Private Practice Sessions
Structural Coaching for Specific Challenges

You know what needs to change in your practice or you are thinking of moving to private practice.

This has been on your mind for a while.

It might be:

The rate increase you need to make.

The shifts in focus or clientele that are overdue.

The schedule that's just not working anymore.

The referrals you keep saying yes to even though inside of you says no.

The challenge: knowing what needs to change is easier than making the change.

The hard part is all the stuff that comes with it.

The fear that if you raise your rates, you'll lose everyone—or worse, that you're being greedy or abandoning the people who need you most.

The guilt about ending with certain clients, because you're a helper, and helpers don't give up on people. Even when staying is hurting you. Even when you know it's not working.

The exhaustion of trying to restructure your schedule when it means disappointing people or changing patterns you've had for years, and you're already too tired to think straight.

The shame of saying no to referrals when you know people need help, but taking them on is not right for you right now.

This is genuinely hard stuff to work through alone while you're still seeing clients, managing crises, keeping everything running—makes it even harder.

This work now lives in The Practice Shift.

Private Practice Sessions have grown into The Practice Shift: individual coaching for clinicians changing how they work.

It's five private, 50-minute sessions over eight to ten weeks. Together, we'll clarify what you need, support the decisions you're facing, and help you navigate the practical and relational work of making a change—including the fee conversation, the client ending, the schedule you can no longer sustain, or the referrals you need to start declining.

It includes a shared working plan and feedback on up to three short drafts between sessions, so you don't have to write the hard email alone.

If you have one specific question you want another set of eyes on, The Consult (a single 90-minute session) is available too. You'll find both on the page below.

This is for you if:

You need to raise your rates and you're terrified of the conversation—what if clients can't afford it? What if they feel betrayed? What if you sound defensive or apologetic and make it worse?

You need to end with certain clients and the guilt is real—you're a helper, ending feels like failure, and you haven't figured out how to do it in a way that feels clean and responsible instead of like you're giving up.

Your schedule is unsustainable and you know it, but restructuring means changing patterns, potentially seeing fewer people, building in time that feels "unproductive" even though you desperately need it.

You're saying yes to referrals you shouldn't take because saying no feels impossible even when you know it's not right—you haven't built the structure or language to decline clearly and kindly.

You're shifting your model—moving away from all 1:1 work, changing what you offer, or stepping back from clinical work—and you need to think through the transition with someone who gets the complexity of changing course when people depend on you.

A little about me:

I'm Hilary Kinavey, and I've been doing this work for 25 years.

I started as a therapist in private practice, co-founded the Center for Body Trust, and have spent the last decade-plus training therapists, coaches, dietitians, and other helping professionals through EMBER—my business development program.

I've made every mistake you can make in private practice. I've undercharged. I've built schedules that burned me out. I've said yes to things that should have been no.

And I've also done the hard work of changing those patterns—not perfectly, but sustainably.

Now I offer The Practice Shift—individual coaching for clinicians changing how they work. It's shaped by my Practice Architecture framework, which looks at how your income, offers, capacity, visibility, and business structure fit together, along with the questions of identity and worth underneath your decisions.

I understand the clinical complexity of what you're navigating because I've lived it. I understand the business side because I've built it (and rebuilt it, and rebuilt it again).

And I understand the emotional messiness of trying to make structural changes when people depend on you, when you're a helper, when the guilt is real and the fear is real and you're already exhausted.

Here's what you need to know about how I work:

Everything we discuss is completely confidential. This is a safe space to talk about what's really going on in your practice—the parts you haven't said out loud yet, the decisions you're struggling with, all of it.

And here's what's important to me: our work together is focused on your well-being, sound clinical decision-making, and client welfare. Those things aren't in conflict—they support each other.

When you're resourced, you make better clinical decisions. When your practice is structured sustainably, you can show up better for your clients. When you have clear boundaries and fair compensation, you can stay in the work longer and serve people better.

Taking care of yourself and your practice isn't selfish. It's what makes ethical, sustainable care possible.

I'm warm. I'm kind. I'm straightforward. I won't judge you for any of it. And I'm going to help you figure out what makes sense for your life and your practice—not what's perfect, but what works.

That's what The Practice Shift is for.

Questions?

The easiest next step is a short introductory conversation: schedule one here. We'll talk about what's happening in your practice and whether this support fits. You can also email me at [email protected] with the subject "The Practice Shift" (or just reply to any of my emails).