Episode Overview

Episode Theme:
In this episode, host Allison Puryear addresses the common challenge of hitting a plateau in private practice—being “almost full” but not quite reaching a sustainable client load. Focusing specifically on virtual, private pay therapists, Allison breaks down why these plateaus happen, dispels myths about their causes, and offers clear, practical strategies for growth so clinicians can finally “pop out” of stagnation and build a fully booked practice.

Key Discussion Points & Insights

1. Understanding the Plateau: “Almost Full” Isn’t Failure

• Plateaus are Common: Allison assures listeners that hovering just below a full caseload is a near-universal experience and “few things are more frustrating than being almost full...except staying in that almost zone for months on end.” (04:05)
• Not Personal—It’s Process: “You are not doing anything wrong. You are stuck in what I lovingly call the ‘plateau of almost there.’ So let’s talk about why it happens and what will actually get you full and keep you full.” (05:09)

2. Why Plateaus Happen: Math Plus Marketing

• Plateaus aren’t mysterious: “They’re just math plus marketing.” (05:30)
• They happen due to issues with:
  • Not Enough Consistent New Inquiries
  • Low Conversion Rates From Inquiries to Clients

3. Consistency Beats Heroic Effort in Marketing

• “Your marketing needs to be consistent, not heroic. Most therapists do a giant push...and then disappear for months.” (06:05)
• Virtual practices especially need weekly, visible activity in a chosen marketing channel.
  • Tip: Pick your most effective past or current marketing lane (SEO, Instagram, networking, etc.) and “stay in it long enough to let it work.” (07:01)

4. Check Your Messaging: Speak Client, Not Colleague

• Many therapists use language that’s too “therapisty”—written for a licensing board, not potential clients.
• “Clients hire you because they see themselves in your words.” (07:54)
• Exercise: Pick an ideal client and write your website/profile directly for them. Strip out anything that sounds like a dissertation or uses jargon.

5. Build a Referral Ecosystem

• Virtual practices need stronger referral networks without the benefit of local community.
  • Aim for 3–5 regular referral partners (other clinicians, doctors, prescribers, yoga instructors, etc.) suited to your niche.
• Stay on referral partners’ radar. “Just reaching out to your typical referral sources and consistently maintaining that relationship can fill a practice.” (09:50)

6. Audit & Improve Conversion Process

• If inquiries aren’t becoming clients, fix the process:
  • Respond quickly.
  • Make consultation calls about the client, not about yourself.
    • “You, you, you, you, you. That’s not helpful. I want you to ask them, ‘Tell me a little bit about what’s bringing you into therapy,’ and then shut up.” (11:10)
  • Demonstrate you understand their struggles — not just your credentials.
  • Avoid overexplaining methods.
  • Assume every caller wants to book an appointment unless told otherwise.
    • “Assume everybody wants to make an appointment from the call.” (12:30)
• Be transparent about fees—don’t hide your rates.

7. Rely on What Already Works

• Double down on strategies already proven in your practice—don’t waste time on shiny new tactics unless you’ve maxed out existing ones.

8. You Don’t Have a Skills Problem—You Have a Structure Problem

• “The bigger truth is that you don’t have a skill problem if you’ve gotten to nearly full. You have a structure problem.” (13:50)
• Success is dependent on a repeatable system with all four working parts:
  1. Predictable marketing
  2. Clear messaging
  3. Reliable referral flow
  4. Steady conversion process

9. Final Action Steps & Mindset

• “You’re not broken. You’re not bad at this. You just haven’t built the system that private pay virtual practices rely on to hit full and stay full.” (15:10)
• Focus on:
  • Consistent marketing in one channel
  • Messaging that truly reflects your ideal client
  • Honing your conversion process

Notable Quotes & Memorable Moments

• On the frustration of a plateau:
  “So few things are more frustrating than being almost full, almost stable. Like almost where you want to be, except staying in that almost zone for months on end.” (04:05)

• On the real cause of plateaus:
  “Therapists love to make this feel existential. It is not. It’s numbers and strategy.” (05:50)

• On real client persuasion:
  “Most therapists write like they’re trying to impress their licensing board. But clients hire you because they see themselves in your words.” (07:54)

• On what fills a practice:
  “Just reaching out to your typical referral sources and consistently maintaining that relationship can fill a practice.” (09:50)

• On the consultation call:
  “That’s not helpful. I want you to ask them, ‘Tell me a little bit about what’s bringing you into therapy,’ and then shut up.” (11:10)

• On the real problem:
  “You don’t have a skill problem if you’ve gotten to nearly full. You have a structure problem.” (13:50)

• Encouragement for listeners:
  “You’re not broken. You’re not bad at this. You just haven’t built the system that private pay virtual practices rely on to hit full and stay full.” (15:10)

Key Timestamps

• 00:00 — Episode start and question introduction
• 04:05 — Allison empathizes with frustrating plateaus
• 05:30 — Plateaus boiled down to math and marketing
• 06:05 — The importance of consistent marketing efforts
• 07:54 — Rewriting your messaging for clients, not colleagues
• 09:50 — How building a referral ecosystem fills your practice
• 11:10 — Best practices for consultation calls and conversions
• 13:50 — Why it’s a structural, not a skills, problem
• 15:10 — Final encouragement and action steps

Episode Takeaways

• Plateaus are normal and reflect structure, not your talent or value as a therapist.
• Focus on consistency in marketing, targeted messaging, referral partnerships, and a client-centered conversion process.
• Don’t look for more tools or credentials—refine what is already working, systematize, and “pick a lane.”
• “If you do those things even imperfectly, you’re not going to be plateaued this time next year.” (15:30)

Download Allison’s free worksheet: ‘Things You Don’t Need for Private Pay Practice’ via DM or her website. For more actionable episodes, visit Abundance Practice Building