In 1977, Ilya Prigogine was awarded the Nobel Prize in Chemistry for his work on “dissipative structures.“  Prigogine contends that because dissipative structures are disturbed i.e. shaken up by definition, they are able to change and evolve.  On the other hand, those structures that are too well insulated, and thus unable to be disturbed, will simply stagnate and die.  According to Ilya,  friction is a good thing!

I was reading about Ilya’s work and got to thinking about how friction has served my practice well over the years. Here’s what I’m talking about . . . .

When my referral sources are disturbed . . . they call me to consult when they are in over their heads.  They call me with referrals. Or, they call me wanting referrals.  They do something different.

When my community is disturbed . . . by elections, substance abuse, suicides, natural disasters, my community gets busy!  It get activated! And, they do something different, too.

When my clients are disturbed . . . they are motivated to pick up the phone and call me. They make appointments and come to see me. They follow through with their homework in between sessions.  And, if they are disturbed with me, the tell me!  And, all of that serves me (and my clients) well.  They do something different.

And, when I am disturbed . . . I seek additional information.  Or, I take action.  I tell someone just to be heard.  I take a class or seek consultation. I learn a new strategy.  I, too,  do something different.

Although I’m always up for a new adventure, I must admit, I don’t always relish the unpredictability of my work being disturbed.  But . . . does it help in the long run?  Keep me on my toes?  Sharpen me mentally and emotionally?  Help me stay flexible and alive in my practice?  You bet!  And, that flexibility and willingness to do something different helps my business stay vibrant and thriving.

So maybe tomorrow . . . when chaos looms out of no where to disturb my daily practice . . . . Maybe, just maybe I’ll remember Ilya Prigogine’s ideas and instead of digging in my heels and whining, I’ll say “thank you” for my dissipative practice and the wisdom to see the gift!

How about you?  Got a dissipative practice?  Or have you gone rigid and stagnate?  Needing a little help loosening up and learning to ride the waves?  If so, email me!  I’m happy to help you get unstuck and start enjoying the fruits of a little disruption.

Tags: Change, Continuous Learning, Disruption

My e-friend, David P. Diana, was kind enough to send a copy of his new book to me.  I’ve only read one hundred pages into Marketing for the Mental Health Professional but already I can tell you that it is an excellent addition to your practice-building library.

As David notes in the preface, this is a book full of ” innovation, opportunity, and abundance.”  He is quick to remind you of what you already know . . . understanding human behavior . . . while teaching you what you may not know as well . . . the tools of marketing, business, and sales.

Here are some of the nuggets that I have already gleaned from David to help you grow your business:

• On making mental health relevant – Become “part of the conversation people are having both online and offline.  Offer helpful information.  Build awareness by sharing your expertise.  Reach out to others in ways that show you genuinely care about them.”
• When you are doing something right – ” . . . you are highly visible within the marketplace . . . ” and  ” . . . you are viewed as a valuable resource and partner, people begin to seek you out without any soliciting on your part.”
• To gain power and influence when networking – “Take some time to notice when you are rushing your speech and begin making an effort to slow down, relax, and confidently present your point.”
• Concerning the need to establish credibility – If you (or any other mental health professional) do not have “distinguishing characteristics or credentials, then why would someone choose that person when so many options are available?”
• About strategic use of your time and energy – “. . . shifting your time and energy in new and more productive ways can have such a powerful impact.”
• On the art of public speaking – “Try to identify two to three new concepts and ideas that you will feature in your presentation.  Your audience will buy you and your message if you are able to do so.”

• And, here’s a tip that I didn’t know – “When customers consider a particular set of choices (services or products), they tend to favor alternatives that are so-called compromise choices. These are choices that fall between what a person needs at a minimum, and what they could possibly spend and fully desire at a maximum.”(Thanks to David, I’m actively re-thinking my menu of services and ways to include more-than-the-minimum compromise choices.)

So have I peaked your interest in Marketing for the Mental Health Professional? If I’m learning from it, I’m betting you have some things to learn, too.  Run out and get the book.  Read it.  Apply it.  And, let me and David P. Diana know what is changing because of it!

Tags: Choice, Credibility, Menu of Services, Power and Influence, Public Speaking

Are you looking back to the “good ole days” when your practice was shiny and new . . . ? Remembering when your appointment book was full and you had a two week waiting list and wondering where all the clients have gone?

Well, I’m here to tell you that they are all still right here . . . right around the corner from you and they are wondering what happened to their bright and enthusiastic therapist that you used to be!  That’s right!  You heard me!  Any client will tell you that s/he would rather return to the same therapist s/he’s seen before rather than change to a new one.  They only change when they have no choice but to go elsewhere to get the help they are seeking.

If your old clients are going elsewhere for their counseling services, then it might be time for you to give your practice a facelift and that means taking a fresh look at your office, your office practices, and yourself.

Outside the Office

• Take a look at the appearance of your building.  Has it fallen into disrepair?  Does it need trim work or to be repainted?
• Is the landscaping well-tended?
• Is the parking for your clients easily accessible and is the lot well-lit?  Does it feel safe?
• Are the windows clean?

Inside the Office

• Inside the office, take a look at the paint on the walls.  Is it dingy?
• Is the carpet dirty or stained?
• How does your office smell?
• Is the lighting warm and welcoming?
• Is your office well-insulated for privacy?
• Is the temperature in your office comfortable?

Office Practices

• Does your office staff greet your returning clients as warmly as they greet your new clients?
• Is your staff well-trained on respecting clients’ privacy?
• Are you records safely locked away out of sight so that clients do not see information about other clients?

Self Check

• Are you taking care of yourself outside of the office?  Eating and exercising?  Getting enough rest?  Attending to your personal relationships?
• Are you arriving at the office in time to get settled in and appear calm and focused when your clients arrive? Or are you rushing in harried at the last minute?
• Are you scheduling your clients far enough apart that you have time to attend to phone calls, go to the bathroom, and complete your notes in between appointments?
• Do you have a plan for continuing your professional competency and are you following it? Are you continuing to learn new and interesting things to help you in your clinical work?

These are useful things to discuss with your peer consultation group.  A fresh pair of eyes can help you identify areas that need a bit of a facelift.  And, that, in turn, may help you re-engage some of those wayward clients.

Can you think of other areas in your practice that may need a facelift?  If so, I hope you will let me know!

Tags: Location, Office, Records & Documentation, Self Care

This is the 3rd  post in the series
Reduced Fees, Sliding Scales, and Lessons Learned.
The series actually begins here.

If You Choose to Provide  a Reduced Fee, How Long Should You Do So?

I’ve had clients who were unemployed when they began working with me, so I offered my services at a reduced fee.   Later, when they secured six figure incomes, they continued to pay the reduced fees.

Lesson learned?  Yep . . . .

Lesson #1

My own issues with money got in the way.  Otherwise, when it came to my attention that my clients were in better financial situations, I would have addressed it directly with each of them rather than feeling taken advantage of.  If that is true for you, you have some work to do and a good therapist can well be worth her full fee to get that cleaned up early.

Lesson #2

What is understood to be “less than enough” by one person may appear to be “more than enough” to another . . . and vice versa.  Get really clear about the circumstances under which you are comfortable providing reduced fees.

Lesson #3

Reduced fees need to have time limits.    Unless you are operating as a charitable organization, consider how long is “long enough” to help someone access your professional services. Limits are good for your client and they are good for you.

Lesson #4

If you offer anyone a “good deal,” they’ll probably take it.  Make sure to think through the offers you want to make before you make them.

Drop me a line and let’s talk about if / how you provide services to clients at a reduced fee.  What does that look like in your practice?  Is it working well for you and your clients?

Tags: Boundaries, Fee, Gullible

I have made the choice not to contract
with managed care companies
for my professional services.
Here’s the  8 reasons why . . . .

Conflicts of Interest

As a Licensed Professional Counselor, I am required to avoid potential conflicts of interest.  My primary concern is for my client’s well-being.  Therapists working under the constraints of managed care companies are sometimes put in the position of having to choose between what is in their own best interest and what is in their client’s best interest.  I do not want to be put in that position.

Managed care companies were created to “manage” and contain escalating health care costs.  Their bottom line is to reduce costs and raise profits; it is not to increase the quality of care or quality of life for my client.  In many cases, therapists who contract with MCC are actually paid to NOT see clients.

Restricted Choice

Often managed care companies restrict the client’s choice of therapist by offering only short term / brief therapy that I refer to as “drive-by” therapy.  Such therapy meets the financial criteria of managed care companies but may fail to afford my client the opportunity to get the information / therapy that s/he wants / needs.  It is my belief that this often results in my client’s quality of care being compromised. And, this, of course, can result in the possibility of my client’s needs going unmet.

Managed care companies often choose to limit what  therapies are offered, can restrict what is discussed in therapy, and decide which clients can be seen and for how long. Some managed care companies have even included “gag clauses” in their contracts to prevent therapists from suggesting more effective treatments.

Professional Expertise

I believe that my client should be able to access the full range of mental health professionals according to client needs.  Often managed care companies restrict the professionals that clients are allowed to work with – preferring to refer clients to therapists who have a record of providing short term therapy rather than to other therapists who may provide better results or offer a different packaging of services.

Contractual Limitations

I believe that a client has the right to full disclosure of any arrangements, agreements, contracts, or restrictions between any third party and me that could interfere with or impact your treatment.  Managed care companies may label counselors’ choices to advocate for clients in this manner as “Managed Care Unfriendly Behaviors” and take such actions as they deem fit.  Typically “violations” such as these result in therapists being removed from provider panels or censured in other ways.

Privacy / Confidentiality

By contracting with managed care companies, it is likely that I would be required to share my client’s deeply personal information with gatekeepers and utilization review professionals; it would mean potentially allowing literally hundreds of other to have access to my client’s personal information.

Medication

Research has consistently shown that medication for problems with mood is most effective when combined with psychotherapy.  Nevertheless, managed care companies frequently approve medication only for their members rather than permitting them to also work with a mental health counselor.  Again, the appearance is that of being more concerned about money rather than my client’s needs.

Time

Managed care companies usually require therapists to justify and convince Utilization Review professionals before treatment is approved / continued.  This is time consuming for the therapist and for the client who is required to continue his / her therapy in “fits and starts.”

Diagnosis and Stigma

Managed care companies typically cover only those services deemed medically necessary which is defined as being literally about life and death and the treatment of illness. This means that they require a diagnosis of mental illness for my clients.

My practice is solution- focused on quality of life and personal goals. My work with clients focuses on prevention, exploration, and personal growth rather than simply survival. We typically talk in terms of possibility and resourcefulness, gratitude and integrity, commitment and personal responsibility.  Working with managed care companies is not a choice that I can ethically make.

I Know Better

I have mental health professionals declare on a regular basis that you “can’t survive in private practice without participating in managed care.”  But, I know better. What I know is that you can’t thrive – both personally and professionally – while participating in managed care.

Once I realized the ethical implications of working with managed care companies, I terminated all of my contracts with managed care.  It’s not a decision that is right or necessary for all therapists but it was the best decision that I’ve made to date.

I am now celebrating 10 years of being an insurance-and- managed-care-free  private practice. I’m thriving and you can, too!  All it requires is courage.

If you, too, run a practice without managed-care, I hope you’ll drop in here to chat about your experiences.  And, if you have yet to make the choice to opt out of managed care, I would be happy to help you find your courage and to help you create a path to a fee-for-service only practice.

Tags: Choice, Contract, Courage, Ethics, Packaging

I just discovered a free source for professional development (no CEU’s) at

"Podcast Subscribe" by Derrickkwa

CounselorAudioSource.net .  This website offers free weekly podcasts on topics primarily of clinical interest to counselors.

Additionally, if you would like to expand your resume to include your own podcasts on topics relevant to counselors, you can check out their guidelines and suggestions for contributing here.

Do you know of other free resources for the professional development of counselors and allied health professionals?  If so, please let us know!

Tags: Free, Podcast, Resume

"Start / Finish" by I Like / Alice

Just today I ran across this manifesto on the cult of being done.  It fits in nicely with the topics we’ll be covering in the  January session of Private Practice from the Inside Out Annual Series so I thought I would share it with you here.  See my comment in the brackets below.

The Cult of Done Manifesto

1. There are three states of being. Not knowing, action and completion.  [Which state trips you up most often?]

2. Accept that everything is a draft. It helps to get it done.  [Love this!  For those of us who were raised at the knee of perfection, it's easy to forget that first drafts are often acceptable even if they are not perfect.  And, when they aren't acceptable, usually you can do them over -- especially when it comes to your marketing!]

3. There is no editing stage.  [This is often true in marketing your private practice.  Opportunities abound and they don't always give you a 48 hour notice.  Think of the unexpected contacts you meet, the conversations that you find yourself in, and the opportunities you have to promote your business.  If you delay taking advantage of those spur of the moment opportunities because you want to clean up your thoughts, your language, your marketing materials . . . it's often too late!  There is no editing stage in marketing your practice.]

4. Pretending you know what you’re doing is almost the same as knowing what you are doing, so just accept that you know what you’re doing even if you don’t and do it.  [OK, so I'm talking about marketing here, not clinical work.  In your marketing, it's critical that you jump in now to respond to current events and your community's needs. Trust that you'll get better in your marketing by simply doing it.]

5. Banish procrastination. If you wait more than a week to get an idea done, abandon it. [Procrastination can be your nemesis.  Whatever it is . . . do it now!]

6. The point of being done is not to finish but to get other things done.  [YES! When coaching clients on their marketing, I often hear the excuse . . . "I can't do Z because I haven't done X & Y yet."  So then I ask about X & Y only to find that they can't do those because they "haven't done V & W."  You can't do everything at once to build your private practice but you can complete something to move toward your business goal.]

7. Once you’re done you can throw it away.  [There's no point in hanging on to completed projects.  Move on to the next one."]

8. People without dirty hands are wrong. Doing something makes you right.  [Many professionals are struggling because they are trying to figure out what the one right way is to build a private practice.  There isn't one right way.  There are many ways which is why doing any one strategic thing to build your practice is better than doing nothing.]

9. Failure counts as done. So do mistakes. [ The great thing about mistakes and failures is that they give you much to learn from. Embrace your stumbles and learn your lessons.  The sooner you learn your lessons,  the sooner you grow your business.]

10. Destruction is a variant of done. [Yes!  And, that's because if it's destroyed, you get to start over!]

11. If you have an idea and publish it on the internet, that counts as a ghost of done. [That's because it's dead! You've put it out there, others have seen it, taken it and run with it, and you are in need of a fresh idea.]

12. Done is the engine of more. [That's right!  You get to check it off of your list and move on to the next step in building your vibrant private practice!]

Are you getting things done to build your private practice?  If so, drop me  a note right here to brag on your accomplishments.  If not, then let me know where you are stuck and I’ll see what I can do to help you get things done!

The Cult of Done Manifesto was written by Bre Pettis and Kio Stark.  Here is a link to the original online post as well as a link to printable posters right here.

Tags: Failure, Finish, Perfection, Procrastination

Before you even decide where you are going to locate your office,

"Mr. Zip, 1966" by Roadsidepictures

you need to conduct market research on possible locations. 

One way to begin that process is to learn about the demographics of different zip codes in your area.

Check out ZipSkinny to help you start your own market research because location matters.

Tags: Demographics, Location, Market Research, Office

Are you still marketing yourself as a generalist?

"Donald Roller Wilson" by Wonderlane

Do you pride yourself as a Jack or Jane of all trades i.e. “I work with everyone!” ?

If so, you are confusing what you do with how you market.  What you do and who you work with may very well include a large variety of issues and clients.  However, if you have too many empty time slots on your calendar, your generalist marketing may be your problem.

There was a time when marketing yourself as a generalist was the hallmark of a go-to therapist.  It was thought that she could do it all.  But things have changed and so should you.

• Today, clients want an “expert” and nicheing lends itself to the perception of expertise.
• Marketing yourself as a generalist makes you forgettable.  And, marketing yourself as someone who has a special interest in X, makes you memorable.
• Nicheing allows you to market your services in a more focused way.  That translates to less money, less wasted time, and more strategic contacts.

So the real question is . . . What’s keeping you from nicheing your practice TODAY?

Tags: Niche

I was reading this post by Jennifer Gandin Le

Making Notes on GTD" by Stompy / Abizer

in the blog, Crucial Minutiae.  In it she references Natalie Goldberg’s concept of a “Practice Notebook.”  According to Le, Goldberg suggests using a notebook to establish a habit of self-monitoring your writing practices.  I love this idea . . . and not just for writing!

Your habits of private practice need monitoring, too! Borrowing from Goldberg’s suggestion, one way to do this would be to designate a practice notebook.  In it, you should record the date every single day, whether or not you have worked on your practice, and any related thoughts you may have .

Remember . . . working on your business is not the same as working in your business.  Your practice notebook should contain your notes and thoughts about working on the business.

Go ahead!  Give it a try for 30 straight days and let me know what changes for you!

Tags: Habit, Practice Notebook

If you have been marketing to the educational community with little success, you may need to slow down and reassess your own educational history.  Your personal relationship with education may be getting in the way . . . .

Linda L. Lawless and G. Jean Wright suggest in their book, How to Get Referrals: The Mental Health Professional’s Guide to Strategic Marketing, that you ask the following questions when reviewing your educational history:

"Not My Hat!" by Alan Levine / cogdogblog

• Are there any teachers in your family? Are any family members employed by the school system?  What is their input to other family members regarding their work and the system?
• What has been the family response to their vocation?
• What educational levels have been attained by family members?  Did they attend public or private schools?  If private, was it religious or nonsectarian?
• What has been shared about their experience?  What was the quality of the experience?
• What has been your educational experience from kindergarten through graduate school?  Your siblings?  How do you rate it?
• Who were your favorite teachers?  Worst teachers?  In your experience and /or perceptions, what were the characteristics of each that made them “good” or “bad” teachers?  As you reflect on these relationships, what are you feeling now?
• What are your family’s belief systems, biases, prejudices, regarding education and the educational system (school taxes, the school board, election of board members)?
• Did any family members ever serve on the school board?
• What is your trust level of teachers?
• Do you have special training that would correlate with the experiences and needs of educational professionals?
• Do you have children in school?  If so, public or private?  How do you make decisions regarding your children’s education?

It is critical when marketing to the educational community that you feel comfortable and that they know that. Liberally share your unique school stories with other professionals in the educational community.  Use your unique experiences to help guide where you choose to enter the market.  If you attended a private or parochial school, consider focusing your energy on the same.

By taking the time to reflect on your own school experiences, you will increase your comfort and effectiveness in marketing to this community.

Related Posts

Another Strategy for Marketing to the Educational Community:
Collaborating with Your Competitors

Gathering Market Research on the Educational Community

Teachers Needs Vary and So Should Your Marketing Strategies

Tags: School, Stories

I’ve been reading Louis Baraja’s book, Small Business, Big Life: 5 Steps to Creating a  Great Life with Your Own Small Business.  In it he lists the  22 Temptations of a Small Business Owner that entrepreneurs often fail to notice and then stumble over while building their businesses.

That list got me to thinking about the many ways that psychotherapists and allied health professionals get tripped up on the way to building their businesses so I decided to share my list of 22 things you say (with a nod t o Louis Baraja) before you even know your private practice is in trouble .

You Know Your Private
Practice is in Trouble When You Say . . . .

1. “I’ve always been ‘Dear Abbey’ with my friends so I might as well hang my shingle out and charge for it!” Just because you are good at something doesn’t mean that you should do it professionally.  And, even if you decide that you want to work in health care, you need to take time to consider the huge differences between working for yourself and working for someone else.  Those differences matter.
   
2. “I’m not really sure what I’m doing business-wise . . . but I have a client!” The vast majority of businesses that succeed start with a plan . . . not necessarily a Business Plan but they all have a plan.  By that I mean you need to have an understanding of how the business fits into the larger plan for your whole life . . . and how it contributes to that bigger life plan.
   
3. “I haven’t thought about how many hours I want to work or how much money I want to make this year . . . but I know I want to help people. When you enter into private practice especially in health care, you need to begin with the end in mind.  The end matters and will actually dictate the choices that you make along the way.  By keeping your values and your priorities at the forefront  (including how many hours you want to work and how much money you want to make), you will be better able to stay focused on the tasks necessary to achieve your ideal business.
   
4. “I don’t have regular business hours.  I work late into the night on my business” and eventually “I’ve burned out.” It’s easy when you’re getting started to over-commit and over-invest in your business.  What I know is that you cannot give what you do not have . . . good boundaries, balanced life, energy and focus, etc.  Self-care is critical especially at the start of a new practice or a new project.  Reinforce those habits now . . . at the beginning.  And, if you don’t have them, find a therapist or coach to help you put them in place.  Otherwise, you will not survive the demands of private practice.
   
5. “My preference is to hire and network with people just like me.” I know that you’re more comfortable with people just like you (Me, too!) but they won’t help you long term take your business to the next level.  Differences in skills, experiences, and even politics will be assets to you in many ways.  As long as the people you hire and network with can share your vision for your practice, their differences can serve you well.
   
6. “My business partner and I constantly struggle with the direction of the business.” If that’s true, then you’ve got too many leaders in the room.  In your practice, your vision is the one that needs to be the guiding force.  Be cautious and be clear about why you want to partner with someone.  Often it is a better choice to hire or consult with individuals (assuming they buy in to your vision) rather than bringing in an actual partner (who has a different / competing vision on his own).
   
7. “I am constantly reinventing the wheel.” Take the time to create systems and templates to streamline your work so that as your appointment book begins to fill in, you are able to efficiently delegate or complete your repetitive tasks.    
   
8. “I work with everything and everybody.” Don’t say it!  Stay focused on your ideal client and market to him or her.  Of course, you’ll work with others but target your message and your efforts to working only with your ideal client and withing your niche.
   
9. “I need to work harder at ___________.” [fill in your weakness] Successful entrepreneurs delegate or manage their weaknesses; they focus on their strengths.  In fact, Marlane Miller in her book, BrainStyles, says that by focusing on our weaknesses, we just build stronger weaknesses.
   
10. “I can’t spend money until I start making money.” Wrong!  Have faith in your calling and invest in your practice.  If you aren’t willing to invest in you, don’t expect anyone else to invest in your either!
    
11. “My friend needs a little extra income so I’m going to hire her to do my accounting.” Hire people because they are exquisitely qualified and not because they are your friend and you want to help someone out.  You are running a business, not a social service organization.
    
12. “I’m really good at flying by the seat of my pants so I’ll just deal with it when it comes up.” Not a good idea.  Take the time to create a plan . . . a blueprint for your practice and for your life.  Then, stick to it.
    
13. “I don’t need to hire anyone to do anything.  I can do it all myself!  (And, besides, I’ll save money doing it this way!) If this is what you’re thinking, then you have some control issues to deal with.  You cannot do everything well and if you cannot do it well, you need to find someone i.e hire someone else who will do it well. 
    
14. “I’ll hang my shingle out and the masses will come!” No.  They won’t.  What will get clients is a strategic plan and follow through.  Who are you going to talk to about your practice? Where are you going to publicize your practice?
    
15. “In order to open my private practice, I need all the bells and whistles . . . a white noise machine, new office furniture, a posh location, special software to keep my progress notes in, etc.” Not really.  What’s going to prepare you to open your private practice is you laying the foundation for name recognition, building trust in the community, and following through on your commitments.
    
16. “I will work with anyone who will pay me.” Another bad idea.  Work with your ideal clients.  It’s your calling.  Refer the others out.
    
17. “This is too hard so I quit.” Many therapists throw in the towel and quit too soon because they didn’t go get the info that they really needed – the business and marketing info that you didn’t get in graduate school.  Take the time to learn the info . . . take classes, read articles, interview other more seasoned therapists, hire a business coach.  Learn what you need to know in order to jump start your practice. 
    
18. “I’m doing great so I’m not going to ask for feedback.” When you’re doing great, is the perfect time to ask for feedback!  Learn what you are doing well so that you keep getting that feedback.
    
19. “I know everything there is to know about being in private practice” or “There are things I need to know but I’m not going to pay another professional to get that information because  I’m not worth it or I’ll figure it out.” Again, quit fooling yourself and go get the help / info that you need.  Hire a counselor or an attorney or a coach or whomever.  Don’t just delude yourself into failing.  It’s not necessary!
    
20. “I don’t know how to explain to clients why they should work with me.” That’s a really big problem.  Then you need help learning to articulate what gifts you bring to your practice.  Sign up for a class, hire a coach, work with a copywriter or wordsmith.  It’s one of the single most important things you can do to build your reputation in the community.
    
21. “What’s wrong with my clients?  They aren’t getting better.” Well, that’s definitely a problem . . .  and it’s a bigger problem for you than it is for your clients!  If your clients aren’t getting better, you need to change . . . start or stop doing something, learn something new, talk with a consultant, etc.  Whatever you do, don’t blame it on “resistent clients.” 
    
22. “I don’t need an exit strategy because I’m going to be in this business forever.” Even if you do plan to be in private practice forever, you still need make an exit plan.  It will help you focus on building your practice up . . . to promote, to sell, or to expand.

Have you tripped up on these already?  Or, do you have other red-flag statements to share?

Tags: Priorities, Strategic Plan, Systems, Vision

When I left employment to begin my own private practice in 1991,

"Question Marks on the Wall" by Lone Black Rider / Filip Bunkens

I started by identifying therapists that I believed to be highly successful.   Then, I picked up the phone, introduced myself, and asked if I could take them to lunch or coffee to pick their brains about being in private practice. Whether you are just starting out in private practice or are wanting to revitalize your practice, that’s a good place for you to start, too.

Most mental health professionals will be flattered if you call.  Let’s face it, it’s an ego boost when someone else thinks that you are successful.  And, many mental health professionals really enjoy mentoring others in the field.

Once you’ve made your phone calls and scheduled your lunches, here are 20 questions for you to ask:

1. How long have you been in private practice? This is really important.  you want to identify therapists who have longevity in the field.  They are who you can really learn from.
2. How did you learn what to do when you were ready to go into private practice? If it worked for him, there’s a good chance that at least part of his learning can work for you, too.
3. What do you know now that you didn’t know when you got started about being in private practice? You might as well learn it now rather than wait.
4. How did your clients initially learn about your services and how do your clients learn about your services now? You want to know about how it was in the beginning for them.  Back then, they were probably on a shoestring budget at best (perhaps like you are now) and still they survived.  In the process of learning what they did back then and what they do now to get clients, you’ll most likely hear how their income and their efforts have changed and refocused.  
5. What mistakes did you make in your early years of private practice? Find out now so that you don’t have to reinvent the wheel.
6. What critical decisions did you need to make about your private practice and why? You may choose to make different decisions but it is often helpful to understand why someone in private practice makes the decisions that they make . . . about policies, workload, billing and fees, etc.
7. Did you ever have a mentor?  Do you now? And, how did you find one? One of the fastest ways for you to jump start your practice is to have a personal mentor to shepherd you on your journey.  Hiring a business coach is one way to find a mentor but it is certainly not the only way.
8. How much time do you set aside to work on the business (not the clinical) of private practice? Successful therapists in private practice spend time visioning, developing, and implementing new ways to grow their businesses.
9. What is your biggest challenge now? Challenges continue throughout the life cycle of a private practice.  Challenges happen; they do not disappear.
10. How long did it take you to turn a profit? The Small Business Administration says that most small businesses fail within the first 5 years and that most successful small businesses take 3-5 years to turn a profit.  I’ve certainly taken it take less time to break even or fail.  However, be wary of those who promise that you’ll be earning big money fast.  Research clearly shows to slow and steady is the way to build a strong foundation for a long-term practice.
11. What do you believe causes a practice to succeed?
12. What do you believe causes a practice to fail?
13. What type of clients do you see? Remember this when you need to refer a client of your own to another therapist.
14. What type of clients do you refer out? If this is a population / issue that interests you, make sure this therapist knows that.  If it is not, then keep an ear open so that you can refer another professional to this therapist.  This is how you network.
15. What resources can you recommend to me as a new therapist that can help me get started on the right track? He may have a favorite website on developing a private practice or an online diagnostic code finder. He may know another therapist looking to share an office or a CPA who can help you set up your quarterly tax payment.  Or, he may have a favorite book or magazine or office supply store to send you to.
16. What do you do to take care of you? Balancing work and home (much less children and additional schooling) is one of those topics that is hardly addressed while you are in school.  Take time to identify now how you will put systems of self care in place.
17. How has your practice changed over the last X (number) of years? It’s important to understand about the life cycle of a practice.  Once it’s up and running, it doesn’t necessarily stay up and running at that level.  Change happens . . . a group practice moves in next door, the local school system has an unexpected need for counselors, an army base closes, you get new clinical training, etc.  Your practice’ life cycle will be different than the therapists’ that you are interview but it is helpful to be reminded that change happens and what you need to do to recognize it as another opportunity for growth.
18. What is the hardest thing about being in private practice? Again, what is hard for him may not be hard for you but knowing about the challenges helps you prepare for them from the beginning.
19. How is your personal life affected by being in private practice? Your professional life and your family’s lives will be impacted by your decision to practice mental health.  When you are in private practice, that impact is even greater.
20. What precautions do you take to keep you and your clients safe in your office? This is another area that is not adequately addressed in graduate school.  There are many things you can do to increase your safety.  Learn about them now.

Remember to take pen and paper with you so that you can take notes.  I’m sure you’ll think of more questions along the way!

If you use this list, I hope you’ll drop back in and let me know how the questions worked for you.  Are there other questions that would be helpful to ask other therapists?

And, if you are a therapist who has been in private practice for a while, why don’t you drop in here  and answer all 20 of these for us.  It’s a good way to introduce yourself and your practice to our community!

Tags: Mentor, Network, Self Care, Vision

As I was reading Jung at Heart, one of my new and favorite blogs by Jungian psychotherapist, Cheryl Fuller, I ran across her post on the importance of boundaries in scheduling.

"Wall of Clocks" by rustman / Russ Morris

Check out her inspiration for the post, her own post, and then drop back in here to share your thoughts about scheduling clients and the transition in between them.

Tags: Boundaries

If your post-graduate supervision is not all that you had hoped for, there may be a really good reason.  Do you know that clinical supervision is different from administrative supervision?

An administrative supervisor typically operates from a business model rather than a clinical model.  His priority is to make sure that the organization (or her department) runs smoothly. There are local, state, and federal regulations  (like the EEOC guidelines and the Disability Act) that impact his decisions concerning her supervision of you.

Administrative supervisors are often

"In Which Zac Never Realized . . . " by Zac Peckler

what you encounter as a new graduate entering the workforce through an agency, hospital, or school setting. You will recognize an administrative supervisor because he will emphasize paperwork and productivity, managing your caseloads, scheduling, and accountability.

An administrative supervisor must train employees to systematically complete basic paperwork, manage crises, work within systems, and deal with large numbers of clients needing many different things at the same time.  There is much to be learned from an administrative supervisor that will serve you well throughout your career but this is NOT clinical supervision.

If you are frustrated with the quality of the supervision you are receiving, perhaps you assumed that the supervision you would be receiving from your supervisor would be clinical supervision rather than administrative supervision.  Here are some things that you can do to insure that your experience under supervision is all that you want it to be.

Related Posts

9 Steps You Can Take to Insure a Great Supervisory Experience

4 Things to Consider if Your Supervision is Less Than Ideal

Supervision or Consultation?

Tags: Client Load, Crisis, Documentation, Schedule