Running a private therapy practice comes with its own set of challenges, but what happens when you’re also managing a chronic illness? In my latest Good Enough Counsellors podcast, I spoke with therapist and author Elizabeth Turp about navigating private practice while living with an energy-limiting condition.
If you prefer to listen, I also have a podcast that explores this topic. You can listen below.
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Elizabeth has over 25 years of experience as a therapist and specialises in working with clients who have chronic conditions. She also supports other therapists who are trying to build a sustainable practice while managing their health. In this conversation, she shared valuable insights into the adaptations she’s made, the importance of boundaries, and why self-care isn’t just a buzzword – it’s essential for survival.
The Reality of Private Practice with a Chronic Illness
One of the biggest challenges for therapists with chronic conditions is the invisibility of their illness. As Elizabeth put it, “Nobody really believes me because I look well.” This can make it even harder to explain the need for adjustments, whether to clients, supervisors, or colleagues.
Beyond perception, the physical and emotional demands of therapy work can be difficult to balance with fluctuating energy levels, pain, or fatigue. The key, Elizabeth says, is adapting your practice to fit your health – rather than forcing yourself into a traditional model.
Adapting Your Private Practice to Work for You
Elizabeth has learned to structure her practice in a way that prioritises her well-being, which has allowed her to maintain stability in her client work. Here are some of the key adaptations she recommends:
1. Setting Firm Boundaries
For therapists with chronic illnesses, boundaries aren’t just about work-life balance – they’re about survival. Elizabeth has built non-negotiable blocks of rest time into her schedule, ensures she has gaps between clients, and sticks to a maximum number of sessions per week.
“I work on a maximum client number rather than a fixed schedule,” she explained. “If I push beyond that, I know I’ll pay for it later.”
2. Pricing Your Services for Sustainability
Many therapists, especially those with chronic conditions, feel guilty about charging higher fees. But Elizabeth is clear: if you can’t work full-time, you need to charge enough to make a living.
“If you’re only seeing 12 clients a week, you need to price your sessions in a way that reflects your experience and makes your practice viable,” she shared.
She also highlighted the importance of reviewing fees regularly and not undervaluing your expertise – especially when working in a specialist area like chronic illness.
3. Planning for Unpredictability
Chronic illnesses are unpredictable, so planning ahead is crucial. Elizabeth recommends:
- Scheduling regular breaks (even if you work part-time)
- Creating a financial buffer for when you need time off
- Learning to say no to additional work if it will impact your health
She also emphasized the importance of working within your worst-case scenario – not your best. “Plan your practice around the health level you can always sustain, not your best days,” she advised.
4. Finding the Right Support
Supervision is essential for all therapists, but if you have a chronic illness, having a supervisor who truly understands can make all the difference.
Elizabeth shared that her own supervisor also has a chronic condition, which means she doesn’t have to constantly explain her limitations. If your current supervisor doesn’t fully understand your needs, it might be worth looking for someone with a similar lived experience.
You Can Make Private Practice Work – On Your Terms
One of the most powerful takeaways from my conversation with Elizabeth was the idea that you can still build a successful private practice – it just might look different from the traditional model.
For many therapists with chronic conditions, the fear of being unable to work “normally” can lead to guilt, self-doubt, or burnout. But with the right boundaries, pricing, and support, it’s possible to create a practice that is both sustainable and fulfilling.
As Elizabeth put it, “I may not be able to do everything, but I can do something – and that something still makes a difference.”
If you’re a therapist navigating private practice with a chronic illness, know that you are not alone. There are ways to adapt, thrive, and continue making an impact – without sacrificing your health in the process.
Want to Learn More?
Listen to my full conversation with Elizabeth Turp on the Good Enough Counsellors podcast.
Check out Elizabeth’s book: Chronic Fatigue Syndrome and Me: Support for Family and Friends.
Explore Elizabeth’s podcast: How We Care
What are your thoughts? If you’re a therapist with a chronic condition, I’d love to hear how you’ve adapted your practice. Let me know in the comments!