8 Red Flags Before You Join a Group Practice

Group practice can be a genuinely great starting point. Built-in referrals, a ready-made space, colleagues nearby. For many new therapists it is the right first step.

But not all group practices are set up with your best interests in mind. Some arrangements look reasonable on the surface and reveal themselves slowly, after you have already signed and started building a caseload.

As a clinical supervisor and group practice owner, I have heard so many heart-breaking stories from therapists in toxic environments, and these are the things I wish someone had told them before signing that first contract.

This is not legal advice. Every therapist's situation is different, and I strongly encourage you to consult an employment or contract lawyer before signing any agreement. What feels like a significant upfront cost could save you considerable time, money, and stress down the road.

1. Non-Compete Clauses

If the contract restricts where you can work, who you can see, or how close to the practice you can set up independently, get legal advice before signing. Non-compete clauses vary widely in scope and enforceability, and a lawyer can help you understand what you are actually agreeing to. It is also worth knowing that therapists and group practices do not OWN clients. Clients have the right to choose their own therapist, and when a therapeutic relationship ends, ethical practice requires providing referrals that support informed decision-making, which can include your new location.

2. No Control Over Your Schedule or Time Off

As an independent contractor, control over your own schedule is one of the defining features of that working arrangement. If a practice is dictating your hours, filling your calendar without your agreement, requiring you to be available at times that were never mutually discussed, or if taking vacation requires an unrealistic approval process (e.g. booking 6-12 months in advance), that is a control dynamic. You do not need permission to manage your own schedule. These dynamics can blur the line between contractor and employee in ways that have practical and professional implications. If something feels off about how much control the practice has over your availability, it is worth getting clarity before you sign.

3. A Commission Split That Does Not Add Up

Fee splits vary, but there is a point where the math stops making sense for you. If the practice is taking a significant percentage and not providing commensurate value in return, such as consistent referrals, administrative support, proper systems, and genuine infrastructure, you may be subsidizing their business while building yours from scratch. Ask what you are actually getting for what you are giving up.

4. Clinical Supervision Used as a Control Mechanism

Supervision should be a space for clinical growth and support. When a practice owner requires sign-off on clinical decisions in advance, restricts who you can seek external supervision from, or uses supervision primarily to monitor productivity rather than support development, that is worth examining. If your group practice owner is also your clinical supervisor, this is a dual relationship. Without open acknowledgement of the power imbalance, this arrangement can significantly impede effective supervision.

5. Pressure to Take Every Referral

You have the right to decline referrals that are outside your scope, not a clinical fit, or not appropriate for your caseload. A practice that treats a decline as a problem is prioritizing fill rates over your professional judgment. That affects your clients and your clinical practice.

6. You Are Expected to Cover Your Own Advertising

Some practices charge for directory listings, website profiles, or marketing costs on top of the fee split. This is not inherently unreasonable depending on the overall arrangement, but it should be discussed and clearly documented before you sign. Make sure you know exactly what is and is not included in your split.

7. Everything Runs Through Email

No booking system. No client management software. No clear intake process. If the administrative infrastructure is a shared inbox and a spreadsheet, you will spend unpaid time doing work a proper system would handle automatically. That is time you are not billing, and it adds up quickly.

8. You Are Blamed When Clients Do Not Convert

Client conversion depends on fit, timing, finances, life circumstances, and a hundred other factors outside your control. If a practice owner treats a client who did not book as your failure, or tracks your conversion rate as a performance metric, that is a boundary issue. You are a clinician, not a salesperson.

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None of these red flags mean every group practice is a problem. Many are well-run, ethical, and genuinely supportive of their therapists. But these situations are real, they come up regularly, and they are worth knowing before you sign anything.

You deserve an arrangement that supports your clinical work, respects your autonomy, and makes the business side of practice sustainable. Read the contract. Ask the questions. Get proper legal advice (not only advice from a FB group). And if something feels off, trust that.

Save this before your next contract conversation and share with any therapist friends.