The Practice of Therapy

David Khalili
Okay. Hi, my name is David Kelly. And I'm happy to be here with Gordon on the practice therapy. So let me pull up my where's the email that you sent me, like I just have

Hi, my name is David, Chloe. And I'm happy to be with Gordon on the practice of therapy Podcast. Today we'll be talking about running a group practice around sex and relationships.

Gordon Brewer
Hello, everyone, and welcome again to the podcast. And so happy for you to get to know David Carr, Lily. And hopefully I'm saying your last name correct, David, but as so good to have you.

David Khalili
Thank you very much, Gordon. It's good to be here. Yeah.

Gordon Brewer
Yes. Yes. So, David, as I start with everyone, why don't you tell folks a little bit about yourself and how you've kind of landed where you landed in the Bachelor practice.

David Khalili
Yeah, thank you for having me. So I am a sex and relationship therapist in San Francisco and also founder of a group practice called Rao's relational wellness, where we focus on helping people feel less shame around their sexual and gender identities. We work really well with polyamorous folks, kinky folks, LGBTQ folks, people in the bipoc communities. And I really love my work. I love working as a therapist, and as a group practice owner. And kind of straddling the lines between clinical work and running a business and doing the kind of entrepreneurial type work.

Gordon Brewer
Right, right. Yeah. Yeah. And, and one of the things about your practice, and, you know, it's interesting, the demographics of the country, there's probably more, you know, I would say, there's probably more LGBTQ folks. Maybe? Well, I don't know, let me let me back up on what I'm gonna say here, because let me let's just start over here. Because I'm gonna get myself and I'm gonna get myself in a hole here, if I'm not careful. I was about to say. It seems like there's more openness around LGBT issues. Yeah. In your area than there would be where I'm located here in the southeast.

David Khalili
Right, right. Yeah. There's more kind of a more space to talk about it. And we're supposed to be open about it. Yeah,

Gordon Brewer
yeah. And so yeah, I'm just curious how you kind of landed on your niche? And just, yeah, and what what that means for you?

David Khalili
Cool. Yeah, actually, I just gave. So part of my postgraduate training was at this place in Berkeley, California, called the psychotherapy Institute, and the psychodynamic focused postgraduate training program, which is great, and they offer really, really excellent moderate V therapy. So if you're in that area, reach out to them. But I just actually talked to some of the staff therapists that are in training, they're about finding their niche and marketing and all that good stuff. So this is a topic that I was just recently talking about. You know, part of all these are a part of my identity, like I'm work with people who are first generation American born and both of my parents immigrated to the states, my dad from the Middle East, and my mom from Europe. And so I got to experience very different cultures, very different religions, and also experienced what that was like to be in the the liminal space of straddling these cultures that were from my parents, and that were very much in my home life, and then going into school, and there was not that representation. And there was a lot of loveliness to that. And there was also a lot of kind of tension with that. And so working with people who hold different identities that there might be tension between the two, like, I got my master's degree in sexuality studies before I did my studies in counseling psychology, and a part of my, my thesis for sexuality studies was Middle Eastern and queer folks, and talking about the tension between their ethnic identity and their sexual identity, and what that was like to kind of hold that. And so I really find that it's important to provide that space for people who are going through that journey themselves in a therapeutic sense. And so the clinicians that I hire kind of hold multiple identities, and we will all hold multiple identities, but the clinicians I hire, kind of have an awareness around that and they incorporate social justice issues into their work and it's So we market to clients that want that in their therapy. And so, yeah, a lot of that matches my identity, but also just kind of like being a guy who likes to talk about emotions and has emotions and was kind of shamed about that growing up in our culture, and wanting to provide space for men to be more open about their emotions and about their vulnerability. So I run, I run men's groups, and then I also work with men individually.

Gordon Brewer
Right, right. Yeah, it's wonderful work. And I think it's, you know, it's really affirming, as we were talking about, you know, just kind of, before we started recording just the importance of vulnerability and being paid, being able to give people a safe place to talk about the things that maybe they find internally difficult to talk about.

David Khalili
Yeah, yeah, yeah, absolutely. You know, and I was telling you before the recording that I appreciated your vulnerability in past episodes, and how it kind of really created that space to talk openly about you know, I think as a therapist, we are sometimes told, and we sometimes believe that we can't have that vulnerability that we can have, we should have it but we shouldn't show it. And so to have the spaces where it can be appropriate, or that we have where we can take that space is nice to show our humaneness.

Gordon Brewer
Yes, yes. And that's, that's been kind of a theme that has kind of come up on on some more recent episodes is just being able to, on the clinical side of things, I think one of the things that kind of gives us credibility with clients is to be able to do some self disclosure, just about our own struggles about things. I'm reminded of a recent episode with my good friend, Stacy Lanier, and that the title of that episode was when therapists are a hot mess. And I think, I think for a lot of us to be able to share with our clients, you know, yeah, we go through some, you know, exactly the same struggles. And, and I think that just gives more credibility to what we do. So

David Khalili
yeah, I, I have a, I work with a lot of relationships, I love I love working with relationships. And I'm also a very proud new parent of a very adorable seven month old kid. And congrats, congratulations. Yeah, thank you. Yeah, no, he's very, very cute. And he also had a really terrifying entry to this world. Where we almost lost him on his third day of life. And, you know, we spent two weeks, two plus weeks in the NICU, not knowing what his life would be like, and we still don't know, really, and we're getting some really good feedback right now are good signs, but just that terror of that first month of his life, you know, I think I'm, it's put me on a different level of both like, acceptance and calmness, and also definitely hyper vigilance and trauma. You know, and so I think there's some ways that I've been able to disclose that where I'm not taking up the emotional space, in our work with my clients. But just to kind of name the humaneness of, you know, being able to sit in that terror or sitting in that very difficult unknown. Right, both with you know, life, but also with relationships where you, you know, you might be staying, saying these things to a partner, not knowing how they're going to take it, not knowing how it's going to affect the relationship, but you need to say your truth.

Gordon Brewer
Right. Right. Yeah. I love that. I love that in that, yeah. Being able to, to share, again, the vulnerable vulnerability of it all. But at the same time, holding that space that I think when we do that, is that it when we share that vulnerability, it almost gives the client permission to share their vulnerability. Yeah, yeah. Yeah. letting those walls down.

David Khalili
Yeah, right. Right. Right. Have you ever run groups?

Gordon Brewer
I haven't. We have just recently in my practice, we're just recently starting a teen group, although I know, I don't necessarily work well with children, as my daughter used to say when she was little as I sucked at playing Barbies, but I don't generally work with children, but by the rest of my group practice. They're real enthusiastic about IQ and they're getting ready to start. A teen group.

David Khalili
Oh, nice. That's really neat. Yeah, I used to run groups in high schools. And that was a lot of fun and a lot of work.

Gordon Brewer
Right. So I know you've got some groups that you're doing and it'd be interesting to know how you've incorporated that with just kind of your busy In this model and all of that sort of thing, and and what's your, what's your figuring out about all those kinds of things?

David Khalili
Yeah, I, let's see. So, you know, when I was getting my hours, I worked for a nonprofit agency that worked on recovery and addiction. And as a part of that they had a program that would put counselors into middle schools and high schools and the East Bay in the Bay Area. So I worked in Berkeley and and as part of that around groups, it was kind of just part of the program. And, and I found myself really enjoying it. And then I started to run trainings, and was running trainings with a colleague of mine, Ally kennel in Oakland. And she's also a certified group therapist, and she was kind of encouraging me to do more group therapy. And so, you know, I hemmed in hard for a couple of years, and I definitely had impostor syndrome. I'm like, you know, sometimes it's hard enough to sit in the room with a couple or, you know, I work with Polly folks, I will sometimes work with triads, but the idea of working with like eight people and eight adults, and they're looking at me, and but actually, she went on maternity leave, and I covered her group for 12 weeks. And that was a really good kind of reentry, or practice. And so I work a lot with men and men who have anxiety around sex and relationships. And so for a couple of years, I've been playing around with the idea of, of doing that. And so then, in 2021, I took the leap, and I created a, an eight week, kind of psycho Ed, process group, kind of combination, psycho Ed, we do a little bit of mindfulness work in the beginning and then process for a majority of it. And it was, you know, I filled the group very quickly, and had a wonderful group of guys that talked openly about their experience of feeling anxious when it comes to sex, or relationships and feeling like they can't talk about that, or they shouldn't talk about that. And then to watch that, open up, and watch them all feel really vulnerable in front of each other and be like, Yeah, this is actually sometimes exes terrifying for me. And to not feel like that's taking away from their masculinity, or their view of masculinity. And so then I decided to do it again. And so I recently, but as a more of an ongoing process group. And so I recruited for that, and my, I have one on Tuesday evenings, that's pretty much full, and I'm currently recruiting for Wednesday, early afternoon, or afternoon time. And that's been a really good way both, like switching things up for me, and clinically, where I'm not just doing individual work, I'm not just doing couples, but a little little mix of all the above. It's a different level of engagement, working with groups, you know, there's definitely like, a lot more involved. But there's also just a different energy, a different liveliness that happens with that. And a different form of healing that I'm seeing, which has been cool to see. And then business wise, it's a good, it's great financially, you know, you I have asked the participants to pay up front for the month. So it's consistent income that I can rely on. And so I think it really kind of hits a few different needs, both clinically and business wise.

Gordon Brewer
Right. Right. You said something that I'm curious about, that you feel like people in groups are healed in a different way. I'm paraphrasing, I think what you say, Yeah, say more about that.

David Khalili
Yeah, I just think that there is I'm still doing it myself, I'm sure someone else out there has found words to this. But the experience of seeing someone hit their vulnerability and kind of challenged their own shame when I'm working with them one on one or when they're in the presence of a partner is very healing, you know, it has has its purpose and its process and all that. But when I see it happen in a group, and I just kind of see the, you know, the square peg fall into the square hole, and it just kind of clicks for them. There's this this feeling of belonging or feeling of you know, the not enough meter goes a little bit higher to enough where it's like, you know, I imagine and I've been told that men have been like, Yeah, but your therapist your I'm paying you to tell me that I'm okay. I'm paying you to tell me that things are gonna be alright. And I'm like, You're not paying me to tell you what you're paying me to give you your my, my own accurate reading of what's going on. But they kind of trust it more from strangers so they trusted more from other men or they trusted more and you know, it's not there. partner, not someone they're paying. And so I think that there's this different type of social connection that happens in that format.

Gordon Brewer
Yeah, I would, I would imagine, too is, as people in groups begin telling their stories with each other. People recognize that okay, oh, wow, I'm really not that much dissimilar than any anybody else. And, you know, it just that is trans, transformational, and that they recognize that they're not alone in it.

David Khalili
Yeah, absolutely. You know, and I work with therapists, as a consultant and running, continuing education workshops. And to get them to be encouraged to talk openly about sex has been really important so that their clients don't feel alone, because I talked to many clients who have worked with therapists who don't bring up sex. And I feel, personally, I feel like that should be in your intake form. That should be your one of your first questions. In your first session, just to say, like, we can talk about it, don't hammer in, don't get don't don't demand talk about sex. But, you know, but let them know, like, alright, well, this topic is here. And so I think the fact that it's not openly talked about is representative of cultural norms that really police and like restrict how we can talk about pleasure and desire and anatomy and all that good stuff.

Gordon Brewer
Right. Right. Yeah. I love that. Yeah. So what as you have built your built your practice? What are some things that you feel like are important piece for people to know that maybe you didn't know going along?

David Khalili
Yeah. I'm like, I have a, I just put up my first whiteboard. On my office, I'm like, I'm looking at my whiteboard to be like, is there anything I've written? And maybe that's, that's a piece of it is, for me, organization has not been the easiest. And so I've found that relying on things like simple practice, and relying on things like, you know, being okay with having, like, technological accommodations is really important. And asking for help. And reaching out to colleagues has been really important for me, I booked this just because this can be really isolating. And also, you know, I very much believe in paying people for their time and their worth, but also that can be expensive as you're growing your practice. And so, you know, finding colleagues that are in a similar boat as you and learning from each other is really important, because it can that imposter syndrome, and the shame can tell us to hide and not seek help and not ask for help. But, you know, if you can work through that, then you can really make some strides. Right?

Gordon Brewer
Yeah, I couldn't agree more. Because I know, as I, as I've said, on here on the podcast, before, I've learned a lot of stuff the hard way. And if I had to do it over again, I would have sought out help sooner in terms of finding, you know, finding people to help you work through the kinks. And yeah, like, it's important to have those people in your practice, I mean, in your, in your life, so to speak, or call trusted colleagues that are in, in this space that you can share with, you know,

David Khalili
I'm yeah, I'm in this point of learning right now, in my group practice, where I'm doing everything in the admin and all that good stuff inside, like I'm meeting with, like, just this week, I've been meeting with virtual assistants to possibly hire and have some assistance, but like, I'm in that spot where I don't know what help I need. You know, there's, there's so much swirling that's going on. And so even just meeting with people to talk about social media management, and help with formatting the workshops, has been really helpful to be like, Okay, I can take that off my mind at some point. So yes, I think in any suggestions you have, I'm totally open. I know. Yeah.

Gordon Brewer
Yeah, that to me, when you as you start to scale, in a practice, I think that's the first place the low hanging fruit, so to speak, is to begin to outsource and handoff those things, particularly those administrative tasks that can bog us down and can eat up a lot of our time. Yeah. You know, I think a common fear I hear from people is, is that well, if I get a virtual assistant or get somebody else to do that, then they're not going to do it as well or not to my liking or not with the same finesse that maybe we would and you're correct, they're not going to do it in the same way you would, but it's going to be just as effective. Particularly if you get someone that you can train and you can, can work with and and are you Going with, you know, the various companies around that help provide virtual assistants and that sort of thing. You're gonna get somebody that can do the job. And yeah, any, anytime we're spending our time on things that don't necessarily move the needle forward in terms of bringing us return on our investment. It, it can bog us down.

David Khalili
Yeah. Yeah, like in graduate school, I used to kind of enjoy the the monotonous tasks, like if I needed work to get work done on my thesis. But I didn't have the mental energy to do to do the writing part, I would just like format, my citation page. So that sometimes I'm like, Alright, I'm really I need to get some work done. And so I'll just do some organizing of some spreadsheet, but I would love to have that taken off my plate. So I can, you know, right, relax or do some reading on sex and relationship therapy or meet with my Yep. Anything.

Gordon Brewer
Right, right. Yeah. Well, the other thing, too, is if you're, if you're spending money on someone else, that's going to actually bring you income. You know, certainly if you were able to gain one extra client, one or two extra clients out of having a virtual assistant, it absolutely pays for itself. Right.

David Khalili
That's good point. Yeah. Yeah.

Gordon Brewer
I mean, that's, that's the least the way that I think about those those kinds of things.

David Khalili
No, I agree. Yeah, I think that's when, you know, this, actually, this week, I also took some time off from clients to focus on a group practice and some of the business sides of it. And so that's when I actually took some time to meet with potential DBAs just to kind of get a sense of like, okay, what, what would it be like to work with you all, and it feels really good. It feels like it's moving in the right direction.

Gordon Brewer
Right. Right. Good. Good. So I'm curious what, what have been some of the bigger challenges for you as you've grown and scaled and, you know, gone from solo practice to group practice and that sort of thing?

David Khalili
Yeah, I think it's been the the impostor syndrome, you know, I really love my community, and they've been amazing in bolstering me up. And it's amazing how how powerful impostor syndrome can be because I have, you know, this group of people, community, people that are telling me that, you know, I'm filling a need, and, you know, but I'm also then having these moments of, can I match it? Or can I follow through with this? Can I can I do that. And so to have the had that struggle has been has been kind of the the biggest growing edge, but I I'm pushing through, and it's, I think, just looking at the facts, looking at, like, we're continuing to get clients and the clients are reporting the clients are staying, the clients are saying that they're having, you know, finding good progress in their treatment. And then having feedback from other therapists and people saying that, you know, this is a need to focus on sex and relationships and anxiety has been really helpful. I think, you know, it would would have been nice if our graduate program involved some business acumen or business side of it, because I think that's, that's been a big part of it has been kind of keeping track of all the information, especially in you know, running a business, HIPAA compliance, employment law, you know, all that all that stuff, ADA compliance, like all these things that we need to have, but I'm in this space of my business where I don't I can't hire the big lawyers to keep track of all that, you know. Yeah, I think that's a kind of a challenge of juggling all the way.

Gordon Brewer
Sure. Sure. Yeah. Well, I think, certainly your, your, to me this time. This this season, insane season, and a general term of being in mental health care is a great time to be in it. Because we're coming out of the COVID pandemic, and just more and more people aware of mental health being just as important as physical health. And I think there's just a lot of opportunity for us in in all of this and I think you're right in that. There's certainly the need and then it's just a matter of organizing our our systems and processes to where we can accommodate people's needs.

David Khalili
Yeah, yeah. Yeah, you know, and another way that I've been accommodating that is by having other resources. And so like, I do a weekly blog, on our website around sex relationships and anxiety and kind of giving free information has been really important. I know, like, you offer a lot of free free information on your site, I just think that that's both good business and also good value to have, like, you know, offering different levels of access to people. And then I do my, you know, my workshops that I think about a lot, because it's new to me, it's I'm talking about a lot. And it's, it is a lot of monologuing to this screen. And so, you know, there's gonna be times where I'm going to, you know, I think in the future in the next six months or so, I want to do some in person workshops. And I've been talking to actually have a family member who has been running her own retreats for a long time and is now got into the process of helping other wellness practitioners run their own retreats. Awesome. Yeah, yeah. And so we're looking at a space locally soon, but you know, I see your Instagram posts in Costa Rica, and really beautiful places, and I'm like, okay, maybe one day? Yes, yes. That's I live in San Francisco where it's very foggy right now. I would love to be in the sun.

Gordon Brewer
Sure. Sure. Yeah. I'm feeling that too here in East Tennessee, Upper East Tennessee. Oh, really? Springs coming coming out. But it's, we're supposed to have a hard freeze tomorrow night. So yeah. So anyway, such such as life so Well, David, I want to be respectful of your time. I've really enjoyed our conversation. tell folks how they can get in touch with you. If they have more questions about you or your practice or your specialty. That's that sort of thing.

David Khalili
Yeah, absolutely. You can check us out at rouse therapy.com That's r o u s. E therapy.com. And we're also rouse therapy on all the social media platforms have a lot of fun on Tik Tok giving out information around sex and relationships and Instagram and Twitter as well.

Gordon Brewer
Yeah, yeah. And by the way, chat, do check it out, because he's got some great stuff there ahead of time, and there's some really clever things going on there. So

David Khalili
yeah, I appreciate that.

Gordon Brewer
Yeah. Well, David, well, we'll have all these links in the show notes and show summaries for folks and so glad you join me.

David Khalili
Yeah, thank you very much, Gordon. I really appreciate your time.