Adding Therapists to Your Practice: What Your Agreements Should Address
A psychotherapy practice has more enquiries than it can accommodate. The owner decides to bring in another therapist, expanding appointment availability and allowing the business to serve more clients.
The parties agree on a percentage split. The practice will provide referrals, booking software and administrative support. The therapist will provide clinical services.
The arrangement appears straightforward.
Several important decisions sit behind that summary. What happens when a client does not pay? Which administrative services are included? Who is responsible for the clinical record? How will clients be supported if the therapist leaves?
These questions affect both the economics of the relationship and the way care is delivered. Leaving them unresolved can create difficulties that become apparent only after the practice has committed resources and clients have begun treatment.
A psychotherapy practitioner agreement should reflect the arrangement the parties intend to operate. Reviewing it before the therapist starts gives the practice an opportunity to clarify responsibilities while expectations are still being established.
Begin with the Structure of the Relationship
A group practice can operate through different models.
A therapist may provide services within the practice’s business. Another arrangement may involve an independently operated practice purchasing space and administrative support. An employment relationship raises a different set of considerations.
The agreement should follow the intended model.
Who enters the service relationship with the client? Who sets and collects fees? What does the practice provide? Which responsibilities remain with the therapist?
The answers influence the documents needed and the obligations they should address.
Describing the relationship as an independent contractor arrangement does not settle every question about its status. For tax and CPP/EI purposes, the CRA considers the facts of the relationship as well as the parties’ stated intention. Employment and other legal issues may require separate assessment.
The working practices and the written terms should therefore be considered together.
Make the Percentage Split Administrable
The percentage split is often the first commercial term discussed. Its calculation deserves equal attention.
The agreement should explain which amounts form the basis of the calculation, when payments are made and how relevant adjustments are handled.
Consider a client who is charged a cancellation fee that remains unpaid. The therapist expects payment based on the amount billed. The practice calculates the split using amounts collected.
The parties may have agreed on the same percentage while holding different understandings of what it applies to.
Similar questions can arise around refunds, reduced fees and outstanding accounts.
The review should also establish who has authority to make relevant financial decisions. If one party agrees to waive a charge, both should understand how that affects payment.
Tax questions may require accounting advice, coordinated with the proposed legal arrangement. The percentage alone does not explain the complete financial relationship.
Define the Support the Practice Provides
A practice’s share of revenue may support several services: enquiries, referrals, booking, billing, software, rooms and marketing.
Those services should be described clearly enough for the therapist to understand the offering and for the practice to administer it consistently.
A therapist may expect staff to follow up on unpaid accounts and manage appointment changes. The owner may expect those activities to remain with the therapist.
Neither expectation is inherently established by a general promise of administrative support.
The agreement should distinguish included services from activities requiring separate approval or responsibility. It should also avoid implying a guaranteed flow of referrals unless that is a commitment the practice has assessed and intends to make.
Clarity at this stage helps both parties evaluate whether the arrangement meets their needs.
Separate Operational Procedures from Clinical Responsibilities
A group practice needs consistent procedures for booking, billing and communication. Therapists also have professional responsibilities associated with the care they provide.
The agreement should distinguish these areas.
A practice may need a defined process for enquiries and appointments. Clinical decisions, professional documentation and the suitability of treatment require consideration of the therapist’s role and applicable standards.
Problems can arise when broad management language does not reflect that distinction.
The review should establish which procedures support the operation of the practice and how they interact with professional responsibilities.
Where the team includes professionals regulated by different colleges, one therapist agreement may need adaptation before it is used across the practice.
The documents should reflect the actual team rather than assume that every practitioner operates under the same requirements.
Clarify Responsibility for Records Before Granting Access
A shared record system can make administration easier. It does not, by itself, explain every person’s responsibility for the information within it.
The practice and therapist need to understand the applicable custody, access and privacy arrangements. Relevant roles under Ontario’s Personal Health Information Protection Act require assessment in the context of the practice model.
The agreement should work with the practice’s privacy documentation and operating procedures.
Practical questions include who responds to record requests, what access staff require and how records are managed when a therapist is absent or leaves.
These decisions should be reflected in system permissions. A broad confidentiality clause offers limited practical guidance if the access arrangements remain unclear.
The objective is a coherent structure that the practice and therapist can apply during ordinary operations and changes in the relationship.
Give Clients a Clear Understanding of the Arrangement
Clients should receive information that accurately reflects how the practice operates.
The practitioner agreement, intake materials and consent documentation should be reviewed together where relevant.
CRPO’s guidance on group practice departures emphasizes the importance of clients understanding which business or individual has primary responsibility for them and their record. Establishing that understanding at the outset can reduce confusion later.
For the practice, this means assessing whether existing forms remain suitable as the team grows.
A document developed for a solo practice may describe responsibilities differently from the arrangement now being introduced.
Financial policies, privacy information and treatment consent address distinct matters. They should be coordinated without assuming that one form resolves every issue.
Plan Scheduling Around the Actual Working Model
Appointment availability affects both client access and the economics of the practice.
The parties should establish relevant expectations around scheduling, room use and communication of changes.
A therapist may expect particular days or facilities to remain available. The practice may need flexibility as demand and staffing change.
Those expectations should be assessed against the relationship being created.
The agreement should also consider planned absences and changes in availability. Administrative procedures may need to support client communication and appropriate arrangements for ongoing care.
Where services are provided virtually, the review should identify relevant responsibilities for platforms, environments and access.
Clear procedures help the practice plan resources without leaving each change to an urgent informal discussion.
Address Registration, Supervision and Insurance Where Relevant
The practice should understand the incoming therapist’s professional status and the requirements relevant to the services they will provide.
The proposed arrangement may require consideration of registration conditions, supervision and insurance. These matters should be assessed against the therapist’s circumstances and applicable professional requirements.
Where supervision is part of the arrangement, its scope and responsibilities need to be understood. Providing a workplace and providing clinical supervision are different roles.
The agreement should also establish an appropriate process for communicating material changes that affect the relationship.
Insurance arrangements deserve practical review. The owner should understand the practice’s coverage and the therapist’s position rather than assume one policy addresses every exposure.
These decisions are easier to resolve before services begin.
Plan Departures Around Clients, Records and Operations
A therapist’s departure can affect ongoing care, appointment scheduling, outstanding fees and access to information.
The agreement should provide a practical transition framework.
Notice procedures should be considered alongside the work required to manage the departure. Relevant responsibilities may include communication, completion of documentation and the handling of outstanding administrative matters.
Client decisions also need to be respected. CRPO’s guidance recognizes that clients may wish to remain with the group practice, continue with the departing therapist where appropriate, seek another provider or discontinue services. The applicable professional and contractual issues require assessment in each situation.
The records arrangements should be coordinated with that process.
Planning these matters at the beginning gives both parties a clearer basis for managing an eventual change.
Assess Restrictions Against the Concern They Are Intended to Address
Practice owners may want provisions addressing solicitation, confidential information or competing activities.
Those requests should begin with the actual business concern.
Is the owner seeking to prevent misuse of confidential information? Protect an investment in marketing? Establish an orderly departure process?
Different concerns may require different approaches. Broad restrictions copied from another agreement can create questions about enforceability and their interaction with professional responsibilities.
CRPO advises practitioners to consider contracts carefully before signing because restrictions can complicate the application of professional standards when leaving a group practice.
A considered review should assess the proposed wording, the working relationship and the implications for clients. The practice should not assume that a standard clause guarantees its preferred outcome.
Use a Consistent Framework Without Ignoring Meaningful Differences
A growing practice can accumulate different agreements through individual negotiations.
One therapist may have a different payment process. Another may receive additional administrative support. A third may have a distinct room arrangement or supervision relationship.
Some differences are appropriate. They should be visible and administrable.
A common framework can establish recurring terms, with schedules addressing relevant practitioner differences.
The appropriate structure depends on the practice. The goal is to avoid rebuilding every relationship independently while ensuring the documents reflect meaningful distinctions.
Existing signed arrangements require separate assessment. Introducing a new template does not automatically change agreements already in place.
Before You Confirm the Therapist’s Start Date
If the parties have agreed on a percentage but cannot explain records responsibilities, included support or the departure process, the arrangement needs further definition.
Adding a therapist, introducing another regulated profession or changing the billing model can provide a useful point to begin.
The proposed practitioner agreement, description of the working arrangement and relevant client documents offer a practical starting package.
Reviewing them before access is granted and appointments begin gives the practice more room to resolve questions while expectations are still being established.
Discuss Your Psychotherapy Practitioner Agreements with Delta Law
Delta Law helps psychotherapy practices review and develop practitioner agreements around their operating model, financial arrangements and professional responsibilities.
A consultation provides an opportunity to discuss an incoming therapist or existing arrangement, identify the documents requiring attention and consider an appropriate scope for review or drafting.
