Are you feeling the squeeze yet? Private practice for mental health is being upended by national chains and franchise-style operations, such as Ellie Mental Health, that promise standardization and efficiency. Much like McDonald’s muscled out local eateries and Amazon decimated local bookstores, franchise mental health poses a real threat to private practices.
The threats from Big Therapy are real, but you can take practical steps to thrive in this market. You have critical competitive advantages that the national and regional chains do not.
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Meet the players putting the squeeze on your practice
National companies such as Acadia Healthcare (over 253 locations) and Summit Behavioral Healthcare (80 locations), as well as regional chains such as Pacific Clinics (more than 2,100 employees in California), have deep wallets and economies of scale. BetterHelp, with over 34,000 therapists and annual revenues exceeding $1 billion, affects all private therapists.
Big Therapy is already playing in your market.
Franchise mental health often has deep pockets
Private equity deals have funded the growth of franchise mental health, with deals of $50 million or more not uncommon.
- Ellie Mental Health: significant investment from Thompson Street Capital Partners (TSCP), a private equity firm.
- Acadia Healthcare: now a public company with a market capitalization exceeding $6 billion, was funded by Waud Capital Partners, a private equity firm.
- Summit Behavioral Healthcare: backed by Lee Equity Partners.
- LifeStance Health: now a public company, was backed by private equity firm TPG Capital.
- Discovery Behavioral Health: private equity backing from Webster Equity Partners and Frazier Healthcare Partners.
Does “Big Therapy” provide value?
In some cases, the answer is yes. If not, Big Therapy would not be growing. To address the threat from franchise mental health, we need to understand what it does bring to the table.
For clients: chains offer convenience, appointments at multiple locations or online, streamlined intake processes, and often lower fees. They market themselves as the antidote to long wait times and opaque billing systems associated with many private practices.
For providers, Big Therapy offers a franchised model of care that promises a ready-made business model, access to corporate resources for practice management, and the marketing power of a national or regional brand.
Will you be squeezed out?
Only if you allow yourself to be squeezed out.
Franchise mental health is a formidable challenge to traditional private practice. Well-funded Big Therapy corporations with powerful marketing machines pose a serious threat. However, the practices most at risk are those that don’t adapt.
By adapting, you can grow your practice and become more profitable while prioritizing personalized, relationship-centered treatment. You can maintain autonomy and the integrity of your practice.
You can compete and offer high-quality care in a field increasingly dominated by large corporate entities.
10 ways you can compete and thrive
You can compete and offer high-quality care in a field increasingly dominated by large corporate entities.
- Prioritize personalized, relationship-centered treatment.
- Deliver continuity of care. (The franchise models tend to have relatively high turnover.)
- Offer options for premium care at premium prices.
- Be local! The regional or national reach of Big Therapy is its Achilles heel.
- Be lean! Be agile! Layers of bureaucracy hamper Big Therapy.
- Be engaging. Create a digital footprint that drives new clients into your business.
- Build your referral paths. (Therapy Everywhere can help.)
- Focus on quality and specialties. An impersonal, conveyor-belt style of care characterizes franchise mental health.
- Harness marketing expertise. Backed up by many millions of data points, the team at Therapy Everywhere can deliver better results for your practice and your catchment area than a corporate marketing department that is less focused.
- Grow your practice. You can offer associates a more attractive environment than in franchise mental health.
Will you be squeezed out?
Only if you allow yourself to be squeezed out.
Franchise mental health is a formidable challenge to traditional private practice. Well-funded Big Therapy corporations with powerful marketing machines pose a serious threat. However, the practices most at risk are those that don’t adapt.
By adapting, you can grow your practice and become more profitable while prioritizing personalized, relationship-centered treatment. You can maintain autonomy and the integrity of your practice.
You can compete and offer high-quality care in a field increasingly dominated by large corporate entities.
6 mindset shifts to guide your private practice to growth
- Lean Into Specialization
One of the major advantages private practitioners have over chains is the ability to specialize. While national chains often provide generalized services, private practices can offer niche treatments that cater to specific populations or therapeutic modalities. Whether it’s EMDR for trauma, couples therapy, or specialized work with LGBTQ+ clients, specialization allows you to stand out in a crowded market. - Expertise
By becoming known as the go-to therapist or practice for specific issues, you position yourself as an expert in your field. This not only allows you to attract clients, but also enables you to charge premium rates for your services. - Build Strong Client Relationships
Corporate chains often lack the deep personal connection that clients seek in therapy. Private practitioners should capitalize on this by emphasizing the personalized nature of their work. Foster strong, lasting relationships with clients by offering flexible scheduling, more attentive follow-ups, and a collaborative approach to treatment. Clients often value the personal touch over large mental health chains’ impersonal, assembly-line feel. - Be Flexible
Consider offering longer sessions or extended therapy packages for those seeking a more immersive therapeutic experience. This reinforces the value of individualized care that private practices can provide. - Invest in Your Online Presence
Your digital footprint is crucial. National chains like Ellie Mental Health excel in SEO and digital marketing, but that doesn’t mean private practices can’t compete. A polished, informative, and SEO-optimized website can go a long way in attracting new clients. You can be more focused than giant corporations. Ensure your website, content, social media, links, and Google Ads speaks directly to your clients. - Highlight Your Autonomy
Promoting the fact that you’re not beholden to corporate policies or quotas. You can create customized treatment plans, and give clients the undivided attention they need. Position yourself as a boutique, client-centered alternative to the factory-like operations of larger chains.
You can not only survive the competition but thrive in it. The key is to highlight what makes your private practice unique—its personal touch, flexibility, and focus on long-term, meaningful change in clients’ lives.
Get and retain quality associates
In franchise models, mental health professionals frequently find themselves burdened by productivity quotas, high caseloads, and diminished autonomy. The emphasis on volume over depth risks diluting the therapeutic relationship and leads to burnout among practitioners. These issues run counter to the core values of many therapists who seek to build meaningful relationships with clients and provide tailored, patient-centered care.
You can grow your practice by providing an environment where caring, talented therapists want to work. Get the word out about your practice.