Why I Left a Traditional Private Practice to Create a Hybrid Career I Love

If you’ve ever felt torn between taking insurance or going fully private-pay, or wondered whether it’s even possible to have a sustainable practice that doesn’t burn you out, you’re not alone. Many of us enter private practice with the dream of freedom and flexibility, only to realize that it can quickly become overwhelming to manage marketing, billing, and the emotional weight of client work all on our own.

I get it. When I started my practice, I wanted to help as many people as possible, which meant saying yes to insurance. But I also wanted the freedom to create, to teach, and to build something that could grow beyond my one-on-one sessions. At times, those two goals felt at odds.

Over time, I learned that sustainability doesn’t come from choosing one path, it comes from creating a model that truly fits your life. In this essay, I’ll share how I built a hybrid practice that combines insurance and private-pay clients, group programs, and workshops, and how doing so has not only improved my financial stability but also protected me from burnout and reignited my love for this work.

Why the Standard Model Didn’t Work for Me

Like many therapists, I was taught that success meant picking a lane, either accept insurance and stay full with steady referrals, or go private-pay and focus on attracting a smaller, niche clientele. For a while, I tried to fit that mold, but it never quite worked for me.

I’ve always worn multiple hats. I’m a licensed marriage and family therapist, an EMDR and Gottman-trained clinician, and a bilingual Latina therapist passionate about relationships and cultural identity. I also run coaching programs, lead Gottman Method workshops for couples, and host a podcast called Amor Crudo where I explore real, unfiltered conversations about love and emotional health.

When I first opened my private practice, I thought I’d focus solely on insurance clients to ensure a full caseload and steady income. But after a year, I realized that even though my schedule was packed, I felt emotionally drained and financially limited. Insurance reimbursements often didn’t reflect the level of care and time I was putting in.

That realization pushed me to experiment. I began integrating private-pay slots for clients who wanted more flexibility or couples work, which often isn’t covered by insurance. Later, I expanded into coaching, workshops, and group programs, avenues that allowed me to express my creativity, reach more people, and make my work more financially and emotionally sustainable.

Confidence came gradually. Seeing clients benefit from my workshops and hearing feedback from my podcast reminded me that diversifying wasn’t a distraction, it was an evolution. I wasn’t leaving therapy behind, I was building around it.

The Pros and Cons of a Diversified Practice

The Pros

Creating a hybrid practice changed everything. By balancing both private-pay and insurance clients, I’ve been able to meet my financial goals while staying true to my values of accessibility. Insurance clients keep my schedule steady and help me reach individuals and families who might not otherwise afford therapy. Private-pay clients, especially couples and trauma cases, allow me to work deeply, flexibly, and without the red tape.

Diversifying also reignited my professional curiosity. My Gottman workshops and coaching programs connect me with couples who may not need or want therapy but are eager to strengthen their relationships. Teaching these skills reminds me why I became a therapist, to help people build healthier, more fulfilling lives.

Content creation, podcasting, and workshops also serve a deeper purpose, they keep me inspired. I’m constantly learning, collaborating, and growing as both a clinician and entrepreneur. That stimulation helps prevent burnout, the creative parts of my work refill the emotional tank that clinical work often depletes.

And, perhaps most importantly, multiple streams of income give me peace of mind. If insurance reimbursements change, or if I need to reduce my caseload temporarily, I know my income doesn’t depend entirely on session hours. That stability allows me to rest when I need to and continue showing up as my best self for my clients.

The Cons

Of course, it’s not all effortless. Running a hybrid practice means juggling multiple systems, insurance billing, private-pay marketing, and workshop logistics, all at once. Early on, I underestimated how much time and organization this would require.

Marketing private-pay services, in particular, can feel daunting. It took time to clarify my message, learn SEO, and show up consistently on social media without feeling like I was “selling” therapy. There were also trial-and-error moments, workshops that didn’t fill, podcast episodes that underperformed, and ideas that needed refining before they resonated.

There’s also a mental load that comes with wearing many hats. It’s easy to overextend yourself when you’re passionate about multiple things. I’ve learned, sometimes the hard way, that sustainability isn’t just about financial balance, it’s about emotional pacing and protecting your energy.

Still, even with the occasional chaos, I wouldn’t trade this approach. The flexibility, growth, and resilience it brings far outweigh the challenges.

Practical Insights for Going Hybrid

If you’re considering a hybrid practice, start with systems. Use a platform like Alma or a similar network that simplifies billing and credentialing for insurance clients so you can focus on clinical work. Automate what you can, appointment reminders, invoices, or intakes, to free up mental space for creativity.

In marketing, lean into your strengths. If you love teaching, start with a small workshop or free webinar. If you enjoy writing, build visibility through blogs or social media posts. You don’t need to do everything at once, just one new stream at a time.

Avoid the trap of comparison. Some therapists thrive fully private-pay, others find meaning in community mental health. What matters is that your model aligns with your goals, values, and lifestyle.

And if you’re afraid of failing, remember, experimentation is data. Each misstep teaches you what your audience actually wants and what energizes you. The one piece of advice I’d give anyone starting out, build sustainability into your schedule. Leave space each week to rest, create, and strategize, not just see clients. That’s how you make growth sustainable.

Falling in Love with Work Again

This journey taught me that sustainability isn’t about doing less, it’s about doing what fits. I stopped chasing the “right” model and started building a practice that reflects who I am, a therapist, educator, coach, and creator.

Diversifying my work not only stabilized my income, it deepened my sense of purpose. My days feel more balanced, my energy more consistent, and my vision for the future clearer than ever.

If you’re reading this and wondering whether you can mix it up too, you can. You don’t have to choose between insurance or private-pay, or between therapy and creative work. You can build a practice that honors both your professional skills and your personal rhythm, and in doing so, you might just fall in love with your work again.