In a previous article, I discussed 3 reasons why, despite the proliferation of healthcare franchises, a successful counseling franchise hasn’t existed. In this column, we’re going to investigate the issue from the opposite perspective—why a counseling franchise could work, and how a franchise could benefit both clients and the counseling industry as a whole.

1. Training, Guidance, and Support

When counselors go into private practice, the day they open their doors is often their first experience owning and running a business. In fact, some clinicians don’t realize they have a business at all.

I’ve heard some counselors say, “I don’t think I have a business…I have a practice!”

Counselors love the work of counseling, and they often venture into private practice because they want to be their own boss, deliver excellent care, and find success working in their profession at a level above what other settings have offered. To this end, a franchise could be an asset to counselors. A franchisee (one who purchases a franchise) is not an employee—he or she is a bona fide owner of their own company. At the same time, a franchisee receives valuable training, guidance, and support from the franchising company (the franchisor).

2. A “Turnkey” Business

While every counselor is unique and brings his or her own style to the counseling process, there are many parts of running a counseling business that are always the same: the phone needs to be answered, the appointments need to be scheduled, the bills need to be paid, etc.

In addition, a counseling franchise could provide additional value to franchisees if it connected franchisees with operational services, such as medical credentialing, medical billing, reception, scheduling, recruiting, Electronic Health Records, and other services. The more a franchisor can take administrative burdens off the shoulders of counselors, the more they can focus on their first passion—helping clients.

3. Brand Trust & Industry Standards

Starbucks reinvented the coffee industry in America. Before them (i.e., before 1971), most Americans were drinking what Howard Schultz* describes as “swill”—coffee made from low grade Robusta coffee beans instead of higher quality Arabica coffee beans. Many Americans settled for an inferior brew because they didn’t have high quality options, and they didn’t know what they were missing. While small coffeehouses love to pick on Starbucks for being too corporate, Starbucks set the bar in the industry.

Today, few coffeehouses will succeed by providing a low quality Robusta bean product, but a business that offers a high-quality alternative to a recognizable brand like Starbucks may do extremely well. Shultz explains, “Clearly there’s room for many different styles of coffee stores or coffeehouses…[customers] decide which coffeehouse to visit. They may vary their choice of establishments, depending on their need or mood. In the end all of us benefit.”

While many practices provide excellent care and service, a few bad apples can spoil the bunch. This has led to a caricature of a ditzy or aloof therapist that is portrayed in some media. This happens because most people who receive poor clinical care don’t realize that they’ve stumbled upon a sub par practice. Because there’s defined standard, they may assume counseling is a sub par profession.

A counseling brand could give clients a benchmark of service and care to expect, not be surprised by, and the industry standard could serve to help improve the reputation of the counseling field as a whole. This is happening right now in the massage therapy field with the proliferation of Massage Envy centers. Their franchise is improving the reputation of massage therapists, which in turn allows independent massage practices to benefit. Like massage therapy and even coffee, counseling needs a brand to set the standard.

4. Community & The Family Effect

An irony of having a counseling practice is that even when counselors are in session with clients all day, counseling can still be a very lonely job. A counseling franchise could offer community to private practice owners, as well as peer supervision and support. Such a community could be unusually strong because, since every franchisee has a protected trade area (as is customary with franchises), no franchisee would be in competition with another.

In fact, the exact opposite would exist! The success of any franchisee would benefit the system as a whole, promoting unity and vested interest among the franchise’s multiple practices. This type of environment incentivizes counseling professionals to share their insights and successes openly with the community at large.

5. Bargaining and Purchasing Power

While small mental health practices can struggle to make ends meet, being part of a larger system leads to increased bargaining power in areas such as marketing, technology, recruitment, and perhaps even the ability to negotiate higher rates with insurance companies.

In addition, it’s reasonable to expect that a franchise would be better equipped than a traditional private practice to purchase or develop valuable resources and technologies. For instance, developing an EHR program, creating validated psychological tests, or even commissioning an iPhone or Android App might be outside the resources of a solo practice. But for a franchise—a community of practices—such endeavors could be just another day’s small investment in the pursuit to continually expand and improve service offerings.

Red Herrings

When I first began considering whether a counseling franchise was a viable idea for our industry, I consulted with a number of professionals in the field. While many saw the value a franchise could bring, there were also concerns and “what ifs” such as:

  • What if the franchise didn’t focus on quality clinical care?
  • What if the standardization of practices took the “soul” out of therapy?
  • What if the franchise interfered in the client-counselor therapeutic relationship?

It became clear that professionals who expressed concern weren’t worried about a Ritz Carlton- (who uses the motto “We are Ladies and Gentlemen Serving Ladies and Gentlemen”) or even a Starbucks-caliber brand joining the field. They worried more about their practice becoming something like McDonald’s, focusing on quantity over quality.

It was clear that if a franchised brand were to exist, that brand would need to be dedicated to excellent clinical care, clinician creativity, customer service, and the power of counseling relationships.

A franchise could help counselors because franchisees wouldn’t need to reinvent the wheel or participate in costly, time consuming trial and error to figure out what works. Franchises are designed to be “turnkey businesses,” which means that they include everything one needs to start running the business on day one—including a proven business model.

While some worry about what will happen to the field if there is a recognizable brand, I tend to worry about what’s going to happen if there isn’t. But no matter which worry you have, one thing is clear: the time to discuss the need for a recognizable counseling brand is now.

*Howard Schultz is Founder and CEO of Starbucks

Note: The following article was written prior to us starting our counseling franchise.

3 Reasons Why a Counseling Franchise Doesn’t Exist

If someone came up to you and asked you to give an example of a franchise, the first company or brand you’d probably come up with would be something like McDonald’s. That makes perfect sense considering McDonald’s owns and operates over 30,000 restaurants in more than 100 countries.

When McDonald’s began in 1955, the concept of franchising was still in its infancy, and 50+ years later, franchises are no longer limited to fast food. In fact, one out of every 12 operating businesses is a franchise.[1] Whether it’s a major national brand like The UPS Store or a regional favorite like Dunkin’ Donuts, franchises can be desirable for aspiring entrepreneurs looking for both the freedom of self-employment and the security of a proven business model.

The best part? Research shows that franchised businesses have a 92% average success rate over five years, compared to 23% for independent businesses.[2]

A Counseling Franchise NOW EXISTS!! Learn More Here: Mental Health Franchise

Franchising Hits Healthcare

While franchising is still heavily associated with fast food (Subway, Dairy Queen, Quiznos, Burger King, and hundreds more), the model has expanded into almost every other major consumer market over the years. Even healthcare franchises have been taking off recently. For example:

Planet Fitness: A 24-hour fitness center with affordable membership fees, Planet Fitness offers members a “judgment free” place to get in shape. Since its initial franchise offering in 2003, Planet Fitness has grown to over 600 locations.

Massage Envy: Providing licensed massage therapy services, Massage Envy began franchising in 2003. In 2012, they grew to 845 locations; up from 742 in 2011. A competitor, Massage Heights, began franchising in 2005 and has 81 locations.

Doctors Express: Offering convenient, walk-in urgent care, Doctors Express began franchising in 2008, and listed 52 locations in 2012.

The Joint: A chiropractic franchise, The Joint began franchising in 2003, and it listed 98 locations in 2012; up from 52 in 2011.[3]

Franchise Roadblocks for Counseling

Given the recent proliferation of healthcare franchises, one might ask why there is a dearth of successful franchises for counseling and mental health. Below are three theories.

1.Counselors Want to Do it Their Way

Counselors go into private practice for a number of reasons, not the least of which is the freedom to practice counseling “their way.” Counselors see their trade as both a science and an art, so it’s common for providers to develop their own unique ways of running their practices. For instance, one counselor might see new clients for two hours during their initial sessions. Another counselor might require a 30-minute telephone consult before agreeing to schedule a new client an office visit. A third counselor might want to close his or her office every Friday, and the list goes on.

When one signs on with a franchise, he or she must forego doing things “their way,” and instead agree to follow a proven business model designed by the franchising company. Generally, a franchisee is trained to follow an exhaustive operations manual that details everything from the color of paint on the walls to what services the business can or can’t offer. A franchisor will promise that following the franchise’s system is necessary to ensure a profitable, well-run business that is a consistent brand experience for customers.

2.Upfront and Ongoing Costs

The cost of buying into a franchise may be financially out of reach for many in the mental health counseling industry.

Take Massage Envy: the franchise fee (an upfront fee paid to the franchising company) is $45,000, and the total investment to setup a new location is $351,985 – $568,623. The fees don’t end there. Owners of a Massage Envy location pay a royalty fee of 6% revenue in perpetuity.

Though Massage Envy is definitely an expensive franchise, a modest franchise fee can still be around $15,000, and a royalty of 5% is more common. Still, these costs are typically beyond the budget for many counselors in the industry.

3.Worries about Cookie Cutter Counseling

McDonald’s is the most successful franchising company in history. But for all the millions (or billions) of people who love McDonald’s, it has its share of critics! McDonald’s receives criticism for their low employee wages, their arguably low food quality, the lack of nutritional value in their meals, intermittent poor customer service, and more.

Because McDonald’s is the poster child for franchising, people often associate the brand with franchises in general. This means that franchised services can be mistakenly perceived as low budget, mass produced, or lacking a personal touch. It’s easy to see how these biases would pose a challenge for the mental health field.

No one (neither client nor counselor) wants to take a fast food approach to psychotherapy. It’s an intimate and personalized experience, and a counseling franchise may induce a worry that the sacred therapeutic relationship between a client and counselor could be restricted or damaged in a franchise model.

Under What Conditions?

This article reviewed the proliferation of healthcare franchises and listed three theories why a counseling franchise doesn’t exist. Still, more questions remain. For instance, after more than 100 years of psychotherapy, why is there still no major, recognizable brand? Could this change? Under what conditions could a counseling franchise thrive? We will address these questions—and more—in next month’s column. Stay tuned!

[1] according to the International Franchise Association

[2] according to Franchise World magazine


*While the title of this column asks “why a counseling franchise doesn’t exist,” a more accurate question is why there is no relevant franchise that has captured even a small percentage of the market, or made a significant impact in the field of counseling.

Anthony Centore

Anthony Centore

Anthony Centore Ph.D. is Founder and CEO at Thriveworks--a counseling practice, focused on premium client care, with 80+ locations across the USA. He is Private Practice Consultant for the American Counseling Association, columnist for Counseling Today magazine, and Author of How to Thrive in Counseling Private Practice. Anthony is a multistate Licensed Professional Counselor and has been quoted in national media sources including The Boston Globe, Chicago Tribune, and CBS Sunday Morning.

Check out “Leaving Depression Behind: An Interactive, Choose Your Path Book” written by AJ Centore and Taylor Bennett."

Interested in writing for us?

Read our guidelines
Share This