Patrick Casale, Therapist and Coach

Patrick Casale

Hi, I’m Patrick Casale. I live in Asheville, NC with my wife and two dogs. I moved down in 2011 from upstate NY. I was basically running from a life that really wasn’t functioning healthily or optimally. It was a scary experience to move somewhere that I didn’t have a job or community. The last 9 years have been challenging and beautiful. The growth and transformation that has taken place is truly incredible.

Patrick Casale’s Work Experience

I’ve worked in the helping profession since 2008. In the last 12 years, I’ve worked in several different arenas in community mental health. From qualified professional to program director, I found myself constantly being promoted to middle management roles where I was able to see both sides of the coin. It was hard watching my staff work so hard for so little while trying to appease the powers that be who typically were out of touch with day to day operations. I have worked full time as a private practice therapist for the last two years. In those two years, I’ve traveled to 8 different countries, taken lots of vacations, grown my business to a point where it feels easy and routine, and have helped other therapists in the area do the same.

More About Patrick

In my free time I play soccer, hike, read, travel, spend time with my wife and dogs, and eat good food. Working for myself has truly given me more time, more freedom, and more flexibility.


I love helping other people face their fears and grow through them. I love coaching and encouraging other helping professionals to achieve their dreams. Connecting people to resources that can help them has always been a passion of mine. I often find myself in leadership roles whether at work or on the soccer field. Coaching and leading people towards a goal is something that really excites me. I want to empower and encourage you to face your fears, work towards achieving your goals, and create more financial freedom and flexibility.


My Journey

I decided that I wanted to go out on my own but was fearful. I was scared of the unknown, the uncertainty, and the lack of consistency. I think it’s natural to be scared of what we don’t know. Most people who decide to go into the helping profession don’t have a lot of business training, if any at all. It’s hard to imagine how to start a business if you know nothing about it which makes perfect sense. 

Eventually, I decided to take the leap and bet on myself. I started a part-time practice at night and felt confident enough to put my notice in. The feelings I experienced when going into my own office, seeing my own clients, charging what I wanted, and working in a way I felt comfortable, I felt re-energized. I felt excited again to work in the helping fields. Too long had I felt burnt out and overextended in community mental health. Too many clients, too big a caseload, and never enough time or resources.  

I built up a caseload of 15 clients at night. I was exhausted, working a salaried job at a very busy agency in town. The more I saw people in my office the more confidence I gained. I put my notice into my employer and excitedly planned my exit strategy. On my last day of work, my manager told me “you’ll be back, no one makes it working for themselves.” I felt enraged but I also felt motivated. Any time someone tells me that I can’t do something it only makes me want to do it even more. 

My first couple of months were not easy. I lost clients and I stopped receiving calls. I started panicking, thinking that my former manager was right. Impostor syndrome started to creep in quickly. I checked in with myself and realized I hadn’t had free time in over 8 years. The new-found freedom I had made me feel like I wasn’t doing enough, not for myself or my business. I started networking more than I had been, way more. I started blogging. I did everything within my power to ensure that I would be successful.  

For almost two months I maintained an 8-10 client caseload and felt fearful that things would never change. I continued doing what I knew to be true and what I knew to be effective. That third month it was like the dam burst. Call after call after call. Since that time I’ve always been busy and usually full.  

I think that networking is important but doing good clinical work is equally important. You need to be able to do both at the same time. Marketing, networking, and good clinical work. I know great clinicians who are terrible at marketing and networking and who look at it with disgust. I know great business-minded therapists who do mediocre clinical work but stay busy all the time. When you decide you are going into private practice you are also committing to becoming a small business owner. You cannot do one without the other.  

I am coming up on 2 years of full-time private practice ownership. I am full constantly and referring out weekly. I feel grateful for the reputation I’ve developed but it did not happen overnight. Like any other business, you have to create and foster a reputation. You need to do good, sound clinical work. You need to call your prospective clients back (please don’t get me started on this). And you need to network and market your services. You are selling health, healing, the ability to grow and change, and the process of navigating pain, trauma, and suffering.  

If marketing, setting fees, charging for services, and networking makes you feel uncomfortable, check in with yourself. Ask why? What feels uncomfortable about this process? Do you not feel confident or competent enough to charge for services? Remember that you are not just charging for the 60 minutes of therapy but for your training, licensing, supervision experience, your work experience, your mental space where you will safely hold your clients information. You are selling so much more than just an hour of your time.  

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