The Therapist’s Guide to School Contracting with Elise Mitchell

Nov 1

There is a moment a lot of therapists quietly reach where the math stops working.

The caseload feels heavy. The pay scale feels fixed. You know schools need support, but the idea of jumping into school contracting feels confusing, risky, or like something only big staffing agencies can pull off. So you keep doing what you know, even when it no longer fits.

That is exactly why this conversation mattered.

In this episode of the ScaleSmart Podcast, I sat down with Elise Mitchell, a speech therapist who has seen school contracting from every angle. Elise worked her way up inside large, investor run staffing agencies before walking away, burning out, and eventually building something very different. She is now the founder of The Therapist Support Network, where she helps SLPs, OTs, and PTs contract directly with schools on their own terms.

This conversation was honest, practical, and grounding. Not hype. Not shortcuts. Just what actually works.

School contracting is not the problem. The way it is done usually is.

One of the biggest takeaways from this episode is that schools are not the enemy, and school contracting itself is not broken. What often breaks is how therapists enter these agreements.

Elise shared story after story of clinicians who jumped into contracts without the right legal structure, only to end up unpaid, overloaded, or stuck with a caseload far worse than when they were employed by a district. Schools often hand contractors generic vendor agreements that were never designed for therapy services. Without strong, provider specific contracts, therapists are left with no protection.

School contracting is a business to business relationship. Treating it like a side hustle or something you can wing almost always backfires.

Why private practice owners are adding school contracts

About half of the therapists Elise works with also own private practices. That surprised her at first, but it makes sense when you look at how the two models work together.

School contracts bring predictable revenue. You sign one agreement and suddenly have dozens of students on your caseload. That kind of stability can help offset insurance cuts, denials, and the constant marketing required to keep a private pay caseload full.

Private practice and school work also run on opposite cycles. Schools slow down in the summer, while many practices see a spike. During the school year, contracts bring consistency when private practice can feel more unpredictable.

For practice owners who want to pay their team steadily and reduce financial stress, school contracting can be a smart, sustainable addition when it is done correctly.

School contracting is more than just direct therapy

Another eye opening part of this conversation was how many ways therapists are serving schools beyond traditional treatment.

Elise shared examples of clinicians providing AAC evaluations, bilingual assessments, compensatory services, IEP compliance support, professional development, supervision, and even evaluation only contracts. Some therapists intentionally stay small and focused. Others build agencies that serve multiple districts.

The common thread is flexibility. Schools often need targeted help, not just full time placements. Therapist run businesses can meet those needs in ways large agencies simply cannot.

Relationship building is everything right now

Schools are being sold to constantly. Software companies, equipment vendors, Medicaid services, staffing agencies. Everyone is pitching.

Because of that, transactional sales no longer work.

Elise explained that relationship based outreach is not optional anymore. It means asking more questions than you pitch. Learning about the school, the district, the people behind the titles. Following up even after a no. Staying present without being pushy.

Schools remember who treats them like humans instead of leads. They talk to each other. One positive experience can quietly turn into referrals you never directly asked for.

This is where therapist run businesses have an advantage. We are not working from call quotas. We are able to build trust, show flexibility, and offer real solutions without rigid minimums.

Trust comes from structure, not just good intentions

Caring about students is not enough to build trust with schools.

Elise emphasized that professionalism matters. Clear contracts. Consistent communication. Testimonials. Data points that show reliability, like meeting IEP deadlines or stepping in quickly when a school is in crisis.

Trust also comes from being adaptable. When schools say they do not need full time support, therapists who can offer evaluations, overflow coverage, or short term solutions stand out. Being willing to meet schools where they are builds long term partnerships.

You can start at any time of year

One of the biggest myths around school contracting is that there is a perfect season to begin.

According to Elise, contracts happen year round. January is often busy. Spring contracts are common. Even reaching out when a school says they are set creates an entry point for the future.

There is no wrong time to start building relationships with districts.

From therapist to business owner is a series of steps

This part of the conversation went beyond school contracting and straight into the heart of entrepreneurship.

Elise shared that fear did not disappear when she started her business. She did not suddenly feel confident or safe. She took steps anyway.

She reduced her own contracts before letting them go. She blocked small chunks of time to sell and build. She invested in support when she was scared to do so. Each step created more stability and clarity.

You do not have to leap. You do have to keep moving.

The real lesson

If there is one message I hope sticks from this episode, it is this.

You do not need permission, investors, or a business degree to build something that works better for you. You do need to treat your work like a business, invest where it matters, and stop trying to do everything the hard way.

School contracting can be a powerful, ethical, and sustainable path for therapists. It can also be a mess if you walk in unprepared.

This conversation with Elise is for anyone who knows there has to be another way, and is ready to build it thoughtfully instead of burning out trying to survive what no longer fits.

If you are curious about school contracting, adding revenue to your private practice, or simply what it looks like to step into business ownership as a therapist, this episode is worth your time.