The owner of a group practice ends up doing every job because the practice grew faster than its written ways of working. Each new clinician adds money, supervision, hiring and payroll work, and until a task is written down only the owner knows how to do it, so the owner keeps doing it.
Several owners describe it in their own words. Shannon Heers, who owns Catalyss Counseling, a group practice in the Denver area, put it this way: "You just can't keep up doing that role, all of those roles forever" (Practice of the Practice).
What jobs land on a group practice owner?
Money comes first for many. Heard asked nearly 2,000 therapists and wellness practitioners about their businesses for its 2026 report, and 53.6% named taxes as their top business challenge (Heard, 2026 Financial State of Private Practice). Heard sells bookkeeping, so read its numbers as a vendor's survey.
Supervision grows with every hire. Karyn Noel, an LMFT who leads six clinicians at Calliope Coast Therapy Group, writes that supervising "demands more: more hours, more admin stuff, more work" (Heard, June 11, 2026).
Payroll arrives with the first employee. Lisa Savage, who runs a group practice in Delaware, recalls the day she had 77 people looking at her and had to tell them "we're not going to make payroll on Friday." Of those years she says, "I was working 24/7" (Heard podcast, June 24, 2024).
Is this the same as burnout?
It is related, and the research points away from the usual advice. A review that pooled 33 studies put emotional exhaustion among mental health professionals at 40%. It names work-related factors, such as workload and relationships at work, as key determinants of burnout (O'Connor, Muller Neff and Pitman, European Psychiatry, 2018).
For an owner that is useful. The load is a design problem in the practice, and a design problem can be fixed one piece at a time. A self-care plan will not move the payroll.
Which job should the owner hand off first?
Start with the job that comes back every week and that someone else could do from written steps. Checking each clinician's license, setting up a new hire's first month and gathering the weekly numbers are typical. Each one is a checklist the owner carries in their head.
Keep the work that needs your license or your judgment, such as clinical supervision, hiring decisions and the hard conversations. Hand off the rest by writing it down, naming one person who owns it and giving it a date. A job that is written down can be done by someone else, and a job that is not cannot.
The guide to Texas license lapses is an example of one such job written out, from what to check to where to check it.
What to do this week
- For one week, write down every task you do that is not therapy or supervision, and how long each took.
- Mark each task as only I can do this, someone else could do this from written steps, or this should not exist.
- Write the steps for the most frequent task in the middle group, and hand it to one named person with a start date.
- Choose five numbers you check every week and put them in one place where a manager can read them without asking you.
- When a number was not filled in, leave that week blank rather than guessing, so the gap stays visible.
Sources
- Group Practice episode with Shannon Heers, Practice of the Practice.
- The Heard 2026 Financial State of Private Practice report, Heard.
- From solo to group practice: what I wish I'd known before I started supervising, Karyn Noel, Heard, June 11, 2026.
- Building a better group therapy practice business model, with Lisa Savage, Heard podcast, June 24, 2024.
- Burnout in mental health professionals: a systematic review and meta-analysis of prevalence and determinants, O'Connor, Muller Neff and Pitman, European Psychiatry, 2018.
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