Is it better to work for myself in private practice or an institution within the social work field?

Answer 1

Depends on what your values are, what populations you like working with, and your own personal work style. Working in private practice has its perks; being able to choose your clients/specialty areas, you can potentially charge more by not taking insurance or only accepting private insurance, working for yourself means less red tape/corporate bureaucracy. On the other hand, if you own your private practice, then you have to deal with all of the business side of things, hiring staff/secretaries, paying for insurance/malpractice insurance, renting office space, insurance tomfoolery if you choose to take it, billing, payroll, taxes, etc. Which might be more of a headache than you're willing to handle. Generally the people you see in private practice are "the worried well" i.e. middle & upper class people with minor mental health problems, and a chunk of your population might be more severe and accessing higher levels of care in addition to outpatient services.

On the other hand working as a clinician in an institution will likely expose you to a more diverse set of presentations and people; I work at an outpatient nonprofit and my caseload is about 90% state Medicaid recipients and 10% private insurance folks. I see folks with severe schizophrenia and other thought disorders to people just trying to cope with chronic illness and generalized anxiety disorder. I've also worked for crisis stabilization units, an in-home therapy agency, a community health center, and a veterinary hospital. I really value all of the experience I've gained at each of these places but there are some pitfalls to working for an agency; usually pay and benefits aren't great, depending on the structure of the agency you might be more or less prone to burning out, and if working on or as part of a team isn't your jam then it might be harder to cope with a job at an agency/institution. On the plus side, you get a lot more variety in clients and you're usually helping those with the highest risk/greatest need, and if you work for a non-profit for 10 years you could qualify for PSLF and have the remainder of your student loans forgiven.