The Practice of Therapy

Gordon Brewer:
You know, one of the things I love about doing this podcast every week is just the responses I get from people. You know, every week I get several people that will contact me, just letting me know that they're listening to the podcast and that they're, that they find it helpful, which that's the whole purpose in me doing the podcast. But what's interesting to me though, is just really some of the themes that come up of things that people ask. And in last week's podcast episode, you know, we talked about pivoting and transitioning your practice. And one of the things that is unique about the practice of therapy, or, well, really just this, this whole niche that we're in or whatever is, I realize that people are at different levels within their private practice journeys. There are those folks that are just getting started are really trying to figure out kind of the, the nuts and bolts of how to even get started in a practice.
Gordon Brewer:
I know when I first started my practice, there was very little information on having to on how to start a practice. And which is one of the, one of the reasons that I was just kind of motivated to start the practice of therapy. But there there are a lot of basics that I think are important for people to know. And so in this episode, that's one of the things I want to kind of go back to, or just sound back to the basics of just really thinking about what it is that is needed in order to have a successful practice. And this is stuff that I've learned through my own successes and failures. I've had a lot of failures along the way, which you, you learn from, but also just what I've learned from other clinicians and conversations we've had.
Gordon Brewer:
So that's what this, this particular episode is going to be about. One of the things that that happened this past week as well is that I was get to reconnect with my good friend, Julie Harris, who is the is the person behind green Oak accounting. If you hear a little rustling here, it's because a cat is trying to jump on me while I'm recording this, but anyway jelly and I at Julie's getting ready to launch her podcast, which I'm so excited about it. And you're going to hear more about that and green Oak accounting and what they do, but she had me do a recording for one of her episodes. And that was really kind of the topic was what have I learned about reasons that people don't have a successful practice. And I think it's because most of the people that I've seen struggle in practice is because they don't have some of the basics in place.
Gordon Brewer:
So anyway, that's, that's all we're going to talk about today are just some of the basics of being in private practice. So for any of you that have visited my website and also signed up for my email email list or my kit to get on my distribution of emails that I send out every week and just stuff that I resources that I provide one of the things you'll get is the free private practice startup guide that I wrote. And it's it really kind of I won't go over all the details of that here in this podcast, cause it would be awfully long, but one of the things that I would encourage you to do if you haven't done so already is to download that or just to get the download and you can just go to practice of therapy.com and you'll see several links there to be able to download that or get that sent to you by email.
Gordon Brewer:
But in that, in that guide, I kind of outlined just kind of what, at least to me are the steps that a person needs to kind of go through in order to start a private practice. It doesn't cover it all. I mean, there's just too much to cover and just one you know, little, little 28 page booklet, but to be but I want to kinda go over today in this episode, some of the highlights of that and things that I tend to think about and talking with people about starting a private practice. So first of all is just one of the things, and you'll hear this from me again, and I'm not going to spend a lot of time talking about this, but one of the things that you think you always need to begin with is your why.
Gordon Brewer:
And so really thinking about in depth and really having clarity for yourself as to why you want to start a private practice versus just working for someone else. As you've heard me say before, in other episodes, private practice isn't for everyone. And I think you have to have a bit of a mindset shift from being an employee to becoming a person that is self-employed you have to really kind of get your head around that. And so that's an important step and just really looking at your reasons why you want to be in private practice. So one of the things is I think for most people is that they just really want some of the autonomy that all of being a private practice brings and just being able to be your own boss, set your own schedules, all of those great things that private practice, private, private being a private practice affords us.
Gordon Brewer:
So the first thing to think about is just what sort of business model you want to use in your practice because like it or not being in private practice is running a business. And you have to be able to have a little bit of, if not, a lot of business savvy in running your practice. So again, in the private practice startup guide, there are some links there to one of the most popular blog posts that I did early on was just business models of private practice of just thinking about different ways to set up a practice everywhere from just being a solo practitioner or sole proprietor all the way up to setting up a, grow a group practice, or even a large group practice for that matter. And there's lots of different ways to set those things up. One thing that obviously is going to be needed as a place or a method to meet with clients, because that is what we do as therapists and counselors and social workers and psychologists.
Gordon Brewer:
We meet with clients and we have to have a private space to do that. And as we all know, with the times we're in telehealth has changed has been the predominant way of providing services. And so essentially one of the things is, is that you can have a a practice does that is online and that's a huge game changer in terms of saving costs and being able to cut down on overhead, which is the cost of Doosing doing business. So that's something to consider and I've heard from a lot of people that are getting started now, and they're just quite frankly, just starting online without even having an office space. The one thing too, just about our professions is now more than ever is a great time to go into private practice or to be a mental health provider because there is a shortage of us folks.
Gordon Brewer:
And there are just lots of opportunities for growth and that sort of thing, but you need to set it up correctly in order to you, can't just hang out a single and, and hope that things will go well. But and also your geographic area has a lot to determine of your determined, the needs that are there. But nonetheless, what, we're, what we do day in and day out as mental health providers is something that is just so much needed. So it's a great time to do, to be be in private practice. So in addition to just thinking about your, why also thinking about how you want to, how you want to set up your, your business model or your way of providing services. The other thing that is, and this is the one that I think is is probably the most intimidating to people, but it's just really understanding the financial side of private practice and really understanding what it takes financially and also how to run a business.
Gordon Brewer:
As you've heard me mentioned on several others, we've got a course out money matters in private practice was a it's an eCourse that's available and you can get to that by going to practice a therapy.com/money matters and teamed up with Julie Harris again from from green Oak accounting on that particular particular project. And it's a great resource and it just goes into, it goes into detail with the nuts and bolts of being in private practice the financial side of that. But one mistake that I think a lot of people make when going into private practice is they jump into it too quickly. And one of the things that you've got to do is make sure that you've got a financial buffer for yourself. So I think if you're going into private practice and even, even if you've been in practice awhile, this is a good exercise to do.
Gordon Brewer:
I know it's been something I've been working on over the last several months because of all the changes with COVID and all of that sort of thing. It's this kind of changed the landscape of the financial side of, of, of my practice. And so one of the things that I think is good to do is really have a clear picture about what sort of income you need from your practice to support your, to support your lifestyle. You know, I think a lot of times people get too simplistic and they think, Oh, I'm going to hang my shingle out. And people are just going to flock to me and I'm just going to make lots of money and I'm going to be so happy. Well, it doesn't work exactly that way. One of the things that you need to do as a business owner, and this is just and this is holds true also for your personal finances, you really need to have a financial buffer.
Gordon Brewer:
And I was in my conversation with Julie. We, we really recommend anywhere at the minimum two months of both what it takes to replace your income, what you pay yourself and what it takes to keep the business going. So, in other words, if you went a minimum of two months would be the starting place, but really about six months or more is even better. So for example, if you didn't see any clients for a month, would you be able to pay yourself plus be able to cover your expenses? And so one of the things in getting started that I really recommend is to really put a lot of effort into creating that buffer for yourself, for those folks that might be transitioning from agency work. What I did when I started my practice is as that I was did it part time.
Gordon Brewer:
And because I had my income from the agency I was working for, I didn't feel the financial pressure of having to get income from my private practice. It was almost like the private practice income was really just kind of icing to the cake, so to speak. And so when I made the decision to move fully into private practice, in other words, quit my full time job. I spent six months and it might've might even been a year. I can't remember now just taking all the profits that I made from the private practice and, and putting that, saving that away, and then tracking that so that I knew that when I hit a certain amount, which was an amount that covered six months of income and six months of expenses, all of that. And once I had that in the bank, and I knew that I had that buffer there, then I CA then I was able to resign for my agency job.
Gordon Brewer:
And I think that's that's a very good way to go about it. One of the things about building a private practice is that you've got to have a, as my friend, doctor, dr. David Hall says, you've got to have a bit of intestinal fortitude to be able to, to stand the ups and downs of the practice because there will be some months where your income will be low, but your, your expenses will still be there. You still need to pay yourself. And then the other months where you'll have just a, a huge month where you'll just have a lot of income and that's, that's kind of a natural progression with most private practices is to be able to have is having that fluctuation in what you bring in. The other thing about starting a private practice is obviously you need to have a way to get clients.
Gordon Brewer:
And that's when we tend to think about the M word marketing are being able to get people to know who you are and be able to find it. I love Alison careers description of marketing. Alison is another, is a fellow private practice consultant. And she's she has abundance abundance practice abundance practice. I believe that saying that right, Alison, but anyway she she talks about marketing as just being a, able to help people find you so that you can help them. And I love that description of that, because that doesn't feel like we're being pushy or salesy, and you do not have to be pushy or salesy when it comes to marketing. Marketing is just simply relationship building is making sure that you're putting yourself out there to where people can find you, because believe me, people are looking for us.
Gordon Brewer:
People want help and people want to be able to connect with the right person, find people that can help them with the things that they're struggling with. So two parts of marketing that I tend to think about, they're two kind of aspects of that. One is just simply networking, being able to build relationships within your community and that's with other, other professionals, other colleagues also with doctors, clergy, people, anyone that might potentially refer to you, the more that you can make them aware that you're there and you're available and you are taking new clients. The other part of that is with the niche that you defined for yourself. It's so important to really kind of define a specialty area for yourself. Again, that could be a whole whole episode here just on defining your niche, but being able to, to be known as the person that, that works with these types of clients or certain types of clients.
Gordon Brewer:
So when I first went into private practice, there were very few mirrors and family therapist in our town. And so I really got to be known as the marriage guy, you know, the marriage, the marriage counselor. And so even today for some reason in our re region, there aren't that many MFTs. And so there are a lot of folks that come to us because we offer marriage counseling and marriage therapy. So again, that's a broad niche, but you can also define it more. And all of that ties into your networking of being able to put yourself out there. The other part of, of marketing. And this is what I like to refer to as SEO, your search engine optimization, and that is just your web presence. And it is so important to have a website that people can find, you can build a website, you can put it out there, but if you don't have that search engine optimization you're not going to be able to people aren't going to be able to find you a couple of resources on that.
Gordon Brewer:
I'll mention here by my friend, Jessica [inaudible] is really an SEO guru, and we'll have links here in the show notes to Jessica's website in what she does, but also being able to if you, if you're a little intimidated by the tech side and just doing all of that SEO stuff and that sort of thing, you should always feel free to outsource that. And the people that are recommend for outsourcing as far as websites, and they are really very much the experts or is brighter visions. And if you'll just go to brighter vision.com/gordon and if you'll use the coupon code Gordon, I think it is what a double check that, but if you use that link, you can get, get a disc and get a month free of their services and really just try them out. But they just they build beautiful websites and they'll work with you individually to build the kind of website that rev represent to you are, if your website isn't bringing you people, then you need to really check up on that.
Gordon Brewer:
My one of the things that I will say is that I would say probably 80% of the new clients that we get come because they found our website. And if you think about it, if you're looking for anything in this day in time, you're going to Google it first. And so you want to be able to come up on the top side of that top on the come up on the top end of, of the search pages, when people are searching, searching for your services are searching for you. So that's the marketing piece, I'm networking with people building relationships and your community, and then also making sure that you've got a good website presence. The other thing that I want to mention here is just again, going back to the financial piece is just understanding how all of the money flows through your practice and what you really need in order to do that are systems and processes in place and the, the systems and processes.
Gordon Brewer:
When I talk about when I mentioned that that is really just building a platform for yourself. In other words either through an electronic health record system like therapy notes, or being able to set up a system like with Google G suite of being able to have a way to track everything that happens within your practice, also automating those tasks because as you grow, one of the things that will will happen is, is that you can get real busy with a lot of stuff that really doesn't bring you in, in, in any income. And so that's when you want to begin to automate and outsource. Now, one of the things I'll mention about outsourcing, and this is, again, a conversation that Julie Harris and I had is one of the big mistakes that people make is they, they really create for themselves a mindset about money that doesn't really work when it comes to business.
Gordon Brewer:
So let me explain a little bit about that. One of the things about being able to run a business is you've got to be able at different times be able to invest in your business. So investing either your time, which when you're starting out, you're going to have a lot of time, and that's the time to kind of bootstrap and do that. Think of it as a learning period, thinking about you know, being able to set up things on your own, if you're comfortable with that, all of those things is an investment of your time. And you should be able to at least over time be able to get a return of the investment of your time in your practice. In other words, it's gonna pay off besides spending time on getting your website, right, spending time on getting your systems and processes set up, right?
Gordon Brewer:
We'll make the flow of things go much better. Once you start to grow and start getting a lot of clients. The other part of of just thinking about your mindset and particularly your money mindset is not to be afraid to spend money. One of the things that I hear from people and I think, again, this goes back to the mindset is they're afraid to spend money on things that are going to give them a return on their investment. And I think that's one example of that would be like a psychology today profile or psychology today listing costs about $30 a month. That is absolutely a good investment because if you got just one client from that it would pay for itself. The other part of it is being able to spend your time spend your, spend your money on things that are gonna free up your time.
Gordon Brewer:
So for example one of the, one of the resources I have is the session note helper, which is just simply a a system that you use within Google G suite that allows you to check off some boxes on a Google form. And then it produces a, a document near in narrative format of what you checked off on the form. So it really streams streamlined your, your, your note taking and saves you a lot of time. You can, you can create a session note in five minutes or less using that, using that system. Now, part of one of the, one of the reasons that system works is you because of an add on that, you can get that again, all of this has HIPAA secure form publisher. Now, one of the things that I hear people kind of balk at is for publisher has a free version, but it only allows you 20 documents for it to convert over in a month's period for the free version.
Gordon Brewer:
And so people will kind of balk at spending $78 a year in order to get the unlimited use of that. Well, if you break that down by month and you think about the amount of time that will cha will save you again, it pays for itself. If you were to free a free up the ability to write notes and five minutes or less, thank how many, how many more clients you could see. And again, it brings you brings you in money again, think about the ROI. And that's, that's something that I think people in going into private practice. Yeah, it's a good idea to save money. It's good idea to bootstrap in the beginning stages, but don't be afraid to outsource another one is paying people in order to, to answer your phones and to, to do the phone calls and all of that.
Gordon Brewer:
Yes, they're not going to do it like you would do it, but to be able to let go of that, to turn that over to somebody else is going to free you up. If you were to able to spend, say, for example you were able to pay somebody $200 a month to do your virtual assistant work. And by doing that, it was a gonna enable you to bring in more clients. And so by bringing in more clients, here's some figures to think about if I if I spent $200 and it brought in a thousand extra dollars for me that month, because I had more clients, that's a good investment. It's simple math. So think about in terms of spending money on your practice in terms of return on investment. If it's not going to bring you a return on your investment, I wouldn't do it.
Gordon Brewer:
So anyway that was a little bit of a tangent there, but again, getting back to the basics about starting a practice, it's important to think about those things. So real quickly, I realize I've been talking awhile here now. Quick review, think about your why and just getting back to basics, you know, why you want to do look at your model of wanting to practice, how you want to do that, whether it's in an office face to face with people are doing tele-health looking at understanding that, understand your own personal financial situation and understand and have in mind how much you need to bring in from your practice in order to pay yourself to maintain the lifestyle that you need for yourself. The other thing to think about is really making sure that you understand and know the financial workings of a practice, understanding about business finance, understanding the small business, part of being in a practice is such important information have, because practices do fail because they don't understand the financial side of their practice, understand cash flow, understand profit and loss and all that sort of thing.
Gordon Brewer:
And again, the you can learn more about that using if you'll, if you will get the money matters in private practice II course that I have available getting that practice of therapy.com/money matters. The other thing is and understanding all of that as an understanding, the importance of creating a financial buffer for yourself, having money in reserve for those slow times, or even times like we've just gone through, are going through with COVID. I would not have been able to survive COVID if I had not have had the financial buffer that we had, because there was a lag time and things slowed down, I'll do the, wasn't having the income that we had. I know that looking back at my numbers, April, March, and April, when COVID first set, we had a big dip in our income. And so by having that financial buffer there, we were able to weather the storm, able to get through and things, things are turning out okay with that.
Gordon Brewer:
The other thing is just thinking about marketing your practice, and that's just simply building relationships and also making sure that you can be found online again, real important stuff in terms of making sure that you've got a steady referral form for sources for yourself, steady referrals coming in, and that builds the cashflow by having those, those sessions you know, kind of in the bag. The other part is being able to make sure that you've got systems and processes in place to be able to automate things and also outsource things. And again being able to think about the importance of outsourcing as a form of return on your investment to be able to pay somebody else to do those things that they can do that doesn't use up your time because your time is best spent in the therapy room with clients, and that's where your income is going to come from the predominant part of your income. Again, we can talk about passive income sources and all of that. That's a, that might be a whole another episode in and of itself. So anyway, hopefully this has been helpful information for you. And just thinking about getting back to basics, just really understanding what it takes to run a private practice.