow anything as a one-person show. The resistance to hiring - the sense that spending money on support before it feels financially comfortable is a luxury - is one of the most common things slowing therapists down. The return isn't always immediate, but it's real.
Lesson 6: Technology Works When It Protects Presence, Not Just Time
Alicia is thoughtful about AI, and her framing is worth noting.
She built a custom GPT around her own training materials - guides, courses, a full intake process - so that the therapists in her community can generate social media content, business frameworks, and practice materials in their own voice. She describes the feedback as some of the strongest she's received: clinicians who had been dragging their feet on starting a group practice suddenly had the flyers made, the pay structures broken down, the decision in front of them.
On documentation specifically, she points to AI scribes as genuinely useful for clinicians who are overwhelmed or behind, she just recommends verifying HIPAA compliance and end-to-end encryption before adopting any tool. She's also direct about the reason these tools matter: a therapist who isn't mentally writing notes during a session is more available to the person in front of them.
That's the point - not efficiency for its own sake, but being fully there for your clients.
A Final Thought
What Alicia built came from a moment of honest accounting- the life she was living wasn't sustainable, and the structure she was in wasn't designed for it to be.
She planned carefully, found people who believed in the vision, did her own values work, and hired help before it felt comfortable to do so. She also gave herself permission to change - her niche, her structure, her role - as her life changed around her.
For therapists somewhere in that middle space - not burned out yet, but watching the numbers and feeling the water rising up to your nose - her story is less a blueprint than a reminder. You don't have to build what she built, you just have to be honest about what the current structure is actually costing you.
Listen to the full conversation with Alicia Murray on the Berries Podcast:
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Professional Disclaimer: This article is for informational purposes only and is not a substitute for professional clinical judgment, supervision, or continuing education. Therapists should consult current clinical guidelines and use their professional discretion when applying this information to individual client cases.