We were lucky to catch up with Nick Salisbury, LMSW-C, CAADC recently and have shared our conversation below.
Alright, Nick thanks for taking the time to share your stories and insights with us today. Setting up an independent practice is a daunting endeavor. Can you talk to us about what it was like for you – what were some of the main steps, challenges, etc.
I never wanted to be a therapist and certainly not one that owned their own practice. In social work grad school, I focused on integrated healthcare. I loved working in hospital and clinic settings. The connection between physical and mental health made sense and I wanted to work collaboratively with other healthcare providers. My background as a nursing aide and phlebotomist made me a great fit for that environment. As the pandemic hit in 2020 and life shifted, I decided I wanted to move back home to Michigan from Pittsburgh, PA. So, I just took the first job offered to me as a outpatient therapist at a local nonprofit. I was assigned to 110 clients with a salary of 45k. I lasted there six months. But I realized I really enjoyed therapy. I found a group practice that paid way more and a quarter of the caseload! I honed my therapy skills there and became fully licensed. I ventured out on my own about a year and half later as what I thought would be a group practice owner as well. I learned very quickly that I did not want to work that much or be tied to insurance. I decided to take the leap into private pay Summer 2024, working solo, and haven’t looked backed since.
That group practice owner really set the foundation for the therapist I am today. Having support, guidance, and sense of community allowed me to discover what populations I wanted to serve and what modalities would help those folks most. When I decided to be private pay, I knew I needed a different kind of support. I joined a coaching program to help me build a private pay practice. My coach and others in the program have been instrumental in my success today. Having folks that align with your values and vision is key to not only running a business but being an exceptional therapist as well. Without community this would not be possible for me.
The biggest challenge was not knowing how to run a business effectively and the financial investment that it requires. Therapist are not taught how to be business owners in grad school. I knew I enjoyed being a therapist but didn’t understand how my own money mindset, trauma, and negative narratives were impacting my financial well-being and sustainability of my practice.
It’s hard to say what I would have don’t differently. I think I did the best I could with the tools and resources I had available to me. Life threw me curveballs that forced me to change directions many times. I am not the same social worker I was when I graduated ten years ago (thankfully). I do wish I had prioritized myself more. Addressing my money mindset, practicing my values, and finding community sooner.
My advice to others is to find community and mentorship ASAP. Be measured and intentional with your business. And six months of savings!
Nick, love having you share your insights with us. Before we ask you more questions, maybe you can take a moment to introduce yourself to our readers who might have missed our earlier conversations?
I’m a Licensed Clinical Social Worker and Certified Advanced Alcohol and Drug Counselor based in Michigan. I am the owner and clinical therapist at Multiple Minds Psychotherapy LLC. I work primarily with adults navigating trauma, eating disorders, gender/sexual identity, and substance use. I also really enjoy supporting healthcare professionals who are burned out, overwhelmed, or just need a space that’s actually about them for once.
I got into this work because I’ve always been drawn to the quieter, more complicated parts of people’s stories, the stuff we’re taught to hide, manage, or “fix.” Over time, I saw how powerful it can be to have someone witness those stories with care and curiosity instead of judgment. Having a space for clients to put down their burdens can lead to remarkable changes in someone’s life.
My practice is built around offering online individual therapy and therapy intensives for folks who want to dive deep. I use Brainspotting, EMDR, DBT, and IFS. I’m especially passionate about gender-affirming care and providing support that’s inclusive, trauma-informed, and beyond traditional talk therapy. Sometimes we need a place to talk about the COWs (Crisis Of the Week). I find the true change most folks are looking for comes from deeper work. Combining looking back while moving forward.
What sets me apart? I keep things real. Clients often tell me they feel comfortable to be fully themselves in our work together, and I take that seriously. I don’t believe in rigid therapy or forcing people to fit into a “treatment plan” or diagnosis. Instead, I offer something that’s collaborative, respectful, and deeply human. I do not shy away from discussing how politics and oppression impact our mental health daily. I strive to decolonize myself and my practice daily.
What I’m most proud of is creating a space where people feel seen—especially those who haven’t felt that in traditional systems. If someone walks away from a session feeling a little more like themselves, that’s the win.
At the heart of it all, I want folks to know: You don’t have to have it all figured out to ask for help. You’re allowed to show up messy, uncertain, or even skeptical. I’ll meet you there.
Other than training/knowledge, what do you think is most helpful for succeeding in your field?
I think believing in yourself, especially when things feel messy—is huge in this work. There are moments in this field where you won’t have a clear roadmap, income changes, where a session ends and you’re wondering, Did that even help? Belief in yourself helps you keep showing up anyway.
It’s not about ego—it’s about trusting that your presence, your care, and your ability to sit with someone in their pain matters. You won’t always have the “right” words, but if you lead with compassion and curiosity, that’s enough. Believing in yourself is what allows you to keep learning, stay grounded, and do this work sustainably.
How about pivoting – can you share the story of a time you’ve had to pivot?
A big pivot for me was stepping away from taking insurance. At first taking insurance, it felt like the “right” thing to do—more accessible, more in line with the traditional model. But behind the scenes, it was exhausting. I was constantly battling red tape, navigating confusing benefits, and wondering when/if I was going to get paid. It took a serious toll on my own mental and physical health.
Eventually, I realized the system was dictating the therapy—not me, and definitely not my clients. And, that is not in alignment for my values. So, I made the (honestly terrifying) decision to leave insurance panels. It meant restructuring my practice, adjusting how I talked about money, and leaning more into values-based care. Not being surveilled by insurance companies means my client and I are truly in charge of their care. I can now offer therapy intensives which are proving to have incredible results for folks. Therapy can be something more than one hour once per week, This allows for change on the client’s timeline, not insurance.
Now, I get to show up more present, offer therapy that’s actually tailored to the person in front of me, and do the kind of work that feels sustainable. It was a big leap—but it brought me closer to the practice I believe in.
Contact Info:
- Website: https://www.multiplemindspsych.com/
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