The Practice of Therapy

Well, hello everyone. And welcome again to the practice of therapy podcast, and some happy to have with me today. Angela James and Angela. Welcome to the podcast. Thank you so much. Thank you for having me. Yes, this is, uh, this is great. And so Angela is located in California, but as I start with everyone, Angela, tell folks a little more about yourself and your private practice journey.

Absolutely. Yeah. So my name is Angela and I am in California. Um, I. Left. I had worked in agency jobs from grad school and after, and, um, just kind of serendipitously or, uh, spiritually ended up one day deciding that I needed to go in a different direction. Um, so I opened my practice, which was great and successful very quickly.

Um, and as I continued to go through that process, I just, I I'm really grateful for that experience because I think for the first time in my career, I really. Found out who I was as a therapist, because I had the freedom to do so to kind of be authentic in the therapy room, without all the restrictions of agency work, you know?

Um, so I was really grateful for that. And then that process I've always been passionate about. Seeing people meet their full potential and not just in client work, but with other people around me too. So I found myself eager to help other therapists and like encouraging them, like, Hey, you should really start a practice.

You know, you don't have to leave your job, but just start one, cause there's really will help you grow as a therapist. And then of course there's financial and tax benefits and all that stuff too. But, um, the more I kind of gravitated towards that, that led me to. A moment of, you know, I, I really need to, to hone in on this because I was getting more and more people that I was able to work with.

And of course it was taking up more and more time. So that led me to open classroom in couch, which is my coaching business, where I help therapists, um, get to the steps to start their practice. Uh, that's the main focus is helping them start because I know when I went to go start my practice, I was kinda lost and didn't know where to go, what to do.

Um, cause I'd never owned a business before. So helping therapists get over that hurdle has been. So rewarding and beneficial to me. I just, I really get excited about it. Yeah, that's good. That's, that's great. And I, I, I think your story echoes a lot of what I hear and to know, just kind of echoes my story, um, in that you start out at an agency work, which I, you know, unfortunately I'm, um, you know, I think a lot of grad schools just kind of.

You know, kind of ingrained people that that's the route you're supposed to go. You know, you get, uh, you get employed by somebody and then go that route, but they really don't talk much about what it means to be in practice on your own and have for a lot of folks. I think that's really kind of their life dream.

Yeah. That's so funny. Yeah. That's that was that. I talk about that. So I met my husband in grad school as well. We were in the same program. So I talked to him a lot about that, about how, when we were in grad school, the vast majority of the students in our cohort wanted to own their goal was to open a private practice.

I was one of the few who didn't want to actually do that. I ended up, but it's funny. It's ironic to me. And disheartening that the majority of our program wanted to open a private practice, but yet no part of our program teaches you how to open a practice, how to work in a PR any, any business, any marketing.

I mean, none of it, you know, so it's just, it it's, it's sad. They should really integrate that a little bit more. Right. Right. So how was it that you went about learning what you've learned so far? As far as starting a private practice. Well, so I kind of the serendipitous moment, um, with my best friend, um, who kind of encouraged me to go that route, which like I said before, it was never in my radar.

Um, so when I, I took off the week of the 4th of July one year and I was like, okay, I'm going to do it. I'm going to do all the steps and I'm going to, I'm going to start this process. So I took off the entire week and I literally just like sat down with my laptop and was like, I'm, I'm gonna. Get this done this week, I'm going to get as much done as possible to just make this happen.

Because when one thing about me once I got my, my eyes locked in on something it's going to happen. So, um, I, you know, I reached out to colleagues and I got feedback from them, but many of them were either just starting themselves or had been in private practice for so long that they were like, I don't remember kind of those initial steps.

So it was those business, the business part of it. How to get started. So I, I mean, endless hours of just Googling and going on the camp website. And then, I mean, just. Really just blindly navigating and making mistakes along the way where I would go to do a step. Like for instance, I'd go to say, Oh, you need an EIN.

Okay. I'm going to go apply for an EIN. And then when I get there, they're asking me questions that I haven't, I haven't established yet. Like, Oh, I don't have an address yet. Okay. So I need an address. So just kind of fumbling through the process. And I just had this really clear moment where I was like, it shouldn't be this hard.

Um, it should be a lot easier. And when I looked at there, I know there's other coaches in this realm. So when I looked into several, um, I was kind of disappointed that many of them were so far out of my price range, you know, and I was like, there's no way I can afford, you know, a $6,000 program. And many of them didn't talk about the business part.

And that was my struggle because I felt like, okay, I already knew I wanted to get on an, on a local insurance panel because my. I didn't want to do part-time. I wanted to immediately leave my job. So I was like, I need to get clients fast, and this is a surefire way to get them fast. And I know that side and clinically, I was pretty sound in my, in my clinical skills.

I had been graduated for quite some time. Um, but the business part was the part where it was lost that, and I was really struggling to find assistance in that way. So I just kind of fumbled my way through the process and. Kind of made it my, my mission to make it easier for other therapists. Cause I was like, this is a terrible process.

Right, right. Yeah. Yeah. That's uh, yeah, that, yeah, that again, that echoes kind of how I, uh, you know, how I've learned. A lot of what I've learned is just, um, a lot of the hard way and it really shouldn't have to be that hard for people. Um, just being able to, and, you know, fortunately we do have more resources now than, you know, I'm dating myself.

But back when I first went into private practice, there was little or nothing. Um, there were a couple of books out, but, um, you're right. They really didn't go into kind of the nitty gritty of the business side of things, which I think is what I think a lot of people are searching for. Yeah. Yeah, I agree.

We don't get that training. So most therapists don't have that knowledge. Would you say this might be a weird question, but what would you say has surprised you about putting the process together and just being in private practice? What what's um, yeah, what's, what's been kind of some aha moments maybe.

You know, I, I had a couple, I think my, and the ones that come to my mind, the initial one was the sense of isolation, which I had never experienced before. I'm a pretty social person. So working in agencies, I always had coworkers to talk to and bounce things off of. So there was this initial kind of, um, you know, life.

I strained it in a boat in the middle of the water. Like, wait a minute. I'm out here all on my own. Um, Which leads me to the kind of second aha, which was really, it forced me out of my comfort zone and forced me to start really connecting with other therapists in the community that normally is not really something I do.

I kind of stick to the people well that I interact with normally, um, And actually I've done a lot more of that since COVID. I think that the zoom thing has been really beneficial because it's just quick and easy to meet people, but building that community of, in that network of local therapists. And I I'll say that that's probably my number one referral source is other therapists in the community.

So it's really taught me a ton about. Just connecting with, with other therapists and other professionals in the community and getting to know them and getting to know what their practice serves and them getting to know me and how my practice serves in the population that I see so that we can kind of generate that, those, those flows of referrals, which in the baby steps of my practice, I was, I wasn't doing any of that.

So I was just kinda like, okay, I'm just out here, you know, alone, you know, I'll figure it out as I go, but that's been really beneficial. Right, right. Yeah. And I think that's, um, I think that's one myth that a lot of people that go into private practice have is that they see the other therapist in their community as competition, so to speak.

And I think that's a huge mistake because like you said, um, you can really draw on those supports and, and they can really be pretty good referral sources, um, because, um, You know, I, I know that's, that's something for us in our practices that especially here lightly, and I think a lot of other therapists now, in fact, I was talking with another therapist here in the state of Tennessee earlier this morning and, um, We were just talking about how we're just really having trouble finding new therapists for our practice.

And, um, just the, um, I think the demand for mental health services now more than ever, the stigma is starting to go away and people are really recognizing that we're needed. And so, you know, there, there is no, no competition. There's more than enough. Um, People for us to see and help them. Yeah. It's a, I totally agree.

Absolutely. I think you have to have that abundance mentality there's enough to go. Yeah. Yes, yes. So, yeah. So, um, now that you're starting to coach other people in private practice and getting started in that, can you kind of walk us through kind of your process for helping people and how you do that?

Sure. Yeah, absolutely. So, um, I have, uh, right now I have a three-step process, so I kind of break it down into three steps and all of my services are one-on-one individualized. So we talk about exactly what the one thing about, you know, private practice is different areas. Are they have different cultures, you know, the more rural areas and the more city areas and urban areas.

So we talk about, you know, what are your goals? In private practice and how can I help you reach those goals? So that's kind of the individualized part, but the three steps are pretty standard. So step one is all about those business basics, because that's the biggest thing that I'm passionate about. So we actually walk through what the heck is an EIN and why do I need one?

Um, and what are the different business structures that are out there? And what's the difference in which ones are available to me? Um, I don't give tax advice or advice on which business structure is best, but I do present them all. And the cool thing that I think is, is that I think is cool about my step one process is that it goes in sequential order, because that was the one thing that was frustrating for me.

Like I said before, I'd hit roadblocks and I'd have to backtrack and go do something else in order to finish that step. So they go, I give everyone a PDF checklist, which goes literally in order. So as soon as you check off the first item, you move on to the second. And if you get through that whole page, you're officially a small business owner and you have a private practice.

Um, so once I get through that step, We have a step two call, which, um, involves HIPAA compliance and Phi and BAS and what all that means and how you can make sure that your practice is abiding by those things. And how you can tell if your email is HIPAA compliant or zoom is HIPAA compliant and all those things.

And then step three is all about. Networking advertising and marketing. So I don't go really heavy into that cause that's not my field of expertise, but I do talk about, okay, here's some ways that you can generate some referrals. Um, let's talk about insurance pros and cons so that you can decide for yourself if insurance is right for you or not.

Right for you. You just want to do cash pay. And how do you network with other therapists in private practice? Um, because you know, you don't have coworkers necessarily all the time, so how do you find them? How do you network with them? How do you. Gain that trust so that you guys can distribute referrals back and forth and go from there.

So that's, that's the walkthrough of my process. Um, and one of the things that I'm I'm also, I think is really important is that my program is affordable. Because again, like I said before, you know, a lot of the programs I found were, I mean, upwards $6,000, I didn't have it. So I really try to. To make my program attainable for those I've been in agency work.

I know what the pay is for even a licensed therapist. So I really try to make it affordable and attainable, which is important to me. Yeah. Yeah. I would agree with that. I think that's something that I've tried to focus on as well as it, you know, you can, you can pay a lot for consulting and coaching and that sort of thing.

Uh, but you know, I think, um, Being able to, I love what I love that. How would you describe your process? Because I guess the metaphor that came to mind for me is just, you're helping a person create a roadmap of getting from point a to point B and, and just really, um, Telling them, which steps, steps along the way, which I love that.

I love that. Yeah. So, yeah. So, you know, to shift gears a little bit, I know we were talking a little bit about this before we started recording is just the impact that COVID has had on how we do private practice and how we, how we run things. Um, And I know one of the things that, um, is really cha been a game changer is just the switch to tell a mental health and doing things online.

So what what's, what's your experience been like for you and your practice and. You know, you coach the coaching you're doing and that sort of thing. Yeah, definitely. I mean, a huge impact is for all of us. Right. It's funny. I signed a five-year lease on a brand new office in, uh, March, March 1st and then March 13th was the last day that I've seen a client in that office.

So of course sitting there kind of, it's not collecting desks because there are other therapists using it. But, um, I have two boys who are distance learning, so I, I have to be home. So. Literally over a weekend. I switched my entire full-time practice. I mean, we're talking like probably between 25 30 clients to tele-health and I had never conducted one tele-health session.

So it was, I mean, it was literally a Friday, our kids' schools closed and I said, okay, I'm going to just shift to telehealth. And I had to build an entire tele-health practice for an, a huge caseload. In the span of a weekend and let them all know and get consents to them all so that we could get started.

So it was kind of insane, but I noticed that I didn't lose very many clients. Um, I, I, especially, I think there was a lot of tension and anxiety, like what the heck is going on right now? So I didn't lose many clients a lot stayed on. And even some that were like, no, I'll just wait until you go back and person money.

Most of them, I would say came back later and said, you know what? Let's just, let's just try the tele-health thing. I noticed. A lot of the teams were much more comfortable on tele-health. I love working with youth and they just seemed much more comfortable in their own bed. You know, they would show me their posters and their room led lights and all the different things in their room.

And we'd listen to music and all different things. So. Those kinds of things are really cool. I noticed myself because I'm human and I'm flawed and I hate change. Like I definitely struggled initially. And I was like, Oh, this is terrible. I hate this. But I adapted and grew in and got into it and it became really cool.

And I think the coolest part for me, outside of all of that is that now California is such a big state and a huge densely populated state. And now with this new addition to a practice, You have access to anyone in your entire state, whereas. Before it may have been what, like a 20 minute radius, 20 ideas that people would come see me, but I could see people in San Francisco, San Diego, you know, anywhere in this entire state now, which is amazing.

So that really opened my eyes. And actually my coaching business was born out of COVID because I that's, when that push really came, because I said, you know, this is a great opportunity for people to open their practice. Not only do you not need a lot of money to start up a tele-health practice from your home, but you also have access to a cotillion times more clients than you would have in telehealth.

So that kind of burst that out of that. Um, so it's, it's, it's, that's kind of the, so I think the PR in the mental health world, COVID, hasn't. Been a bad thing. As far as from the professional side, there has been a huge impact, like you were mentioning, you know, on, on the people obviously on all of us. So the, the flood Gates have opened and.

There is less stigma for sure. Especially with the younger generation. And right now there are so many people, all of us are struggling on some level and on some days with just everything, the weight of this year. So there is an abundance, you know, of, of people out here who need services and having, you were mentioning, having a difficult time, finding people to join the practices.

And I'm having a difficult time finding people to refer out clients who called me cause I'm full and I've been full for so long. Yeah. In my list of tos, they're all full, you know, so I'm like, there's an opportunity here really, honestly, for people to open a practice. And just, even if you're just seeing one client, I mean, just open that door to trying something new and getting a little side cash and also the tax breaks and all the other things that come with it because there is an abundance right now, this, our field has I think, thrived in and grown exponentially and caught up with the times.

Due to COVID. Yes. Yes. I would totally agree with every bit of that. And it's, uh, you know, that's, um, again, something that I'm thinking about, I was, uh, I was, um, doing, uh, uh, doing some recording with my friend Daniel fava who's on another, has another webs, uh, another podcast, um, Private practice elevation is the name of his podcast.

And he's, he's a, um, Daniel's not a therapist, but his wife is. And his really, um, Daniel's expertise is a website design and helping, you know, clinicians build those kinds of platforms with their website and marketing in that way. And, um, He, and I were talking about this very same thing is that now the geographic bounds of your practice has changed.

And so it's going to change the whole way that we market our practices, the whole way that we think about it. You mentioned too, the office becomes less important, you know, it's uh, and so it's really, um, Yeah, I totally agree. It's just a wonderful time to be either establishing a practice or really shifting the practice that you're in to, to reach our lot, a larger group Archer group of people.

So, um, yeah. And, and like, like you, I had. We had kinda the same experience where we switched to tele-health just overnight. Um, you know, we had some, some clients that would say, you know, I'll wait till you get back. But again, eventually they got to a place where, well, I want to meet with you or I need to meet with a therapist.

And so they, uh, The telehealth riots. So yeah, I know this might be two weeks too. I mean, we're on month, like eight now or something. So I think a lot of people were like, Whoa, I didn't know. I'd have to wait this long. Like, I don't want my mental health. Yeah, it is. And even that, like, you're talking about getting a wait list and all of that now.

And so yeah. Uh, I think people are just really hungry to get the help. I mean, it's just been, been tough. Yeah. I still get calls. I tell people all the time I get calls multiple calls a week. I didn't know, a week does not go by where I don't get calls from potential new clients saying, do you have any openings seek, you know, can I come in and see you?

And I've been full for so long. So there's definitely a need there. I mean, the world is hurting and I don't think, I think you'd have to be. Naive, you know, to not see that the world is hurting right now. And so of course, you know, with more hurt comes more need. And as in a healing profession, that's, this is our time to kind of step up and do what we can.

And there's just, there's just immense opportunity there for practices to grow and single practices to turn into group practices. And I mean, just so much, so much opportunity there for, for our field had touch and reach and help. So many more people. Yeah. Yeah. So how are you, how are you thinking about your own practice in terms of the shift you're thinking about?

I know as I'm, um, you know, what, what happened with COVID is our priorities just immediately changed. I mean, this is kind of like all the, I was just looking back at some of the goals I had written down for myself for this year and every, uh, pretty much. The majority of them got put on the back burner, just because everything changed.

And so how are you thinking about your practice moving forward? Or even if somebody were to want to start a private practice, how would you kind of suggest they look? I, my, so I always tell the people I work with, you know, that I'm always going to present the easiest. Cheapest and quickest, possible way to get started.

And then we'll talk, we'll branch out from there, you know, so I think that, you know, starting a tele-health practice right now is from your home is great idea to vendor, same century, um, because it's just, it's easy, it's quick. And it doesn't, it doesn't have a lot of startup costs, barely any at all to kind of get started that way for myself.

I know that. My, my kids will be distance learning until for the rest of the year. So the earliest I'll be back physically in my office will be next August. Um, so that'll be like a year and a half, you know, from when I was in there. But I there's no way you can't be changed through this process. Right?

There's no way your practice can go back. In my opinion, go back to what it was before there will be some changes, good things I think. But some changes, I don't think. I, I, I don't think tele-health is going anywhere. Honestly. I think there are people who prefer it. I know there are people who prefer it, um, who didn't know that they preferred it because they never been exposed to it before.

So I think my practice moving forward, we'll probably integrate both. I think I'll be able to have. Some telehealth days and some in-person days, um, so that I can just kind of meet people's needs. And, um, and also like we were talking about expand that reach to be able to see so many more people across the that if you get licensed enough places across the nation, but for me, the state, you know, so I think that that will change my practice.

Um, A lot, you know, just, just, just that piece of it. And I would encourage, I, I do encourage the therapist and the clinicians and the psychologist that I work with. To consider keeping tele-health as a part of their practice because of those two reasons. I don't want, I think that a lot of people are going to prefer it moving forward.

Um, and two, I think it just expands your reach. Uh, so, right, right. Well, one of the things that I've learned, or I think a lot of people have learned, especially, uh, Both on my side and client side is, um, it's really much more convenient. Um, and that, um, you know, from a client side, they don't have to take off work to come in to see me.

They can, you know, they can go to their car and meet with a, you know, with her. With their phone or whatever. And, you know, it's just, um, it's just much more convenient. They don't have to drive to the office and where, where I'm located. We, we actually get clients from a pretty large geographic area and that we're, we actually get clients out of.

Several States, uh, because of where we are. I mean, um, we're in a, a small metropolitan areas, surrounded by a lot, very large rural area. And so, um, it's just made it so much more convenient for people. Yeah. And I think on my end, I've seen a lot less cancellations because it's like you said, it's easy to just go sit in my car and pop on a therapy call.

Whereas if I'm going in office, I need to get up. I need to get ready. I need to get a babysitter or I need to call off work. Like you mentioned, and I need to drive over there and maybe there's traffic or maybe there's bad weather, or maybe I just don't feel like it. And so I canceled. So I've seen way less cancellations now.

Right. And we've had many, a car sessions that seems to be a great place for people to get some privacy. Right, right. Yeah. And that's, uh, that's just, uh, yeah. And you have to kind of get used to looking up people's noses. I mean, there's just, yeah.

And dogs barking and yelling, you know, all the different things which happens at my house too. So no judgment.

Oh, yeah. Oh yeah, yeah. It's uh, yeah. I have to sequester our cats when I'm working for moms. Yeah. And that's, that's the other thing too, is just for them on the, on the clinical side. I mean, it's a, you really can literally work from home. You just don't call, you have to worry about what's in the background and some privacy and that's it.

And so it makes it pretty easy. Yeah, it does. It's convenient on both ends for the therapist, the client. Well, I think we both agree that it it's, uh, it's here to stay and I think it's a, it's good for us to embrace it. And it really has created a lot of opportunities that maybe were unforeseen before.

COVID. Yeah, absolutely. Yeah. I absolutely agree. A hundred percent. Right, right. So, well, Angela, I want to be respectful of your time and I'm so glad you joined me on the podcast. Tell folks how they can get in touch with you and, uh, your website and all of that sort of thing. Thank you. I will. And thank you again for inviting me.

This was a lot of fun. I love, love. Talking I'm a talker. So I appreciate you inviting me. Um, you can reach, you can find my website@wwwdotclassroomtocouch.com all spelled out, no numbers, classroom to couch.com. Um, you can find me on Instagram. My handle is Angela dot James underscore MFT. Um, and pretty much all my info.

If you find me on Instagram or Facebook, um, you can. Find all my contact information on there. You can call me, email me, send me a private message. DME, leave a comment. Any, any type of way. I'm really responsive. I don't have a virtual assistant. It's me. I respond, you know, and I try to get back to everybody within 24 hours if I can.

So yeah. Do you have any questions about anything whatsoever? Please don't hesitate to reach out. Like I said, I'm a social person and I'm a talker, so awesome. That's great. That's great. And we'll have links to all of this in the show summary and show notes for people to get easy access. So, Angela, I know as we're recording, this is the day before Thanksgiving, so happy Thanksgiving and um, yeah, and I hope you have a good holiday season and gag so glad and I'm sure we'll reconnect.

Absolutely. Yeah. I'm looking forward to it and same to you. Enjoy your Thanksgiving and your holiday season. Take care. All right. Thank you, you too.