Why I Love Having a Private Practice (And Why You Might Too) (1 of 2)

A therapist’s joy in small rooms with big conversations

Lex E. Santi, LCSW, MFA

One of the wonderful things about becoming a therapist — whether your route is through social work, counseling, or one of the other mental health professions — is that at some point, you get to decide how you want to practice. For me, one of the greatest joys has been creating and tending my own private practice.

There’s a unique kind of magic in working with people who found you on purpose. They saw your picture, read your words, or maybe heard about you from someone they trust — and they decided that something about you resonated. That something is often what makes private practice so joyful: people come because they want you.

Small, quiet room with big ideas...

As Ram Dass once said, “The quieter you become, the more you can hear.” Private practice is the quieter room where therapists and clients meet, without the noise of institutions, clinics, or systems pressing down. It’s where the real conversations can unfold.

For me, that often looks like working with individuals drawn to mindfulness, people who are asking questions about the curriculum of their lives — how experiences shape them, and how they might live with a deeper sense of presence. Sometimes that work looks like sitting with someone as they navigate career change and the vulnerability of writing a new resume. Other times, it’s opening up a page of the Bhagavad Gita and exploring what it means to live a meaningful life when everything around us seems transient.

It also means couples. I love working with couples who love each other — couples who know they want to get it right, but just can’t quite find the map. I am not, truth be told, the best therapist for couples who sit across from each other already entrenched in resentment, unwilling to budge. But for couples who see love as a shared project, a community of two that needs tending, I am at my best.

Private practice lets me shape that. It lets me choose the work that lights me up, and it lets clients choose me for the same reasons. It’s freedom and responsibility at the same time.

Or as Ram Dass’ friend Stephen Levine put it: “If you were going to die tomorrow, what would you do today? And why aren’t you doing it?” For me, one answer is clear: I’d still sit down, open Zoom, or open the door to my office, and meet the people who have chosen to do this work with me.

Private practice isn’t just a business model — it’s a reflection of who you are as a therapist. Your niche isn’t a marketing trick. It’s your training, your identity, your perspective, the way you show up for people. That’s the beauty of it.