The Hidden Work of Building a Practice with Tracy LMHC

By Leila Ghaznavi  

This interview has been edited for length and clarity.

Tracy LMHC, The Bad Indian Therapist, is a licensed mental health counselor in New York City and Florida whose cultural background has given her a unique perspective on therapy and the cultural challenges within families and communities within the US. I recently had the pleasure of sitting down with Tracy to discuss how she used her own personal experiences to create a specialized practice with a unique brand.

What personal experiences helped you discover your brand?

I am Tracy LMHC and I help South Asian Americans and adult children of immigrants who struggle with cultural guilt, shame, anxiety, and community related trauma. I practice in New York and Florida virtually with in-person sessions offered at my Manhattan office. I am trained in trauma therapy with a specialization in EMDR. Specifically, I help South Asians work through their own healing and the complexities of their personal relationship with South Asia diaspora, religion, or other issues that they may be facing. What I tell clients is that if you've ever been called a “bad Indian”, I've been called a “bad Indian” too, so let's be “bad” together. It’s therapy for South Asian misfits and I’ve made it a central tenet of the brand for my practice. For example, I am “The Bad Indian Therapist” on Instagram (@thebadindiantherapist), Twitter (@baddesitherapy), Tiktok (@thebadindiantherapist), and my website is www.thebadindiantherapist.com.

How did you identify that there was a need for this specialization?

So many South Asian Americans are afraid of going to therapy, especially with a South Asian therapist. They are worried that a South Asian therapist will prioritize cultural values over their welfare and will judge them for the life choices they’ve made that would be viewed as unconventional from a traditional cultural perspective. 

It is a concern that I understand personally. I have met with South Asian therapists for my own personal therapy who have made micro-aggressive backhanded comments and judgmental statements about my own unconventional career path.

You don't see a lot of South Asian American therapists for a reason. This field is not encouraged by the culture. I went against my parents wishes which were for me to stay in my hometown and become a pharmacist. Instead I moved away and have had a series of unconventional jobs. I've worked for non-profit community mental health settings, giving family therapy in people's homes across New York City, and working with the incarcerated patients of Rikers Island. I’ve intervened in crises in neighborhoods late at night where “good Indian girls” don’t go.

By choosing this career, I have challenged the norm for South Asian American women. Growing up, I was always the outcast because I was vocal about having different opinions and didn’t hesitate to share my thoughts. I was told that I wasn’t “brown enough” or that I had been whitewashed. It was these adverse experiences that have helped me to become who I am today and why the services I offer are so important. 

When I started my private practice and began working with South Asian American clients, I quickly discovered that I am not alone in the challenges that I faced growing up and that there are plenty of people who are just like me that are looking for support in their personal journeys. I started the @thebadindiantherapist to serve those people because we exist, we’re out there, and most importantly, we are not alone.

What would you say is the biggest misconception about starting a private practice?

There are expectations to manage when it comes to being a therapist in private practice. A lot of people go into this field thinking: I'm accepting new clients and am open for business so people will come. What they don't know is there's a lot of startup costs and unpaid labor that goes into managing a practice. It can get very expensive.

For example, if you don't see clients, you don't get paid but you still have to pay for your own health insurance, retirement plans, liability insurance, electronic health records system, therapist listings, and the list goes on. Plus you have to manage the billing, administration, marketing, calling insurance companies, etc. All these things happen outside of the one hour a client gets with you a week. 

That’s why working with a company like Nirvana is so important. Nirvana takes the headache out of out-of-network insurance billing which saves both my clients and myself time and money. With Nirvana, I can track when my client will receive reimbursements, I can verify a client’s out of network benefits and what their expected reimbursement is — that can really make or break whether a client chooses to work with me or not. 

I had a client recently who had no idea that she actually had out-of-network benefits. But with Nirvana, I was able to tell her exactly what her network benefits were and what her reimbursement would be. She was thrilled. Nirvana has helped demystify insurance benefits for a lot of my clients and has become an important part of my practice by helping my clients, who wouldn't otherwise be able to afford it, continue with their care.

I can't even imagine what it was like for therapists 20 years ago. I don't know how they made it work without the tools and resources that a company like Nirvana provides. 

Since Nirvana has been helping you with insurance, what other administrative task takes up the majority of your time?

Marketing! There's a lot of incoming private practice therapists who don't know how much marketing they actually have to do outside of sessions to get clients. That's how clients find you and that is yet another cost you have to budget for in your business plan. 

It’s important to note that you don't have to have a private practice to be a therapist. But if private practice is your goal, I think it's important to understand the challenges and the demands going in. It is a therapists’ responsibility to make sure our clients get the quality care they need. I think senior therapists need to be more open about acknowledging those realities so we can demystify the mental health field and help set realistic expectations for people who want to do this meaningful work. 

What marketing are you currently doing for your therapy practice?

My social media is always a work in progress but the online reaction has been very good. I had several reels on Instagram go viral. I have had a lot of requests for care from my social media promotions but that can be very overwhelming because I'm only licensed in certain states. I'm getting requests from parts of the country, and parts of the world, that I can't provide services. So it has become a question of how do I refine my online marketing so I am honing in on the markets that I can serve. But overall, there are a lot of people who resonate with my work. I'm hoping to grow and share my message with even more people so I am continually working on strengthening my online presence so I can open more avenues for my brand.

How should a therapist work on developing their online presence?

One pro tip for therapists who are looking to elevate their social media presence is to invest in a really good business therapist coach. I'm in a business therapist coaching program right now. My business coach helped me to identify who my ideal client is. For me, that is a South Asian American person who's in their 20s or 30s. Specifically those who are wrestling with the expectations of their family/community and their own hopes/dreams/goals and are struggling with anxiety and fear of judgment. I am marketing to that specific person because I know what their concerns are and I can offer a safe space for them to express themselves. 

On Instagram I’m not trying to show my skills as a therapist because social media is not a replacement for therapy. But I do want to give potential clients a taste of my personality. So I try to create content that says: Hello I am Tracy and this is my personality. I am approachable and relatable. Book a session and we can talk in a safe space. That has been key to my strategy overall, showcasing that working with me is a safe space.

Is there a therapist support program that you would recommend?

That's a very important question. Not just as a practice owner but as a therapist. It’s essential that therapists take care of ourselves so we’re able to offer the best care possible to our clients. This means thinking very strategically about the choices we make. 

Kelly McKenna runs a therapist coaching program called The Mastermind Intensive. It's a three month program where therapists across the country who are looking to grow their brand get group coaching and/or individual one-on-one coaching. You can find Kelly at @businessoftherapy and sitwithkelly.com. 

Having that sounding board of somebody else who gets the challenges of being a therapist, who's been there, who's gone through the same struggles that you're having as a practice owner, is so important. It's incredibly helpful to hear the perspective of other therapists and what's worked for them and to get the reassurance that this career is possible. If they can do it, you can do it, you just might have to try a different strategy. 

What are some of the challenges that you’re currently facing and what have you been doing to address them?

That's very relevant because I am a South Asian American therapist who helps people work through their cultural guilt and the people pleasing anxiety created by that guilt. And here I am as a therapist struggling with my own guilt and people pleasing anxiety because as my practice grows that means having to manage costly ever increasing business expenses. This is a really difficult thing that many therapists don't like to face because that means increasing our fees which can make it very hard to market ourselves.

People who are looking for mental health care are understandably hesitant about the price. But as a therapist I have to be able to say, “This is an investment and I promise you that this is worth it,” in a way that feels therapeutic while working against my own guilt and what my people pleasing anxiety is telling me to do. 

As a practice owner that has been one of the hardest things for me to do personally as my business grows. There are the hard costs of what it takes to give good care but care also needs to be affordable and accessible to all which is an ongoing political/social issue in the US. It’s another reason why I’m glad to work with Nirvana because making mental health care accessible is one of their mission statements. It’s why Nirvana was created in the first place and is another reason why I am a client.