Before You Begin

You've been running a solo practice and something in you is ready for more. Maybe you want to serve more people. Maybe you're dreaming about building a team. Maybe you just want to stop doing everything alone.

Whatever's pulling you toward growth, this checklist covers the foundational steps for expanding from a solo practice to a group. It's not exhaustive (every state and every practice is different), but it will make sure you don't miss the big things.

And if the logistics feel overwhelming, skip to the last section first. The culture piece is what actually makes it all work.

Your Progress

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Phase 1

Business Structure Upgrades

Before you bring on staff, you need to be operating as a formal business entity - not a sole proprietor. Most solo therapists never get around to this, and that's fine until it isn't.

Form a PLLC (Professional Limited Liability Company) in Texas - this protects your personal assets and is the standard structure for licensed therapists operating a group practice Register your PLLC with the Texas Secretary of State Obtain an EIN (Employer Identification Number) from the IRS - you'll need this for payroll, taxes, and opening a business bank account in your practice name Open a dedicated business bank account under your PLLC (if you haven't already - keep personal and business finances completely separate) Apply for a Type 2 NPI (organizational) - you'll need this to bill under your group practice name Update your professional liability insurance to reflect a group practice structure - solo coverage does not extend to associates Consult a CPA familiar with therapy practices to make sure your structure is set up cleanly from a tax perspective

Phase 2

HIPAA & IT Security

Solo practice HIPAA compliance is one thing. The moment you bring on staff, your exposure and responsibility increase significantly.

Conduct a formal HIPAA Security Risk Assessment (required by law, but most solos skip it) Update your Notice of Privacy Practices to reflect a group practice Create a HIPAA training process for all new staff and document completion Assign or designate a HIPAA Privacy Officer and Security Officer role (can be you, but name it) Audit all systems staff will access: EHR, email, video platform, cloud storage, scheduling Ensure all vendor Business Associate Agreements (BAAs) are current and on file Create a policy for staff device use, password management, and remote access Establish a process for handling a potential breach (you need a written response plan) Review your EHR permissions - staff should only access records relevant to their caseload

Phase 3

Hiring Associates: The W-2 vs. 1099 Decision

This is one of the most consequential decisions you'll make, and it's worth slowing down here. Getting it wrong has legal and financial implications.

Understand the IRS and Texas Workforce Commission criteria for employee vs. independent contractor classification Key questions to sit with: Do you set their schedule? Provide their equipment? Control how they deliver services? These factors push toward W-2. Consult an employment attorney or CPA before you hire your first person - this is worth the cost Choose your model deliberately based on your values and the kind of culture you want to create (W-2 employees tend to build more cohesive team culture; 1099 contractors offer flexibility but less integration) Draft your Associate Agreement accordingly - have it reviewed by an attorney Set up payroll processing if going the W-2 route (Gusto, QuickBooks Payroll, etc.) Establish clear policies on caseload expectations, documentation standards, and communication norms

Phase 4

Intake & Scheduling: Redesign for a Team

Your current intake process was built for you. It needs to be rebuilt to match clients to the right clinician.

Create clinician bios and specialty profiles so intake can match on fit, not just availability Define your matching criteria (presenting issue, population, modality, fee, availability) Update intake forms to capture information needed for effective matching Build a referral and assignment process: Who triages inquiries? Who makes the match? How is the handoff communicated to the client? Create a consistent new client onboarding experience regardless of which clinician they're assigned to Establish a protocol for what happens when a client is a poor fit with their assigned clinician Update your website to reflect multiple providers and a clear intake pathway

Phase 5

Becoming a Supervisor

You cannot host practicum or internship students without supervisor licensure - this is non-negotiable in Texas.

Confirm you meet Texas eligibility for LPC-Supervisor status (typically 2 years post-full licensure) Complete a Texas board-approved 40-hour supervisor training Apply for LPC-Supervisor designation with the Texas State Board Review Texas Administrative Code on supervision documentation and hour requirements

Phase 6

Building a Student Intern Program

Connect with university field placement coordinators at programs you want to partner with Review each program's specific site requirements, supervision ratios, and hour documentation needs Draft a Site Supervisor Agreement and Learning Contract (most universities have templates to start from) Confirm your liability insurance explicitly covers practicum students Create a student orientation and onboarding process Build a system for tracking and documenting intern hours

The Part That Actually Makes It Work

Culture & Values

Here's what the checklist can't capture - the reason some group practices thrive and others quietly fall apart. The logistics above are learnable. The culture you build from day one is what determines whether your clinicians stay, grow, and do their best work.

Before you hire your first person, get clear on these questions:

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What do you want this practice to feel like to work in?

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What values are non-negotiable - in how you treat staff, clients, and the community you serve?

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What kind of supervisor and leader do you want to be?

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How will you handle conflict, underperformance, or misalignment?

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How can you make the job sustainable for your clinicians (money, benefits, growth, work/life balance)?

The answers to those questions should shape every policy, every hire, and every decision along the way. A group practice built on values isn't just more meaningful - it's more sustainable. For everyone.

📖 Want to explore the deeper work behind building a values-aligned practice? Trust Yourself: A Mindfulness-Based Practice Building Workbook walks you through the foundations - from reclaiming your internal compass to building sustainable systems.

Want a thought partner for this process?

I'm available for coaching anytime.

Learn More at saraweber.org Get the Workbook

The business is just the vehicle. The impact is the point.

Growing from Solo to Group

Before You Begin

Business Structure Upgrades

HIPAA & IT Security

Hiring Associates: The W-2 vs. 1099 Decision

Intake & Scheduling: Redesign for a Team

Becoming a Supervisor

Building a Student Intern Program

Culture & Values

Thinking about starting a Group Practice?

Start here.

Before You Begin

Business Structure Upgrades

HIPAA & IT Security

Hiring Associates: The W-2 vs. 1099 Decision

Intake & Scheduling: Redesign for a Team

Becoming a Supervisor

Building a Student Intern Program

Culture & Values

Thinking about starting a Group Practice?

Start here.

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