Season 5 Episode 8: Stepping Into Private Practice: Navigating Autonomy, Admin, and Sustainability in Mental Health OT

In this episode of OT Coaching Confidential, I’m joined by Marie, an experienced occupational therapist who has recently transitioned from hospital and community mental health into private practice.

With over 15 years of experience, Marie reflects on the shift from structured public health roles into the autonomy of private work. While the transition has brought flexibility and creative freedom, it has also introduced new challenges particularly around business systems, financial management, and the invisible load of admin.

Together, we explore what it really looks like to build a sustainable mental health OT practice while balancing clinical care, business responsibilities, and personal life.

We explore:

Transitioning from public mental health roles into private practice

The emotional and cognitive load of managing admin, finances, and systems independently

Navigating payment boundaries and discomfort around money conversations

Structuring caseloads across NDIS, Medicare, and private clients

Letting go of work streams that don’t align (e.g., functional capacity assessments)

The tension between flexibility, family life, and financial sustainability

Using tools (like AI and practice software) to reduce admin burden

The difference between “being the therapist” and “running the business”