Your practice is full. On paper, it’s working. And yet it feels heavier than it should. This is not failure or burnout. It’s often the moment a practice enters its second build. The stage where growth shifts from doing more to designing better structures, clearer decisions, and systems that hold the work without depending on constant vigilance from you.

Hiring in private practice is never just about filling rosters. The model you choose — contractors or employees — shapes your cash flow, your culture, your compliance risk, and ultimately your ability to grow. Most psychology practice owners start with contractors. It feels flexible and lower-risk. But as practices scale, many owners hit the same wall: high turnover, limited buy-in, and a team that feels more like a collection of individuals than a cohesive practice. That’s w