Marcus Williams spent eight years in community mental health. The work was meaningful. The pay was modest. The burnout was severe.
"I loved the clients," he says. "I hated the system. The paperwork, the underfunding, the impossibility of doing good work inside broken infrastructure."
In 2022, Marcus made the leap to private practice — but he didn't want to serve only those who could afford $200 sessions.
A Hybrid Model
Marcus built a practice that splits his caseload: 60% private pay (individuals and corporate EAP), 40% sliding scale through FollowUp's community access program. The higher-paying clients subsidize access for those who couldn't otherwise afford it.
"It's not charity," he clarifies. "It's a business model that aligns with my values. And it works."
The Technology Shift
Going fully telehealth was initially terrifying. Marcus worried about therapeutic alliance — the research-backed relationship quality that predicts outcomes.
"What I found was the opposite of what I feared. Clients in their own homes, in their own clothes, often disclosed more quickly and more deeply. The intimacy of the screen surprised me."
Revenue and Growth
In his first year, Marcus earned less than in community health. By year two, he had a three-month waitlist and was earning 60% more. By year three, he'd hired two contract associates.
Key Lessons
- Niche clarity matters (Marcus specializes in men's mental health and occupational stress)
- Telehealth expands your geographic reach dramatically
- Community and peer consultation prevent isolation
- Systems and boundaries are acts of self-care, not selfishness
