Alright – so today we’ve got the honor of introducing you to Sara Macke. We think you’ll enjoy our conversation, we’ve shared it below.

Sara, looking forward to hearing all of your stories 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 started my journey in college when I entered the Social Work program at Mizzou. I had a wonderful first internship at a Child Advocacy Center where I was able to observe Forensic Interviews. Basically, I got a deep dive look into the horrors of the world. College classes are great but working to get good grades versus putting yourself in uncomfortable growth opportunities in a workplace, that’s where the magic really happens. My second internship was at an outpatient therapy center, where I actually spent most of my time next door in the adult psychiatric inpatient unit. This was not at all what I wanted to do, but it really showed the human side of clients and what they were experiencing in raw time. I was able to be part of treatment team meetings, biopsychosocial interviews, and group therapy with the patients/clients. I learned a lot about differential diagnosis.
When I graduated, I wanted a job immediately working as a therapist. I knew the only way to learn was to get started. I applied and interviewed at two places. I chose the one that felt right. The other place quickly proved my decision was correct when the director told me in other words best of luck regretting my choice.
I worked in Community Mental Health, which many of us do off the bat. I was provided an amazing supervisor and had the blessing of being involved in so many areas of the therapy world. I did group therapy, family and individual therapy, sibling sessions with other therapists involved, treatment team meetings with the in-house psychiatrist, home-based services, extra-curricular therapy group outings, and so much more. This experience absolutely shaped me into the therapist I am today and I still hold so many fond memories of what I learned at that job. I ultimately left after the typical burnout, but will always be grateful for everything during those years.
My next job was in the school district working with Tier 3 children. So much love for teachers and their care and passion for the kids, but not my cup of tea for what is required – the amount that teachers have to do in their own time (without students present) is wild. It’s absolutely not an 8:30-3:30 job.
After another community mental health job combined with my experience working in schools (School-based therapy work), I decided to make the jump into my private practice.
We had just gone through the COVID-19 pandemic. I wanted to be a mom, not a work supervisor. I was burnt out and underpaid. My dad had just died suddenly, not from COVID. Life didn’t make sense. I needed more flexibility. Private Practice provided that. I did my networking and background work and started making moves.
I wish I had an active ongoing support system during that time. Collaborating with professionals should never stop. I went from having supervisors to turn to for almost ten years or being on my own. I ran into a few challenges and didn’t give myself enough credit or power at times. I was a victim of a very well-known therapist scam (which I didn’t know because I was truly alone). That actually took years to recover from.
Advice for young professionals would be: Ask questions, network, reach out to people smarter than you who may know more. Be a sponge with information. You never know it all! Don’t forget to stay connected to other professionals, always.

Sara, 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 started my therapy journey wanted to make sure every client felt heard, understood, and validated. This is still my goal, while adding in how to help clients create a life worth living. We dive deeper in unique ways to identify core fears and core beliefs. I am straightforward and lovingly blunt. It works, and my clients are amazing. They generally want to learn more about themselves too. Most of my referrals come from fellow professionals or word or mouth from other clients. It’s amazing seeing different journeys from different individuals. I learn more about the therapy process every year. It continues to make me a better therapist. I set aside a specific training every year that I want to use to strengthen my skills as a therapist. This year it was training through the International Obsessive Compulsive Disorder Foundation. I had been on a waiting list for years. It was truly inspirational. Now I want to continue my work with OCD by adding an intensive training through Postpartum Support International. As a mother myself, the supports for postpartum and the fourth trimester are laughable. Adding in my OCD training, this can appear often with postpartum. I want to grow those two trainings together. I am also utilizing my trauma experience from the therapist scam, and want to create an online awareness training/video to spread awareness to other professionals so they also don’t fall victim to the variety of scams out there.

How’d you build such a strong reputation within your market?

I truly believe that being a good therapist will keep the referrals coming. I take my business seriously. Even before I had my own business, I would treat every client with the same level of respect. I am prompt in my replies (which sadly is apparently rare sometimes in the therapist world) and I follow through. I encourage ongoing processing during therapy sessions or when a client discharges from treatment. I am available for quick questions or prompts when appropriate. I remember details that are important to my clients, and I take notes to follow up on later. Showing my clients that they are important, valuable, and worthwhile may feel basic, but extremely necessary when building the therapeutic relationship. Unfortunately, when you work at an agency where they push numbers over quality, the therapist may be unable to do these things and think this way because the burnout is so heavy. I truly believe I was able to leave my previous jobs before I lost touch on these skills, which is why they have remained so consistent in my own practice. When I have clients that come back and see me after a few years, I am ready to ask those filed away questions: “how’s your aunt Becky? Did you end up quitting Five Guys? How is your childhood best friend Susanne?”

If you could go back in time, do you think you would have chosen a different profession or specialty?

The hard part about becoming a confident therapist, is that it takes time and experience doing so. I would absolutely go back and choose the same profession, but I wish we were more informed and prepared with all of the choices there are during out college programs. When I went through my BSW and MSW programs, there were no more than 25-30 other students. I cannot say for certain, but probably half, if not more, went a different direction. Social Work is such an amazing choice as a major, as you can really take it anywhere, but it’s not truly expressed just how far this degree can go. I probably would have wanted to zone in on a specialty early on, but I also wouldn’t have wanted to limit myself. Having a few professors who were actively in the field would have been helpful. Adjunct teachers are gold – they bring additional experience from the outside world rather than just a college professor (who is also extremely valuable in their own way!). My favorite classes were taught by adjunct teachers. I craved hearing about real-life experiences to know what I was getting myself into. I just wish we knew exactly how far and wide this field could go. So many therapists in the Facebook groups have started asking what else is out there besides clinical work – since the world is so heavy right now – and we having to find those answers ourselves.

Contact Info:

• Website: https://SaraMackeLCSW.com
• Linkedin: https://www.linkedin.com/in/sara-macke-lcsw/
• Other: My blog is a huge part of my website: https://www.saramackelcsw.com/blog