Being a group practice owner is an incredible accomplishment—but it also comes with responsibilities that many therapists didn’t anticipate. One of the biggest challenges I hear from group practice owners is a reluctance to embrace the title of “leader.” Many of us feel self-doubt, fear of hierarchy, or simply aren’t sure what leadership looks like in a collaborative, supportive environment.

In this blog, we’ll explore what leadership truly means, why you already are a leader, and how you can step confidently into this role while aligning with your values.

You Are Already a Leader—Whether You Want to Be or Not

Here’s a truth: when you start a group practice, people are following you. You are setting the tone, establishing processes, and guiding your team. That makes you a leader—whether you like it or not.

I asked a few group practice owners why they resist this title, and their answers were enlightening:

Self-doubt and imposter syndrome: Feeling like they “fell into” the role rather than designing their path.
Discomfort with hierarchy: Preferring collaboration over a traditional power structure.
Societal or cultural pressures: Especially for women, who may be taught modesty and politeness over self-assertion.
Emotional responsibilities: Handling conflict, navigating projections, and making decisions under scrutiny.

All of these are valid. But avoiding leadership doesn’t change the fact that someone must guide the practice. That someone is you.

Rethinking Leadership

Many therapists equate leadership with hierarchy, rigid authority, or being “bossy.” In reality, leadership is about direction, guidance, and support. Consider these definitions:

A leader is “a horse placed in advance of the other horses of a team.”
A leader is “someone who guides the way, especially by going in advance, directing the operations, activity, or performance of a group.”

Your team looks to you to establish structure, model professionalism, and create the environment in which they can thrive. Without leadership, confusion and inconsistency quickly arise.

You Don’t Have to Be a Cookie-Cutter Leader

Here’s the good news: there’s no one-size-fits-all approach to leadership. Your group practice, your clients, and your therapists are unique. The way you lead should be too.

Two books I often recommend to group practice owners are:

“21 Irrefutable Laws of Leadership” by John Maxwell
“Traction” by Gino Wickman

Both offer practical guidance for identifying strengths, gaps, and opportunities for delegation. Leadership is not about doing everything yourself—it’s about leveraging your strengths and surrounding yourself with people who complement your skills.

Four Leadership Principles to Elevate Your Practice

From Maxwell’s 21 laws, here are four particularly relevant for group practice owners:

1. The Law of the Lid

Your leadership ability sets the ceiling for your practice’s growth. Limited leadership skills can cap your team and practice. For example, avoiding conflict can create unresolved issues and dissatisfaction. By stepping into leadership, improving communication, and setting boundaries, you elevate the entire practice.

2. The Law of Influence

People follow leaders they trust, not just those with a title. Influence comes from consistency, fairness, and modeling your values. When you lead with empathy and clarity, your team will willingly follow your initiatives. Leadership here is relational—rooted in respect and authenticity rather than authority.

3. The Law of the Inner Circle

The people closest to you determine much of your success. In a group practice, this includes your admin team, lead clinicians, and mentors. Invest in their growth and delegate effectively. For instance, a skilled practice manager frees you from day-to-day chaos, allowing you to focus on vision and leadership.

4. The Law of Legacy

True leadership is measured by the impact you leave behind. Develop systems, train leaders, and create a culture that outlives you. For example, training a senior therapist to act as clinical director ensures the practice maintains high-quality care even as you step back. Working on the business rather than in it is key to sustainable growth.

Putting Leadership Into Action

Leadership is practical and actionable. Here’s how to begin:

Identify which of the four laws resonates most with you.
Pick one action step to take in the next week, such as:
- Joining a professional community like the Group Practice Connection.
- Holding a values-based conversation with your team.
- Strengthening your inner circle through mentorship or delegation.
- Reading one of the recommended leadership books and reflecting on your practice.

Every small step strengthens your leadership and creates a thriving, sustainable practice.

Conclusion: Step Into Leadership With Confidence

Leadership is not about hierarchy or bossiness—it’s about showing up authentically, guiding your team, and creating a practice that thrives. You already have the qualities that make you a successful CEO and leader. Now it’s about building on those strengths and seeking support where needed.

Pick one law, take one action, and embrace your role as a leader. Leadership can feel daunting, but it’s empowering. Step into it with confidence, and your team—and your practice—will follow.

Embracing Your Role as a Leader in Your Group Practice