"I Know I Could Be Doing Things Better. I Just Don't Know What I Don't Know."
- Disco Rodeo Group
- Jun 1
- 5 min read
One of the most common things I hear from psychology practice owners isn't:
"How do I get more clients?"
Or even:
"How do I grow my private practice?"
It's this:
"I know I could be doing things better. I just don't know what I don't know."
And honestly? That's one of the hardest places to be. Because you're aware there's room for improvement, but you can't yet see what needs to change.
Because the challenge isn't a lack of motivation, intelligence, or care.
Most of the psychology practice owners I work with are deeply invested in doing things well. They care about their clients, their team, their reputation, and the long-term success of their practice.
The problem is that somewhere along the way, what started as a clinical career became a business.
And suddenly there were decisions nobody had prepared them for. Decisions that had very little to do with psychology, and everything to do with leadership, systems, people, finances, and growth.
The Hidden Challenge of Running a Psychology Practice
As psychologists, you're highly trained in understanding people.
You're taught how to assess risk, build therapeutic relationships, hold complexity, and support meaningful change. You spend years developing your clinical skills and continuing to refine them throughout your career.
What you're not taught is how to run a business.
How to build systems that don't rely on memory. How to hire and onboard clinicians. How to lead a growing team. How to create sustainable referral pathways. How to make confident business decisions or identify operational risks before they become problems.
Instead, most practice owners learn these skills in real time while carrying a full caseload and trying to support the people around them.
It's no wonder so many feel like they're making it up as they go.
The Things Practice Owners Don't Always Say Out Loud
Interestingly, it's rarely the obvious things that bring people to me.
It's not usually a question of whether they're a good psychologist.
It's the quieter concerns sitting underneath the surface.
The thoughts that arrive at 10pm while finishing clinical notes.
The questions that show up on a Sunday afternoon when you're thinking about the week ahead.
Things like:
What if I'm missing something important?
Why does everyone else seem to have this figured out?
Am I building this practice properly?
How do I know whether my systems are actually working?
Why am I working so hard but still feeling behind?
What would happen if I stepped away for two weeks?
At what point does this start feeling easier?
And perhaps most commonly:
"I feel like I'm making it up as I go."
The reality is that many practice owners feel this way.
They just don't talk about it.
Because from the outside, things often look successful. The diary is full. The team is growing. Clients are being supported. Revenue is increasing.
Yet behind the scenes, many practice owners are carrying a quiet mental load.
The feeling that they're responsible for everything.
The fear that something important might slip through the cracks.
The pressure of making decisions they've never had to make before.
And the constant question:
"Am I actually doing this right?"
When You're In It Every Day, It's Hard To Zoom Out
One of the challenges of running a psychology practice is that you're making decisions from inside it every single day.
You're responding to enquiries, supporting clients, managing clinicians, reviewing reports, solving problems, and putting out fires. And somewhere amongst all of that, you're expected to step back and think strategically about where the practice is headed next.
That's incredibly difficult to do when you're carrying the mental load of the entire business.
Over time, things become normal. The workaround you've been using for six months becomes "just how we do things". The process that only exists in your head becomes part of your daily routine. The bottleneck you've adapted to becomes invisible.
Before long, you're working around problems rather than solving them.
Just recently, I spoke with a practice owner who came to me convinced they needed more marketing. They felt like they needed more visibility and more referrals.
But after digging a little deeper, it became clear that marketing wasn't actually the issue.
Enquiries were sitting unanswered for too long. The onboarding process relied heavily on manual follow up. Key information lived inside people's heads rather than documented systems.
More marketing wouldn't have solved the problem. It simply would have increased the pressure on an already stretched practice.
This is something I see often. Practice owners are incredibly good at identifying symptoms, but when you're in the day-to-day, it can be difficult to identify the root cause.
This is also why comparison can be so misleading.
It's easy to look at another practice's website, social media, team, or growth and assume they've figured something out that you haven't.
What you don't see are the challenges behind the scenes, the lessons they've learned the hard way, the support they have around them, or the years they've spent building the foundations that make growth possible.
The Goal Isn't a Perfect Psychology Practice
One of the biggest misconceptions I see is that successful practice owners have everything figured out.
They don't.
The practices that grow sustainably aren't run by people who have all the answers. They're run by people who stay curious. People who ask questions. People who seek support. People who regularly review, refine, and improve the way their practice operates.
Most importantly, they're led by people who recognise that being an exceptional psychologist and running an exceptional practice are two completely different skill sets.
Both can be learned.
Neither requires perfection.
If This Sounds Familiar...
If you've ever found yourself thinking:
"I know I could be doing things better. I just don't know what I don't know."
You're not alone.
In fact, you're probably asking exactly the right question.
Because sustainable practice growth doesn't come from having all the answers.
It comes from creating space to step back, zoom out, and look at your practice with fresh eyes.
To identify what's working.
To uncover what's not.
And to build the systems, structure, and confidence that allow your practice to grow without everything resting on your shoulders.
That's often where the next chapter begins.
Wondering What You Might Be Missing?
If this article resonated, you're not alone.
Sometimes the biggest opportunities for growth aren't the things you're aware of. They're the blind spots that are difficult to see when you're carrying the day-to-day demands of running a practice.
If you'd like a fresh perspective on what's working, what's not, and where your biggest opportunities for growth might be, I'd love to help.
