Navigating Employee and Contractor Hiring for Your Behavioral Health Private Practice

Greetings fellow behavioral health practitioners! As the demand for mental health services continues to rise, many of us find ourselves considering expansion by hiring employees or contractors to join our […]


Greetings fellow behavioral health practitioners! As the demand for mental health services continues to rise, many of us find ourselves considering expansion by hiring employees or contractors to join our private practices. This step can be transformative for both your practice’s growth and the clients you serve. In this article, I’ll guide you through key considerations when hiring employees or 1099 contractors for your behavioral health private practice, helping you make informed decisions that align with your practice’s mission and values.

Understanding the Distinction: Employee vs. Contractor

Before delving into the hiring process, it’s crucial to understand the distinction between hiring employees and engaging 1099 contractors:

  • Employees: Employees work under your direct supervision, following your practice’s policies and procedures. You have greater control over their work and how they deliver services.
  • 1099 Contractors: Contractors, also known as independent contractors, work autonomously and are responsible for their own methods of service delivery. You have less control over their work processes but can define the scope of their services.

Key Considerations for Hiring Employees

  • Role Definition: Clearly outline the roles and responsibilities of the employees you’re hiring. This includes the services they’ll provide, expected work hours, and any specific qualifications.
  • Licensing and Qualifications: Ensure that employees possess the necessary licenses, certifications, and qualifications required for their positions.
  • Supervision and Training: Plan how you’ll provide supervision and training to employees, ensuring they understand your practice’s protocols and maintain high-quality service delivery.
  • Benefits and Compensation: Determine a competitive compensation package that includes salary, benefits (if applicable), and any incentives. Consider industry standards and the local cost of living.
  • Policies and Procedures: Develop clear policies and procedures that govern employees’ conduct, client interactions, and administrative tasks.
  • Tax Withholding: As an employer, you’ll need to withhold taxes from employees’ paychecks and contribute to Social Security and Medicare on their behalf.
  • Employee Relationships: Foster a positive work environment by nurturing open communication, recognizing achievements, and addressing concerns promptly.

Key Considerations for Engaging 1099 Contractors

  • Scope of Services: Clearly define the scope of services you expect from contractors. This includes the types of therapy they’ll provide, the client population they’ll work with, and any specific requirements.
  • Contract Agreement: Draft a comprehensive contract agreement that outlines the terms of engagement, including compensation, services provided, confidentiality, and the nature of the contractor relationship.
  • Independence: Contractors operate independently, so avoid exerting excessive control over their methods of service delivery. You can define the outcomes you expect but generally allow them flexibility in their approach.
  • Liability Insurance: Contractors should carry their own professional liability insurance to protect both themselves and your practice from potential legal claims.
  • Tax Considerations: Contractors are responsible for paying their own taxes and don’t receive benefits like employees do. Ensure that you classify contractors correctly to avoid tax issues.
  • Client Relationships: Communicate clearly with clients about the contractor relationship, ensuring they understand that contractors are independent providers affiliated with your practice.
  • Collaboration and Communication: Maintain open lines of communication with contractors, fostering a collaborative environment that benefits both the contractors and your practice.

Making the Right Decision

When deciding whether to hire employees or engage 1099 contractors, consider these factors:

  • Level of Control: If you need more control over how services are delivered, hiring employees might be the better option. For greater independence, contractors offer flexibility.
  • Cost: Hiring employees generally involves more financial commitment due to benefits and taxes. Contractors may be more cost-effective, but they set their rates.
  • Long-Term Vision: Consider your practice’s long-term goals. Hiring employees can contribute to building a team with a shared vision, while contractors offer flexibility for short-term needs.
  • Skillsets Needed: Assess the specific skills and expertise your practice requires. Hiring employees allows you to train and mold individuals, while contractors bring specialized skills.
  • Client Relationships: Think about how you want to present contractors to your clients. If you want them to perceive contractors as integral parts of your practice, hiring employees may be preferable.


Hiring employees or engaging 1099 contractors for your behavioral health private practice is a significant decision that can impact your practice’s growth and the quality of care you provide. By considering factors such as control, costs, long-term goals, required skillsets, and client relationships, you can make informed choices that align with your practice’s mission and values.

Remember that clear communication, comprehensive agreements, and a commitment to ethical and professional standards are essential regardless of whether you choose to hire employees or work with contractors. With careful planning and thoughtful consideration, you’ll build a team that contributes to the success and positive impact of your behavioral health private practice.

Photo by Charanjeet Dhiman on Unsplash

Written by ChatGPT & Reviewed by Clinical Psychologist: Yoendry Torres, Psy.D.