The Practice of Therapy

Gordon: Well, hello everyone. And welcome again to the podcast. David is a friend and I've gotten to know David over the years.
He he actually did some consulting with me early on and then He's also now gone into consulting with Wise Practice and Whitney Owens. And I just needed to have him back here on the podcast. So welcome back, David.
David: Thank you.
Gordon: Yes. So David, for folks that might not know you tell folks a little bit more about yourself and how you've landed where you've landed.
David: Well long, long, long time ago I worked as a 9 1 1 operator for a police department in my area. It was right around 9 11 kind of the, the year before and after. And in the pursuit of, of that, got interested in psychology and then went into grad school and got my counseling degree. And so for about 17, 18 years now I've been doing, Therapy started out in residential treatment facility for child adolescents and about 11 or so years into that.
Started to feel the bug for private practice and kind of getting out of community mental health and hospital stuff so I started to Figure out how to do that. And I think that's one one aspect of consulting That is critical that a lot of people might not understand but we're trained to be conditions We're not trained to be business centers.
And so if you don't have the knowledge of small business ownership You you gotta figure out, you know, that before you're going to be successful in running a private practice. And so, about the last year of hospital life, I started to do private practice on the side. And with doing the math with my wife we figured when I could leave hospital and hit the gas on private practice.
And Been doing that for a few years now. I actually left officially from the hospital about nine months before quarantine. So that was a, fun little year to start private practice. Yeah, but do a lot of work with responders. A lot of faith based work and have my practice in Marietta, Georgia.
And then I do consulting with wise practice consulting where I focus primarily on those solo practice owners that are either in transition or they've been in practice for a long time. But they're wanting things to. Be more profitable and maybe have a different lifestyle which doesn't necessarily mean more money, you know, it might be more freedom rather than you want the latest Ferrari but really understanding what is the lifestyle we want and what are organizations that we're passionate about that we want to help fund or, you know, We want to spend our time in and helping those practice owners get to a point where that can be their reality.
Gordon: Right, right. Yeah. I think you and I met around the time that you were making that transition when you had started your practice and then moved or kind of moving and trying to figure out okay, can I make it full time? And, and that's a scary time for a lot of people, particularly, I know that's, that's kind of how I got into private practice as well.
I was working for an agency at the time and started doing a little bit of private practice on the side and, you know, okay, how am I, you know, if I'm going to get, be able to get the autonomy that I'm looking for with being, having, being an owner, you know, what you got to have in place in order to do that. I think one of the things that I wish I had had more of in the beginning stages was more help and mentorship from others. I mean and I think that's, that's an important piece.
David: Speaking to our consulting relationship early on one of the courses that I took from you was the Google workspace course. And it was such an economical way to get. Everything started and organized and that foundation. And also the aspect of, you know, what is the BAA and Google cover and what is it not?
Right. 'cause there's a lot of misunderstanding out there about that one. Yeah. And even something as simple as that was so helpful for me. Mm-Hmm. , you know, and then. The ideas of masterminds and, you know, one on one consulting it is an investment but it's invaluable. I mean, the return on that investment is exponentially greater than what the.
Investment is
Gordon: Well, I know one of the things in your work, David, that if you kind of come up with or just kind of some key things or key things to be aware of in just your mindset shift, you want to say some more about that? Just what what you've learned and and really what people need to kind of keep in mind.
David: While we are helpers and we want to help everyone you're not going to be able to do that if you can't keep your doors open. And, and so it's understanding.
Business in the sense of, do you want an insurance based model? Do you want a self paid model? Do you want to try to do a hybrid of those two? What does insurance look like in terms of. You know, liability insurance, slip and fall insurance taxes. How do we get those, those write offs, you know? I think also the idea of business ownership a lot of people do not, don't have that identity.
We're, we're great clinicians, but the idea of I have a business and that Think differently from a return on investment standpoint where our time and our money are very much the same. And so an example I always use with folks is how much does it cost to have somebody cut my grass for me versus how much can I make and maybe that two hours of cutting right.
That that's a return on investment type of business mindset. So in three ways of kind of shifting from therapist to business owner, it's changing the way you think about getting help and then changing the way you think about money and time. And then change the way you think about marketing in terms of a niche population.
And we are human. We've got things from our past that come up in terms of money issues, you know, maybe it's a scarcity mindset because of things from childhood.
Maybe we feel. guilty, you know, for the sacrifices having to be made when we have a family, you know, things of that nature. But then just the, the humility of, we don't know what we don't know. And, and it can be intimidating. I remember looking at people like you and Whitney and a couple of other folks that, that you and I are, are close to and just like, oh my gosh, you know, it was almost starstruck, right.
And I can't ask them that question kind of thing. But then it was like, they're the perfect people to ask because they are a few steps ahead of
Gordon: them.
David: They're, they're demonstrating. The reality that I want and the competency of getting that done. And so it's a mind shift in terms of not being a, an annoying burden by asking somebody or you don't know what you don't know.
So just be curious with it.
Gordon: Right. I think that's so important in that. Being able to, as I like to say, give yourself some grace over stuff and I think there's I think we do, we, we can, you know, mindset things. One thing is Is the information shaming that we can do to ourselves. In other words, we don't, because we don't know this, we think we're, you know, leads to that whole imposter syndrome kind of thing.
But yeah, and I totally agree. I think it's being curious and, and also like we tell, you know, do we tell clients and stuff? There are no dumb questions. I mean, it's just. I mean, it's just getting, and so being able to, to get around that, that kind of thing, you know.
David: And I have often found consulting and therapy are very similar, right?
You know, as a consultant, we're, we're looking at that big picture of this person in this environment, being a business owner. And. What, what systems need to be implemented that aren't, you know, what are the barriers to those things getting put in place? Is it simply skill teaching, right? Or is it one of those thinking errors and posture syndrome type of thing?
And, and asking the right questions to challenge that, to help, you know, these, these other therapists, these business centers again, have that lifestyle that, that they define And I think in the idea of thinking about getting help, um, another kind of bullet point in that is this kind of idea in the private practice world of, okay, I've started a private practice and now I'm supposed to go build a group practice.
And that's not necessary. And so, that idea of, I need help being a better solo practicer, is, is fine.
Gordon: Right. You have to start with why of you know, why do you want to be in practice, private practice in particularly one, you know, why not work for somebody else and why not you know, you know, just be an employee somewhere. Right. And I think so. And I think it just takes, a clear understanding of exactly as you talked about already, David, of really being clear about, okay, going into private practice to what end?
What is it that you need from it in order to create the lifestyle that you want to lead for yourself? And I think sometimes, as you also kind of alluded to, we can caught in, get caught up in this hamster wheel of, of, Oh, I've got to, I've got to push and I've got to grow and I've got to be this big thing and I've got to, got to do all the stuff.
But. No, not necessarily. I mean, right. So having clarity around that is important, I think.
David: Yeah. And some of the, the kind of pain points, so to speak that I see a lot is our folks are not charging enough. They're, they're charging too little for their sessions. And especially as solo practice centers, you know, you're only going to earn as much as your The number of sessions in a week, right?
And there's only so many hours of that as well. And so if, if you're kind of capping out on what I kind of think from a healthy perspective, is that 20, maybe 25 a week
Gordon: you
David: know, that, that's a lot of sessions in a week. If you're charging a hundred bucks for that, Well, there's the max you're going to make, you know, and that's a lot of time for that little bit of money.
But when I suggest raise your rates to 150, you know, I, in my early years was like, nobody's ever going to pay that. They will yeah, because they do all over the place, right? Right. Yeah. But you know, it, it, it's that imposter syndrome, scarcity, mentality, and this, this idea that, well, it's therapy.
And so it, it should cost less than, you know, other things. Because we're helping people and I think that changing the way you think about getting help, changing the way you think about money and time really kind of start to meld together and shift the way we view our business, shift the way we view.
Our, our time and the way we think about money.
Gordon: Right. And you've got to, you know, another thing is, is that I think for most of us in this field, our kind of one of our biggest goals is we want to help people. And the thing about it is, is if we're going to continue to help people, we need to be paid appropriately for the work that we do.
Right. Because if you're, if you're operating in a deficit or not getting your, Getting what you're worth, then it's going to quickly unravel.
David: The idea of where and how do we market that that's a skill all in and of itself and we certainly don't learn that in therapy school. I think also knowing your why. Parks into knowing your niche population. Part of my transition from residential treatment to private practice was my oldest was starting to become an adolescent.
I did not want to work with psychiatric adolescent population and come home to adolescent population. population. I also had a passion for the first responders, having been one many years ago. And that that's a niche in terms of cultural competency. That is as unique and specified as working with I don't know, think about your, your most culturally diverse needed cultural competency type of population.
There's a million of them out there, right? Yeah. Even the idea of some responders are veterans. I've worked with veterans, so I can work with first responders. No. That that does not equate. There's a lot of things about the responder community that you have got to be culturally competent on in order to be effective with them.
And knowing which populations exhaust you and which populations excite you. I think that that can change. And yeah. I think a lot of therapists think I've worked with this population forever and I've got to keep working with this population
Gordon: forever.
David: And that's, that's not necessarily true, you know?
If you, if you found your, your groove and you love working, doing art therapy with kids, cool. Have at it, you know, do that for 30 years. And it's okay to to change things up a little bit And then learning how to market to find that population we sometimes have to be creative in the consulting realm, you know It's a little more complicated than psychology today.
com,
Gordon: right? Right. Yeah. Yeah. Well, I think that's so true I think which ties back into kind of your why You I think to some degree in that once you kind of figure out your niche. a way to figure that out is to figure out, okay, what types of clients energize me rather than deplete me. And I think that's a good thing to pay attention to.
And, you know, you actually, we, we do better therapy and better work with people that we are enjoying being with rather than looking at the client list and saying, Oh no, not them today. Kind of.
David: Yes.
Gordon: Yeah. Kind of thing. So yeah. So I think it's good to know that about yourself and, and that in and of itself helps create the niche for people,
David: you're going to have more energy in your week when you're working with folks that you really enjoy being with.
Gordon: So David, one of the things I know we had discussed maybe chatting about are just the systems that you Work with people on and getting set up and you know, particularly in those beginning stages What is it that's needed in order to make things run smoothly and that sort of thing?
David: Number one is consulting Right. Going back up to asking, you know, about getting help a lot of people kind of have some sticker shock with some consulting, you know, packages and services. But again, it's, it's invaluable. Your, your return on investment is going to be exponentially greater.
Having a good EHR is important. There's a lot of EHRs out there that do a lot of great things that charge a whole lot more than, than what's necessary.
But you, you certainly need. An EHR that can do billing of any kind, whether it's self pay or whether it's insurance based having one that incorporates telehealth,
The next one is Google workspace. It
Gordon: does
David: so many great things for your practice, it's a wonderful platform that can scale and change with you as your practice changes.
I would say that the biggest thing with Google Workspace that I've got to slow people down and get them to focus on is that BAA and HIPAA compliance aspect. People think, Oh, well, there's a BAA so I can send emails. I can use Google voice and it's all covered under that HIPAA BAA. And that's not what Google works space BAA covers is everything within the account,
Gordon: the
David: second you send an email, it's not encrypted.
Google voice. You know, is, is not an encrypted phone service.
Gordon: Yeah.
David: And so if you're going to use stuff like that, you've got to account for that.
Gordon: Yeah, it's a, one of the things though I've learned recently is, is that, um, Google workspace, particularly email, like the Gmail part of Google workspaces that they're, they're upping the encryption. Of course you have to pay. A little extra to get the full encryption end to end encryption. But yeah, and that's I think too, measuring your own comfort level with all of that is important. I have read here recently, David, that Google Workspace is going to be adding it's going to be housed on on their platform that for the true end to end encryption.
David: Personally for me, I, I like fun gadgety new things and there's a package. I want the biggest package.
And the next system is the phone. This is where I really encourage folks to make sure that they understand the HIPAA law and the BAA stuff.
So things like Spruce is one that I've, I've gotten turned on to. And it, it provides that end to end encryption texting ability with clients.
Gordon: I've been using using the phone. com for years. We've been pretty pleased with it. It's not, not, not had a lot of problems with it. So that's, that's good.
David: Then the next one is kind of ties into that marketing aspect in, in terms of your website and Google analytics, your Google, my business irregardless of your business model being self pay or insurance based, you have got to make sure that your website is, Not just attractive, but it's functional.
And there are key things that need to be above the fold as, as the term is. And there's a lot of backend type of stuff when it comes to SEO and backlinks, keywords, things of that nature. And if you want to learn that wonderful, learn it. Get real good at it. Handle it yourself. I do not want to learn it.
I have zero interest in learning all of it. And so there's there's a couple of great folks that you and I are very close to that do a phenomenal job with website development and SEO And, and Google Analytics you know, one thing that I know you've talked about and what we talk about too is KPIs or those key performance indicators, right?
And we have got to have our data. We have got to know who is out there. What are they searching for? What are those keywords that somebody is searching for? What, what pages on our website are doing well and, and all of that shapes from a marketing niche population standpoint. What kind of blogs do we need to write?
Because if people are searching for this in my area, why don't I get some blogs out there on social media and Google my business and, and link them directly to my website and there is marketing, there is speaking to a pain point of your niche population. It's all going through your website, whether that's you doing it, because it can be kind of I'm costly as well, or that return on investment, you're paying for somebody to do it for you and or or with you.
And so that's, that's one of those systems that I think kind of needs to be a higher priority than many people.
Gordon: Yeah. Your website really is, I think in this day and time really is your front door. That's your, and that's how the, the, the vast majority, I know I'll almost go out on a limb and say everybody when they're looking for a therapist, that's what they're going to do is they're going to go online and that's what they do first.
Yeah. So it's important to have a website that's functioning well and that ranks well in the Google search.
David: Right. Yeah. It, people go to social media for the quotes and the, the, you know, cool tagline type name stuff when it comes to mental health. People do listen to the vlogs and the reels and things like that.
They go to Google to search for that therapist, their pain point, and who's near me. And so, you know, I'm not knocking the, The reals and the memes and stuff like that. I'm not a real kind of person like a couple of our friends are. You know, but the idea of putting that information out there and, and allowing that to exist out there people are going to run across it.
They're going to save it. They're going to share it with the family, friend, the neighbor, things of that nature. They're
And eventually they'll, they'll come directly to your website. Right,
Gordon: right.
David: And the last kind of system is some sort of financial management system. And so I'm a big fan of profit first for therapists.
Yes.
And having something like QuickBooks There's several different, you know, software things like QuickBooks, but Profit First it, again, you know, we don't think of therapists and profit, right? But without it, our doors do not stay open.
Gordon: It's so important to really, you know, they hear from all of us all the time, know your numbers and in order to do that, you've got to have a system in place to track it and, and, and I couldn't agree with you more on the profit, profit first, and then having a QuickBooks or some accounting system that's separate from your clinical accounting.
One of the things that, I teach is, is that you really have two financial systems. You have kind of your individual client records and what they pay you and that sort of thing. And having a good EHR like Therapy Notes who sponsors this podcast. Yes. It in place helps you manage the individual client records and the individual client accounting, but a separate accounting system that gets the global practice accounting and looking at the numbers and that sort of thing.
You really need kind of both of those systems in place for all of that. And
David: Absolutely.
Gordon: And then having the, having the knowledge about how money works, that's where Profit First comes in. And again, shout out to our friend Julie Harris and her book, Profit First for Therapists. This is a great book, great go to book to learn, to learn that.
And then also the original book by Mike Michalowicz, Profit First is two, two, I think two essential reads for anybody that's going into into private practice. I think once you get that, it'll put you at ease and you'll feel better about all of that. So, but well David, I know you've got some things coming up.
You want to share those about your mastermind group that's going to be starting. And also we've got the Wise Practice Summit coming in October that will both be added. That'll be a fun event.
David: I am hosting a webinar on June 18th. And we're going to kind of be going through in a little bit more depth some of the things that we've talked about today and part of that is going to be focused on kind of when to pull the plug on agency work.
transition into growing your faith based practice.
That webinar is Tuesday, June 18th at 1. It is free. And so, That'll be a good hour. And then I do have a mastermind that is beginning in July. We're going to meet twice a month between July and December. And this is primarily for solar practice centers.
That are, are looking to again, either they're brand new into owning a practice or they're wanting to evaluate and make some changes in their private practice as well. And so you can go to the website, wisepractisconsulting. com and we've got those events on the website. I do have a scheduling link that we'll put in the show notes.
I can do 30 minute free consultation intro call and help folks get answers to a couple of questions and learn more about consulting and how it can help them get. You know that success and and goal that they're looking for. And then we do have the Wise Practice Summit in October.
It's October 3rd through 5th at the Grand Bohemian Hotel in Charlotte, North Carolina. We do have NBCC approved 15 credit hours. And so you know, your, your CEs are always something that we're, we're hunting down. And you can learn more about that and register for the summit on WisePracticeConsulting.
com's website as well. The program agenda is there. You can buy the ticket there see the speakers and, and things like that. Julie will be there with Profit First,
Selling the book
Gordon: next
David: week. Quite a few other folks as well.
Gordon: Right, right. It's going to be a good conference. A lot of good speakers lined up.
David: You'll be there as a speaker as well. Yes,
Gordon: I will be. I will be. Yes. So glad we had this conversation. It's a good, good reminder for regardless of your. level or how long you've been in, in the business or just getting started, it's good to kind of hit on some of the basics.
And I think we did a pretty thorough job of that in this, this particular episode. So David, I'll be seeing you here soon.