Purpose and Profit: Scale Your Therapy Practice

Cecilia Mannella
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Host Cecilia Mannella is on a mission to help therapists scale their therapy practice - she scaled from solo therapist to 7-figure group practice. This show is for therapists ready to ditch the "hustle harder" mentality and scale without sacrificing values or sanity. Learn sustainable growth strategies that don't require 60-hour weeks or caffeine IVs. Whether you're hitting $100K or scaling beyond, get real tactics for building a profitable practice that serves your life. Scale without sacrifice.

  1. 4D AGO

    24 | From Care Aide to Grief Specialist: Building a Practice That Honours the Messy, Non-Linear

    What happens when everything you learned in graduate school about grief contradicts what you experienced in real life? Eliezer Moreno, grief and loss therapist in Vancouver, shares the powerful story of losing his friend Ryan shortly after learning "all the right things" about supporting people in grief—only to find himself confused, lonely, and unable to cry at the memorial. This conversation explores how his grandmother's nursing legacy, hospice volunteering, and personal loss shaped a practice that rejects pathologizing grief and instead walks alongside people in their messy, non-linear healing. What You'll Learn: + Why the hospice model of "companioning" differs radically from clinical training's pathologizing approach + How losing a friend shortly after grief training revealed the gap between theory and lived experience + The physical manifestations of grief that aren't talked about enough + Why disenfranchised grief keeps people stuck and how to validate every type of loss + The power of saying "I don't know what to say" instead of trying to fix or solve + How to build a grief therapy practice that honours mess over models + Why YouTube and email marketing are essential for grief therapists in 2025 + The one-to-many service model that extends your impact beyond the therapy room Key Topics Discussed: + Eliezer's journey: grandmother's nursing legacy in the Philippines → care aide work → collecting stories from clients + The shift from practical care to therapeutic presence (noticing photos on walls, asking about people's lives) + Social work training: learning modalities and clinical interventions focused on pathology + Hospice volunteering: discovering the "companioning" model that honours grief as natural, not broken + The contrast: graduate school taught five-stage model (Kübler-Ross) in one paragraph; hospice taught complexity + 2017: losing friend Ryan shortly after 10-year high school reunion + The loneliness of being the only one not crying while surrounded by grieving people + Disenfranchised grief: losses that aren't socially recognized or validated + The pressure to "get over it" after arbitrary timelines (6 months, 1 year) + Why grief isn't linear and models can be more harmful than helpful + Supporting LGBTQ2S+ folks in grief (chosen family, complicated relationships with biological family) + Lessons from Full Practice Formula program (first cohort member) + Current challenge: wanting to create YouTube content but feeling overwhelmed + Cecilia's coaching: breaking YouTube into manageable steps (pick topic → record video → create 5-min clip → distribute) + Email list strategy: nurturing relationships through resources and video content Mentioned in This Episode: + Eliezer's Grandmother - Nurse from the Philippines, came to Canada in the 1960s, inspired Eliezer's helping profession path + Hospice Volunteering - Where Eliezer learned the "companioning" model vs. pathologizing approach + Elisabeth Kübler-Ross - Five-stage grief model taught in graduate school + Disenfranchised Grief - Losses not socially recognized (friendship loss, non-death losses, ambiguous loss) + Full Practice Formula Program - Cecilia's program, Eliezer was first cohort member + Jane App - Practice management software where Eliezer has email permission but hasn't launched list yet + Meaningful Counselling - Eliezer's practice serving Surrey, Coquitlam, and online in BC The Physical Reality of Grief: Eliezer shares his personal experience of physical grief symptoms many people don't talk about: jaw clenching at night, body tension, the confusion of not crying when "supposed to." This vulnerability normalizes the...

    40 min

  2. JAN 27

    23 | The Social Worker's Dilemma: Making Money Without Betraying Your Values

    Social workers are trained to fight capitalism and poverty—so what happens when you decide to open a private practice and charge for your services? April Griffin, MSW and group practice owner, gets brutally honest about the identity crisis, money shame, and values conflict that social workers face in the private sector. This conversation tackles the elephant in the room that nobody in social work education wants to discuss. What You'll Learn: + Why social workers struggle more than other therapists with the transition to private practice + The values conflict: anti-capitalist training meets the reality of needing income to survive + How social work education fails to prepare practitioners for private practice (or even acknowledge it exists) + Why private practice social workers aren't winning "Social Worker of the Year" awards + The scarcity mentality that prevents social workers from investing in their practice growth + How April built a 400-member Facebook group for BC social workers in private practice + What it takes to reconcile social work values with running a profitable business + Why "I just wanted to help people for free" is an unsustainable business model Key Topics Discussed: April's journey: Ukraine volunteer work at 18, Downtown Eastside, addiction/trauma/domestic violence work + Transition from Fraser Health (Maxine Wright Centre) to private practice during COVID + Starting in 2020: offering in-person therapy when everyone else was virtual only + The slow-and-steady build: hourly rental → sublet → own space → group practice (3 associates) + Social work's "client first" values that leave no room for practitioner sustainability + The cousin nobody talks about: private practice as the ignored sector in social work + Money shame: the discomfort of making money from people's pain + The values contradiction: being praised as a saint in healthcare but judged in private practice + How having three kids and a partner in school forced a mindset shift about money + Creating the BC Social Workers in Private Practice Facebook group (started from zero, now 400members) Mentioned in This Episode: + April Griffin's Group Practice - Emotion Wise Counselling, 3 associates, started ~3 years ago + BC Social Workers in Private Practice Facebook Group - 400 members, co-created with Dorcas -https://www.facebook.com/share/g/1B8H5Twurm/ + Fraser Health - Maxine Wright Community Health Centre (pregnant/parenting moms, substance use, trauma, domestic violence) + LinkedIn Strategy - April manually messaged social workers to build community + Social Work Education - MSW programs that don't teach business or acknowledge private practice + Anti-Oppressive Values - How they help clinical work but create friction with money + The COVID Bubble - In-person therapy demand during isolation + Slow Recovery - April's own journey from "I want to see people for free" to sustainable pricing The Social Work Values Conflict: + What Helps: Anti-oppressive lens, understanding social injustice, systemic awareness, trauma-informed care + What Hurts: Money shame, self-sacrifice narrative, capitalism guilt, scarcity mentality + The Paradox: Same salary in healthcare = saint; same salary in private = selfish + The Reality: "This is my only income now. I have three children. I had a partner at school for two years not working." + The Betrayal Feeling: Moving to private sector feels like abandoning social work's...

    42 min

  3. JAN 20

    22 | Live Coaching: When Your Two Niches Feel Like They Don't Belong Together

    What do you do when you have two completely different niches that you're equally passionate about? KelliWheatley is a first-year therapist in North Vancouver who loves working with both chronic pain/mind-bodyconnection AND walk-and-talk nature therapy. On the surface, they seem unrelated—but Cecilia coaches herthrough discovering the powerful connection that makes both niches work under one cohesive brand umbrella. What You'll Learn: + Why two different niches can work together when YOU are the umbrella + How to position yourself as the brand instead of fragmenting into separate identities + The biggest mistake therapists make when entering private practice (expecting to be fully bookedimmediately) + Why niche clarity is burnout prevention and creates practice longevity + How to write blog content at a conversational level (the 13-year-old test) + The mindset shift from "content creator" to "service provider" (one-to-many education) + Why marketing as a therapist feels gross (and how to reframe it as getting in front of people you cansupport) + How to connect two seemingly different specialties through the common thread Key Topics Discussed: + Kelli's background: competitive ballet, body image struggles, chronic illness journey, mind-bodyconnection + The "COVID bubble" myth: why the "everyone has a wait list" messaging set up new therapists fordisappointment + First-year reality check: the expectation vs. reality of building a private practice + Niche confusion: chronic pain/mind-body work AND walk-and-talk nature therapy—how do theyconnect? + The umbrella concept: YOU are the brand that holds everything together + Blog writing strategy: conversational tone, accessible language, service-focused content + Content as service: educating one-to-many instead of performative social media + The competitive mindset from dance that translates to business + Making language accessible (masters-level educated people need to simplify) Mentioned in This Episode: Kelli Wheatley - First-year therapist, North Vancouver, UBC graduate Kelli's Website - https://www.kelliwheatleycounselling.com Walk-and-Talk Therapy - Nature-based counselling approach Mind-Body Connection - Chronic pain, HPA axis, Gabor Maté's work The 13-Year-Old Test - Would a 13-year-old understand your content? Psychology Today - Where Kelli expected immediate results AI Tools - Mentioned as helpful for content creation Live Coaching Breakthroughs: The Problem: Two niches (chronic pain + walk-and-talk) felt disconnected and confusing The Reframe: YOU are the umbrella—both niches are tethered to your brand identity The Connection: Both niches are about embodiment and being present in your body The Solution: Position yourself as the intervention, not the modalities The Relief: "I don't have to dance on TikTok"—content can be written, educational service The Permission: You can pivot and evolve your niches over time; you're not married to them forever Key Coaching Moments: "You're not two separate entities floating around. They're both tethered to you. YOU are the umbrella." "Would a 13-year-old understand this? That's the filter. It's not about dumbing down—it's about making language accessible." "You are here on this podcast because of content that I produced. Content creation IS service." "You are the intervention. Your clients need to know who they're going to get—and that's who they're going...

    42 min

  4. JAN 6

    21 | Beyond Resolutions: The CEO Pause You Actually Need (New Year Reflection)

    New Year's resolutions feel empty because they skip the most important part: honest reflection. This isn't another "new year, new you" message—it's the anti-resolution episode you need. Before you set any goals for2026, you need to pause and look honestly at where you've been and who you're becoming as a practice leader. What You'll Learn: + Why reflection matters more than resolution-setting for sustainable practice growth + The exact journaling questions Cecilia uses every quarter to assess her practice + How to evaluate your year through the lens of lessons learned, not just wins and losses + What made 2025 successful in Cecilia's practice (ecosystem building, strategic hiring, marketing experiments) + The habits you need to start and stop to become the leader your 2026 vision requires + How to identify what needs to be released before you can move forward + Why personal growth is the prerequisite for business growth (not the other way around) Key Topics Discussed: + The CEO pause: taking off your clinician hat to reflect as a business leader + 2025 wins: building an ecosystem practice with diverse specialties, promoting from within, experimenting with AI optimization + 2025 challenges: bad hires, letting go quickly, investment experiments that didn't pay off Lessons learned: + Experimentation mindset, stabilization after growth, team culture importance + Releasing unfinished conversations and letting go of what no longer serves + Committing to stopping harmful habits and starting wellbeing habits + The identity shift required for your next chapter: who do you need to become? + Measuring success: defining what makes 2026 successful on your own terms + Growth happens at the edges, not the center—embracing discomfort as necessary + Personal disclosure: Cecilia's commitment to stop phone scrolling and prioritize self-care habits Mentioned in This Episode: Reflection Questions Worksheet - Download the complete journaling prompts from this episode Full Practice Formula Program - Over 50 graduates excelling in practice growth Marketing Experiments - AI optimization, blog post format testing (changed 5 times) 2026 Focus - Stabilization year after growth and experimentation Key Frameworks: The Reflection Process - What went well, what didn't, why it happened, lessons learned? Habits Assessment - Committing to starting new habits and stopping old ones Identity Evolution - Who you need to become for your success vision The CEO Pause - Stepping into leadership perspective quarterly Success Definition - Your definition, not external benchmarks Reflection Questions from This Episode: + How did 2025 go for you? (What went well and why?) + What lessons did you learn that you're taking forward? + What needs to be released before moving into 2026? + What habits are you committing to starting and stopping? + What would have to happen by the end of 2026 for you to consider it successful? Who do you need to become for this year's chapter to turn out the way you'd write about it? ABOUT YOUR HOST: a href="https://www.ceciliamannella.com/about-cecilia-mannella" rel="noopener...

    35 min

  5. 12/09/2025

    20 | Why Great Leaders Still Drown in Chaos (4P — Process Pillar)

    You've got your purpose clear, your profit strategy solid, and your team aligned with your values. So why are you still spending 17+ hours a week drowning in administrative chaos? Here's the truth nobody tells you: You can have the best vision, strongest profit margins, and most authentic leadership—but if your operations don't have clear systems, they're going to burn you out. This final episode in the 4 Pillars series tackles the unsexy but essential foundation that makes everything else possible: processes. What You'll Learn: Why 50-80% of your non-clinical time goes to operational issues that could be systematisedThe hidden cost of hiring without a structured process (and how it's draining your time and money)How to stop being the bottleneck in every single decision your team needs to makeThe six priority systems every therapy practice needs—and the exact order to implement themWhy documentation isn't bureaucracy—it's the key to scaling without losing your mindHow to build team communication structures that actually work instead of fragmenting across platformsThe firing and off-boarding process you need before you need it (because it never gets easier) Key Topics Discussed: Operational chaos symptoms: hiring without systems, financial mystery, communication fragmentation, performance management avoidance, documentation resistance, and crisis-mode firingThe real cost of not having processes: reactive hiring, constant re-explaining, self-doubt, financial uncertainty, wasted time, team frustration, legal vulnerability, and burnoutSix priority systems in implementation order: hiring and onboarding, financial tracking and reporting, performance management and feedback, team communication and decision authority, regular check-ins, and firing/off-boarding protocolsHiring system essentials: clear job descriptions, structured interview processes, comprehensive onboarding plans, and 30-60-90 day check-insFinancial clarity requirements: monthly profit and loss reviews, quarterly projections, clear bookkeeping systems, and knowing your numbers at all timesPerformance management framework: regular check-ins, real-time feedback culture, documented conversations, and early issue identificationTeam communication infrastructure: choosing one platform, creating decision-making matrices, and eliminating the bottleneck dynamicDocumentation as protection: policies and procedures that prevent misunderstandings and provide legal coverageClient-centred off-boarding: respecting client autonomy, ensuring continuity of care, and maintaining ethical standards during transitions Mentioned in This Episode: Sustainable Practice Framework™ - All 4 Pillars working together: Purpose, Profit, People, ProcessRECLAIM Process - Applied to the Process Pillar for operational...

    37 min

  6. 12/02/2025

    19 | Why You Can't Scale Without Letting Go (4P — People Pillar)

    You've built a thriving practice, you're at capacity, and you know the next step is hiring—but here's what nobody tells you: being an excellent therapist doesn't automatically make you a great leader. Most therapy practice owners struggle to scale not because they can't, but because we were never taught how to shift from clinician to leader. And the fear of becoming the kind of manager you never wanted to be? That's keeping you stuck in solo practitioner mode even after you've hired associates. What You'll Learn: Why clinical excellence doesn't translate to leadership skills (and what actually does)The three most common leadership scenarios that keep therapy practice owners stuck in micromanagement modeHow to create boundaries between being a leader and being a therapist for your teamThe difference between transactional leadership and transformational leadership—and why only one works for values-driven practicesFive essential leadership conversations every practice owner needs to masterPractical strategies for building team culture that reinforces your practice valuesHow to step into authentic leadership without becoming someone you don't want to be Key Topics Discussed: The leadership crisis: transitioning from solo clinician to team leader without any trainingThree common struggles when scaling: micromanagement, blurred boundaries, and leadership resistanceWhy most business leadership advice doesn't work for therapists (and what does)The myth of "natural born leaders" and why your therapeutic skills are actually your secret weaponBreaking down transactional vs. transformational leadership modelsFive critical leadership conversations: vision alignment, performance coaching, difficult feedback, growth planning, and boundariesCreating intentional team culture through values, rituals, psychological safety, and consistencyThe RECLAIM process applied to the People Pillar Mentioned in This Episode: Sustainable Practice Framework™ - The 4 P's Strategic Pillars: Purpose, Profit, People, ProcessRECLAIM Process - Seven-step methodology for leadership transformationStory Reference: "Maria" - Cecilia's personal experience with micromanagement in early group practice yearsLeadership Development Resources - Coaching, mentorship, peer groups, and masterminds Key Frameworks: People Pillar - Build and lead values-aligned teams through authentic leadershipTransactional Leadership - Management based on tasks, performance metrics, and complianceTransformational Leadership -...

    38 min

  7. 11/25/2025

    18 | Why Therapists Leave Thousands on the Table (4P —Profit Pillar)

    How much money would you be making if you didn't have beliefs about what therapists are "supposed" to charge? This episode tackles the profit problem in our profession: why therapists with incredible expertise, advanced training, and transformational impact are charging as if they're fresh out of grad school—and leaving tens of thousands of dollars on the table every single year. What You'll Learn:Identify five core money beliefs - Recognize the limiting narratives keeping you stuck, including "therapists don't get rich," the guilt loop around profit, the martyr narrative, accessibility traps, and growth mythsUnderstand the roots of therapy's money issues - How patriarchy and the historical undervaluing of women's work created the belief that good helpers aren't motivated by moneyDistinguish revenue from profit - Why six-figure income doesn't equal six-figure security and how to calculate healthy profit margins (goal: 30% or higher)Navigate Canadian-specific considerations - Provincial regulations, tax implications, business structure decisions, and regional fee variations across CanadaImplement strategic pricing - How to structure fees that reflect your expertise, specialisation, training, and the transformational value you provideApproach fee increases confidently - Annual review strategies, gradual implementation plans, and communication frameworks that announce rather than apologizeCreate sustainable sliding scales - How to offer genuine accessibility by setting floors, limiting availability, using strategic scheduling, and giving yourself permission to say no Key Topics Discussed:This episode explores the inherited beliefs that create artificial income ceilings for therapists, including how the guilt loop equates fees with ethics and the martyr narrative connects to centuries of undervaluing women's work in a profession that's 90% female. We examine why financial security for therapists isn't selfish but sustainable, and how having associates complicates rather than fixes money mindset issues. The conversation covers the critical distinction between revenue and profit, with most therapy practices operating at 5-10% margins when the goal should be 30% or higher. Cecilia provides specific strategies for fee structuring, annual increases, and sliding scale implementation, plus guidance for group practice owners on pricing leadership value appropriately. We discuss sustainable profit metrics including calculating revenue per billable hour, tracking profit margins, building emergency funds, and creating long-term wealth beyond annual income. Mentioned in This Episode:This episode continues the Sustainable Practice Framework™ series with the Profit Pillar, exploring how ethical profit supports rather than compromises your purpose. We reference how the Purpose Pillar (Episode 1) connects to profit decisions, the importance of knowing your numbers for sustainable practice management, Canadian tax considerations including RRSPs and TFSAs for wealth building, and the upcoming People Pillar (Episode 3) on authentic leadership and values-aligned hiring. Key concepts include the difference between revenue and

    32 min

  8. 11/18/2025

    17 | Why Your Profitable Practice Feels Empty (4P — Purpose Pillar)

    You've hit your revenue goals, your calendar is full, and your practice looks successful from the outside. So why does it feel hollow? This episode tackles the growth paradox nobody warned you about: you can build a massively profitable practice that feels like a complete betrayal of why you became a therapist in the first place. What You'll Learn:Identify the growth paradox - Why hitting revenue markers can feel surprisingly empty and what this disconnection reveals about misalignment between external success and authentic purposeRecognize common misalignments - The four ways therapy practices drift from their original vision, including the gap between the practice you built versus the one you actually wantedUnderstand the real cost - How misalignment creates burnout that vacations can't fix, affects your team and relationships, and builds resentment toward the business you're creatingDefine authentic purpose - What purpose actually means beyond fluffy mission statements and how it becomes your operational North star for business decisionsApply the four elements of purpose - Vision alignment, values integration, energy sustainability, and meaningful impact as the foundation for sustainable practice growthUse purpose as your decision-making compass - How clear purpose prevents decision fatigue, protects you from comparison, guides you through challenges, and invites others into your authentic visionImplement the RECLAIM Process - Practical steps to recognize external expectations, examine inherited beliefs, and build a practice that actually reflects your values Key Topics Discussed: This episode explores why inherited success narratives from business culture don't fit therapy values and how financial pressures push therapists to follow blueprints that weren't designed for healing practices. We examine common misalignments—like building 40-hour practices when you wanted 20 hours or marketing services you've lost passion for—and their real costs including deep-seated burnout and building something you resent. The conversation covers the four elements of authentic purpose (vision alignment, values integration, energy sustainability, and meaningful impact) and how purpose becomes your decision-making compass that protects you from comparison and compromise. Cecilia shares her real-world experience of two different paths to seven figures, contrasting hustle-driven growth with purpose-driven rebuilding, plus practical implementation steps including free-writing exercises and the RECLAIM Process. Mentioned in This Episode:This episode introduces the Sustainable Practice Framework™, a four-pillar approach covering Purpose, Profit, People, and Process for building therapy practices that thrive. We reference the RECLAIM Process (Recognize, Examine, Challenge, Liberate, Affirm, Integrate, Manifest) as the methodology for transformation, discuss the Growth Paradox where external success feels hollow without authentic purpose, and break down how purpose functions as a decision-making compass. This is Episode 1 of a four-part series diving deep into each pillar of the framework. strong...

    31 min
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About

Host Cecilia Mannella is on a mission to help therapists scale their therapy practice - she scaled from solo therapist to 7-figure group practice. This show is for therapists ready to ditch the "hustle harder" mentality and scale without sacrificing values or sanity. Learn sustainable growth strategies that don't require 60-hour weeks or caffeine IVs. Whether you're hitting $100K or scaling beyond, get real tactics for building a profitable practice that serves your life. Scale without sacrifice.

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