4 Questions To Ask Yourself When Hiring a New Therapist

One of the wonderful challenges that comes from having an abundance of business is the need to add new additional clinicians to your practice. But how exactly do you know who will be a good fit? How can you be sure to make the best choice that will benefit both the clients and your practice? Not too long after opening Wasatch Family Therapy, I had created relationships in my community and built my online presence to the point that the demand for my services exceeded the supply I could provide. In other words, I needed to hire new therapists! Since I do not have a background in business, the process was entirely new to me, but thankfully I found that it happened quite naturally. I identified a few key criteria (beyond simply having required credentials and experience) that a candidate must possess in order for me to feel like he/she was a good enough match to hire. Here are 4 questions to ask yourself when meeting with an applicant who you may potentially bring in to your practice:

• Do I like him/her?  

It may seem obvious, but it's critical that you feel comfortable with an individual who may be working for you. If you do not like to be in his/her presence, why would a client? It goes without saying that people skills are invaluable in this profession; it's what we do! Look for someone who puts you at ease, is warm and inviting, and who you find yourself attaching with. Be mindful of the emotional climate of your practice; you want to bring someone in who will work well with others, avoid drama, and of course help clients through their emotional struggles. Whether or not I genuinely like someone is the most important factor determining if I hire him/her (interestingly, this same criteria is also usually first on the list of what a client looks for in a therapist).

• Were they born to be a therapist?   

When looking to add to my practice, I look for individuals who I can sense were born to do therapy. It's common for practitioners to work with a lot of graduate level interns, and there are a select few who truly stand out; people who are naturally thoughtful, reflective, and sensitive to others' needs and feelings. I want someone who's always had the intuition and instinct of a therapist who just had to go through the official training to actually become one.

• Are they emotionally stable?  

This question is admittedly a bit delicate. While no one has it all together all the time, it naturally follows that someone who has a handle on his/her emotional issues can better assist clients in managing their own. Good therapists often use difficult past life experiences to relate to and help clients, so being "emotionally stable" doesn't necessarily mean you've never struggled mental health or relationship problems; quite the opposite can be true! To use an analogy, you cannot be a tour guide for other people to places you've never traveled. Still, I need my therapists to be healthy in order to best serve our clients.

• Do they reflect the values of my practice?

As the owner of my practice, I need therapists who work for me to be similar to me in many ways. This is not to say, of course, that I am wanting someone with the exact personality, training, and expertise that I have. Still, there needs to be a continuity of approach and therapy style common to our clinicians. Throughout the years, we've had inquiring individuals wanting to see me specifically after hearing me speak or learning about me through social media. When I don't have an available opening to see someone new, I like to be able to state my confidence in another therapist and tell the prospective client that I've hand-selected a particular counselor that I wholeheartedly trust to do good work. I suggest that practitioners looking to hire new therapists identify a few specific values that are key to the philosophy and setting of their private practice to look for in applicants.

What do YOU look for when hiring new clinicians?

Let me know!

This post was adapted from an interview I did with Joe Sanok, LPC on" Practice of the Practice." Click here for access to the full podcast.

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6 Things I Learned from 'Breaking Up' With Managed Care

It was a scary step to resign from all insurance panels! I wasn't aware of any therapists who had built a fee-for-service practice in my area. The things I learned in the process of were better than I had expected. When my practice Wasatch Family Therapy transitioned from managed care panels to a private pay model over a decade ago, I anticipated a few things would happen; I knew that this business decision would help allow me more control over the type and length of therapy, that I would have less paperwork, and I would get paid at the time of service. However, there were some unexpected lessons I learned as well. Here are 6 things I learned from breaking up with managed care:

I Learned:

•  the value of my perceived value.     

When potential clients learned that I employed a private pay model, they seemed to perceive me as a more competent provider. "You must be really good if you don't have to be on insurance panels." My clinical skills hadn't changed, but my perceived value went up because of how I presented my services. It's surprising how much the way we clinicians value and present ourselves affect how others see us.

• that I felt more alive in my clinical work.    

The stress of constant paper work and phone calls that was part of being on managed care panels unfortunately led me to resent the work I was doing. However, after transitioning to a private pay model, I could refocus my energy on the reason I went into the mental health profession. Since I no longer felt drained by jumping through hoops for insurance companies, I was able to rediscover my passion and love of doing clinical therapy.

• that I deserved to be compensated well.

The work we do is vitally important, and it's not selfish to desire income stability for yourself as a mental health professional. Resigning from managed care helped reaffirm to me that I do deserve to be well compensated for my clinical services.

• that I had more time and energy for family and other passions.   

The income stability, decreased stress, and increased time that a private pay model afforded me meant that I could invest more in my hobbies and in my relationships. I've been able to pursue many of my passions, including songwriting and getting my PhD, and I've cherished the relationships that I've been able to nurture and devote more time to.

• how to present my fees with confidence.  

Understandably, a mental health professional transitioning from managed care to private pay may feel some hesitation about talking about his/her service fees. I initially felt this reluctance as well. Few people are confident in talking about money! But, as time went on I learned to overcome this challenge and present my fees and talk about a fee-for-service model with ease (click here for more about how to create and assertively implement a financial policy for your clients).

• how to generously refer to colleagues. 

It can be difficult for many clinicians to refer potential clients to other providers. We may feel somewhat of a scarcity mentality, and that if we don't decide to do therapy work with a certain individual there may not be any other clients who want our services. I realized that even if I didn't see a client for therapy, I could still serve him/her by providing referral options. For example, I could identify sliding scale fee clinics in the area or email names of therapists who were on an insurance panel or were in some way a better fit. By doing this, not only was I helping individuals find the care they needed, but I was also helping other colleagues in my community by providing them with more business. Referring to outside sources has been an incredibly important aspect of working with a fee-for-service practice, as Wasatch Family Therapy currently refers at least 50% of our inquiries to other providers in the community.

Click here for access to the full webinar "How to Break Up With Managed Care and Build a Thriving Private Pay Model."

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How Media Exposure Can Grow Your Practice: Podcast Interview

I thought you'd you enjoy this lively interview with Joe Sanok of Practice of the Practice Podcast about my private practice journey from a solo practitioner to a clinic with 3 locations and 20 employees. We cover a lot of ground during this podcast!  In addition to tips about gaining media exposure you'll also find: Tips to land high profile media interviews.

The biggest lesson I learned when resigning from managed care.

The book that helped transform my practice.

Tips for finding blog topics to write about.

How to find quality therapist to expand your practice.

How to encourage to see my colleagues when you don't have openings.

The role of social media and building an online presence.

How I became a private practice consultant.

Listen to the podcast interview here

..and here's a fun graphic specifically about how to add top-notch clinicians...

Find out more about the MostAwesomeConference.com with fellow PsychCentral Bloggers Kelly Higdon, Miranda Palmer, and Joe Sanok.

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4 Ways a Private Pay Practice Model Benefits Clients

The value of using a private pay model (instead of a managed care system) for your therapy practice is clear: less stress about additional paperwork requirements, greater autonomy to provide the services you deem are in the client's best interest, and immediate payment of your full fee are some of the main advantages. But some therapists are understandably hesitant about how to make the switch because of the potential impact this choice it might have on their clients. Some common fears are “Clients might stop getting the therapy they need because they can’t afford me” or “charging a higher fee is selfish and means I care more about money than helping people.” When I was considering making the switch, I too had thoughts like these cross my mind. But I discovered that the opposite was true; breaking up with managed care and embracing the new way of structuring my practice actually benefited clients who received services. Here are 4 ways that a private pay model benefits clients:

1) No Mandatory Diagnosis

Many managed care systems require that you diagnose a client's specific mental health condition condition prior to paying you for your services. In some cases, insurance companies will only pay for certain diagnoses. Often, relationship issues are not covered. However, this can turn in to serious ethical problems.

I remember years ago I was referred an urgent client - a child who was sexually assaulted. I determined that she had no clear-cut symptoms and didn't meet a diagnosis that her insurance benefits would cover. I was in a terrible dilemma: do I give an inaccurate diagnosis to satisfy the requirements of managed care, or do I get paid for the initial? No therapist should ever have to find him/herself in this kind of a situation, and no client should be subject to this either.

One of the best parts of employing a private pay model is that there is obviously no such requirement. Diagnosis can be used as a tool, but you are not obligated to provide one. By eliminating the need to diagnosis a condition that may or may not fully exist, you can ensure that your clients receive ethical, honest, and accurate care.

2) Higher Quality of Service

Back when I used a managed care system, I was receiving approximately 40-70% of my stated fee. This meant I was in survival mode, seeing more and more clients just to try to get by and meet my own financial needs. And all the while, I still had the stressful task of running the business side of things. It’s not surprising then that I wasn’t able to give as much to my clients. As much as I tried, unfortunately the standard of care I could provide was compromised. That was unfair to me and unfair to the people who were paying me to help them.

By changing to a private pay model, I was able to see fewer clients and, which reduced my stress, which allowed me to be more present for my clients. I also no longer spending hours per week on phone calls and paperwork that came with using a managed care system, which freed up my energy to give to those I served.

3) Better Therapist/Client Match

A private pay model also lends itself to a better fit between the therapist and the client. If you have fewer clients, you can be selective about the ones you see. The opposite is also true; if someone is willing to pay more for professional therapy, it’s likely that he/ she has done his/ her research and sought you out because of your specialty and the expertise you provide. To put it simply, you want them, and they want you.

I’ve found that using this financial model attracts highly-motivated clients. Although they are required to pay more, they place high value on therapy and budget accordingly.

4) More Clients Reached

A private pay therapy model allows you to have a greater outreach and help more clients. This may initially seem counter-intuitive; how does seeing less clients serve more people? The answer is that if you have a surplus of potential clients or have people come to you with needs that are different that the expertise of your practice, you can refer them to trusted outside resources. You’re helping other therapists while simultaneously ensuring that clients receive the best care specifically for them.

The other thing I have found is that the income stability provided by a private pay model allows my colleagues and me to do more pro bono work. Paradoxically, because we earn more, we can provide more volunteer service when we choose.

All in all, switching to a private pay model was one of the best business decisions I made to benefit not only myself, not only my practice, but the clients and the community we serve. Charging a higher fee does not mean you are inconsiderate or selfish; it means you are valuing yourself and providing the best quality care to your clients.

*If you find that finances are legitimately a concern for some of your clients, you may decide to provide alternative choices, such as reduced fee sessions with Masters’ student interns. My practice Wasatch Family Therapy does this, and it works well for those looking for a more affordable option.

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5 Common Barriers to Building a Fee-For-Service Practice

Building a fee-for-service practice can be scary, especially if it means resigning from insurance panels and finding other ways to attract clients. Others may have already made the switch, but don't know how to successfully navigate the change. I have found some strategies to help ease the transition. Here are 5 common barriers to building a fee-for-service practice and ways to overcome them: 1) "I'm uncomfortable marketing myself"

I often hear therapists say that marketing themselves feels like bragging or tooting their own horn by self-promoting. In order to move past this barrier, it's helpful to reframe the way you think about marketing. Consider it instead as REST: Relationships, Educating, Serving, and Trust Building. You are building relationships with potential clients who might see your website or other media, you're serving your community by educating them about important topics related to your niche, and you're establishing rapport and building trust with those who encounter you through your (online) content (REST is essentially why you're in the profession in the first place, right?). If you can focus on these 4 things, you can (and will!) attract clients who will pay your full fee. While your "marketing" strategy (I'm not a fan of that word, by the way) REST strategy is meant to benefit you by helping your community become familiar with you and your services, it's really about those who you can potentially help through receiving services through your practice. Don't be shy in getting the word out about yourself; it's a way for you to use your professional skills to serve and educate your community.

2) "I'm afraid of the ethical issues surrounding social media"

Those new to the world of social media may be wary to fully embrace it because of the potential ethical problems that may arise. Potential for unethical dual relationships, confidentiality concerns, and lack of knowledge are common fears. But these fears (and others) can be overcome: having an official social media policy included with your intake packet, avoiding directly soliciting your additional products or services to existing clients, being familiar with privacy settings online, and overall just using your ethics training and common sense will help you be prepared to face these potential issues.

Click here to read a more comprehensive article about overcoming fears associated with social media.

3) "I'm not good with technology"

The internet gives us incredible opportunities to communicate and reach an audience that is unprecedented in size. However, for those unfamiliar with all the ins and outs, it can also be intimidating, overwhelming, and frustrating to start. Mari A. Lee, an LMFT who specializes in sex addiction recovery, understands this feeling all too well. She describes being scared and resistant to learning new technologies. But she was able to overcome her "technophobia" by starting with manageable goals, finding a patient and persistent mentor, asking lots of questions, and setting aside time to devote to learning and practicing new tech skills. Her success in building an online presence paid off big time; she's currently a best-selling author! "If I can figure out how to blog, attend and facilitate webinars, host online trainings, navigate my Facebook business page, and so forth, anyone can... If this 52 year-old former tech scaredy cat can do it, so can you!" Mari explains (read more about her experience here). 

Understanding and applying the language of technology does not happen overnight. Be patient with yourself, as there's certainly some trial-and error learning here. Remember that everyone starts somewhere. And just like Mari, look for a mentor to guide you and bounce ideas and questions off of. You've proven yourself to be an apt and competent learner by becoming a licensed therapist; have the courage to learn another skill set as well.

4) "I can't do media appearances or speaking engagements because I hate seeing and hearing myself"

Therapists tend to get shy about media interviews. It's one thing to sit in front of a client and offer counsel in a one-on-one session, but speaking in front of large audiences can bring out anxiety in even the most confident clinicians. But remember how much you know; you are a trained and experienced expert. The aesthetic and "performance" aspect of media appearances will come with time. The more prepared you are, the more comfortable and relaxed you'll be. And if by chance you do feel like you bombed a television interview or radio podcast, learn from it and try to move on. It's not the end of the world if you make a mistake!

Read here for more tips on how to look good and sound professional in your media appearance.

5) "If I'm a great clinician, my work will speak for itself"

Some therapists plan to rely on their hard-earned reputation as an excellent mental health professional to be their main source of client referral. They then focus solely on refining their clinical skills, as they don't see the need to engage with their community beyond private sessions. While referrals can be an effective strategy to build your clientele, depending on others in the field to refer to you should not be the only way you attract people to your services. The harsh truth is that there are a lot of excellent therapists who fail in developing a successful private practice. Everyone has to start somewhere, and it takes time and experience to gain a loyal following and individuals who actively seek you out.

You may find that by being persistent in building trust in you and your services over time will be the major benefit to the growth of your practice. Because we have worked hard to establish ourselves as trusted professionals by embracing social media and building our online presence, my practice, Wasatch Family Therapy, receives most of our referrals from Google searches. This is something I feel very grateful for, and it's largely due to the fact that I stopped participating on managed care panels and consequently had to work within the community to build trust directly with potential clients.

Embracing a private pay practice model brings more than a few questions, unknowns, and worries. But by using these strategies, you can overcome barriers and build a thriving practice.

Besides the obstacles presented in this article, another major reason why clinicians may be wary of switching to private pay involves how they think their clients will be affected. I address (and debunk!) these fears here.

Click here to view my webinar and learn more strategies and tips about breaking up with managed care!

Join my Private Practice Toolbox Facebook group and connect with 2800 therapists around the globe in 2 simple steps: 1) Click request to join the group and 2) Fill out this brief questionnaire before you'll be added to the group.Get practice tips and blog updates in your inbox.

Sign up for the Private Practice Toolbox Newsletter here.