The Practice of Therapy

Russell DuBois
Hey, everyone, my name is Russell Dubois. I'm excited to be on the practice of therapy podcast. I will be speaking about measurement based care for group practices as well as my company blueprint.

Gordon Brewer
Well, hello, everyone, and welcome again to the podcast. And I'm excited for you all to get to know Russell Dubois. And Russell, welcome to the podcast. Thank you so much. It's great being here. Yes. And so what I'm excited about with this is that, you know, every now and then, you know, most of the time with the podcast, we talk about the business side of things. But one of the things that I'm excited about you learning from Russell, is their company, blueprint, blueprint health, and the evidence based practice measurements that they put in place that really can help us on the business side of things, particularly for those of us that are insurance based. So Russell is I start with everyone, tell folks a little more about yourself and how you've landed where you've landed and something about your background?

Russell DuBois
Yeah, no, that's a great question. So let's see, I'm a psychologist by trade. Currently, I direct the clinical operations and customer success teams at a company called blueprint. We are a software company that develops digital tools for mental health providers to deliver the best possible care as well as for group of practice owners to help scale their business, we're especially focused on this idea of measurement based care. So I've been operating in the behavioral health technology space for a couple years now. But that wasn't always the case, and certainly wasn't the plan. When I was going through my doctoral training and beyond, as well, I really had plan to stay in academia and pursue a career in research. And at that time, I was really interested in what's called clinical data science, which is basically a field with dedicated to understand, understanding how we can use different forms of data to inform, enhance, and predict clinical care that we provide. So it's working with some amazing people, some leaders in the field and sort of in that context, was feeling really optimistic about our work, and to know that we were making a difference. And during that time, as you do in a clinically focused psychology program, part of my training was also actually doing therapy like working out in the field. And so alongside my research life, doing all this sort of clinical data science stuff, I went out and find, you know, found some jobs as a therapist, I worked in most all different kinds of care settings from private group practice, residential treatment centers, state hospitals do a lot of work with children and families. So sort of the Whole Care spectrum. And through these experiences, working directly in these different types of therapy settings, there are two sort of lessons that I learned. One was that most therapists out there, myself included, didn't have the tools and resources needed to make it a bit easier on us to provide top quality care without feeling burnt out. Like we're all trying our best. But sometimes it can be challenging to effectively manage, you know, a caseload of 2530 clients. I know, some of you out there see way more than that, which is amazing. But it's hard, like it's hard to keep up and be effective and stay engaged day in and day out, when you're doing therapy full time. And all the cool stuff I was working on in the research lab are wonderful tools that can and do make our lives easier. But in the real world clinical setting, nobody was actually practicing this way. And the second lesson was that a lot of therapists out there historically don't really care all that much about clinical data science, like it's not a topic that you go out with your therapist, friends then sort of talk about at lunch, like the culture is not measurement focused, which for me was so unfortunate because I, I had seen how leveraging data in the work that we do is sort of a secret sauce that can add value in all aspects of the therapy business. And so that's sort of a long winded way of saying that, you know, through these lessons, I became really interested in how we can sort of translate some of this like nerdy clinical data science, measurement based care, stuff like this stuff that truly can change the way we provide care, and bring it to the everyday therapist or group, this owner out there who may have never otherwise thought to practice this way and do so in a way that's fun and engaging and that, you know, is approachable and just makes sense, regardless of who you are and what type of work that you do. So I left a research base, I connected with some smart people in the field who were not clinical at all, but I wanted to help solve these same problems and became the change the culture around measurement and technology. And one thing led to the next blueprint was born with these aspirations in mind. And here.

Gordon Brewer
Oh, yeah, I love that backstory. Because I think that that is something that I think for a lot of us that go into private practice, you know, clinical outcomes. We, we learn about it in school, and we learn about it in grad school and all of that. But, like you said earlier, it kind of can take the back burner, but that it's interesting that you say that that's also what I think leads to burnout with folks, you want to say more about that?

Russell DuBois
Yeah, I think it's, you know, as I was saying, it's, you know, we're all busy, we're all strapped for time, we're all struggling to keep up with the requirements of what it takes to be a therapist, whether it's, you know, not only seeing clients, but showing up emotionally for them, and being ready for, for what, you know, what is entailed in the process of therapy, to the documentation to sort of everything else. And because of that, I think one observation I've made is that a lot of us really go into our therapy sessions blind, like we sort of do do the same thing. We, you know, clients show up every week, we asked how things are going and it gets really repetitive, and it gets really difficult, especially if you're doing therapy full time, and have been doing that for a long time. And so that's sort of, at the heart of burnout, I think a big piece of burnout, too, is losing a sense of curiosity, in the work that you do, I think being curious about your work and about your clients, and just about change in general is really at the heart of staying engaged as a therapist. And so one of the really exciting things about I think measurement based care in general, but specifically about about blueprints, and the tools that we provide is it helps you, number one, be much more informed about your clients and their lived experiences, if you have a lot of information that you can learn and use during session just to help you out. So you aren't sort of flying by the seat of your pants. But I think like a hidden gem as well as it sparks systems of curiosity, were when you're able to collect information and get data about your clients that you never thought you would otherwise you can approach your work with clients in a really curious way, which I think is is healthy from a burnout. perspective.

Gordon Brewer
Right? Yeah. And some, you know, what, what, what I was thinking of, as you were saying that is that a lot of times, and I'm sure others have experienced this. After the session is over, particularly those intake sessions, you go, you start thinking about is that Oh, I wish I would have asked this, I wish I would have asked that. And and I had had the pleasure of getting to see a demo of the the blueprint platform this past week. And what I love about it is is that it's really geared to asking the right questions, to really get solid data about things. Do you want to maybe Russell, tell folks a little bit about how you kind of pulled all this together? And kind of you know, what were the How did you know what measures to start with? And all of that sort of thing?

Russell DuBois
Yeah, it's it's a great question. And I'd say we relied heavily on all of our wonderful partners who we've worked with throughout the years, we've, you know, we've been going for two almost almost three years now. And you know, when we first started, it was just a very small, you know, amount of us there's only a handful of people on the team, we had just a handful of therapists who were using our platform and you know, now it's, it's amazing to see our growth we're, we're across, gosh, I want to say 35 plus states, you know, we have over 100,000 clients on the platform like where we've really grown and a lot of that growth was listening to our customers like listening to both the therapist and the clients who were using blueprint and sort of CO growing with them. So that's a big part of it is like we we didn't come into to this feeling like we knew everything like here's exactly what you know, the therapy space needs, like I know best and I'm just gonna roll it out. You know, we really took a different stance on what How can we listen to the needs and the problems that are being experienced by therapists out there and create a wonderful product and wonderful therapist experience based on those stories? And so you know, in light of that we started small, you know, the measures that we use, there's there's some common ones out there to Ph. Q. nine people might be aware of for depression, the Gad sevens, another common one. And, you know, we've we've since grown from there. But yeah, I mean, that's kind of the backstory as to the creation and how we've grown. And the other thing I'll add there is, is alongside all of that, we've grown a beautiful and wonderful team, like the people that I work with every day are absolutely amazing. And the important pieces, they come from all different kinds of backgrounds. And that's really important, because you want diversity of thought, and you want people to have different perspectives on the type of stuff that you're building. And so I think it's the it's the combination of us being willing to listen to the needs and the wants of the therapy field and growing this amazing team that sort of got us to where we are right now.

Gordon Brewer
Yeah, right. Right. Well, I love I love the concept. And so two questions for you. And these can maybe kind of piggyback on each other. Number one is just maybe explained a bit, not a question, but a statement, but maybe explain to folks a little bit about how the platform works. And then number number two is why would they want to use it?

Russell DuBois
Yeah, those are those are excellent questions. So at a basic level blueprint is a digital platform that operates at three different levels. So first of all, is clients like clients who are in care who are seeking therapy, or who are currently receiving therapy can sign up for a blueprint, we have a mobile app that clients can download. And through the blueprint app, they can track really important information about their mental health and wellness. So they can track things like trends in their mood and their energy. They can record their sleep quality and social engagement over time. We even have what's called passive behavioral data. So So clients can connect their blueprint app to their GPS in their health kit on their phone, so they can track number of steps taken each day. And they can track number of hours spent at home each day. And like homestays, what we call it, so some really pretty advanced things. And in light of that, it's a wonderful tool for clients to use to improve self awareness, and hopefully, getting clients interested in just understanding themselves a little bit better. At the next level up, clinicians or therapists can use a blueprint to become more informed about their clients. So they can assign a variety of different measures that we have, we have all different types of screening measures, outcome measures, process measures, as well, where we're a very big fan on aligning the measurements library that our partners have with the type of work that they do. So there's this misconception that, you know, measurement based care is this like, medically feeling thing where you can only track you know, pathology and that type of thing, but very much can be done in a in a warm and welcoming way. So we have measures on couples satisfaction on family, cohesion, mindfulness, whatever it is, there's probably a measure for it that's on blueprint. And so, you know, through that process, clinicians or therapists can get access to all this information in real time, just to help learn and educate themselves about their clients and their progress over time. And that sort of cultivates in what we call a measurement based care. So clinicians can use blueprints can rely on this data to provide this higher quality measurement based care. And then the sort of last level up is at the group of practice owner level where blueprints an easy way to track and report on population outcomes, as well as grow their revenue through submitting insurance claims for blueprint assessments. And then also this, there's this new trend where, you know, a lot of you group practice owners out there are going to have to start to adapt to this new, you know, emerging values based contract field where some of the payers out there are going to start changing contract types from fee for service to these performance based contracts. And so, you know, that's sort of the three different levels of blueprints in terms of why people should care. I think, you know, there's a lot to sort of say about that. First and foremost measurement, basically improves client outcomes, if that's what we all want, right? It's a easy and simple way to be a better therapist is, is to start integrating and measurement into practice. And we've created an experience that's really easy to do that. So you don't need to be a data scientist, you don't need to have any measurement background, it's all sort of done for you, just for you to practice at the height of your license. Um, client engagement is another big one, as well, it's almost like a secondary game where, you know, there's a lot of research out there. And we've found as well that when clients experienced this measurement based care, their engagement in treatment actually goes up. So there's a study recently published that found that measurement based care reduced dropout rates by 20%. So from a from a group of practice owner perspective, like that's a pretty important thing to be aware of. And you certainly can have revenue implications if you have clients who are no showing in their appointments or being filled? Yeah.

Yeah. And then I think that just the the last thing to comment on here that I almost want to just like spread this information is that there's a lot of untapped revenue, through the the ability to submit insurance claims for assessments, and a lot of people don't know that. But there's CPT codes out there, where you can bill for different types of assessments and different ways, and it can be a wonderful way to get another revenue stream into your

Gordon Brewer
practice. Wow. Well, that's, yeah, and I think that's, that's something that, that you just taught me that I hadn't really thought about that kind of way of thinking about it. But you know, the, the other thing that is, occurs to me is just really on the, on the whole client patient side of things, of them really being able to see for themselves the value of coming to therapy, because I think a lot of times, for me, I know, and just doing the work that I've done is that a lot of times, you know, we'll ask clients, you know, at the beginning of a session, you know, how are you doing? How do you feel like you're, do you think, do you think things are getting better, and a lot of times, just change occurs so incrementally for them that they really don't recognize the change they've gone through. And so an assessment like this can really kind of show them the change. I know, in the past, one of the things that I've done is, is had clients just kind of track their mood, you know, give it a give it a score each day. And let's kind of look at what what your mood has been like, over the last week, week or two. And yeah, so I love that this gives more meat to that. And being able to, to give a true measure of what's going on with a client internally.

Russell DuBois
Totally, I would completely agree. And we've we've heard so many stories about that, that clients feel validated to be able to, to look back and actually visually see the progress that they've made, I'd say at the at the same time, too. We've we've, you know, we've certainly seen that, that clients feel a sense of validation as well, when you put a number to they're struggling, because oftentimes, it can be difficult for clients to understand their own mental health, and they want to get a better understanding and grasp on it. And there can be, you know, it can be a really normalizing experience to say, hey, it sounds like you're, you're experiencing depression or anxiety or whatever it might be. And we have this tool that's actually validating that like, like, here's, here's where you stand, how do you, you know, do you agree with this, do you not agree with this, but being able to put it out there, you know, on on a screen or on on a graphic clients experience, as long as they're, they're feeling comfortable enough to have a conversation around it, like you aren't just saying, here's where you are, that's it. But if you include the client, you know, as a collaborator in understanding their information, it can be a really validating and normalizing

Gordon Brewer
experience for them. Right, right. Yeah. And it's a it's a concept that, you know, that, you know, what comes to mind are just kind of like the dieting or fitness apps. It's a big motivator for people to be able to say, Okay, I can track my progress here to see how well I'm doing with this with as good these goals have set for myself. So I think it would just really be a big value add for for clients on that. on that.

Russell DuBois
Yeah. And and it's so interesting, too, because I think we're getting to a place where clients are excited. directing their care to be digitally enabled or data driven in some way. Like if you think of the amount of things in just a person's life that are that are, you know, digital and data driven, it's amazing like you order a pizza, you can see in real time where it is history, right? Yeah, your, your phone can display back all all this information, like, whether we like it or not, I think, you know, we're moving into in an era where just individuals are understanding themselves in part through through data. And so I think we owe it to ourselves as a field to figure out how we can align with that mindset.

Gordon Brewer
Right, right. Well, I know one question that will come up for folks is just, you know, when we think about data and sharing information, particularly online, and all of that sort of thing, one thing that comes up is the big, the big, the big brother called HIPAA. Our I tried to discourage people to think about it that way. It's really just keeping information confidential. But you want to maybe say a little bit about how that how blueprint is, takes that into consideration and all of that,

Russell DuBois
of course, yeah, and like data privacy, I think is, is what we do and care about more than anything else, we want to be sensitive to this information, because it's it's highly personal information. And, you know, it's it's worth noting that we are HIPAA compliant, we are very much, you know, aligned with all of the standards in in accordance with HIPAA, we're also sock to compliance. So we went through a sort of, external review process and, and sort of met all of the gold standard criteria there. So very much, you know, have data security and privacy, Top of Mind, all of the data that comes into a blueprint is, is owned by the clinics and by the clients themselves. So we don't sell any data. You know, we don't we don't do anything without very explicit consent in very specific use cases for, for example, if we're partnering with a clinic on a research study, right, there's this sort of separate procedure there with its own consent process. But you know, if you're a therapist out there, and you sign up for blueprint, you have full full rights over that data. Yeah, and I think part of part of it, too, is explaining to clients and setting that expectation, because they're the ones that are going to care the most about it. And so a nice thing about blueprint, as well as we have sort of client facing language that explains that to clients as well. And so they're not feeling like oh, what's going to happen with my data? Or they're going to sell it to somebody else? So it's all, you know, as as, as out there and clear as possible.

Gordon Brewer
Right, right. Yeah. Well, that that's good to know. Well, I know that folks hear from me all the time, the importance of knowing your numbers, and most of the time, when I say that, I'm usually referring to kind of the business side of things, your financials and that sort of thing. But what I love about this, is this is adding to that by knowing your clinical numbers, in terms of being able to really see the efficacy of what you're doing, and to really get Not, not only would it be rewarding to the client, but also to those of us in practice to feel like our work is really meaningful, and that we're to what we're doing is actually helping people.

Russell DuBois
I absolutely love that. And what's so interesting is that, up until recently, with the advent of these types of measurement tools, it's it was almost impossible as a group practice owner to know like, how effective is my practice? Like, how are clients improving over time? And is that changing? Like maybe as I scale, you know, and I hire more therapists, like is my is, is the practice effectiveness going up? Is it going down? It's so exciting for me to see this evolution where we can actually provide group practice owners with really simple and easy to understand information about their clinical numbers and about how things are going, you know, and how things are changing over time. So that's, that's very exciting.

Gordon Brewer
Yes, yes. Well, well, Russell, I'm excited about learning about blueprint health and, and all that it's going to be doing. In fact, one of the things I want to just announce for this episode is we've kind of formed a partnership and that we're going to allow people to, there'll be links here in the show summary and show notes. Once we get that link up and going here for people to try it out for a month. And to be able to, you know, do a test drive of this, of this wonderful thing, in their practice. And so We'll have those links, I believe it's going to be blueprint. hyphen health.com. Yes, the URL anyway, slash Gordon or something like that. So anyway, we'll have the links in the show notes. But regardless of that, Russell, tell folks how they can get in touch with you and find out more.

Russell DuBois
Yeah, great, pretty simple. So best, best way to do that would be to go to our website, as Gordon said, It's www dot blueprint, dash health.com. Feel free to also email me directly at Russell. It's ru SS e Ll, at blueprint dash health Comm. I'm more than happy to answer any questions. Yeah, I'll also say too, that we have a lot of fun webinars and workshops. We're really big on education and just spreading the word about measurement based care. So all that information should be up on our website as well.

Gordon Brewer
Awesome. Awesome. And again, we'll have those links in the show notes in the show summary for easy access for folks. Well, well, Russell, I'm so glad you joined me today. I think this is one of the best sets of episodes I've had on the clinical side of things. And in a while and I'm excited to know more about blueprint.

Russell DuBois
Wonderful. Sounds great. It was it was great being here as well. And I'm excited about our partnership going forward.

Gordon Brewer
Yes, sounds good. So be sure to check it out, folks. And there'll be links again, here in the show summary in the show notes for you to find out more about blueprint health. So take care, folks.