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”

Key takeaways:

• A smooth clinical transition doesn’t always mean a well-structured business foundation
• Discomfort around money is common and requires clear, consistent systems
• Not all work streams are worth keeping, alignment matters more than opportunity
• Admin overwhelm is often a mix of clinical and business tasks, not just “extra work”
• External accountability (deadlines, supervision, structure) supports follow-through
• Autonomy is powerful but requires intentional boundaries and decision-making
• AI and digital tools can reduce cognitive load when used intentionally
• Sustainable practice comes from aligning workload, income, and lifestyle priorities

Mentioned in this episode:

• Halaxy practice management system (invoicing, Medicare, client management)
• ChatGPT and AI tools for documentation, planning, and communication
• “She’s on the Money” podcast (financial literacy and planning)
• The concept of separating you from the business when setting boundaries
• Virtual assistants vs. clinical admin realities
• Financial planning, payroll setup, and income structuring for private practitioners

Brought to you by Alyce Svensk at The OT Coach Australia

Supporting occupational therapists and allied health professionals to build confidence, clarity, and connection through mentoring, supervision, workshops, and The OT Coach Academy.

If this conversation resonated with you and you’d like support through supervision, business mentoring, or reflective practice, visit www.theotcoach.au  to explore how The OT Coach Australia can support you.