A client came to Harper Psychology barely able to speak. They'd had a severe attempt on their life. They were deeply depressed and struggling to engage. And every week, without fail, Paddy — a one-eyed collie who lives at the practice — would jump up onto the sofa, put his head in the person's lap, and look up at them.
At the end of therapy, that client said something that has stayed with Alison Harper ever since.
"It was Paddy that made the difference. Paddy made me better."
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In this episode of Scale HER Up, Alison and her colleague Sara Huibregtse Van Loon join Brenda to talk about what it actually looks like to build something slowly, carefully, and with real purpose — and what it means to want to hand it on rather than cash it in.
The practice that wasn't supposed to happen
Alison Harper qualified as a clinical psychologist in 2000. She joined the NHS, worked in primary care and then in a day patient unit for people with severe and enduring mental health problems. She loved it. She was never going to go into private practice.
And then her children started school.
The maths is simple and brutal: 50 weeks of nursery a year becomes 14 weeks of holidays. One of her children wasn't going to be happy in a holiday club or a sports camp. Alison needed flexibility that NHS employment couldn't provide.
"I initially went out thinking, 'I'll work a tiny bit while the kids are little and see what happens.' And then it grew and grew."
Twenty years later, here she is. Harper Psychology — a practice of six, working across clinical psychology, CBT therapy and counselling psychology, with a particular expertise in anxiety, depression, OCD, trauma and eating disorders. And two dogs in the room most days.
Building a team in a field where continuity matters
The biggest challenge Harper Psychology has navigated wasn't finding clients. It was keeping therapists long enough to make client relationships stable.
Early on, Alison saw the practice partly as a training ground — a place where people could build experience before going on to further clinical training. A generous model in theory. In practice, it meant a revolving door. Clients in private practice don't have the same expectations as NHS clients; they've chosen their therapist and they don't expect to be handed on after six months.
"Coming from the NHS, that's what happens all the time. You'll see somebody and then they move on. It's in your GP practice you may see a GP and then move on. But it's not the same if you see the same therapist."
The change came through a shift in thinking: realising that CBT therapy is a destination, not a stepping stone. That someone can build an entire meaningful career as a CBT therapist and go on doing extra training throughout it, without ever needing to move on to clinical psychology. Once Alison stopped nudging people towards the next thing, people stopped leaving.
"It was me actually just getting into my head that actually people are different and they're on different training routes, and you can keep on doing extra training from whatever initial training you come from."
Now three of the therapists are in their mid-to-late 20s with long careers ahead of them. Nobody's going anywhere. And the practice is stable enough to think about what comes next.
The team that got built during COVID
The expansion to six happened because of COVID — or rather, because of the gap COVID left.
When the NHS was struggling to see people, Harper Psychology kept going. Alison and Sara moved overnight to Zoom. No downtime. And the demand that couldn't be met elsewhere — particularly in adolescents, in OCD, in eating disorders — started coming their way.
"We thought at that point we could help take on more people if we had more staff, and we could do training and help with training."
The team that came out of that expansion meets for lunch together. They share a group chat where people post podcasts and articles. They support each other with supervision and shared learning. For a team working in one of the most emotionally demanding fields there is, that's not a nice-to-have — it's the infrastructure that makes the work sustainable.
Sara puts it simply: "I can imagine working completely alone could be pretty isolating. There's just so much benefit from having a team around you."
Passing the baton
Alison is in her mid-50s. She's clear that she won't be running the practice in five years. And rather than sell it or close it, she wants to hand it to the people already in it.
Not because it's a clever business strategy. Because it feels right.
"I've done my part of the relay, and as I get to the end I just want to be able to pass the baton on."
The model is still being worked out — who takes what, what the structure looks like, how the finances work. But the direction is set. Someone who'd gone away to do their training is coming back to join the team. The three late-20-somethings have a long working life ahead of them. And Alison's hope is that they'll take it somewhere she hasn't thought to go.
"You hope that people will progress and be able to come up with new ideas and develop further."
The stigma that's still there
Alison heard someone talking about the stigma around therapy the morning of this recording. It made her want to address it directly.
Mental health, she says, is no different from dental health or physical fitness. If you want to be physically fit, you exercise. If you want good dental health, you brush and floss. If you want good mental health, you have to challenge your thinking, understand what keeps it stable, and get support when you need it.
"Nobody has a stigma about going for physiotherapy. Nobody has a stigma if they need an operation. And we're taught so many things when we're at school — maths and English — and we're not taught how to navigate emotions."
We're taught what to think. We're rarely taught how to think about how we're doing.
Her equivalent for wellbeing: "Mental health is like dental health is like physical fitness." Three things with something in common — they all require maintenance.
For employers, the advice is practical. Be non-judgmental. Listen. Give people ownership over their work and avoid micromanaging. The research is consistent: punitive responses to sickness absence don't reduce absence. Supportive ones do.
About Alison Harper and Sara Huibregtse Van Loon
Alison Harper is the founder of Harper Psychology, an Edinburgh-based private psychology practice specialising in anxiety, depression, OCD, trauma and eating disorders. She qualified as a clinical psychologist in 2000 and has been in private practice since around 2006. Sara Huibregtse Van Loon is a psychological therapist at Harper Psychology, trained in CBT and EMDR trauma therapy, who joined Alison after completing her training under Alison's supervision at university.
