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The Three S's for Scaling a Group Practice

By Maureen Werrbach, LCPC on April 11, 2019
The Three S's for Scaling a Group Practice - TherapyNotes with Maureen Werrbach

You’ve built something. You’ve poured your time, energy, and life into building something bigger than you for yourself and for your community. You’ve chipped away at tasks, moved the needle forward bit by bit, and are finally getting the hang of business ownership (mostly).

Maybe you’re noticing things flat-line in your business. Perhaps you’re not sure what to do next, or you have so many ideas that it’s chaotic. We all know that our society prides itself on a workaholic mentality to get it done and grow until you burn out. Before you jump into the next big thing, let’s step back and take a global look at your business.

It’s helpful to set aside time to look at what I call the Three S's of Scaling: Strategy, Systems, and Support.


When we look at strategy, we are looking at the bigger picture. Strategizing assists you in making conscious and informed decisions about the future of your business. Having a business plan in place is one of the most important parts of this step. Your business plan organizes your thoughts about the current state and future intentions of your business. It gets you thinking about various aspects of your business that you normally wouldn’t.

Strategy is also the actual thinking process itself. Did you know that a vital part of entrepreneurship is giving yourself time to reflect on your business? It’s important not to just do things for your business but to let your mind go in different directions. Mike Michalowicz discusses the 4 D’s of doing, deciding, delegating, and designing in his newest book, Clockwork. Designing is thinking time, or the space where entrepreneurial creativity comes to life and you transition from staleness to movement. In fact, most business owners do little to no thinking (designing) for their business. Michalowicz mentions that business owners should spend most of their time “designing” for their business and delegating the rest.


The second S is systems. Systems are often the obvious workflows we know we should do but do not usually put the appropriate time or effort into creating and maintaining. Think about your systems for interviewing, hiring, and onboarding new candidates. Review your administrative workflow and your clinicians’ workflows. Examine your systems for the intake process, the billing process, and your policies and procedures.  When it comes to systems, group owners often throw something out there to see if it sticks and never update it if it works. My challenge to you is to not let a working (or non-working) system continue forever. Research what other processes are available. While my systems work, I frequently find quicker and more efficient ways to do the same things, which can yield even better results than before. Try it out.

The latest, lifesaving piece in my systems arsenal is a dashboard. A dashboard is a real-time platform that shows the health of your business at any time. This can be handled in something like Google Drive, which can organize your key metrics such as income, expenses, client retention, rate averages, monthly calls versus scheduled calls, and patients who came in for an intake session. Its purpose is simplicity. Instead of searching for different metrics from your admin or VAs, you have them in one place that can be viewed while you are away or on vacation.


The last S in scaling is support, which is often the most overlooked piece of the puzzle. We think we can do it alone or we don’t want others to know we are struggling; yet research shows that the most successful entrepreneurs are the ones who have a support network of family and business contacts alike. Things like Facebook groups for group practice owners, membership sites, and get-togethers with other local group owners are all vital for feeling a sense of community and connection. Support helps us grow as leaders and know we are not alone when the going gets tough. Who’s your support?

* The content of this post is intended to serve as general advice and information. It is not to be taken as legal advice and may not account for all rules and regulations in every jurisdiction. For legal advice, please contact an attorney.
Maureen Werrbach, LCPC

About Maureen Werrbach, LCPC

Maureen Werrbach, LCPC, is a therapist and owner of Urban Wellness, a counseling group practice in Chicago. She started Urban Wellness in 2012, which has grown into a team of 20+ clinicians with multiple locations. Maureen is also the owner of The Group Practice Exchange (TGPE), a consulting business and platform for current and aspiring group practice owners. TGPE provides guidance for starting a group practice, as well as marketing, organizational structuring, business development, and leadership advice. Visit for more.

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