The Practice of Therapy

Well, you know, one of the things that I began thinking about, and part of this is with the upcoming wise Practice Summit that is gonna be held in as a matter of fact, as this episode is coming out, it might be that that conference has all already occurred, but I'm gonna be presenting at the Wise Practice conference this year and just talking about my own grief journey and just working through.
Being able, being a caregiver, and going through some hard things in my life personally, and how I was able to do that and maintain my practice and all that I work on. For those of you that are maybe new to the podcast, or maybe haven't heard some of my previous episodes last year in 2023, I unfortunately lost my wife.
She was a long term breast cancer survivor. She had gone through 13 years of surviving. Breast cancer, a brain tumor, also just several recurrences of her cancer, and also just me having to be a caregiver for her. I did have two kind of permanent caregivers that were with her during the day, but she reached the point to where she was in a wheelchair.
Had to be helped with everything and all of our daily functions, and we were all doing that at home. And then in July of last year, we started hospice, and then my wife passed away in November of 2023. And so it was quite a journey of just not only trying to work and maintain all of that, but also going through my own grief.
struggles with just finding a new normal over this last year, you know, it's not, we're not quite to the one year mark, but, you know, I've learned a lot over this last, last year or so. You know, one of the things as I look back, On that whole time in my life, which is just a year ago, and just how much life has changed since then.
And I look back to and just think, you know, how did I make it through that? How did I maintain running a practice? How did I keep this podcast going? How did I kind of hold it all together? And I think for people looking from the outside, they would think, wow, he's, he's really doing well or whatever. But inside, you know, it hasn't been that way and I'll be, want to be a little bit vulnerable here.
There's been a lot of deep, dark days where I'm just in the throes of grief. You know, even though, ironically, kind of one of my niches is helping people with grief my previous career before I got into the mental health field and went back to graduate school, which again, this is pretty ironic was, is that I was funeral director and worked at funeral homes.
And so I knew a lot and know a lot about grief. I know a lot about death and dying and that whole process. When you live through it yourself, even though I wasn't in a helping role, I was in a helping role with my wife, but being the one on the receiving end of that is something totally different. And I've learned a lot from that.
You know, I could tell my, I, I knew what I was going through. You know, clinically, I mean, I knew that I was, you know, experiencing as they refer to it as the different stages of grief, although I don't like to think of them as stages more as like a range of emotions that people go through when they're grieving.
I could see myself doing that and I could understand what was happening, but still there were times when it was debilitating. There were times when I just couldn't handle anymore or have anything else put on my plate. And I think one of the things that has helped me through that whole period is I, as I say to my clients all the time, I gave myself permission to put a lot of things on the back burner and to put a lot of things on hold.
And I think that during the, particularly those, those last few weeks of my wife's life, I was able to do that and allow myself to do it. And I, you know, fortunately And this is maybe a kind of a take home point here to think about is if something were to happen to you, what would happen to your practice?
Or what if you were incapacitated in some way? How would things run in your practice? So one of the things that I'd like to. Kind of point out here is to have a good contingency plan. And the other thing that I've learned through all of this that I think is a good take home point is you need to have people in your practice that can jump in and do the things that you normally do even as the owner of the practice to be able to jump in and do those things and for them to have the ability to do those things when you're not able to.
So that's something to just kind of think about getting off on a little bit of a tangent here, but one of the reasons that I was able to make it through, and this is, I'm not saying this in a, in a, in a bragging way, but I had the right systems and processes in place for the practice to run without me even being part of it.
And so one of the books that I really like is Clockwork by Mike Michalowicz. It's kind of a sequel to his other book, Prophet First. But I would encourage you to read that book to really think about, What is it that is going to support you when you're in a place in your life when you might need to take some time off, might need to take some downtime for yourself in, in your practice?
So, one of the things I Think is good to think about is how to set up your practice so that it could run without you as crazy as that sounds. Now, I realize in in solo practices, it's maybe a little different in that, you know the income that you produce is dependent on. You seeing clients, but I think being able to have money set aside, having a buffer of cash or savings set aside for your practice is an important thing to always be focused on.
You know, I I did some consulting earlier today as I'm recording this with a person that is wanting to start into private practice and they have been working in an agency setting And one of the first things I told that person was is the number one thing you need to do is to protect yourself financially and don't just jump into private practice without having some financial backing in place.
And what I mean by that is, is having that buffer. So if you work. You weren't able to see a single client for three to four or even six months having the money in place to cover your expenses and also pay yourself during that period is an important piece. So, during the time that my wife was there towards the end, one of the things that I had prepared myself, the staff for, because we knew that, you know, her time was limited, and I prepared my staff for this, I told them, you know, I'm going to take some time off and I'm not sure exactly how much time I'm going to take off, but it's probably going to be a month or two.
And so that's what I did. And so I gave myself permission to do that. Once we got to the place where we were getting close to the end with my wife. I just took the time off. I had also prepared all my clients. I had let them in on the fact that, okay, this is what's going on in my life, so I'm not going to be able to see you for a while.
And I didn't have one client that wasn't wasn't sympathetic to that or wasn't you know, willing to do that. You know, if there were fortunately, I didn't have any really critical clients at the time or people that were you know, kind of high risk cases or anything like that. But if you do have that, being able to hand them off and being able to think about those things ahead of time.
Now, you know, in my situation with my wife is that we were anticipating, you know, her death. It was just that time and we had hospice in place. And so a lot of support around that. And so it was something that I could kind of envision in the future. And so I began to prepare for that of knowing that that was coming.
And so To some degree, I had an advantage in that I could anticipate, you know, something tragic that was going to happen. But a lot of times there are people that are faced with tragedies and maybe a death or an illness or whatever or a child being sick or that sort of thing where you You don't anticipate it, but I think having those contingency plans in place and to put a lot of thought into that just goes a long way.
You know, the other thing that I think was so important for me during that time period, and I think this goes hand in hand with a contingency plan, is having a good community around you. Not only support for you emotionally, but also Just people that would are willing to kind of step in when you have to step out.
So again, having a great staff that is willing to kind of pick up the pieces and do things that I was having to kind of drop the ball on there, there towards the end is I think is important piece, but also just the community having it around me that I could bounce ideas off of. So, you know, being able to talk to colleagues about the situation that you're in, and being able to be vulnerable in that way.
So, it might be that you're in a place where, okay, I'm struggling financially with my practice. Having a colleague or someone that you can talk to about that to kind of help you. give you support goes a long way. Now, fortunately for my practice, I had, like I said, the contingency plan had the financial buffer in there, all of that sort of thing.
So for me to step out, I was prepared for that. But I think thinking ahead, And when I say community, I mean having mentors, trusted people that you can talk to. I think one of the shout out to my mastermind group had that I meet with every week and that's Uriah. Whitney and Jessica, they have become some of my closest friends and they were there to support me along the way.
If nothing else, they just listened. If they, if I had some issues within my practice, like maybe some employee issues, that sort of thing, to be able to bounce that off of them just really gave me the support I needed. To be able to make it through those hard times. Also, just in the emotional and kind of spiritual realm of things, you know, I'm very fortunate here at home to have a core group of very close friends.
One story I'll tell you is that the day that my wife passed away, We had all of the hospital equipment, hospital beds and oxygen stuff and all of those things there in the house. And one of the things that was just going to be so helpful for me and my daughter was to have all of that stuff removed.
And so I called one of my friends And that asked them, they said, you know, Gordon, what can we do for you? And I said, you know, it'd be nice to be able to get all of this stuff moved out of our living room where my wife had been and have that, you know, just put in the garage. I mean you know, the hospice will pick it up later in the week or later over the weekend or whatever.
But just to get that out of sight was just a huge. Relief for us. And, you know, fortunately, with that group of friends, by that afternoon, there were several people, seven people at my house, moving those things out and just having that outpouring of community, close friends, people that you can lean on is so, so important in moving just through grief.
You know, one of the things about the grief process is recognizing the fact that grief is not something you get over. It's something you move through. And one of the things that I can say about, you know, losing a spouse. We were just one month, two months short of our 30th anniversary. So that was, you know, that was bittersweet in that sense.
But, you know, one of the things about it is, is that grief comes in waves. We can feel like we're doing fine. We're moving through things well, and then all of a sudden it hits you. And I think one of the things to recognize in just grief in general is, is that it does come and go waxes and wanes. There were days, you know, shortly after my wife passed away where I just felt lost.
And especially during those times when my daughter, She had to go back home to back to her life, you know, and then being in an empty house and just figuring out all of that stuff was tough, but fortunately, you know, I had people that I could lean on. During that time, and was able to find a new normal and also just allowing myself just to have those breakdowns was a huge help to me.
You know, again, I knew what was happening to me and I knew what I was experiencing. And so just allowing it to happen and allowing myself to be vulnerable with those that were close to me and allowing them just to be coming closer, if you will, and being able to support me through those times. And so in many ways over these last several months, I've been in the process of finding a new normal.
One of the things that I've shared in previous episodes, recent episodes, Because you know those of you might remember that our insurance based, we had the, the problems with the clearinghouse change health care. Just, it got got some ransomware into it, and the whole thing just kind of got shut down, and so the cash flow of my business drastically changed during that time.
Again, because I had contingencies there, I was able to, you know, pay people and be able to keep the, keep the ship afloat while we were kind of going through that low time with not much cash coming in. the cause of that problem. We made it through that just fine. But the other thing that it did for me was, is when I started looking back at that, having given myself permission earlier on the year before to kind of put things on the back burner, I realized that When I had put things on the back burner, I had also let some of my systems and processes slip.
And so one of the things that we realized is, is that we weren't collecting from clients like we had been. And so We had a lot of gaps, or as I like to say, money leaks within the practice. Now, it was one of the things that I think was my initial thought was, well, shame on me, you know, I'm an expert in running a private practice.
I'm using air quotes here. But I let, Something just very simple as just getting sloppy with my the money side or the financial side of my business, which people hear me preach all the time knowing my numbers. Well, I had lost touch with my numbers. Fortunately, I was able to get that corrected. We realized that we had grown in our practice to the point where we needed to outsource all of our billing again, and so we had had a person in house doing that, and so we had outsourced that, and so we were able to get that corrected.
A shout out here to Apple tree Billing. That worked with us to set up a new billing system within our practice. And I can say that they quickly turned us around and we are now electing over 95 percent of of all of our insurance claims now. So that is a huge win for us in our practice. But one of the things too that goes along with that is being willing to outsource.
And I think that's the only way any practice can grow is when they outsource. And particularly for a practice owner, when they start taking things off their plate. That's the point at which they grow. And so silver lining through my wife's death and through going through all of that grief that I've been going through and still go through.
I'm still, you know, like I said, grief is not something you get over. It's something you move through. And I'm very quickly finding a new normal. I have a whole new routine now and do things Just living life in a much different way than I was before. But anyway being able to, the silver lining was is that it allowed me to outsource more, which is something I needed to do.
And as a result of that, my practice has grown yet again. And so again, lesson learned there just I had to. Had to outsource, had to put stuff on the back burner. I had to take my hands off of things and guess what? It had a great outcome. And so again, that is something to think about in your own practice is what are the things that you can take off your plate as a practice owner that You can outsource, and there are lots of ways that you can outsource either with your billing or with hiring a virtual assistant to set your appointments and that sort of thing.
Just lots of different things, hiring someone to do kind of your bookkeeping processes, all of those kinds of things are things that we can outsource in our practices. And actually, that puts us way ahead of the game when we're able to do those things. Thanks.
You know, I think the other thing that you know, and just working with other therapists on building their practices is recognizing that there's no right way to do most of the things that we do. There's no perfect way. There's no exact right way. As a matter of fact, there are probably 10 different ways to do the same thing.
And I think what is important to be able to do is to find what works for works for you. And so, again, I didn't necessarily do everything in the perfect way, but I did what was right for me. And the way that I do things might not be the right way for you either. I think. When when we run into things in our practice of things that we need to figure out and things that we need to do within our practice, so like for example, what is the Best way to keep your books.
What is the best way to pay your people? What is the best way to keep your records all of those different things? Well, guess what? There's any number of ways to do that I can share with you the ways that I do it that are working for me You But that might not necessarily fit for you and your practice.
The other thing I'll say about that is, is recognizing that within a practice, you're going to have to find kind of your sweet spot as far as your size and that sort of thing. One of the things that I've been Kind of struggling with or, you know, chewing over or ruminating on or whatever you want to call it is whether or not to expand my practice more where I'm located here in my office is we are kind of landlocked with my office building.
I own my office building. And I've maxed out the number of people that I can hire currently just because of the space limitations. So I'm in the process, and I'm sure you'll hear more from me about this as I move through this, but I'm in the process of trying to decide, do I open a second location and hire more people?
Do I sell the building and move to a totally new location with my current practice or move to a larger location? Do I keep it at the same size it is and just optimize it and keep it going? There's no right answer to that in whichever way I decide is going to be okay. And so that has been another thing that I've, you know, I've been working through and just finding the new normal because I had put practice growth way on the back burner, you know, when I was going through all the things with my wife, and I guess maybe my point is, is that now that I'm at this place where I think about, Do I grow my practice? Do I sell my practice?
Do I add more clinicians? Do I, you know, find another location? All of those different questions are right here in front of me. And the thing about it is, is I'm not going to make any of those decisions on my own. And that's why you need mentors and people to help you kind of walk through that.
Going back to that theme, I said the importance of having community. So, More to come on all of that with my own practice, and I'll share my journey with that as as I do expand my practice or not expand my practice. I'm going to be sharing some of that with you all as I move through that. And I think the other thing too is I'll just kind of wrap things up here is giving yourself permission to just think outside the box.
Of being able to, create a new path or create a new normal, if you will the way that I do my practice now isn't anywhere close to the way that I did it when I started things. And I think giving ourselves permission to try new tools and do things in new ways is What is going to help your practice survive?
Because things are changing so quickly. I think, I think about just even with the advent of AI of artificial intelligence and what we can do with that now with doing progress notes or Even building business plans or building different content, all of that sort of thing. It's just been a big game changer.
And so that's exciting to me to think about how we can use that in a positive way. I know there are Folks out there that are leery of AI or artificial intelligence afraid that that's going to take over. But I don't think so, because I think that all of us need that human touch and that human human interaction.
Just in a particularly in our fields. I think we've got got to have that. And I think people are looking for that. I know, even here now that we're post covid, most of the people that we're seeing in my practice are wanting to come in rather than just do telehealth. So, again, lots of opportunity there.
So I think that's about it that I wanted to share in this particular episode and just to kind of go back and recap, you know, I was unfortunately I was faced with a very big hardship in my life, but I think the way that I got through that number one is having community around me, having a lot of support around me, having contingency plans in place and having built a solid a pretty solid, systems and processes that were in place that allowed me to step out and be able to take the time that I needed to take care of myself, take care of my daughter and us work through the grief of losing her mom and my wife and being able to take that time off and time away.
And then also just having those trusted mentors and people in your life that you can Be vulnerable with, share information with, is, are the big ways in which I made it through that. So hopefully this will be helpful for you. Those of you that would ever like to talk with me about my experience or maybe you're going through your own hardship at this particular point, reach out to me.
I'd love to hear from you, love to hear your story and hopefully be of support to you as you go through whatever it is that you might be going through. Hopefully this wasn't too much of a downer of an episode, but you know I'm thankful for the things that I've been through. You know, I still have my own grief to work through.
I'm still doing that, but at the same time, I'm finding the new normal. I'm getting out there. I'm dating again, all of those kinds of things, which is that's a whole weird other thing, you know, after being married for 30 years and then you start dating again. Guess what, folks, it's a different atmosphere now.
But anyway, I digress. But anyway, yeah, give yourself permission to seek out the support you need in your life to make your practice thrive. And I think no matter what life hands you, you can make it through with the right supports in place.