Adventures In Private Practice: Trauma Specialist Leticia Reed, LCSW

Less than one year ago Leticia Reed, LCSW opened her private practice in Long Beach, CA. Find out what resources and tools have helped Ms. Reed muster the courage to open her own practice, what she's learned from clients, and how she manages her roles as "therapist" and "business owner".

Tell me about your private practice...

I opened Reed Behavioral Solution in March of 2012. My practice mission is: "Helping individuals, couples and families achieve hope, healing, wellness and freedom. Empowering my clients to leave better than they arrived is what drives me to provide the best and most effective services. I specialize in women's empowerment and trauma, although I provide a wide range of services to other populations in my practice. I also offer Christian counseling for those seeking spiritual connectedness as a means of coping and regaining a sense of purpose and hope.

Why did you decide to open a private practice?

I began my practice after leaving employment with the County of Los Angeles and feeling like individuals were being failed by the system as they were only treated as a number that became lost in a revolving door. I felt like opening my practice provided me with an opportunity to make a significant impact, one with real rehabilitation and healing.

Clients that therapists find to be the most “difficult” are sometimes the ones who can teach them the most. What have you learned from your toughest clients?

I agree that "difficult" clients provide the most meaningful learning experiences. Through my more challenging cases, I have learned the importance of patience, tolerance, unconditional positive regard as well as the real importance of "starting where the client is" to guide them towards healing. The technique- Motivational interviewing has been the principle that I have incorporated to achieve this while increasing motivation.

What’s your biggest pet peeve about private practice?

One of my biggest pet peeve would be the amount of documentation required as it takes away from my time spent in direct contact with my clients. However, it's necessary as it also provides me with a blueprint and framework that guides my treatment and goals.

How did you discover or develop your practice “niche”?

My niche sort of evolved as the majority of my clientele seeking services has been women with self-esteem and trauma related issues.

What resource (book, website, person) helped you the most when setting up your private practice?

The various resources that have aided me in starting my private practice has been the following: Nakeya Fields of Fields Family Counseling who offers a workshop geared towards assisting individuals starts their private practice, while providing lifelong networking and consultation with other group members. I also used and received a wealth of information from Ofer Zur Institute Practice Handbook for HIPAA friendly forms and regulations. My mentor Cynthia G. Langely, my prior clinical supervisor who has many years in the field serving in various positions, including on the CA BBS panel when the Oral examinations were required, has continued to provide me with a wealth of information and support. Lastly, The various Facebook groups I am currently in, including Julie Hanks’s Private Practice Facebook group have also increased my knowledge that has been instrumental in keeping me current in the field.

What has surprised you most about being in private practice?

The things that have surprised me the most about building a private practice has to be the amount of work it takes to stay afloat and monetary resources needed to build and maintain operation. Another surprise has to do with the number of people hurting and in search of HOPE, some of which are fellow colleagues.

Has your private practice helped you grow professionally?

My private has influenced my growth professionally in the sense that it has taught me the importance of being organized, detailed oriented, punctual, and the importance of networking/collaboration.

Has it helped you grow personally, too?

On a personal level it has made me to be more grateful and attuned to the world and my purpose in it, helping me to not take anything for granted.

Being a therapist can be emotionally exhausting. What do you do to care for your own emotional and psychological health?  

Self-care is extremely important to me. I love pampering myself, traveling and engaging in church activities, reading my bible and praying. I also make it a point to surround myself with positive people that are encouraging and uplifting.

How do you cope with the inevitable stressors involved with being your own boss?

I cope with the stressors of being my own boss by consulting with colleagues in practice and digging my heels in the sand and "just doing it". My tenacious spirit and optimistic personality as well as my strong Faith in God has assisted me in my success in this short amount of time I have been practice. Colleagues that know when I began have commented on my rapid success. I am a very blessed woman and I am looking forward to even more expansion in 2013 and beyond.

Find out more about Leticia Reed's private practice at www.reedbsolutions.com

Therapist Blog Challenge #2: Pick An Inspirational Quote

Blog about your favorite quote and how it can inspire your readers to do something differently.

Thanks for the great response to therapist blog challenge #1! I'm impressed by your creativity and inventiveness. If you're just joining us for the blog challenge, please continue to post your challenge #1 posts and jump in on this new challenge #2

This one will be easy and fun. Pick your favorite quote and let it be the inpsiration for your next blog post. I've posted a handful of my favorite quotes for you to use if you'd like. You are welcome to use the graphics below in your blog posts too. I created these cool, shareable graphics with the iPhone app InstaQuote (my favorite new app). OK, that's it for challenge #2. Get blogging!

Additional reminders:

• Write and post your blog article in the next 2 weeks. If you miss the deadline or you read this article months later, that's OK too.
• Post a link for this blog challenge in the comment section of this blog post.
• Read, comment, and share other therapist's articles.
• Tweet your post using hashtag #therapistblog and tag @julie_hanks so I can retweet it.
• Pin it on the challenge Pinterest Board. I've invited everyone who posted a comment on the initial blog challenge post as collaborators so you can pin onto the group board.
• Spread the word and invite mental health colleagues to join the challenge. Articles can be added anytime throughout the year.
• Write no more than 600 words, make it easy to read, use a conversational tone, and gear your articles toward your ideal client (not other professionals).
• The goal of a professional blog is to provide value your website visitors, help them get to know your professional perspective,  increase traffic to your private practice website, and build your practice.

Adventures In Private Practice: Vocational Social Worker Dawn Vincent

Specializing in vocational rehabilitation and work/life issues, Australian social worker Dawn Vincent has been  in the mental health field for 25 years. Like many therapists, she considered opening a private practice, but says she lacked the confidence to actually do it. Read how one private practice course helped her muster up the courage to open her private practice in Camberwell, Victoria, Australia where she helps clients work toward mental health and well-being and navigate changes and choices in life and in work.

Why did you decide to open a private practice?

I had thought about it for about 10 years, but lacked the confidence to go ahead.  After spending over 20 years in vocational rehabilitation I decided to take my long service leave and think about my options.  After an overseas trip I came home and enrolled in an Introduction to Private Practice course run by the Australian Association of Social Workers.  At that time there were only a small number of Social Workers in private practice and it was still somewhat controversial here in Australia.

The profession has a very strong welfare orientation where most Social Workers are employed by the Commonwealth or State governments or work in hospitals and community based settings. Having worked for a large government bureaucracy myself, I liked the idea of the independence and autonomy private practice seemed to offer. I had been a bit of a workaholic and I wanted to move to a better work/life balance and be able to work my own hours.  The course helped me to decide that private practice was what I wanted and I committed to this goal.

Clients that therapists find to be the most "difficult" are sometimes the ones who can teach them the most. What have you learned from your toughest clients?

Before private practice I had worked with clients with physical, intellectual and psychological disabilities, helping them to enter or re-enter the workforce after injury or disability.  At times it was very challenging and distressing working with people with acquired brain impairments and severe physical disabilities, particularly the younger ones whose lives were permanently changed.

I found I was drawn to the mental health clients and tended to specialise in this group and continue to do so in my private work. Working with people with disabilities reminds me how lucky I am to be fit and healthy and not take this for granted. It has also taught me about the dignity of risk and courage and resilience in life. Helping people overcome their barriers and live a full and meaningful life is incredibly rewarding. I learn from my clients daily and I am a better person from my interactions with them.

What's your biggest pet peeve about private practice?

The uncertainty of income. There are obviously times of the year when referrals are quiet and I used to worry about when I would get my next referral. Over recent years I have become more relaxed about this and accept it as part of the natural seasonal variations. I do get annoyed when clients cancel at the last minute when I have made a special time to see them outside of my normal schedule, although fortunately this does not happen often.  As a member of both the Australian Association of Social Workers and the Career Development Association of Australia I have double fees and professional development requirements from these bodies which becomes very expensive.

How did you discover or develop your practice "niche"?

As mentioned above, my background is in vocational rehabilitation specializing in working with people with psychological disabilities.  I always enjoyed working with this client group and was fascinated by the workings of the mind.  When I entered private practice I was naturally drawn to working with mental health clients. Originally I had intended to focus on general counselling and psychotherapy, but I found that some of my colleagues were referring clients to me for career counselling.

With my experience in general counselling and vocational counselling it made sense to continue to use my skills in both areas and mix the two streams of work.  I now see approx. 70% of clients for personal counselling and psychotherapy and the other 30%  for career counselling, although sometimes there is an overlap as people may have psychological issues which impact on their career decisions. I find the career work provides some “light relief” from the common presentations of anxiety, depression and relationship problems as it is shorter in nature and less intense.

What resource (book, website, person) helped you the most when setting up your private private?

The Introduction to Private Practice course I did was based on Lynn Grodzki’s workbook Twelve Months to Your Ideal Private Practice. I worked my way through this workbook and reported back to the group each week. I found this helped me to be well prepared for the realities of private practice.

I still frequently refer to Lynn’s books when I need to focus on how to develop my practice further. One of the social workers who ran the course allowed me to rent her room for half a day a week and on the days I went there we would spend some time talking about my practice and she provided ongoing support and advice to me as I waited for my client base to build up. My husband was incredibly supportive and encouraging.

What has surprised you most about being in private practice?

The number of people who have been prepared to help me learn what I need to know about running a business and the amount of resources available to support this.

I belong to several business networks which have been very useful in making contacts with various professionals with expertise in website development, social media, business systems, coaching etc.  It took me a while to find these, but they are out there if you ask and look.

Has your private practice helped you grow professionally? How so?

Every day I am learning new things. The longer I am in private practice, the more I realize there is to learn. Working with people and studying the human condition  is  exciting and stimulating. My skills and knowledge are continually growing as no matter what I may know about any topic or therapeutic approach, there is a constant stream of new knowledge out there.

Being in private practice makes me resource myself. I am responsible for my professional development – no one else, so I seek out opportunities to grow my knowledge and skills so I can continue to provide my clients with the best service I can and deepen my satisfaction at work.

Has it helped you grow personally, too? How so?

Absolutely. My confidence and self belief  have developed as a result of taking a risk and putting myself “out there”.  I could have continued in my former job with a safe, secure income and never grown to be the person I am now.   It is great to have been able to overcome my own fears and insecurities and put in the hard work required to realize my dream.

I have had to learn about marketing, networking, managing a business, budgets, Business Plans, etc.  I am more independent and I have a better understanding of myself, what I need and what I am capable of.   I am happy doing work that I love and which I believe makes a difference in people’s lives.  It is for me the perfect combination.

Being a therapist can be emotionally exhausting. What do you do to care for your own emotional and psychological health?

I am a great believer in self care and I constantly talk to my clients about this so I make an effort to practice what I preach.  Some days it can be emotionally draining working with human pain and giving out to people. I debrief with professional colleagues as needed and I attend monthly private supervision. I try to exercise regularly, get enough sleep and eat healthily.  My husband and I love travel and we visit our daughter in New York annually and have mini breaks in between.   I make sure I catch up with family and friends on a regular basis.  I use mindfulness breathing and meditation to help me relax and I listen to music and go for walks or do some gardening to unwind.

How do you cope with the inevitable stressors involved with being your own boss?

I love being my own boss so I don’t find it too stressful, but I imagine you are referring to having to do everything myself. I have no office assistance so I manage my appointments, type my invoices and reports, do my own marketing, pay the bills etc.  I’m pretty organised and I am a bit of a control freak so it does not bother me to do all this myself. Sometimes I think it would be nice to have someone take on some of the small practical things while I focus on the things only I can do.

What personal strengths have helped you succeed in private practice?

Well, I think I am persistent and resilient and if I make up my mind to do something I don’t give up easily.  I am quite disciplined and conscientious and hardworking. I am happy spending time alone so although I sometimes do miss having a team of people to work with, I operate better when I have time to think, reflect and plan. Private practice requires a lot of this.

I have good people skills and I have no problem forming trusting relationships with my clients. I network well and I seek out other people when I need social contact, but I don’t need a lot of people around me all the time. I am not afraid to ask for help when I need it and I am committed to life long learning.

To learn more about Dawn's practice visit her website http://www.dawnvincent.com.au

Put These Free Practice Building Webinars On Your Calendar

I've been researching webinar platforms lately and trying to find the time and muster up the courage to host my first webinar. Until then, check out these excellent, and free website building and social media webinars. I've personally attended webinars from both presenters listed below so I can vouch for the quality and relevance of their presentations. Maybe one day you'll sign up for one of my practice building webinars, but until then, put these on your calendar!

Jan. 11 "The Facebook Divide" with Laura Roeder

Social media marketing maven, Laura Roeder is offering a free Facebook webinar about the new Facebook changes, how to separate your personal and professional life on Facebook once and for all, and how to build your business (or your practice). I love Laura's down-to-earth style and her gift for simplifying aspects of social media that overwhelm most people. She's funny, practical, and endearing. Though this webinar is geared for any small business owner, and if you are in private practice you are a business owner. Wednesday, January 11th at 1PM pst / 4PM est Register by clicking here.

Jan. 16 "Wordpress For Therapists" with Therapy Marketing Geeks

Clinton Power of Therapy Marketing Geeks will be covering WordPress installation basics, creating pages, posts and more. This webinar is geared toward mental health/health professionals! You can read more about my personal Wordpress obsession here. I participated in a Therapy Marketing Geeks webinar a few months ago and was impressed with their knowledge and warmth (and charming accents). Monday, January 16, 5pm PST Register by clicking here

Jan 26 "How To Get Started in Social Media Marketing" with Laura Roeder

See how Laura uses social media for her own business, how to use social media to drive traffic to your website, and how to create results from your social media marketing efforts. Though not geared toward mental health professionals specifically, you'll benefit from how Laura simplifies and clarifies the purpose of social media and how to use social media effectively. Thursday  Jan 26th 1pm PST / 4pm EST Register by clicking here.

Why I 'Broke Up' With Managed Care

At times, working with managed care insurance panels in private practice felt like dating a bad boyfriend. I was constantly investing more time and attention than "he" was in the "relationship" and it started to wear me down. I got up the nerve to break it off for good. I've never looked back. I understand that building a practice free of managed care isn't for every therapist. I am grateful for excellent colleagues who participate on insurance panel because and there is a great need for their services and I frequently refer clients to them. However, if you're a private practitioner considering building a practice outside of managed care, I share my experience of resigning from managed care to give you the courage to take the leap, and the faith to know that it can work. So here's my story...

After I received my clinical license I started applying to any health insurance panel. I just assumed that's how you're "supposed" to get clients in a private practice because every therapist I'd known had followed this path to get referrals. I was accepted to many panels and my practice started to grow. I was ecstatic.

However, as time went on I started to resent many aspects of working with managed care panels and it began to effect how I felt about my work in general. I felt overworked and drained and knew that something needed to shift if I was to be in private practice for the long haul. Here's what I started noticing about my relationship with managed care.

• Excessive paperwork: I was spending almost as much time performing unpaid work (paperwork, phone calls, tracking authorizations, and billing) as I was spending seeing clients. I went into this field to do therapy, not paperwork.
• Reduced income: I resented writing off 40-60% of my fee upfront just to be placed on a list with dozens and dozens of other therapists. The managed care companies weren't doing anything to market my practice and yet I was being asked to take a huge pay cut to work with their clients.
• Mandatory diagnosing: I grew tired of having to diagnose every client who walked into my office in order to get paid. When I met with a client who didn't have clearly diagnosable symptoms I was faced with a dilemma. Do I stretch a diagnosis just so I can get paid, or do I do free therapy because insurance won't reimburse without a diagnosis?
• Denied or delayed payments: Being denied reimbursement for a variety of reasons and receiving payment weeks or months after I had performed the service grew frustrating.

My uneasiness led me to critically look at the financial numbers and I was astounded by the amount of money I was writing off just to participate on managed care panels. I decided that there had to be a better way to for me to run my practice. I realized that if I resigned from managed care panels and transitioned to a fee for service practice, I could see half the number of clients weekly and make the same income. Or, I could see the same number of clients and double my income. To top it off, I could eliminate most of my unpaid paperwork hours. Work less and make more? It was a dream come true for a private practitioner and mother of young children.

I resigned from all managed care panels in 2007 and raised my fee by 10%. Since then, my private practice, Wasatch Family Therapy, has grown from a solo practice of one to a thriving clinic employing several therapists. We are adding a second office location later this month. It has taken some relentless marketing, consistent networking, and social media skills to keep a practice growing without managed care or any outside contracts, but it has worked. If I can do it, you can too.