Episode #711: Tips For Private Practice Organization For Therapists With ADHD

Abundant Practice Podcast

Host: Allison Puryear
Date: December 6, 2025

Episode Overview

This episode of the Abundant Practice Podcast centers on practical, compassionate advice for therapists with ADHD (or anyone who struggles with organization) as they start and run their private practice. Allison responds directly to a listener's question about overcoming overwhelm and difficulty breaking down goals, offering actionable strategies, mindset shifts, and tool suggestions tailored for neurodivergent brains.

Key Discussion Points & Insights

1. Understanding the Challenge for ADHD Brains

Traditional systems aren’t always compatible: Allison emphasizes that difficulties with organization are common, especially for neurodivergent therapists, and that standard organizational systems weren't designed for ADHD brains.
Validation: "Not because you're not capable, but because the traditional, like, organized therapist mold wasn't made for brains like yours." (03:09)

2. Getting Started: The Power of Checklists

Downloadable Worksheet: Allison references her “Getting Started Checklist,” a step-by-step, non-overwhelming guide for foundational private practice tasks (e.g., getting an EIN, applying for a business license, choosing an EHR).
- "It lays out all the essential tasks you need to handle in the earlier stages of your practice. Step by step, no overthinking necessary." (04:02)
Acknowledgement of Boring Tasks: These administrative details are rarely fun, but necessary—breaking them down and externalizing them makes them more manageable.

3. Leveraging ADHD Strengths and Prior Strategies

Tap into Historical Success: Allison urges listeners to recall the strategies that got them through other “boring but important” life milestones—licensing exams, grad school papers, etc.—and repurpose those tools for practice-building. (05:12)

4. Actionable Strategies for Getting Things Done

Body Doubling: Do tasks in the presence of another (virtually or in-person) for motivation, even if you aren’t interacting.
Timeboxing: "Set a timer for 20 or 30 minutes, and tell yourself you only have to focus for that long, and then reward yourself when it's done." (05:32)
Accountability: Notify a friend or group when you complete a task to get a dopamine boost from social acknowledgment.
Quote: “The important part is I don’t want you to wait to feel organized to get started. Start with one task at a time. Whether you feel like it or not, you’re building momentum, not perfection.” (06:01)

5. Systems for Ongoing Practice Management

Create Personalized Systems: Routines work best when tailored to what genuinely interests you or aligns with previous successes.
Student Example (Erin):
- Created tracking spreadsheets on topics she found stimulating (like referral sources).
- Developed routines for disliked tasks and built in structure (e.g., "I get my notes done before I can get up and pee between sessions." - 07:03)
- Used templates and automation for emails and notes, shifting repetitive work to “copy-paste” tasks.
- Outsourced early and strategically—tasks she disliked or delayed were delegated (e.g., uploading blog posts, formatting newsletters).
- "It’s not about whether you can do these things, it’s about whether you need to be the one doing them." (07:46)

6. Smart Delegation

Delegate! Assign out tasks that continually get procrastinated—without guilt.
Example: Allison outsources opening her mail.
- "I’m absolutely capable of opening an envelope, but for whatever reason my brain will let a letter sit unopened on my desk for weeks." (08:08)
Warning on Delegation: Don’t delegate core therapist content (like website copy) to non-specialists. It wastes money and usually misses the mark.
Find Marketing That Works for You: "If you hate social media, cool. Don’t use it. Pick a marketing method that works with your brain and your strengths." (08:36)

7. Choosing and Using Technology Wisely

All-in-One EHRs: Use a comprehensive EHR (like TherapyNotes) that handles all admin, billing, scheduling, reminders, and credit card processing in one place.
- "Will you save 0.5% using a different credit card processor? Maybe. But will you forget to bill sessions because it's not integrated?...That lost revenue will be way more than whatever you saved." (08:54)
Automation is Your Friend: Make use of templates, recurring appointments, and available AI features in EHRs.

8. Small, High-Impact Rituals

Set Recurring Appointments: Always make sessions recurring to reduce client and therapist scheduling fatigue.
Never Schedule Without a Calendar: Avoid double-booking mistakes by always scheduling with your calendar in front of you. (09:24)
Batch Tasks: Handle similar tasks (notes, emails, billing) in batches to reduce decision fatigue and context-switching.
- "Ask Allison’s—I do the entire month’s Ask Allison’s in one shot. That’s why I’m always wearing the same thing." (09:36)

9. Core Mindset: Progress Over Perfection

"Your ADHD will not keep you from running an amazing, organized, profitable private practice. You just have to find the right systems for your brain..." (09:45)

Notable Quotes & Memorable Moments

Validation and Motivation:
- "Not because you're not capable, but because the traditional, like, organized therapist mold wasn't made for brains like yours." (03:09)
- "The important part is I don’t want you to wait to feel organized to get started... you’re building momentum, not perfection." (06:01)
- "It's not about whether you can do these things, it’s about whether you need to be the one doing them." (07:46)
- "Your ADHD will not keep you from running an amazing, organized, profitable private practice." (09:45)

Timestamps for Important Segments

[00:36] Listener Question: Struggling with ADHD and organization in private practice
[04:02] Getting Started Checklist: Intro to free worksheet and step-by-step breakdown
[05:32] Body Doubling, Timeboxing, Accountability mechanics
[07:03] Building routines and student example (Erin)
[07:46] Delegating vs. doing it all yourself
[08:36] Marketing and delegation warnings
[08:54] Choosing tech and why all-in-one EHRs matter
[09:24] Scheduling best practices, batching tasks
[09:45] Key mindset reminder and encouragement

Conclusion & Takeaways

Start small using checklists and break tasks into manageable chunks.
Leverage strategies (body doubling, timeboxing, accountability) proven to work for ADHD minds.
Build and refine systems—choose tech wisely, automate, outsource, and personalize routines.
Don’t let ADHD—or fear of chaos—stop you from having a thriving, organized private practice.
Action: Get the free Getting Started checklist via the website, DM “sheets” for links, or see the show notes for resources.

This summary captures Allison’s compassionate, no-shame, highly pragmatic tone and aims to equip overwhelmed therapists with ADHD with clear, actionable tools for business success.

Transcript

A (0:00)

Foreign.

A (0:08)

Welcome to Ask Allison. Y' all ask the questions about having a fun and thriving practice and I answer them. We have a worksheet for you today so you can bring this answer into your life. You can Access that@AbundancePracticeBuilding.com links where you'll also be able to ask any questions you have for Ask Allison. If you want more support, we've got some free trainings in there too. If you can't get enough Ask Allison, check out our YouTube channel for our entire Ask Allison library.

A (0:36)

Welcome back to Ask Allison. Here's today's question. I have ADHD and struggle with organization and breaking down goals. I'm great with big ideas, but the details of running a practice feel overwhelming. Any advice on how to start with that in mind? So, great question. Before I answer it, I would like to thank our sponsor, TherapyNotes. I've talked about Therapy Notes for years and know their features by heart, but here's what truly sets them apart. First, they genuinely care about your experience. It's not just about troubleshooting. They actively implement user suggested features like clinical outcome tracking, real time insurance checks, and their AI feature, therapy fuel. Everyone at TherapyNotes believes in the product and wants you to love it too. Plus, they're independently owned, which means no venture capital and no pressure to prioritize investors over customers. This independence allows them to keep prices fair, focus on innovation, and prioritize customer experience. With over 100,000 therapists already on board, they've proven you don't have to compromise success for quality. If you're ready to see for yourself, try Therapy notes free for two months with the code abundant@therapynotes.com okay, I love this question because it's so real and it speaks to something that a lot of people feel even if they don't have adhd. But for those of you that do, starting and managing a practice can definitely come with extra layers of challenge. Not because you're not capable, but because the traditional, like organized therapist mold wasn't made for brains like yours. So let's talk about how to make this work in a way that fits you. The very first thing I recommend is downloading my Getting Started checklist. That's going to be today's free worksheet. It lays out all the essential tasks you need to handle in the earlier stages of your practice. Like step by step, no overthinking necessary. And these are tasks nobody wants to do. I'll be honest with you, they're not hard, but they're annoying. Things like setting up your employee identification number and applying for a business license and choosing your ehr. All this admin y stuff that feels small, but there's so many of them it adds up quickly. It can feel overwhelming whether you have ADHD or not. These are often the things that people procrastinate on. But here's the thing. You've already done so many boring but important things in your life. Like think about it. You've studied for the licensing exam, you wrote papers in grad school, maybe even learned spss. You've forced your brain to through some truly unpleasant tasks to get where you are wherever you used back then. To get through that, I want you to use it here in your practice. Some of the strategies I've seen work really well are body doubling. If this helps you do it, find a friend who's also starting a practice or just somebody who needs to catch up on notes and just sit together while you knock stuff out. You don't need to talk. Just being in each other's presence, being intentional with what you're doing can really help tremendously. Timeboxing. Set a timer for 20 or 30 minutes and tell yourself you only have to focus for that long and then reward yourself when it's done. That could be getting out of the house or your office. That could be your favorite drink from the coffee shop, whatever. Accountability Text a friend or post in a group when you complete something off the list so you can get those little hits of progress. Dopamine. The important part is I don't want you to wait to feel organized. To get started. Start with one task at a time. Whether you feel like it or not, you're building momentum, not perfection. Now let's talk about what happens after you complete the checklist. Because the day to day ongoing stuff in private practice is often what's harder for ADHD brains. Not necessarily the setup, but the maintenance. And this is where you need to start designing your systems. The best systems are the ones that work for you, not against you and that you don't have to think about a lot. One of my favorite examples of this is from Erin, one of my students who has ADHD and runs a super successful private practice. What worked for her was creating spreadsheets that tracked things that she found genuinely interesting, like where her clients were coming from, which referral sources were working. It gave her some data driven thing to focus on and helped her make really smart business decisions. Building routines around the parts of the business that she disliked the most based on what had worked for her in the past. Settings like grad school or agency life. She ended up just building in routines. That's something that I also have done with my notes. I get my notes done before I can get up and pee between sessions. It works for me, using templates and tools to automate or simplify anything repetitive like her progress notes or her email replies. Or y', all, we write the same email to newer potential clients all the time. Save it, tweak it so that it is generalizable and then you can just copy paste from your notes app if you're on your phone. And maybe most importantly, she outsourced early. So she asked herself, what do I keep putting off that doesn't have to be me doing it? Uploading blog posts? Someone else can do that. Scheduling emails, or formatting your newsletter that can be delegated. You can hire a VA for way less than your hourly rate and take that awake right off your plate. So it's not about whether you can do these things, it's about whether you need to be the one doing them. So a quick example. My executive assistant helps me handle my physical mail. I am absolutely capable of opening an envelope, but for whatever reason my brain will let a letter sit unopened on my desk for weeks. It is a task that doesn't register any urgency. So I hand it off. And that's the point. I'm delegating without shame, something that sure I could do, but for whatever reason I'm not doing. And also delegate smart. Please don't hand off your website copy or your blogs or your marketing strategy to a general marketing company that doesn't specialize in working with therapists. I've seen so many people waste thousands on content that totally misses the mark. If you hate social media, cool. Don't use it. Pick a marketing method that works with your brain and your strengths. There are plenty of options. So let's talk tech. The right tech can take a ton of pressure off your executive functioning. So start by choosing an all in one EHR system like TherapyNotes, something that does billing, scheduling, notes, reminders, credit card processing. Like all of it. You want it all in one place, not scattered across a bunch of platforms that you have to remember to check and manage separately. Will you save 0.5% using a different credit card processor? Maybe. But will you forget to bill sessions because it's not integrated into your ehr? Probably. And that lost revenue will be way more than whatever you saved with whatever fancy integration system you used. So take a couple of hours to explore your EHR's full feature set and use all the automations. It's also great for notes like therapy notes lets you plop in either your last notes. You can also use their AI so the EHRs have really great opportunities to make things simpler. Your future self is going to thank you. So let me give you a few more smart but powerful systems that make a big difference Set recurring appointments When a client starts weekly sessions, make it a recurring appointment in your calendar. That's something that I do. I let my clients know I work with people at the same time each week. Does Tuesday at 2 o' clock work for you? Ongoingly. It makes it much easier for them to ask off of work if they need to do that, then if it's like sporadic and they have to ask on the fly. I know my last job I had to have two weeks notice to take time off work so this just makes this easy for them. Never schedule without your calendar in front of you. So whether you're calling someone back or you're replying to an email, make sure your calendar is open. You are 99% less likely to double book or drop a ball that way. And then batch anything repetitive. That could be notes, that could be emails, that could be billing. Batch them and get into a flow rather than switching tasks constantly. So for example, Ask Allison's I do the entire month's Ask Allison's in one shot. That's why I'm always wearing the same thing. So I get them all done in the same day and that way it's handled. This is all about conserving your energy and reducing the number of decisions that you have to make in a day. Every single system you put in place buys you back time, mental bandwidth, and the capacity to do what actually lights you up. And here's what I want you to remember. Your ADHD will not keep you from running an amazing, organized, profitable private practice. You just have to find the right systems for your brain and give yourself time to figure out what works to get started. Our free checklist is the Getting Started checklist. It breaks down every early task in your private practice, then to these little bite sized doable steps. So whether you love structure or you avoid it like the plague, it's going to give you a clear place to begin. You can DM me the word sheets and I'll send it to you along with links to all the other worksheets in the Ask Allison series. Again, that sheets just send me a dm. I'll take care of the rest. If you're listening on the podcast, then you can hit the link in the Show Notes. All right, have a great week.

Abundant Practice Podcast