Adventures In Private Practice: Child Therapist April Forella, LMHC

Tell me about your practice...

I am a solo practitioner with an office in beautiful Palm Beach Gardens, Florida. I opened my private practice a year ago. As an experienced child, adolescent and family therapist, I understand how difficult it can be to find resources and help for children and adolescents who are suffering from emotional and behavioral issues. In my private practice I specialize in working with children 6+ and adolescents who are experiencing difficulty in their functioning and ability to navigate life’s challenges and relationships. I enjoy seeing children and families learn how to respectfully express their emotions and improve communication. Children and adolescent’s unique situations are addressed with a deep understanding of today’s youth and their specific challenges.

I am an Accredited Standard Triple P Provider (Level 4 & 5).  Triple P is an evidence-based multi-level family intervention and parenting support strategy which is designed to reduce the prevalence of behavioral and emotional problems in children and adolescents.

Why did you decide to open a private practice?

I entered graduate school in mid-life with the goal of opening a private practice. My twenty years of experience working in business (advertising & marketing) prior to entering the field have assisted me in knowing how to reach my target audience. I also wanted the freedom to set my own hours and to foster hope and build relationships with my clients. I knew that having my own practice would allow me to achieve all of these goals.

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?

Young children and adolescents with challenging behavior problems try the patience of parents and caregivers and can be challenging for therapists. I have learned from the most “difficult” clients the importance of meeting them where they are, along with being patient and finding ways to connect and build rapport. By being with a child and engaging them in art, play or games I gain an understanding of what the child’s interests and needs are. Once a child is heard and understood we can begin implementing strategies to meet the child’s needs and overcome challenging behaviors. Understanding the child from the child’s perspective is the key to the process.

What’s your biggest pet peeve about private practice?

The fluctuating streams of income. There are cycles when I’m busy and when I’m not.  I continue to learn and expand my knowledge of marketing utilizing social media and networking to grow my practice. I supplement my income with offering trainings to schools, other professionals, and coaching.

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

My passion in working with children and adolescents has been important to me before enrolling in graduate school. I took course work related to counseling children, completed an internship at an agency specializing in working with at-risk children. Once I was licensed and opened my practice I already had a solid skill base as a child, adolescent and family therapist. I also had the skills necessary to work collaboratively with parents. It was a natural fit.

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

I attended a training by Lyn Kelley, Ph.D., LMFT, CPC “Promote Your Practice Exclusively to a Well-Pay, Fee-for-Service Clientele”, consulted with other professionals and utilize the internet to find other successful private practice clinicians, including Julie Hanks, LCSW's “Private Practice Toolbox”, Tamara G. Suttle, M.Ed., LPC “Private Practice from the Inside Out—All Things Private Practice”. The book The Paper Office by Edward L. Zuckerman, Ph.D has been helpful in getting organized and developing good professional habits. The book provides forms, guidelines, and resources to make your practice work ethically, legally and profitably.

What has surprised you most about being in private practice?

I have found my life’s purpose in helping others. I am truly passionate about coming along side my clients and find it rewarding in so many ways.  The hard work in building my practice is all worth it when I see clients grow.

Has your private practice helped you grow professionally?

I have gained self-confidence not only in my ability to provide quality therapeutic services but in my ability to manage the business side of my practice. I continue to set goals to challenge myself personally and professionally. I plan to present at conferences and seminars to develop public speaking skills, and begin blogging and continuing to utilize social media to develop my practice.

Has it helped you grow personally, too?

On a personal level it has made me aware of the importance of pursuing my passion and the fulfillment that it brings me.  It’s a privilege to come along side the amazing people that I work with and the things they teach me about life.

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

I make it a priority to have time alone to relax, pray, read the Bible and recharge myself. My support system is an amazing loving family and lots of great friends. I enjoy spending time at the beach, listening to music, regular massage to release stress and tension in the body, and going on walks.

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

I handle all of the day to day details of my practice myself. I am an organized person and rely on to-do lists. It can be overwhelming at times! However, the rewards of having flexibility and freedom to make my own schedule out way the stressors.

What personal strengths have helped you succeed in private practice?

My social skills are strong and connecting with people is natural for me. I like to network and build relationships. My business experience has helped me to understand marketing. I also understand that growing and maintaining a private practice is a process that takes a lot of work, perseverance and the need to reach out to my peers for support and encouragement.

To learn more about April Forella’s private practice visit www.aprilforella.com.

10 Things I Accidentally Did Right In Building My Private Practice

As I reflecting back on 10  years in private practice I did a few things right, mostly by chance.

With a business license, professional license, and big dreams, I opened a private practice ten years ago. Having never taken a business, marketing, or management course, I have learned "on the job" how to be a small business owner. Hopefully, you can learn from what I accidentally did right and intentionally apply them as you build your private practice.

1) Start small, think big

At the time I opened the doors I was a solo practitioner. Those of you in solo practice know that means I was the receptionist, the billing manager, the webmaster, the marketing specialist...Being a "one woman show" for a few years not only taught me what it takes to run a practice, but also how to teach others what I had learned as the practice grew. My vision was to grow my practice into a group with several practitioners and over time, that has happened.

2) Grow slowly

I didn't know it then, but one of the main reasons new businesses fail is because they grow too quickly. As a mother of 3 children at the time, I was fine growing slowly so I could manage the multiple demands on my time. Turns out it was good for business too. Growing slowly allowed me to build a business without loans or going into debt.

3) Charge more than you think you're worth

From my first day in private practice I have always charged a higher fee than I felt I was worth. This forced me to deal with my own money issues, and to learn to value my own services and skills more highly. I came to understand the value of the perceived value of my services as clients assumed that I must be very skilled in order to charge at the high end of the scale for my location.

4) Think like a business owner

My family of origin tends to have an entrepreneurial mindset where self-employment, flexibility, and freedom are highly valued. This framework helped me to be able to think like a business owner and a therapist and to find an emotional place where those two roles weren't mutually exclusive. Although they are occasionally in conflict, I've found that that is a rare occasion. Thinking like a small business owner has helped me to set better therapeutic boundaries with clients as well.

5) Trust your gut

In all areas of practice, from office location, to logo design, to who to hire, to which practice software to purchase, after researching the best options I ultimately followed my intuition in making key decisions for my private practice. While the path hasn't been perfect, I can't think of one decision where I trusted my gut and regretted it.

6) Hire qualified people that you trust with your reputation

One of the scariest things in growing from a solo practitioner to a larger practice is hiring people who have the power to impact  your professional and business reputation. In addition to hiring very qualified staff, also hire people that you'd trust and train them how to present themselves in a way that builds your credibility.

7) Set strong boundaries with money

Whether it's following through with your office policies regarding collections, or saving for those dips in client numbers, I have tried to be consistent with money policies. This also applies when hiring employees. My tendency was to give away a little too much at first, because of my inexperience. I soon learned that there is a cost, emotionally and financially, to having employees, and that I deserve to get paid for management time and for holding all of the liability in the practice setting.

8) Create a home away from home

Creating a comfortable yet professional office space has helped me, and my clients, to feel welcomed and safe. I've found self-expression in my private office environment and decor helps foster a sense of safety and nurturing and creates a space where I feel at ease.

9) Integrate your passions into your practice

I have always integrated current interests and passions into my private practice. If there's a film that I really like, I'll use that with clients. More recently I've become a tech geek, so I've integrated technology into my private practice by launching an online therapy division, moving to electronic records, and building a social media following.

10) Take good care of you

Personal self care has always been high on my priority list. I've known that if my own needs were going to get met it was my job to make it happen. Whether it's scheduling exercise, bringing healthy food to work, making time for social events, or attending my own therapy, I am fiercely committed to making sure I am taking care of me. I think those habits have allowed me to energetically continue investing in my clients, my practice, and my employees without feeling burned out.

What things have you accidentally done right in building your practice? Please share so we can learn from each other!

Celebrating 10 Years Of Private Practice Success

From solo practitioner to thriving clinic owner. Celebrating the milestones of 10 years of private practice.

Today marks the 10 years since of the founding of my private practice Wasatch Family Therapy, LLC. I started out as a solo practitioner with big dreams of creating an exceptional therapy clinic that not only provides excellent clinical services, but also provides therapists the opportunity to create their "dream practice" in a nurturing work environment that supports personal growth and strong family relationships.

As I take a step back and reflect on this ten year journey, many tender emotions surface. I am grateful for willing clients who have allowed me to walk with them during life crises and transitions. I am touched by the generosity of the professional relationships that I've cultivated during this period of time. I am amazed at the personal and professional growth that I've experienced. I've learned invaluable lessons about leadership, boundaries, and business. I've developed skills in marketing, supervising, web design, social media, mentoring, public relations, human resources, interior decorating, negotiating contracts, consulting...

This Wednesday we're putting on our party hats and hosting a celebration: a professional networking luncheon in our new office suite for all of our current and former staff, colleagues, referral sources, families, and friends. As a thank you to our colleagues and friends we'll be tweeting and posting photos and links to great websites and resources as a thank you to our attendees. Feel free to follow the fun here on our Twitter and Facebook page.

10 Year Milestones For Wasatch Family Therapy

• 10,000 families served
• 4000 + social media updates
• 300 local and national media interviews
• Grown from 1 to 14 therapists
• 13 interns trained or supervised
• 1 to 2 clinic locations
• 9 babies born to our staff members
• 5 office spaces outgrown
• 0 to 2 office and support staff
• Transitioned from managed care to a private pay practice

Whether you've been in private practice for years or months, I encourage you to take a step back this week and reflect on your journey. What milestones have you achieved so far? What are you grateful for? How have you grown personally and professionally through your private practice journey? And where do you want to go next?

Throughout the month of October I'll be posting more about lessons learned during my 10 years in private practice, mistakes and missteps, brave decisions, and more in the hopes that you can learn from my successes and failures and build your dream practice.

What are the most lessons have you learned in your days/weeks/years in private practice?

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Pros And Cons Of Group Practice (part 1)

A common private practice question is whether a therapist should join a group practice or venture out on their own as a solo practitioner. The answer is different for everyone depending on your strengths, goals, personality, financial needs, and many other factors.

There are also other options in between solo and group practice, like sharing an office space with other practitioners while maintaining your own practice. "There are numerous ways of forming a group practice including cost/office sharing, partnership, and employment as associates under a licensed provider," according to Kansas Psychologist Wes Crenshaw PhD, ABPP of Family Psychological Services, LLC.

To help make your decision easier, here are some of the benefits and drawbacks of joining a private practice group.

Benefits Of Joining A Group Practice

1) Established business systems

If you're considering joining an established practice, a huge benefit is that they already have office systems in place to support the practice. Michigan therapist Jacquelyn J. Tobey, MA, LLP of  Sollars and Associates says, “I have benefited from joining a group because many of the business practices such as marketing and billing are already established.”

2) Shared expenses and responsibilities

Sharing the costs of operating a business can be appealing. Therapists often underestimate the financial requirements when starting a private practice. Sharing operating costs, office space, equipment, marketing, and administrative expenses are just some of the benefits that North Carolina counselor Erika Myers, LPC enjoys about group practice.

Tobey has learned what it takes to run a business by first joining a group practice. She likens a group practice to renting a furnished room in a house that is already built, whereas private solo practice is more like  designing and building the house on your own. I think that is an excellent analogy.

3) Consultation and camaraderie

Meyers enjoys having colleagues to consult with on difficult cases as well as the camaraderie inherent in interacting regularly with colleagues. "The work we do can be isolating, so having fellow professionals around can help you have more social contacts beyond the professional consultation," Meyers says.

Melissa J Templeton, MA, LPC, LMFT compares working in a group setting to a good relationship. “Like a good marriage, it is the ‘fit’ of the various personalities that determines whether the cohabitation is going to work and work well,” shares Templeton.

4) Referral sources

Illinois counselor Melanie Dillon, LCPC, at Center For Wellness, Inc values the internal referrals generated within her multidisciplinary practice.

My business partners are both chiropractors. One provides acupuncture/Chinese medicine and the other chiropractic care/sports medicine. We have also employed a massage therapist. This way we have created a system that supports internal referrals. The other benefit is that all expenses are now shared, and that my income is no longer dependent on how many clients I see, but on the group as a whole.

Now that you have a feel for the benefits of joining a private practice group, check back later this week for part 2 - the drawbacks of group practice.

(c) Can Stock Photo From your experience, what are the benefits of joining a private practice group?

6 Ways To Put Your Practice On Autopilot

Whether you like it or not, when you're in private practice you are a business person. A common complaint I hear from new private practitioners is "I had no idea how much time (and money) it takes to run a business!" I nod my head in agreement.

With no business background, I ventured into private practice nearly 10 years ago. Starting out as a solo practitioner, I have learned how to maximize my time. Over the years I learned the importance of automating as many business systems as possible in order to decreases stress, and free up mental and emotional energy for the things I'd rather be doing...like therapy.

Here are 6 suggestions for automating your business systems in private practice:

1) Automate social media posts

While actual human conversation is the point of social media, I do automate some of my posts, tweets and status updates. The two social media management platforms I use are Hootsuite and Socialoomph. I use both because they have different strengths. Hootsuite allows me to manage multiple social media accounts from it's dashboard and respond to them in one place. SocialOomph is great for posting recurring tweets and updates because you can set the frequency of the recurrence and alter the text slightly.

I also use SocialOomph to set up auto-responders to thank new Twitter followers. SocialOomph also sends me daily digest email of keywords I've chosen to follow on Twitter so I can see who's tweeting about relevant topics and I can find new and interesting people to follow.

2) Switch to electronic health records

This year my clinic switched to online health records. One of the benefits has been that clients can log in, fill out initial paperwork and submit it online. Best of all they can print their own statements to send in to their health insurance company to seek reimbursement, which saves my office a lot of time and money.

3) Try an online scheduler

While I don't use an online scheduler, I know that many therapists do. Clients can book, cancel, reschedule their sessions online. Many programs also send automated appointment reminder emails to clients so they don't forget about their therapy appointment.

4) Schedule blog posts

If you have a blog on your practice website (which I certainly hope you do by now), set aside some time each week, or each month to crank out several posts and have them waiting in the queue. In the Wordpress platform that I use I can schedule the exact date and time that the post will publish. I have a least one post scheduled per week for the next four months on my practice website.

Another helpful tool is to set an editorial calendar for your blog so you know what topics you want to cover each week throughout the year. You may want to schedule them around certain holidays or national mental health awareness days. With your calendar set you can plan ahead for your topics and get them in the queue and off your mind. (This post was scheduled ahead of time.)

5) Automate your newsletter

Several months ago I switched e-newsletter services to Aweber. One main reason is that you can set up automated newsletters based on your blog posts. Basically, I set up the template, set the number of blog posts I want sent in each newsletter, and when it gets to that number of new blog posts, it automatically sends an e-newsletter to subscribers with blog post summaries!

Another cool automation feature is that I have set it to automatically send it out on Twitter and post on Facebook, too. It has saved me and my office manager several hours per month formatting the monthly newsletter. If you sign up for my Private Practice Toolbox newsletter below you'll see first hand what I'm talking about.

6) Set up auto bill pay

Finally, instead of writing checks for rent, water cooler service, cleaning service, web hosting, or any other recurring expense, set up automatic bill pay so you can mentally take those expenses off of your "to do" list.

What have you done to automate business systems in your private practice? I'd love to hear your tips!

photo credit: williamcho