This podcast is here for therapists, counselors, social workers, psychotherapists, and mental health clinicians in their practice journeys. I'm Gordon Brewer and the person behind The Practice of Therapy Blog and Website that provides tools, resources and advice for people starting, growing or expanding their private practices. The podcast will help you learn from other experts in the field to move your private practice forward to success.
Restructuring Your Private Practice For Success | TPOT 156
The shift to telehealth has just created a massive change for a lot of us in private practice. So this episode is all about diving into restructuring your practice. First, ask yourself why you started a private practice, and think about why you want to restructure your practice. Once you know why you can begin to focus on restructuring your workflow. Sometimes, certain aspects of your workflow can be made more straightforward; simple is always better. Stay tuned as I talk about restructuring your finances, increasing your rates, and giving your website a facelift.
Start With Why When we think about our why - go back and think about why you wanted to go into private practice, to begin with. What motivates you to have a practice? For a lot of people, they want the autonomy that it brings. Also, it creates a more significant earning potential for us. So, why do you want to restructure your practice? Perhaps your systems and processes have become overly complicated. Maybe your stress levels continue to rise because of things within the practice that cause you a lot of headaches.
Look At Your Workflow From the time that a new client contacts your practice, what takes place? One client is easy, but if you start getting ten clients a week, what’s the workflow around that? Who is in charge of the workflow? Map this out! The intake procedure should be simple for the client. Think about ways that you can make it easy. Now that everything is online, the process should be as user-friendly as possible. Plus, the process should also be easy for you as a clinician. In private practice, there is an overlap between the clinical and business sides. Keep those processes separate from each other. Having an electronic health record system will help you keep these things separate.
Ditch Your Deadwood There are probably things in your workflow that you don’t need. Simple is always better. Writing session notes can be a massive headache for clinicians. Newer therapists will go into so much detail in their session notes. It will be an entire narrative of everything that took place in the session. This is something that you can cut back on. Progress notes are a reminder for you as a clinician of what you did in that session. If you have things that give you the theme of the session, then that should be documented.
Session Note Helper Your progress notes should only take about five or ten minutes to complete. If they are taking longer than that, you need to streamline it more. People can get really backed up on client documentation. The Session Note Helper is a set of templates that I created. It uses an add-on called Form Publisher that is HIPAA secure. You can check off boxes about what you did in the session. Then, the Form Publisher will create a narrative based on what you checked on the form. You can find out more about the Session Note Helper here. I created this to make my workflow easier. Because it’s in a Google Doc format, I can just copy and paste what I wrote there into TherapyNotes.
Understanding Your Profits One mistake that most people will make is looking at their bank account and thinking they don’t have to worry. You need to do a deeper dive into your profitability. Look at the profits at least once a quarter. Make sure that what you are bringing in is making a profit for yourself, and it’s sustainable. Look at your numbers and think about restructuring your payment system. Anytime there is a change in the pay system, it can be painful. However, once you rip the band-aid off, it can bring long-term benefits. If you will restructure how you pay your clinicians in a group practice, set a deadline for yourself. The first of the year is an excellent time to change things; it’s natural.
Restructure Your Prices If you are insurance-based, look at those contracts and which ones are going to renew. You can set up a new fee
Embracing Changes In Your Private Practice | TPOT 155
This episode is all about embracing the changes that 2020 has thrown at us. As we adjust to the new normal, it's time to think about what opportunities we can find. For instance, if you haven't already, maybe it's time to ditch your physical office and go full-time into telehealth. Also, it's time to start thinking about diversifying your income through Gumroad or Teachable. Tune in as I speak about all sorts of ways you can embrace the curveball that is 2020.
Start With Your Why What are your priorities? Why do you want to be in practice? Why do you want to do the things that you do? This year we learned a lot about making a transition to a whole new business model, and that's the switch to telehealth. Frankly, telehealth will become the new normal over the next year. So, it's time that you think about how you have your practice structured and set up. One of the things about being online is that your office space becomes less important. You don't need the furniture anymore!
Think About Your Practice Moving Forward The boundaries around the types of people you can see for therapy has now widened a great deal. Your potential client base can be the entire state you are licensed in. So, how are you going to start to market your practice? You can think about a broader reach. Does your website need to be updated? This could be a great time to make upgrades and changes. That way, it will reflect that you can see clients from a broader geographic location. Think about doing things in different ways.
It's A Great Time For Private Practice Owners There is such a demand for mental health services during 2020. When you switch to telehealth, it will reduce the geographic bounds of what you do. Are you thinking about having a group practice? The therapists that you can hire has now broadened too; they no longer have to commute! The pandemic allows for more work and less commute time. It's time to think about things differently.
Write Down Your New Priorities When you write down your new priorities, it will help with the overwhelm. When we are overwhelmed, there will be a sense of anxiety. To battle anxiety, do a brain dump! In your planner, make a list and write down everything that captures your attention at the moment. It's a journaling exercise in many ways, and it gives us a new perspective on things.
Why You Need To Embrace Change Our routines have been turned upside down. Particularly for those who have children. It's challenging to navigate work with homeschooling. We need to accept the fact that our routines are messed up. Now, it's time to look at small ways to change our routine and make it work for us. We are creatures of habits, and we get used to doing things the same way each time. When we change that up, it becomes unsettling. Instead, we need to focus on self-care. If you want to learn more about practicing self-care as a private practice owner, listen to my episode with Veronica Cisneros: Unapologetic Self-Care in Private Practice.
The Importance Of Connecting With Others The pandemic has caused us to feel isolated and disconnected from people that matter most to us. Thanksgiving is around the corner. However, many of us have pulled back from our traditions, and we are not getting together with family. It's a hard decision to make. Allow yourself to embrace change, lean into it, and take ownership of how you will reorganize your life. We think about our relationships with others differently during 2020 – embrace it! I recently did an episode with Kathryn Esquer about connecting with other private practice owners during 2020. You can listen to the episode HERE. Plus, try The Teletherapist Network for two weeks free using my link: https://teletherapistnetwork.com/gordon.
Diversify Your Income There are so many great opportunities to create income for yourself in the online space. For instance, you can sell dig
Faith Dulin | Setting Boundaries And Working With Difficult Clients | TPOT 154
In this episode, Faith Dulin and I talk about her experiences as a new therapist and working on boundaries with people. As therapists, we like to be accommodating. However, people-pleasing will take a toll over an extended period of time. One way that Faith works on her boundaries is by seeing her own therapist. Plus, we talk about working with clients who are challenging to engage with, and we give tips on building rapport with clients upfront.
Meet Faith Dulin I moved to Charlotte from the West Coast 20+ years ago. I have a military background and worked uptown in corporate America before completing my degrees in Psychology, Sociology, and Marriage and Family Therapy. In my free time, I gush over dogs on Instagram, enjoy sports, and like taking pictures.
My counseling style is a balance between challenging and cheer-leading. I have a contemporary approach that’s less theory-oriented and more real talk. I’m not reclined in my chair with a monocle, analyzing your every move. I’m listening, I’m curious, I’m aware that behaviors make sense in context. I want to understand you and know what you want in life so we can figure out how to get there. I provide helpful feedback, compassionate support, and take-home strategies and tools. The relationship you have with yourself sets the tone for all other relationships, and I want to empower you to create the love and life you deserve.
In addition to supporting relationships, I work with individual men and women. I'm located near uptown and have evening appointments. Check out my website to see if I'd be a good fit for you.
Boundaries Faith is putting together a book around the concept of boundaries that doesn't have a religious foundation. There are practical ways to set boundaries without feeling like a jerk. Therapists can struggle with boundaries. For example, some therapists will become heavily invested in their client's lives and their success. Another example of poor boundaries is when a therapist may have social media interactions with their clients. Sometimes, therapists will talk to their clients over the weekend. Also, therapists that handle money will have a challenging time setting a boundary with their clients. We need to continue to work on boundaries. One way that Faith works on her boundaries is by seeing her own therapist.
Working With Difficult Clients In graduate school, therapists are told they should be gentle and non-confrontational. Everyone has a different style of working with clients. Faith says that she likes to be direct and confrontational. It's essential to label behaviors, even if it isn't warmly received. If a client does not take the label well, it's probably not the right fit for Faith. Clients need to find a therapist that's a good fit for them. If you are not the right therapist for a client, then you shouldn't take it personally. The client must benefit from therapy. If the client doesn't work well with you, it will be best for both of you to go separate ways.
Working With Difficult Men Faith tends to get male clients that hate therapy – they think it's a bunch of BS. When it's a couple, Faith says that their wife has made them go to therapy. However, men like when Faith gives it to them straight. It's essential to build rapport and trust with your clients. For Faith, she works with police and first responders. A lot of times, these men will come and test her as a therapist. They want to know if their trauma will rattle you. Faith likes to hold a safe space for clients so that they will learn to trust her. When you have that trust, then your relationship with clients can withstand challenging moments in therapy.
Creating A False Mutual Pretense Therapists can create false mutual pretense. When someone is resistant to therapy, then they are probably testing you out. We should be able to label that dynamic from the beginning. Gor
Kathryn Esquer | Connecting With Other Therapists During The Pandemic | TPOT 153
As a telehealth therapist, do you ever feel alone? My guest, Kathryn Esquer, knows exactly what this feels like. She misses the daily interactions with fellow mental health professionals. That’s why Kathryn created the Teletherapist Network, an organization for the next generation of therapists in private practice. Tune in as Kathryn speaks about how she created a community, politics in the therapy room, and the benefits of finding your network.
Meet Kathryn Esquer Kathryn Esquer is a Clinical Psychologist and MBA graduate. She currently works in her rural hometown in central Pennsylvania providing outpatient mental health services integrated into primary care. She loved her career, but COVID helped her realize that something was missing from her private practice. The clinical work was rewarding, but she felt professionally isolated and uninspired. She also knew consultation was a critical part of the ethical practice but didn't know where to find it. So, Kathryn created the Teletherapist Network for modern therapists to crowdsource the knowledge and experiences of other private practice teletherapists so that members can develop their clinical and business skills, all while staying connected to their mission and preventing burnout.
Teletherapist Network Don’t practice teletherapy alone. Join a premier organization for the next generation of therapists in private practice at Teletherapist Network. Kathryn Esquer explains the inspiration behind her network. When COVID hit, there were loads of challenges that therapists experienced. Once we had to switch to telehealth, it felt professionally isolating and uninspiring. No longer did we have peers or other people in the mental health trenches. As a problem solver, Kathryn wanted to find people to connect with. Thus, the Teletherapist Network was born!
Creating A Community Kathryn uses a platform that does all the technical stuff for you. Weekly, they do mindfulness exercises and questions. Plus, they consult with each other and have live consultations every other week via Zoom. Each week, they highlight a new member – they get to know each other on a deep level. People get to pick their brains all day. Therapists will ask questions, and the group gets to benefit from the collective knowledge. Plus, they have guest expert webinars coming in every month. Industry professionals will teach something new to the community. It’s a neat way to connect with people who want to help private practice owners. Now, Kathryn feels more inspired to better herself as a clinician. It’s easy to get out there and learn new things in the Teletherapist Network.
Politics In The Therapy Room Do you disclose your political affiliations or beliefs in the therapy room? We should be aware of what we personally bring into the therapy room and keep it in check. The only way to do that is to consult with peers. There’s a lot of political conversations happening in Kathryn’s community. It’s a skill to have civil discourse with your peers. This year, in general, has been challenging with COVID and the election. A lot of things are affecting our therapy internally. Finding a community will be essential for a therapist.
You’re Not Alone You’re not alone in feeling isolated or uninspired as a private practice owner. It’s scary that this community wouldn’t have happened without COVID-19. Kathryn is glad she has the community to stay on top of best practices and resources. When she started the network, over 150 people were looking to join the group. There’s an overwhelming response for the community – you’re not alone! Therapists need to speak with their peers. If you’re feeling a little isolated, find a community of support. With telehealth becoming so prominent, the barriers to entry for private practice are very low. If you recently went out on your own, you can lear
How Great Clinicians Fail; Reverse Interview with Julie Herres | TPOT 152
In this episode, Julie Herres interviews Gordon about how great clinicians can fail. First, clinicians can fail when they don’t know their numbers. It’s critical to understand the profit and loss of your business. Another significant mistake clinicians make is not charging enough for their sessions. A therapist must understand how their money mindset is holding them back from making enough money to run a private practice. Plus, we talk about the importance of having six months of income saved for emergencies, how to avoid debt, and why you need to stop bootstrapping.
Meet Julie Herres Julie Herres is the owner of GreenOak Accounting. The firm provides bookkeeping, accounting, CFO, and tax services to mental health private practice owners throughout the United States. When Julie founded GreenOak Accounting she started working with a few therapists. Over time, more and more therapist referrals came in and she started noticing trends across the practices that were thriving. Based on those trends she developed success ratios as a way to quickly determine the health of a practice.
Know Your Numbers & Charge Enough To Understand Profit And Loss Understand how the money is coming in. How are your patients paying you? Then, what do you do with the money after that? How are you paying yourself and your expenses? Most people don’t have a clear picture of what those numbers are. A big mistake people make is paying their clinicians too much when you start a group practice. Gordon made this mistake! He was paying his clinicians way too high, and he wasn’t covering overhead. It’s possible to pay clinicians a fair and competitive wage without having to overdo it. If Gordon knew his numbers better at the start, he wouldn’t have made this error.
Money Mindset: Therapists Should Not Feel Ashamed or Guilty About Making Money Many clinicians grow up with money shame. We think that money is evil or making money is bad. As therapists, we have a caring heart. Sometimes we feel like when we charge people money, then we are doing something wrong. Therapists will think that if someone is paying you for something, you are putting a burden on them. It’s a myth! Most people that go to therapy expect to pay. It’s one of the mistakes that a lot of people make. Then, therapists won’t charge enough for their services.
Reserves: Prepare & Plan By Having 2-6 Months of Income Saved For Expenses Set aside a reserve so you can pay for expenses or substantial tax bills. The minimum is at least two months. This money shouldn’t be touched unless you get into an emergency. However, six months of a money reserve is more ideal. This reserve should be created for both personal expenses and business expenses. When COVID hit, the people with reserves were better off than those who did not have a reserve. When thinking about switching to private practice, make sure to have your reserve first! Gordon spent a year accumulating his reserve before he made the dive into private practice.
Startup Expenses: Avoid Debt And Make The Practice Pay For Itself From The Beginning There’s a way to avoid debt when going into private practice. For mental health, there isn’t as much equipment that needs to be purchased. It can be relatively inexpensive to start your practice – you only need a few basic things, and then you are ready to go. Make your practice pay for itself instead of getting a loan to get started.
Bootstrapping: Spend Money To Make Money Because Doing It All Is Not A Good ROI Doing it all is not a good return on your investment. Sometimes you have to spend money to make money. People will hold off on spending money because they are trying to save. However, you are hurting yourself in the long run. For instance, you can hire a virtual assistant to help answer phone calls. If you can hire someone to answer the phone, then you can spend more ti
Danielle Branche | Navigating Perfectionistic Beliefs in Private Practice | TPOT 151
In this episode, Danielle Branche joins the show. She talks about navigating perfectionistic beliefs when it came time to create her private practice. After loads of therapy, Danielle finally came to terms with the idea that a perfect private practice simply isn’t possible. Also, Danielle speaks about the transition from private practice to group practice. Plus, we talk about overcoming shame, the black lives matter movement, and the importance of boundaries.
Meet Danielle Branche If you ask any therapist why they were drawn to this profession, most of them would answer with, "I wanted to help people". While this is true, it is much deeper. Danielle wanted to help people navigate through life in more fulfilling ways. She aspired to teach people how to be in a relationship with their mothers and fathers. Danielle wanted to give couples the tools they need to be the husbands and wives they want to be, not the ones their parents were. Her commitment is to do just that. *Danielle is no longer working out of the Largo area*
Danielle's main focus is working with couples around issues of trust, communication, forgiveness after infidelity, intimacy, sex, and decision making (finances, children, etc.). She does pre-marital therapy and marital/relational enrichment. Danielle mainly uses Emotion-Focused Therapy & Solution-Focused Therapy. Danielle also sees individuals and does group therapy.
As a Licensed Clinical Marriage and Family Therapist, Danielle is trained in understanding how to see things relationally, not just individually. She is versed in locating where behaviors, beliefs, ideas, and feelings originate, how they affect our lives and relationships, and how to effectively manage and/or change them.
Navigating Perfectionistic Beliefs Danielle found herself chasing the high of what it felt like to get praise. There was a high associated with being successful and getting straight A’s. When she started a private practice, part of her was terrified to fail. Every time a client comes in and says something negative about the décor, Danielle would take it personally because she wanted everything to be perfect. Which, of course, perfectionism is unrealistic and impossible. It has been a real struggle to overcome these challenges. Danielle has embarked on her own therapy journey so she can accept the imperfections.
Overcoming Shame As A Therapist Danielle felt many self-doubt thoughts after her first couple broke up after coming to her for couple’s therapy. She felt shame and loads of crappy emotions. Danielle needed to process it deeply and take it to therapy before she was able to accept it. She figured out that it wasn’t her job to fix relationships. That was the pivotal moment that she had as a private practice owner. The perfectionist part of us will take over, and an internal critic will take over – we compare ourselves to others, and we are harder on ourselves than others. The best thing we can do is just dismiss it and move forward.
Flexibility In Private Practice Private practice allows for a flexible schedule. It’s essential to find a practice that works around your lifestyle. Some therapists like high caseloads. Whereas other therapists thrive with a lower caseload. In private practice, you can choose how many clients you see. Make sure you are able to understand where your boundaries are.
Starting A Group Practice Danielle says a group practice wasn’t her version. Danielle thought she would stay in private practice forever with self-doubt – she didn’t want to be responsible for anyone else. However, it felt lonely and isolating. She thrives on community and connection. So, her first independent contractor came from an agency that Danielle used to work for. Actually, the independent contractor came to her – she wanted to join the practice. Danielle didn’t realize that people would like to
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Gordon, I want to thank you for your podcast and going above and beyond in taking time to help clinicians like me move forward in life. Thank you for your support in helping me launch my podcast and so much more! Continue to make a difference in the world.
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An amazing & informative podcast - everything you need to know about private practice!
This is my favorite private practice podcast. You directly speak to my experience, thank you!