During fiscally challenging times and given the prevalence of managed care, it is easy to think that a fee-for-service private mental health practice is no longer possible. This chapter clearly demonstrates how wrong this myth is. Many individuals use their disposable income to purchase goods and services that are of value to them. How to develop and maintain a financially successful fee-for-service private practice is explained. Specific strategies are provided to determine community needs, to develop clinical skills that meet these needs, and to demonstrate the value of these services to prospective clients. Recommendations are made for structuring one’s practice so that clients will be more likely to pay for needed services out-of-pocket and for developing a successful fee-for-service private mental health practice.