Bay Area therapist Michelle Vo, LCSW didn’t always believe she was destined for private practice.

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But once she found her niche, she was determined to give her new business the best possible start. That meant playing the odds.

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Here’s how taking calculated risks and carefully investing her time helped Michelle build a private practice that serves her community.

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Starting down the path

Early on, Michelle knew she wanted to pursue a career in social work.

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"Social work is a pathway where I felt I could balance my interest in mental health services and education, serving diverse communities through a social justice lens, and assisting individuals from disadvantaged backgrounds," she said.

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“So in high school, I spent a lot of time volunteering with Rotary International. Being a part of the community helped me realize that I’m just really interested in learning about people.”

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During her time at UC Santa Cruz, Michelle explored her interests in social work and psychology: student leadership and wellness programs, program management operations, policy and program evaluations, and research courses.

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“Social justice and mental health was where it really hit home,” she said. “It was what I wanted to study for my MSW graduate degree and bring back to the Bay Area.”

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She left California without ever visiting Ann Arbor, Michigan to pursue graduate studies at the University of Michigan School of Social Work. But even after completing her Master’s Degree, she wasn’t sure a career as a private practice therapist was feasible. 

Career or day dream?

“It always felt like a dream,” said Michelle, recalling her early attitudes toward starting a private practice.

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“Throughout my education and career, I felt an immense amount of privilege and responsibility to do good for my parents, community, and clients. Like many children of immigrants, I listened to stories of my parent’s sacrifices that provided me opportunities here in the United States,” she said.

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“Getting a Master’s in general, especially as a first generation college student, always felt like enough. My parents were already so proud of me for pursuing a higher education but extending my career as a practitioner in private practice was a whole new risk,” she added.

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She started her career as a social worker serving in hospitals. 

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“Working at a hospital as a new therapist was humbling, it felt like a dream to walk through busy halls, and to collaborate with interdisciplinary teams. I was aware that many individuals in the therapy field have a hard time navigating the hospital recruitment system. I knew I was doing my job right when I could be a collaborative practitioner for my patients. There was so much a major hospital system offered me: a stable paycheck, flow of patients, continuous consultation at work, training, and more.”

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“My goal was to get as skilled as I could as a therapist,” she said. “And I think during my time in hospital systems, I learned more and more about how I wasn't able to show up as a therapist as much as I would like. There were many politics and expectations on how therapy ‘should’ be—how many sessions, their mood scores, and eventually when to discharge them to make more room for other clients. The mental health system is inundated and so were my colleagues.”

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She realized she wanted to go into private practice. But, at this point, she still wasn’t licensed. And Michelle recognized major hurdles.

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“This was before the tech boom of telehealth,” she recalled. “Every traditional therapist worked in an office or on-site at their client’s homes.”

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There was no way to bootstrap a new therapy practice by exclusively seeing clients remotely. That meant a bigger investment upfront in order to launch her business.

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Michelle decided that, the second she was licensed, she would find a way to see clients on a part-time basis. That way, she could get a feel for private practice and determine whether it was worth the investment and risk.

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Don’t quit your day job

She started to plan.

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“I had this document on how to execute my wildest dreams. And for the title, in big, bold red letters, I wrote, ‘KEEP YOUR DAY JOB,’” she said. 

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“My schedule was packed and I was very tactical. I took calculated risks,” she continued. “Part of it was, ensure you continue your day job and make sure you have the financial backing first. Then explore your options slowly. I adopted a mindset that building a practice was similar to a marathon. I needed to keep my pace to not burn out, do my research, and just start.”

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Once she had the credentials she needed to go into private practice, Michelle started interviewing practicing therapists.

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There were three key questions Michelle asked the therapists she interviewed:

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• “What is your experience in the field and why did you move to private practice?” 
• “What does a private practice life give you, the pros and cons?” 
• “What would you have done differently when starting off?” 

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She also began researching therapist communities on Facebook and talking to past colleagues. Eventually, she leaned into sharing her dream and engaging in intentional conversations about private practice set up, resources, and administrative tasks such as building a schedule and payroll.

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“The first three months were spent gathering information through networking conversations and surveying therapists that inspired me. I started to get a feel of the therapist community in private practice.” she said. 

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She began to budget, figuring out the cost of launching a website, purchasing professional liability insurance, getting her headshots done, and forming a corporation in California.

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At a certain point, she felt as though she’d maxed out her capacity for research. It was time to launch her private practice.

Baby steps

What really got the ball rolling, Michelle said, was Squarespace.

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“They give you a trial for two weeks,” she said. “Okay, that means I have two weeks to make a website!”

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With no background in web design, she gave it a shot nonetheless. She was impressed with the resources online and the website she made. She’d just created her new practice’s first marketing channel.

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After that, she elected to be taxed as an S corporation with the IRS. Her private practice was still new and untested. Michelle knew she needed to proceed with caution.

The power of calculated risks

Michelle took her own advice, and didn’t quit her day job.

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“So it didn't feel like a big risk,” she recalled. “I could kind of consider it ‘fun money’ or money towards my student loans.’’

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“Let's give it a shot,’” she continued. “If I'm willing to spend money on daily expenses, I might as well save up and invest it in something that I am passionate about and helpful for my career. If not now, then when?”

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“Because I didn't jump straight to private practice, I had the opportunity to gradually build my practice,” she added. “I spent about one year building my practice so things felt very consistent and organic.” 

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Even though she didn’t have a professional bookkeeping system in place, Michelle was careful, from day one, to track her income and expenses. With time, she was able to anticipate her average earnings and plan her finances.

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All this careful planning and calculation paid off.

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“By the time I actually quit my full-time job, I had a full private practice the next week,” she said. 

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“That's because I knew I was going to quit three months in advance. I started to focus on marketing [my practice] and started to open up my schedule. As I had more consultations, I offered client’s the opportunity to book in advance or have me contact them when I worked full-time. Thankfully, the clients were understanding of the wait.”

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“Did I work two jobs, and very long hours? Yes!” she said. “But it was short term. And it was worthwhile.”

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Growing pains

Michelle’s new private practice was off to a strong start. But maybe too strong.

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“When your practice grows, sometimes it grows faster than you anticipate,” she said. She had new expenses to track, like a separate business phone and furnishings for her office.

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And there were new expectations from the IRS. Michelle learned that she would need to start estimating and paying quarterly taxes.

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“This was more than anticipated. The unglamorized part of owning your own business. Stuff no one teaches you in graduate school.” she said. “It went over my head.”

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Michelle noted that, while she’d had professors who talked about their experiences running private practices, none of them had made their students privy to the finer details like taxes.

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“Unless someone in your family is a business owner or you have been exposed to building a business from the ground up, as a first-time business owner, you do need a level of coaching and help,” she said.

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She had two urgent needs: the need to get a more comprehensive, less time-consuming bookkeeping solution set up to manage her increasingly complex finances. And the need to get help with big-picture matters like accounting and taxes.

Taking it to the next level

Michelle learned of Heard from a friend of a friend and signed up. Immediately, she was impressed with the guidance she got as a new business owner.

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“When I had questions, [Heard] would work really hard getting me a response,” she said.

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Getting guidance when it came to matters like quarterly taxes helped to allay some of Michelle’s anxieties. Beyond that, she found having her day-to-day bookkeeping automated and handled by professionals gave her more insight into how her practice was running.

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“In the beginning, I viewed my profit and losses statement religiously to better understand my business and my biggest expenses,” she said. She said having that information helped her to make decisions about where to cut back on spending—she used software subscriptions as an example—and where she could afford to spend a bit more to upgrade her practice and continue investing in her business.

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And she named having a single place for all her bookkeeping and accounting info as one of the top benefits of using Heard.

“I found that uploading all my documents in one place—knowing all my information is there for my business—feels good and secure,” she said.

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With all her bookkeeping and accounting taken care of by Heard, and with a team of experts to answer her questions about taxes and financial admin, Michelle had more time to focus on what mattered most to her: her clients.

Bringing it all back home

As her practice has grown, and as she’s freed up more time in her schedule by automating financial tasks with Heard, Michelle has been able to carve out a niche and improved marketing for her practice.

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“Most of my clients are Asian American,” she said. “We work through family of origin issues in our regional group. From generational trauma, anxiety, and depression, interpersonal conflicts, building self-acceptance, and self-awareness to boundaries.”

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She said her current client list is representative of “Asian American adults, working professionals, and women in transitional stages of their life. I enjoy providing a safe and compassionate space for people to explore, accept, and heal burn out, anxiety, depression, and imposter syndrome.”

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It all ties into Michelle’s original motivation, her love of learning about others and working with diverse communities in the pursuit of social justice and culturally responsive mental health treatment. 

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And after taking some calculated risks and finding the support she needed to tackle the financial side of her practice, she says she’s in a good place.

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“I have a really healthy range of people who I work with,” she said, “and the best part is having autonomy in how I show up as a therapist and the quality services I am able to provide.”

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This post is to be used for informational purposes only and does not constitute legal, business, or tax advice. Each person should consult their own attorney, business advisor, or tax advisor with respect to matters referenced in this post.

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Michelle Vo, LCSW (she/hers) is a clinical social worker and psychotherapist whose practice is based in San Francisco. Michelle is a first-generation Vietnamese American and her practice’s value is to provide quality and culturally responsive services. 

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Her specialty is working with perinatal and postpartum mothers, high-achieving professionals, young adults, Asian Americans, and people of color (BIPOC). Michelle is passionate about helping people meet acceptance of their current and past selves and improving their quality of life by assisting her clients with reframing their thinking, self-validation, and assurance.

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Her most common therapeutic interventions derive from a culturally sensitive, trauma and social justice-informed lens. Modalities of treatment include Cognitive Behavioral Therapy, Dialectal Behavioral Therapy, Acceptance and Commitment Therapy, and Interpersonal Therapy. Her experience includes working in inpatient and outpatient psychiatry departments, interdisciplinary medical systems in OBGYN, corporate technology settings, and disruptive events treatment and consultations. 

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