2019 has been an incredible year of professional growth. My practice has grown exponentially – a good, no make that – great problem to have – but when you are a sole practitioner, too much growth too fast can bring some pretty big growing pains.
This year I was finding myself more and more drowning in the weeds. As a sole practitioner, I’m the one scheduling, re-scheduling, following-up on emails, answering the phone and doing consults, marketing, networking, working odd and crazy hours and doing all the things that keep my practice up and running.
But did I mention the errors I was making? Like, having the receptionist text me saying “Your 4:00 is here.” And then: “Oh, and your other 4:00 is here.” Or telling a client I’d email them something and then completely forgetting to do it until three days later I’d get an email saying, “sorry to bug you, but can you send me that thing we talked about in session?”
Yikes.
Full disclosure: last month, I made a huge appointment screw-up and lost a great new client – she was super-mad and I don’t blame her one bit. But instead of beating myself up (which I admittedly did for a full afternoon), I knew something had to change. And fast.
After whining and crying about my life to a trusty mentor, she suggested I hire a business coach.
I’m in a women’s entrepreneurial networking group that meets monthly here in San Antonio, and a woman in that group recently launched her own coaching business. Her name is Robin and since we already had an established relationship, I knew that she’d be up for the task of looking at my business practices and helping me tweak where needed.
And to help me get my business shit together.
Off the bat, she told me this: you’ve got to get your calendar under control. It has to be automated. No more excuses, just get it done. I use Google calendar, but it only sent appointment reminders to me, so if I was off (or if my client input a wrong date), there was no check or balance system in place. I’m currently in the process of using a new calendar system through www.therapynotes.com and it’s already a game-changer, sending automated appointment reminders and confirmations (which yours truly was doing, sporadically at best, and obviously not doing it well). Eventually a link will be added to my website so clients can schedule or re-schedule themselves 24/7 without my direct involvement.
Another problem was my crazy schedule. Most days I work 8-8 with a few breaks in the day but my schedule was killing me. I also began adding 7:00 a.m. appointments to accommodate my busy business executives. I was never home to eat dinner with my family and when I was walking through the door at 8:30 or 9:00, I was certainly not my best self. Robin told me to allocate, at most, one or two nights a week for late appointments for my “grandfathered” clients, but offer only daytime hours to any new clients.
Robin is coaching me on other aspects of my business and helping me plan and strategize for future goals (stay tuned!!) that I’ve been too overwhelmed to think about, much less implement. She is helping me narrow my focus as well as develop a timeline/schedule of action-steps and realistic deadlines (which this procrastinator desperately needs).
So my advice to any fellow practitioners, or small business owners struggling with either growing your business or simply keeping up with your current pace is this: getchu a business coach, and getchu one now. It is an invaluable investment in your business and yourself. My only wish is that I’d done it sooner!
I have two little secrets to share with all you other therapists out there, especially those thinking of starting a private practice. I hate just giving these secrets away, but I’m going to, because they are pretty valuable, and both are something I wish someone would have shared with me before I started out.
Ready for it? Alright, then sit down. And get your egos in check, people. ‘Cause these are some tough truths I’m telling you, but you need to know them and it’s better to figure this out sooner rather than later.
Secret Number One: Not everyone is going to like you.
I’m serious. Not everyone is going to like you.
And that’s ok.
Because here’s the deal – the real deal, the one that no one told you in your expensive graduate school classes, the one that no fancy PhD research study has revealed, the one you are simply gonna have to face: You are not the right fit for everyone that walks through your door.
And that’s ok.
The entire process of therapy revolves around the therapist-client relationship. It has to feel good for both parties involved for it to work. Haven’t you ever had a client that just adored you, but you’d cringe when you’d see them on your schedule? Of course you have!
And that’s ok.
I tell everyone in their intake – especially my teens and tweens – that therapy is a two-way street. The client must feel comfortable with me, and be able to be real with me….otherwise, the whole thing just won’t work. So unless they feel that way, I don’t want to waste their time and money.
But it’s hard. It’s not easy to have someone come in for an appointment, and never call and schedule another one. At first, it hurt my feelers. And made me doubt it I was an effective therapist….and if my practice would make it.
Which leads me to Secret Number Two: It’s not about you.
If they don’t like you, than the therapy process most likely won’t work. And that’s not about you. That’s about the client, and what they need. Maybe the therapy process scared them. Maybe there simply wasn’t the comfort level on their end. Or, maybe it was a good-old fashioned case of Secret Number One.
And that’s ok.
Early in my practice, I saw a client for one session, and never heard from her again. In my opinion, it was a good session (I can usually tell if the session is not working, or the client and I simply aren’t gelling). I was somewhat perplexed that she never called back. My SOP is to give a client after the intake one shout-out (via text or email), then leave them alone if they don’t respond. She never responded, so I thought, well, ok, it most likely wasn’t about me, I just wasn’t a good fit.
Don’t get me wrong. Even if I know I’m not the right fit or someone never comes back after the initial intake, I wonder if they went elsewhere, or I ruminate over the session, wondering if I said something that offended the client or if didn’t ask the right questions. But then, I focus on my clinic full of clients that I do serve, that have seen me for multiple appointments, and are happy enough to refer me to others. At the end of the day, I only want what’s best for my clients. And if that’s not me, then I truly hope they find the right fit for themselves, and get the help they need.
That client I thought clicked? She eventually called me back….for a couple’s session! Seems that was more of what she wanted and needed.
And that’s ok.
I hope these secrets are helpful. If you have any little secrets that you’d like to share about your private practice, I’d love to hear them!
It goes like this: I get a phone call from a potential client. We chat about therapy and their individual needs. We discuss appointment days and times. Then they ask if I take insurance. Instead of simply saying, “No, I don’t, I’m cash-pay only,” my first instinct is to say, “I am really sorry, I only take cash.”
Another scenario: I charge full-price to clients that fail to give a 24-hour notice of cancelling an appointment. This cancellation policy is clearly stated on my website, as well as in all intake paperwork signed by my clients. I also verbally state my policy to all clients in person when they fill out their credit card form (which I keep on file to charge no-shows). I’ve had to implement this policy on ocassion, and each time I found myself telling the client, “I’m sorry, but I have to charge you.”
Why, oh why, am I always compelled to say “I’m sorry?”
Studies have shown that women like to apologize. A lot. We do it in our personal and professional lives on a daily basis. In fact, in a 2010 study in Psychological Science, it states that women are more likely to see a need for an apologies in everyday situations, and suggests that men apologize less frequently than women because they have a higher threshold for what they consider offensive behavior.
So here’s the thing.
Nearly one-year into running my private practice, I am going to stop apologizing for my business policies. The truth is, I’m not sorry I don’t take insurance. I’m not sorry that I charge no-shows for my time. And I’m certainly not sorry that my latest policy is to charge for my intake upon making the appointment (no-shows at 8:00 a.m. on a Saturday morning or 8:00 p.m. at night – and I’ve had both – make me totally not sorry for this one).
I’m in a person-centered, helping profession, but at the end of the day, I have a business to run. My policies are sound and fair, and clearly spelled-out from the get-go. Apologizing makes me sound as if I did something wrong or am worried that I offended someone.
So I’m sorry – wait, not sorry, that I’m done apologizing. I’m proud of my business, and my practices, and for that, I’m not sorry.
When I wrote my original business plan, I had a concrete vision for what I wanted my private practice to look like and the clients I wanted to serve. Adults, 18 and above only, 8-5, Monday through Friday. Period. This was my plan from the beginning, and whenever I closed my eyes and pictured my clients, that was what I saw. Although I had experience working with youth in during my graduate school clinical rotations and previous agency work, I was calling my own shots now and wanted to see only the clients who I wanted to see. And that meant adults, 18 and above only.
Did I say that I only wanted to see adults, 18 and above only?
Rookie mistake Numero Uno.
Guess who my very first, paying client was? One who called and wanted my very first available appointment, same day or next day, if possible? You guessed it. The parent of an 8 –year-old boy.
My next call was for a teenage girl. Then my next call was a middle-school aged girl. And the call after that was for a teenage boy at-risk for substance use and abuse.
Well, you get the picture. None of these calls were for adults. None of these clients were over 18. But guess what? They all wanted to see me. And I had many slots to fill in my practice. And since empty slots don’t pay the rent, I booked the appointments.
The teens and tweens, as I like to now call them, starting coming in. And a funny thing happened. I was enjoying my work with them. They gave me a new energy and excitement that spilled over to my counseling approach and to my practice. There’s something awesome about a kid bouncing into your office, kicking off their shoes, plopping down to LIE on my couch, covering themselves in one of my blankets and stating, “Mind if I just lie here and be a load today while we talk? I have a lot to tell you and I need to be comfy!” Adults simply don’t do that! And it’s great.
I began reading up on the latest research on cutting, social media trends among middle and high school kids and brain development through the ages. I ordered games that encouraged talking and interaction, stocked a shelf with coloring books and colored pencils and printed out many “worksheets” for 8-18 year-olds that focus on core values, anxiety, anger management, gender/sexuality and depression. I attend “teen-centric” CEUs on bullying, cyber bullying and social media. I now assign journaling, and keep up on Netflix Series such as “13 Reasons Why.”
So much for my practice of adults, 18 and above only.
My business plan changed just like that, and I changed along with it. At this point, nearly 10 months in my private practice, more than half of my clients are under the age of 18. My hours are heavy from 3-8, Monday through Friday, and occasional Saturdays, not 8-5 as I originally thought. Kids can’t miss school for therapy, so I accommodate them as needed. I still see many adults, 18 and above, per my original plan, but I love love love working with my tweens and teens.
If your business plan veers off in an unexpected direction, or you find a niche that needs to be filled – go with it – as long as the clients you serve are within your scope of expertise. Change it up when and where you have to ensure success – and a full schedule. If I didn’t change it up, I would’ve missed out on these great kids. And the personal and professional growth that they’ve brought – most unexpectedly – to my career.
I am nine months-plus into owning and running my private practice. From my first night in grad school through successive various agency work, it was my goal to work for myself as a sole practitioner. I opened my official doors on August 1, 2016 and want to share with you so far what I’ve learned.
There have been successes and set backs, and pretty much everything in between. I’m going to write about all of them here. I want to teach others who are considering hanging their own shingle over a shop certain things to do, and absolutely what not to do based on my own humble (and eye-opening) experience.
There’s a huge misconception in the mental health field about opening up your own business. The misconception is this: that people will care. I mean….don’t flatter yourself. You might be great at what you do. You might be marginally good-looking and charming. But you are 100%, absolutely, completely, unequivocally wrong that anyone will care. Trust me, I was one of those people with the same misperception before I started.
No one, I repeat, no one cares about your business.
Yeah, I said it.
Why does no one care? Because. Because there are other people out there that have the exact same thing, offer the exact same service or the exact same product. They’ve done it longer than you. They know more about it than you. Even if they don’t do it better than you, no one cares about that, either.
But you care. Of course you do, otherwise you wouldn’t have taken the leap of faith and done it.
So how do you make other people care? Here are five things I did to make my private practice turn a reasonable profit in nine short months, and to make people care about (and utilize) my business:
- Find Your Niche – In San Antonio, counselors are everywhere. In my zip code alone, there are 40+ counselors within a 10-mile radius. So why choose me? Because I meet people in their homes. Because I provide “Walk & Talk” sessions, where I meet people at work, parks, trails, etc. Because I have dual licenses in Counseling and Substance Abuse. None of those other 40+ people do what I do. And that’s not an accident on my part.
- Hustle – I am a constant marketer. I tell people what I do all the time and am shameless about self-promotion. In the hours I am not seeing client, I am busy marketing. I launched this website (with help). I had marketing materials and business cards made that I hand out on the regular. I’ll write more in-depth about my marketing practices – and the hustle – in future posts.
- LinkedIn Yoself – LinkedIn has been invaluable for me in reaching out to the local mental health community (and beyond) to let people know I am available. I engage with local businesses and agencies as well as individuals about my practice.
- Meet Up – My goal this year is to have one meeting per week with an agency, individual or company that could utilize my services (and that I can refer clients to if needed). This has proved invaluable during the hours that I don’t see clients. If I have a blank day (and believe me, there are some of those), I reach out and set up a meeting or tour of a facility. I’ve had three of those “meetings” so far this week. I’m aiming for 52 meetings (minimum) in 2017.
- Social Media-ize – Build a social media presence for your counseling practice. It doesn’t take a ton of time or energy, just some effort and advance planning. You can find me on Twitter, Instagram and Facebook as @jenniferseelpc. I am on Linkedin as well (see #3). I have a blog on my website (duh, obviously, you are reading). All of these help build my presence and spread my message, as well as connect with a vast audience and potential future clients.
I care about my business. I care about it a lot. I know you care about your counseling practice, too. So start making others care about it. Good luck to you, and check back here for more Private Practice Chronicles.
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