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Compared to creative, media, planning, or experiential, it is a tougher road, for all the reasons mentioned above. Most freelance work in every industry is built around “tangible, hands on output” vs “account leadership”. The exceptions might be in filling in for maternity/paternity leave, but most places generally hope the juniors can fill in during the absence.
It most certainly can be done (I’ve done it); like anything else starting is the hardest part but, once you get going and build up a good rep, you can build up a base and get requests.