May 8, 2024 • 25 mins
Abundance Community member Catherine and Allison discuss the challenges and potential solutions for Catherine's San Francisco-based private practice. They consider focusing on a specific population, increasing Catherine's fees, and clarifying her expertise in working with traumatic childhood experiences.
Want individualized support & group calls with Allison? Join Party+! Learn more here: https://bit.ly/3rrsqK2.
Sponsored by TherapyNotes®: Use promo code Abundant for 2 months free
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:02):
(Transcribed by TurboScribe.ai - Go Unlimited to remove this message) Hey Catherine!
Good morning.
How are you doing?
I'm good.
I've never met like an Instagram person, so
I'm like...
I promise I'm real.
Yeah, yeah, yeah.
I suspected as such.
Well, what would be, what would be helpful
today?
Well, I was definitely obviously thinking about it
(00:23):
and like, I guess just, I do have
a question, um, that I think I, I
don't know, maybe it's helpful to give some
background first, like context.
Yeah.
Yeah.
Um, so I'm in San Francisco and so
I've been, I got licensed in 2020, so
weird time, had my baby in 2021.
(00:44):
And so I kind of really didn't like
card launch until 2022.
Um, and like the private pay thing is
not such an issue here.
It feels like, like culturally people are used
to paying out of pocket and not that
many therapists actually accept insurance.
And so I haven't found that to be
like too much of a struggle, like to
find clients to pay full fee.
(01:07):
Um, and so like I had my fees
200 and it's fine.
Like most people are paying that.
I just have a few people that are
not.
My dilemma is twofold.
One is that like buying a house here
is so complex.
And so like the mortgage people are like,
you need to have a W-2 job.
And so like I've had a part-time
job and I'm starting a new one, which
I have like I kind of have some
(01:29):
shame about that.
Like, just because I'm like, oh, like I
owned a business before being a therapist.
And like, you know, I like, I feel
like confident about the idea of being a
small business owner, but, um, but that is
like a huge pull, right?
Like a three bedroom house here is like
a million dollar house, you know?
So it's crazy.
Um, and so I'm starting a new part
(01:50):
-time job that's three days a week.
And it's like only it's like with Kaiser,
which is big healthcare provider here and whatever.
And it's like a hundred thousand dollar job
for three days a week.
So I'm like, okay, well that seems like
somewhat worth my time.
And so I'm doing that.
And then my plan is to do private
practice two days a week.
(02:11):
And, you know, I don't love it, but
I feel like it's like a plan to
like get us the house that we need.
Um, so there's that.
And the other part of it is, is
that like in private practice, like I'm one
of those people that just seems to like
have endless interest.
And so like, I have a very hard
(02:31):
time saying like I only work with one
particular population.
And so I have had trouble finding like
the right kind of questions to like ask
myself, I guess, like, cause I've done all
of the niching down stuff that you have
and everybody else.
And I never feel like I get to
like a place where I can figure that
out.
(02:52):
Um, like the, the place that I came
to, like, after I had had my baby
and stuff was like around working with like
cycle breaking parents, right?
Like parents who are healing their trauma from
like their own childhood and having little kids.
And, um, so I did this fellowship last
year for infant paramental health, which was like
a lot of money.
Um, but then I'm also doing EMDR. Now
(03:14):
I'm getting interested in CAP therapy and I've
kind of always had this, um, space in
my practice for teens.
Like I did like a, one of my
like training jobs was at a teen agency
and it just, it just seems very hard
to like not continue serving that group.
And families seem very willing to pay for
(03:35):
therapy for their teens.
And so it's been like an easy referral
source and I genuinely like them.
So I'm like, it just seems like impossible
to do so many things, you know?
Well, it's okay.
I want to, first there's a lot I
want to, I want to talk about, cause
there's, I mean, you just brought up such
good juicy stuff.
Okay.
The first thing about the banks wanting you
(03:55):
to have a W2 job, is that because
you need two solid years at the income
you want in like in private practice, you
could do it if you're at the income
you wanted for two years.
Yeah.
Uh-huh.
Yeah.
But they're like, I know what it's like
to have like, I want to buy a
house now.
Yeah.
Yeah.
Yeah.
Um, so one thing I would want to
(04:17):
put out there is that if you were
to work three days a week in your
private practice for two years, the amount of
home that you could buy is much higher
than you could put this a hundred thousand
dollar job.
Yes.
Yeah.
So I'm going to just say that I
understand, like I said, I understand being ready
to move into your own home.
(04:37):
Um, and I know that that sometimes it
gets an emotional decision and there's no reason
to argue with it unless there's a reason
to argue with it, you know?
So putting it out there that like from
a math perspective, which is not emotional, it
would make more sense to fill your practice
and wait two years.
Okay.
Yeah.
(04:57):
I see what you're saying.
Yeah.
Yeah.
I'm kind of, it's an, it's an interesting
juncture because like I am hitting the two
-year mark.
Right.
And like, um, like obviously it's tax season
right now.
And so there's that.
And then my husband is in like a
career shift space too.
He's in an industry that's like dying.
(05:18):
He like kind of like he does telescope
product development, which sounds cool, but like, you
know, like Chinese factories are like basically taking
that over, which makes sense.
So yeah.
So like I, yeah, this is the part
where the shame comes in.
It's like, I know what you're saying.
And it's like, it's so hard to like
make these choices.
Yeah.
Yeah.
And I definitely don't say it to shame
(05:40):
you because no, I know.
Yeah.
There are emotional reasons to buy a home.
Like we shouldn't always just go off math.
First of all, we wouldn't be therapists if
that's how we did things.
That's a hundred percent true.
Yeah.
So, um, I'm just, I've been thinking about
it from the perspective of like, that's a
lot of clinical work.
Yeah.
Yes.
That's so that's the, the, the, the rub
(06:02):
I got in with the job I took
last year.
The only thing different about this job is
it's not like a clinic, it's not a
CAFO job.
It's just like doing triage.
Um, so it's like, um, cause I know
the person who's like the director at that
hospital.
So I kind of like really careful about
like, even going through the interview process.
And so I talked to her kind of
like off the record about, about it.
(06:24):
And she's like, no, it's not, there's no
caseload.
Cause Kaiser is known for having crazy caseloads
for their clinicians.
And I'm like, I don't want to get
into that, but, um, so that's the only
thing is like the job ends at the
end of the day and it's just like,
do you take phone calls?
And I'm like, okay, I think I can
do that and do my practice.
Like that was the intention of this, this
job is that like, then I would have
(06:45):
the energy for my private practice and hopefully
like figure out on the side, like exactly
what it is that I want to like
a hundred percent dedicate myself to clinically.
Cause like I have so many things, it's
like, it seems hard to like.
And rather than a hundred percent dedicate yourself
60%.
Yeah, 60.
We all want, we all want some breadth
(07:07):
in our practices.
Um, the trick is you figuring out which
one you want to fill most of your
practice.
Um, it might also, depending on like, just,
just thinking about the house buying situation, it
might also make sense to increase your rate.
Like you're kind of at a lower rate
(07:29):
for San Francisco.
Yeah.
Yeah.
Um, and it may be like, you're like,
nobody has a problem paying it that you
might like the ease of that, that, you
know, if you're charging 250 or 300, if,
if there was some more, um, Oh, I
can't do that.
Then it might not feel as easy and
(07:50):
flowy, but yeah, it's, it's also the math
with that too.
And that's, this is an area where I
will go harder on the math.
Like if you could work at like two
thirds of the amount.
Yeah.
Um, is that right?
I'm not great with math, but I think
two thirds of the amount instead of the
whole and make the same amount of money
(08:10):
while you're working this full-time or part
-time three days a week job.
Yeah.
It might make it easier.
Yeah.
That's probably true.
Yeah.
But that doesn't answer your question about Mitch.
Yeah.
Like I'm like, I'm just not sure how
to like get rid of anything because I
like, I, I like them all.
(08:33):
Are there, is there a group that you
get referrals from?
Like maybe the teens that like, you don't
market to at all.
You just keep getting those referrals.
Yeah.
The teens, I don't market to them at
all.
Like I just occasionally, like, I think I've,
people will say that they, they got a
referral to me and like, I don't know
the person that they're talking about.
Like, so that has been interesting.
(08:55):
Yeah.
That's awesome.
Yeah.
And what's your website like right now?
Is it, it's not great.
It's like, okay.
And I think the thing that I've found
the most useful actually has been just like
the local, like listservs have been, that's like
how I found like a lot of clients
(09:16):
initially.
Yeah.
And are you sending them to your website
from the listservs?
I do.
I have in the past and I, I
used to have like a calendar release so
they could book like a consultation without talking
to me.
And I took that off just because I
had so much going on.
And like, I do, I mean, I feel
(09:36):
like I don't really have a lot of
capacity to take on new people, but interestingly
this week I've gotten like five people reaching
out.
Like, so they were all, they're all word
of mouth, right?
Like they were all just like, and like
one person coming back from the past.
So.
(09:57):
So it sounds like you have as many
clients as you want.
Kind of.
Yeah.
I wonder if like, and you're, if you're
happy with the clients in your practice, maybe
if it's, it's like a, if it ain't
broke don't fix it scenario.
Yeah.
Yeah.
Like, unless you're looking to really optimize like,
(10:17):
Oh, I've got like a large number of
clients that are in this niche that I
really want to move away from because it's
exhausting or I need to be working less
because I've got this other job and I
need to like not lose income doing that.
Yeah.
I think the thing that like, actually the
thing that like is like my underlying like
(10:38):
rub is that like, I feel like I
want to be like an expert in something,
you know?
I want it to be like, so it's
like kind of why I did this like
fellowship, which was like, awesome.
But like, we have like this ending weekend
coming in April and I'm supposed to have
this big presentation.
(11:00):
And I like, I said that I would
be doing parent coaching as like my thing.
And I haven't done that.
Cause like, I'm like, where do I have
time to add that?
Um, but whatever, I can just talk about
it.
I don't have to have done it.
Um, so yeah, I'm like, well, I don't
know.
I just don't, I can't figure out where
that thing is, you know, that like, I
(11:22):
just want to do all the time.
Like, yeah.
So it sounds like that's not it.
Or you probably would have like pushed it
some in your practice.
Not that I think that parent coaching isn't
it.
I think it's because I think I like
depth work more.
Like, and I think the directive coaching stuff
is challenging for me because I, I, I
think that I, I don't always want to
(11:43):
be giving people such specific advice.
Like, um, because I don't feel like I
always have answers for that.
Like, I don't know why you're doing that
thing, but let me tell you how you
can talk to them in a different way.
And that feels more like therapy than coaching,
I guess.
Yeah.
Yeah.
So I, I mean, it, it sounds like
(12:04):
you get a lot of word of mouth
referrals for teens.
Would you say like you're expert level there?
I feel like I am now.
Yeah.
And is that, but that's not the expert
you want to be.
It sounds like it feels like, yeah, like
I don't want to do that for the
rest of my life.
I don't think for sure.
(12:24):
Um, but I like the, I don't know.
I like the buoyancy of it.
It's sort of like, you know, like I
like seeing the ones that I have, but
I, I guess maybe what I'm thinking about
as I'm talking to you is like, maybe
I don't want to accept those referrals in
the future.
Like, yeah.
Is there any similarity between your teenagers and
(12:48):
the adults you really enjoy?
Like are the adults, those teens grown up
without intervention?
Yeah, I think so.
Yeah.
I think it's like having had like traumatic
experiences in childhood, like, um, the stuff that
I tend to work on with the teens
that I see is like, yeah, like more
(13:08):
depth oriented, like trauma related.
And yeah, like I do EMDR with one
of my teens, for example, you know, that
kind of stuff.
And that's the kind of work that you're
doing with the adults also.
Yeah.
Like I tend to like be more depth
oriented with them around, like usually on trauma,
(13:28):
difficult childhoods.
And then I see, I do have a
good proportion of parent, like adults who are
parenting young kids.
And that's kind of where I started to
see that I liked that population a lot.
Um, yeah.
I mean, so would it be so that
like your expertise is in people who've had
(13:50):
abusive, traumatic, or difficult childhoods?
I think so.
Yeah.
And that, I mean, any age, right.
And that shows up a lot for like
you're mentioning the parents of young kids.
(14:11):
It shows up a lot for parents of
young kids when they realize like wanting to
parent differently, right.
It's cycle break and it's having them reflect
on their own childhood.
They're wanting to create something for their child.
Um, yeah.
What if you just owned that?
That like, that's your niche.
(14:31):
We don't have to worry about the demographic
of it as much as like your niche
is the pain that they feel and the
problem that they're having.
Yeah.
I feel like I need to write that
down.
Yeah.
Yeah.
Yeah.
Yeah.
Yeah.
Yeah.
Yeah.
Like the, yeah.
Like the niche is like the problem rather
than the, yeah.
(14:59):
Yeah.
That makes sense.
So then if we own that or you
own that as your expertise, as your niche,
what pushback comes up inside?
(15:22):
I think it's like, you know, like I'm
not actually in this moment experiencing a lot
of internal pushback, um, which is good.
It's not normal.
Um, I mean, I just think about like,
I, I, cause I remember the moment that
like, I had this idea of like trying
(15:44):
to like talk to like the cycle breaking
parent.
Right.
Like, and so I think about that moment
a lot.
Um, and like what I was feeling and
experiencing myself.
Um, but like, I don't think that there's,
yeah, I think the only thing that I
would push that sounds like a pushback is
like probably parents of teens probably don't necessarily
(16:05):
want to have a therapist who has that
belief potentially.
Right.
Which is fine.
Um, you know, there's that, um, but then
I'm thinking about the teens.
I see they, I mean, they actually own
that their kids had difficult childhoods for various
reasons, like traumatic divorces and whatnot.
(16:27):
Um, so maybe it's not such a big
deal.
Um, yeah.
I'm thinking like, I'm imagining your website, cause
this is how my brain works.
Um, and like your homepage is talking about
like, this is who you treat.
And, um, you mentioned, um, how you work
(16:50):
with teens, how you work with adults and
how you work with new parents, um, who
are cycle breaking.
And then you would have like drop down
specialty pages for each of them that those
link to.
So you have an opportunity to go in
depth, like with the teens, for instance, you
can say, um, like the parents of the
teens, I see, um, exactly what you just
(17:12):
said, but can acknowledge that they've done their
best, but their kid went through a traumatic
divorce or, um, some really difficult educational system
issues or, um, had a friend die or,
you know, you can just list some of
the common things.
Yeah.
The parent doesn't feel immediately defensive.
(17:34):
Right.
And you're, you're giving them some credit that
they're looking for some help for their kids.
So they're definitely like wanting to wanting to
help potentially wanting to take some responsibility if
that needs to happen.
Uh, but ultimately they want what's best for
their kid.
Yeah.
Right.
And that'll help funnel out the ones you
don't want.
(17:55):
That's true.
Yeah.
That is very true.
Yeah.
Yeah.
I have a call after this with a
parent who was like, I feel like I'm
really struggling to communicate with my kid.
I feel like my stuff is getting in
the way of our communication.
And I'm like, Oh God, yes.
Let's do this call.
Like, absolutely.
Yeah.
Yeah.
So yeah.
I think, yeah.
Having that kind of humility is a lot
(18:17):
easier to work with.
So the insight there, you know, like you've
got clients coming in with pretty good insight.
They don't have to change what's going on,
but they, they understand that it's a them
issue, not a kid issue.
Right.
Right.
Yeah.
That's the other thing.
Like when I first started that, um, when
(18:40):
I first started as a therapist, like, like
there's this like whole thing of like, I
work with high achieving perfectionists.
Right.
Like, I feel like that's like such a,
I don't know.
Like when I first started noticing me, Mitch
is like, that was like the one that
I saw all the time.
And I have plenty of friends who go
that route.
Um, and so I, I didn't really like
that language, but like, I do seem to
(19:00):
find that like, I have a lot of,
I have a lot of clients who are
very like highly intellectual and like, they really
like to process things and like, they have,
you know, insight and stuff.
And I've never found a way to like,
find the right word to mark to that
without using the language that I didn't like
before.
Cause I'm like, Oh, you're really smart.
Right.
Right.
Are they overthinkers kind of yeah.
(19:25):
Overanalyzing, you know, I didn't part of the
geographic area tends to skew that way.
It's like people that work in tech and
have like high level jobs and stuff like
that.
So yeah.
Yeah.
Yeah.
I mean, I think you can say like,
you know, that all of this is complex
and you really want to figure it out.
(19:47):
Yeah.
You can think it to death, but it's
not fixing anything.
Yeah.
Or even for the people who like, you
can understand the dynamics really well, theoretically, but
bringing that into your life has been hard.
(20:13):
Yeah.
Yeah.
Yeah.
Yeah.
So it sounds like, okay, we've got your
niche.
We've got some clarity on how to communicate
it.
(20:36):
You're buying a house.
I mean, God freaking willing.
You're buying a house.
You've got this job that you can leave
at work, which is great.
Yeah.
Um, and you have as many clients as
(20:57):
you want with more calling.
You're in a great position.
I hope I think so, but yeah, it
feels tenuous all the time.
It feels overwhelming.
I think.
Okay.
Yeah.
Yeah.
Yeah.
I can see why.
I mean, it's a lot of work.
How many clients are you seeing in those
two days?
(21:18):
Um, I haven't started.
I mean, that job starts in the last
week of March.
And so like, I'm in kind of like
this period of between job jobs.
Um, so I have probably like 12 ish
to 14 people that I could see weekly.
Um, and so I'm not sure exactly.
(21:41):
I, yeah, how I'm going to work that.
Um, I'm going to do math real quick.
So you said 12 to 14.
So I'm going to go for 13.
(22:11):
That might be more than.
So to make the same amount of money
that you're making per week, um, at 200
obsession.
And I know you said somewhere lower than
that, but we're just going to go with
200 for math sake right now.
If you were to charge 300, you would
only need to see nine people.
(22:33):
Oh, so just from a math perspective, just
something to think about.
Um, because I don't know if those are
eight hour days at Kaiser, even though it's
not an ongoing caseload and even though you
leave it at work, it's heavy.
Yeah.
Yeah.
(22:54):
Yeah.
I don't, yeah.
I don't know anybody that's hurting 300.
I do know a lot of people that
are in like the two 25 to 50
range, but, but yeah, some folks at 300,
I know a lot of folks actually at
300.
That's what I think of is like, because
of the people I know, like that's the
same, but yeah, I mean, if two 50
feels better, I can do that math.
(23:16):
Um, it's 10.4
clients.
I always round up.
So like 11 clients.
So that'd be two fewer.
Huh?
So that like, that would be like a
gross annual of like, what did you say?
(23:37):
Like, Oh, that I just did it by
week, but how many weeks do you take
off in a year?
Uh, maybe three, three to four.
I'm having a hard time with backwards math
on the one side.
We'll do four.
Cause that one's easier.
52, 48.
(23:57):
So that would be one 24, 124,800.
Um, making the same amount.
Like if you were, if you're, if you
had 13 people at $200 per session, like
you do now-ish, um, two 50 with
11 clients.
Yeah.
Yeah.
Yeah.
Yeah.
My husband is always trying to get me
(24:18):
to raise my fee.
I'm like, why don't you ask your boss
for a raise?
Yeah.
And there are a million ways to raise
your fee.
You could raise it just for new people.
You could raise it like over time for
current clients.
Like there are a number of ways to
do it in the under special circumstances in
the, um, what to say when course there
are some different ways outlined.
(24:40):
Um, so there's, yeah, there's a way I
promise something to consider just from a workload
perspective.
I don't want you to get burned out.
Um, and I want you to have as
much time with your family as you want.
So, yeah, I never, it's so funny.
Like I never expected to be in this
position like that.
I think that's like the grief that I
(25:01):
probably have to work on when my therapy
is like, I always like, I, it's interesting.
Like I went into grad school knowing that
I wanted to do private practice and like,
I didn't feel like I had the same
like money stuff that a lot of people
have.
Like, I never had that feeling of like,
I'm not doing this to make money.
Like I knew how much I paid my
therapist and I was like, Oh, well that's
(25:23):
how much I can make too.
Um, and so I never had the feeling
that I was obligated to like work in
community mental health or anything like that.
Um, and yet now here I am in
this weird place with money.
Yeah.
Yeah.
I just got here a different way.
Yeah.
Yeah.
And I think if, um, how many people
(25:43):
a day, like let's say if you're going
to see like 13 people over two days,
then you're looking at six or seven.
Yeah.
The other thing that I do, which is
going to sound like I'm again, a burnout
case, um, is I see people every other
Saturday.
Um, so, um, so I probably wouldn't do
(26:05):
like six to seven straight on Monday and
Tuesday.
I would see a couple of those people
on Saturday.
Um, yeah.
Okay.
It sounds like, yeah, it sounds, I hear
myself.
I hear myself.
That's all that matters.
And I think like, if you sat down
with the math of $250 per session with,
(26:28):
I don't know what kind of caseload you
would want, if that was all you were
doing, how many clients would you want to
see?
Yeah.
Um, I'm not sure.
I mean, like on a day, like I
feel like four is like a really nice
number.
Yeah.
Five, five feels like a busy day and
(26:49):
six is like too many usually.
So, yeah.
So I think it's, it's doing the math
to see like, what would, what would it
look like financially?
Does it, would it make sense?
Um, once you, you know, once you bought
the house, um, I don't know how long
(27:10):
you want to stay in this job.
If it's more like getting the proof of
a W-2 and moving on or what,
but doing the math to see if you,
if you went at this full throttle, yeah.
Like what could you make?
What could you let go?
Like Saturdays?
Could you let go of Saturdays and just
trust that the clients who can see you
(27:32):
will see you?
Yeah.
Yeah.
You raise a lot of good points.
Yeah.
It's just a lot.
And I'm, yeah, I want you in this
career.
As long as you want to be in
this I don't want you burned out and
leaving.
I know.
Yeah.
That was a big part of why I
(27:53):
went down this path.
I was like, oddly I was in like,
I owned a fitness business with my brother
and I was like, I don't know where
I can do this forever.
Like I can't do like heavy lifting as
a career when I'm in my fifties.
I guess I could, but I didn't see
it.
And so I was like, Oh, I can
sit on a couch until I'm 75.
If I want to.
There we go.
(28:14):
And then you're in it and you're like,
it's a little different than just sitting on
a couch.
Yeah.
Yeah.
Yeah.
Different kind of heaviness, right?
Yeah.
Not weights, just emotions.
Yeah.
Yeah.
All right.
Well, keep me updated.
I want to hear about it in the
party and yeah.
Yeah.
Yeah.
I was so excited to get this time
and I appreciate it a lot.
(28:36):
Nice meeting you.
Okay.
All right.
Take care.
Bye.
(Transcribed by TurboScribe.ai - Go Unlimited to remove this message) Hey Catherine!
Good morning.
How are you doing?
I'm good.
I've never met like an Instagram person, so
I'm like...
I promise I'm real.
Yeah, yeah, yeah.
I suspected as such.
Well, what would be, what would be helpful
today?
Well, I was definitely obviously thinking about it
(00:23):
and like, I guess just, I do have
a question, um, that I think I, I
don't know, maybe it's helpful to give some
background first, like context.
Yeah.
Yeah.
Um, so I'm in San Francisco and so
I've been, I got licensed in 2020, so
weird time, had my baby in 2021.
(00:44):
And so I kind of really didn't like
card launch until 2022.
Um, and like the private pay thing is
not such an issue here.
It feels like, like culturally people are used
to paying out of pocket and not that
many therapists actually accept insurance.
And so I haven't found that to be
like too much of a struggle, like to
find clients to pay full fee.
(01:07):
Um, and so like I had my fees
200 and it's fine.
Like most people are paying that.
I just have a few people that are
not.
My dilemma is twofold.
One is that like buying a house here
is so complex.
And so like the mortgage people are like,
you need to have a W-2 job.
And so like I've had a part-time
job and I'm starting a new one, which
I have like I kind of have some
(01:29):
shame about that.
Like, just because I'm like, oh, like I
owned a business before being a therapist.
And like, you know, I like, I feel
like confident about the idea of being a
small business owner, but, um, but that is
like a huge pull, right?
Like a three bedroom house here is like
a million dollar house, you know?
So it's crazy.
Um, and so I'm starting a new part
(01:50):
-time job that's three days a week.
And it's like only it's like with Kaiser,
which is big healthcare provider here and whatever.
And it's like a hundred thousand dollar job
for three days a week.
So I'm like, okay, well that seems like
somewhat worth my time.
And so I'm doing that.
And then my plan is to do private
practice two days a week.
(02:11):
And, you know, I don't love it, but
I feel like it's like a plan to
like get us the house that we need.
Um, so there's that.
And the other part of it is, is
that like in private practice, like I'm one
of those people that just seems to like
have endless interest.
And so like, I have a very hard
(02:31):
time saying like I only work with one
particular population.
And so I have had trouble finding like
the right kind of questions to like ask
myself, I guess, like, cause I've done all
of the niching down stuff that you have
and everybody else.
And I never feel like I get to
like a place where I can figure that
out.
(02:52):
Um, like the, the place that I came
to, like, after I had had my baby
and stuff was like around working with like
cycle breaking parents, right?
Like parents who are healing their trauma from
like their own childhood and having little kids.
And, um, so I did this fellowship last
year for infant paramental health, which was like
a lot of money.
Um, but then I'm also doing EMDR. Now
(03:14):
I'm getting interested in CAP therapy and I've
kind of always had this, um, space in
my practice for teens.
Like I did like a, one of my
like training jobs was at a teen agency
and it just, it just seems very hard
to like not continue serving that group.
And families seem very willing to pay for
(03:35):
therapy for their teens.
And so it's been like an easy referral
source and I genuinely like them.
So I'm like, it just seems like impossible
to do so many things, you know?
Well, it's okay.
I want to, first there's a lot I
want to, I want to talk about, cause
there's, I mean, you just brought up such
good juicy stuff.
Okay.
The first thing about the banks wanting you
(03:55):
to have a W2 job, is that because
you need two solid years at the income
you want in like in private practice, you
could do it if you're at the income
you wanted for two years.
Yeah.
Uh-huh.
Yeah.
But they're like, I know what it's like
to have like, I want to buy a
house now.
Yeah.
Yeah.
Yeah.
Um, so one thing I would want to
(04:17):
put out there is that if you were
to work three days a week in your
private practice for two years, the amount of
home that you could buy is much higher
than you could put this a hundred thousand
dollar job.
Yes.
Yeah.
So I'm going to just say that I
understand, like I said, I understand being ready
to move into your own home.
(04:37):
Um, and I know that that sometimes it
gets an emotional decision and there's no reason
to argue with it unless there's a reason
to argue with it, you know?
So putting it out there that like from
a math perspective, which is not emotional, it
would make more sense to fill your practice
and wait two years.
Okay.
Yeah.
(04:57):
I see what you're saying.
Yeah.
Yeah.
I'm kind of, it's an, it's an interesting
juncture because like I am hitting the two
-year mark.
Right.
And like, um, like obviously it's tax season
right now.
And so there's that.
And then my husband is in like a
career shift space too.
He's in an industry that's like dying.
(05:18):
He like kind of like he does telescope
product development, which sounds cool, but like, you
know, like Chinese factories are like basically taking
that over, which makes sense.
So yeah.
So like I, yeah, this is the part
where the shame comes in.
It's like, I know what you're saying.
And it's like, it's so hard to like
make these choices.
Yeah.
Yeah.
And I definitely don't say it to shame
(05:40):
you because no, I know.
Yeah.
There are emotional reasons to buy a home.
Like we shouldn't always just go off math.
First of all, we wouldn't be therapists if
that's how we did things.
That's a hundred percent true.
Yeah.
So, um, I'm just, I've been thinking about
it from the perspective of like, that's a
lot of clinical work.
Yeah.
Yes.
That's so that's the, the, the, the rub
(06:02):
I got in with the job I took
last year.
The only thing different about this job is
it's not like a clinic, it's not a
CAFO job.
It's just like doing triage.
Um, so it's like, um, cause I know
the person who's like the director at that
hospital.
So I kind of like really careful about
like, even going through the interview process.
And so I talked to her kind of
like off the record about, about it.
(06:24):
And she's like, no, it's not, there's no
caseload.
Cause Kaiser is known for having crazy caseloads
for their clinicians.
And I'm like, I don't want to get
into that, but, um, so that's the only
thing is like the job ends at the
end of the day and it's just like,
do you take phone calls?
And I'm like, okay, I think I can
do that and do my practice.
Like that was the intention of this, this
job is that like, then I would have
(06:45):
the energy for my private practice and hopefully
like figure out on the side, like exactly
what it is that I want to like
a hundred percent dedicate myself to clinically.
Cause like I have so many things, it's
like, it seems hard to like.
And rather than a hundred percent dedicate yourself
60%.
Yeah, 60.
We all want, we all want some breadth
(07:07):
in our practices.
Um, the trick is you figuring out which
one you want to fill most of your
practice.
Um, it might also, depending on like, just,
just thinking about the house buying situation, it
might also make sense to increase your rate.
Like you're kind of at a lower rate
(07:29):
for San Francisco.
Yeah.
Yeah.
Um, and it may be like, you're like,
nobody has a problem paying it that you
might like the ease of that, that, you
know, if you're charging 250 or 300, if,
if there was some more, um, Oh, I
can't do that.
Then it might not feel as easy and
(07:50):
flowy, but yeah, it's, it's also the math
with that too.
And that's, this is an area where I
will go harder on the math.
Like if you could work at like two
thirds of the amount.
Yeah.
Um, is that right?
I'm not great with math, but I think
two thirds of the amount instead of the
whole and make the same amount of money
(08:10):
while you're working this full-time or part
-time three days a week job.
Yeah.
It might make it easier.
Yeah.
That's probably true.
Yeah.
But that doesn't answer your question about Mitch.
Yeah.
Like I'm like, I'm just not sure how
to like get rid of anything because I
like, I, I like them all.
(08:33):
Are there, is there a group that you
get referrals from?
Like maybe the teens that like, you don't
market to at all.
You just keep getting those referrals.
Yeah.
The teens, I don't market to them at
all.
Like I just occasionally, like, I think I've,
people will say that they, they got a
referral to me and like, I don't know
the person that they're talking about.
Like, so that has been interesting.
(08:55):
Yeah.
That's awesome.
Yeah.
And what's your website like right now?
Is it, it's not great.
It's like, okay.
And I think the thing that I've found
the most useful actually has been just like
the local, like listservs have been, that's like
how I found like a lot of clients
(09:16):
initially.
Yeah.
And are you sending them to your website
from the listservs?
I do.
I have in the past and I, I
used to have like a calendar release so
they could book like a consultation without talking
to me.
And I took that off just because I
had so much going on.
And like, I do, I mean, I feel
(09:36):
like I don't really have a lot of
capacity to take on new people, but interestingly
this week I've gotten like five people reaching
out.
Like, so they were all, they're all word
of mouth, right?
Like they were all just like, and like
one person coming back from the past.
So.
(09:57):
So it sounds like you have as many
clients as you want.
Kind of.
Yeah.
I wonder if like, and you're, if you're
happy with the clients in your practice, maybe
if it's, it's like a, if it ain't
broke don't fix it scenario.
Yeah.
Yeah.
Like, unless you're looking to really optimize like,
(10:17):
Oh, I've got like a large number of
clients that are in this niche that I
really want to move away from because it's
exhausting or I need to be working less
because I've got this other job and I
need to like not lose income doing that.
Yeah.
I think the thing that like, actually the
thing that like is like my underlying like
(10:38):
rub is that like, I feel like I
want to be like an expert in something,
you know?
I want it to be like, so it's
like kind of why I did this like
fellowship, which was like, awesome.
But like, we have like this ending weekend
coming in April and I'm supposed to have
this big presentation.
(11:00):
And I like, I said that I would
be doing parent coaching as like my thing.
And I haven't done that.
Cause like, I'm like, where do I have
time to add that?
Um, but whatever, I can just talk about
it.
I don't have to have done it.
Um, so yeah, I'm like, well, I don't
know.
I just don't, I can't figure out where
that thing is, you know, that like, I
(11:22):
just want to do all the time.
Like, yeah.
So it sounds like that's not it.
Or you probably would have like pushed it
some in your practice.
Not that I think that parent coaching isn't
it.
I think it's because I think I like
depth work more.
Like, and I think the directive coaching stuff
is challenging for me because I, I, I
think that I, I don't always want to
(11:43):
be giving people such specific advice.
Like, um, because I don't feel like I
always have answers for that.
Like, I don't know why you're doing that
thing, but let me tell you how you
can talk to them in a different way.
And that feels more like therapy than coaching,
I guess.
Yeah.
Yeah.
So I, I mean, it, it sounds like
(12:04):
you get a lot of word of mouth
referrals for teens.
Would you say like you're expert level there?
I feel like I am now.
Yeah.
And is that, but that's not the expert
you want to be.
It sounds like it feels like, yeah, like
I don't want to do that for the
rest of my life.
I don't think for sure.
(12:24):
Um, but I like the, I don't know.
I like the buoyancy of it.
It's sort of like, you know, like I
like seeing the ones that I have, but
I, I guess maybe what I'm thinking about
as I'm talking to you is like, maybe
I don't want to accept those referrals in
the future.
Like, yeah.
Is there any similarity between your teenagers and
(12:48):
the adults you really enjoy?
Like are the adults, those teens grown up
without intervention?
Yeah, I think so.
Yeah.
I think it's like having had like traumatic
experiences in childhood, like, um, the stuff that
I tend to work on with the teens
that I see is like, yeah, like more
(13:08):
depth oriented, like trauma related.
And yeah, like I do EMDR with one
of my teens, for example, you know, that
kind of stuff.
And that's the kind of work that you're
doing with the adults also.
Yeah.
Like I tend to like be more depth
oriented with them around, like usually on trauma,
(13:28):
difficult childhoods.
And then I see, I do have a
good proportion of parent, like adults who are
parenting young kids.
And that's kind of where I started to
see that I liked that population a lot.
Um, yeah.
I mean, so would it be so that
like your expertise is in people who've had
(13:50):
abusive, traumatic, or difficult childhoods?
I think so.
Yeah.
And that, I mean, any age, right.
And that shows up a lot for like
you're mentioning the parents of young kids.
(14:11):
It shows up a lot for parents of
young kids when they realize like wanting to
parent differently, right.
It's cycle break and it's having them reflect
on their own childhood.
They're wanting to create something for their child.
Um, yeah.
What if you just owned that?
That like, that's your niche.
(14:31):
We don't have to worry about the demographic
of it as much as like your niche
is the pain that they feel and the
problem that they're having.
Yeah.
I feel like I need to write that
down.
Yeah.
Yeah.
Yeah.
Yeah.
Yeah.
Yeah.
Yeah.
Like the, yeah.
Like the niche is like the problem rather
than the, yeah.
(14:59):
Yeah.
That makes sense.
So then if we own that or you
own that as your expertise, as your niche,
what pushback comes up inside?
(15:22):
I think it's like, you know, like I'm
not actually in this moment experiencing a lot
of internal pushback, um, which is good.
It's not normal.
Um, I mean, I just think about like,
I, I, cause I remember the moment that
like, I had this idea of like trying
(15:44):
to like talk to like the cycle breaking
parent.
Right.
Like, and so I think about that moment
a lot.
Um, and like what I was feeling and
experiencing myself.
Um, but like, I don't think that there's,
yeah, I think the only thing that I
would push that sounds like a pushback is
like probably parents of teens probably don't necessarily
(16:05):
want to have a therapist who has that
belief potentially.
Right.
Which is fine.
Um, you know, there's that, um, but then
I'm thinking about the teens.
I see they, I mean, they actually own
that their kids had difficult childhoods for various
reasons, like traumatic divorces and whatnot.
(16:27):
Um, so maybe it's not such a big
deal.
Um, yeah.
I'm thinking like, I'm imagining your website, cause
this is how my brain works.
Um, and like your homepage is talking about
like, this is who you treat.
And, um, you mentioned, um, how you work
(16:50):
with teens, how you work with adults and
how you work with new parents, um, who
are cycle breaking.
And then you would have like drop down
specialty pages for each of them that those
link to.
So you have an opportunity to go in
depth, like with the teens, for instance, you
can say, um, like the parents of the
teens, I see, um, exactly what you just
(17:12):
said, but can acknowledge that they've done their
best, but their kid went through a traumatic
divorce or, um, some really difficult educational system
issues or, um, had a friend die or,
you know, you can just list some of
the common things.
Yeah.
The parent doesn't feel immediately defensive.
(17:34):
Right.
And you're, you're giving them some credit that
they're looking for some help for their kids.
So they're definitely like wanting to wanting to
help potentially wanting to take some responsibility if
that needs to happen.
Uh, but ultimately they want what's best for
their kid.
Yeah.
Right.
And that'll help funnel out the ones you
don't want.
(17:55):
That's true.
Yeah.
That is very true.
Yeah.
Yeah.
I have a call after this with a
parent who was like, I feel like I'm
really struggling to communicate with my kid.
I feel like my stuff is getting in
the way of our communication.
And I'm like, Oh God, yes.
Let's do this call.
Like, absolutely.
Yeah.
Yeah.
So yeah.
I think, yeah.
Having that kind of humility is a lot
(18:17):
easier to work with.
So the insight there, you know, like you've
got clients coming in with pretty good insight.
They don't have to change what's going on,
but they, they understand that it's a them
issue, not a kid issue.
Right.
Right.
Yeah.
That's the other thing.
Like when I first started that, um, when
(18:40):
I first started as a therapist, like, like
there's this like whole thing of like, I
work with high achieving perfectionists.
Right.
Like, I feel like that's like such a,
I don't know.
Like when I first started noticing me, Mitch
is like, that was like the one that
I saw all the time.
And I have plenty of friends who go
that route.
Um, and so I, I didn't really like
that language, but like, I do seem to
(19:00):
find that like, I have a lot of,
I have a lot of clients who are
very like highly intellectual and like, they really
like to process things and like, they have,
you know, insight and stuff.
And I've never found a way to like,
find the right word to mark to that
without using the language that I didn't like
before.
Cause I'm like, Oh, you're really smart.
Right.
Right.
Are they overthinkers kind of yeah.
(19:25):
Overanalyzing, you know, I didn't part of the
geographic area tends to skew that way.
It's like people that work in tech and
have like high level jobs and stuff like
that.
So yeah.
Yeah.
Yeah.
I mean, I think you can say like,
you know, that all of this is complex
and you really want to figure it out.
(19:47):
Yeah.
You can think it to death, but it's
not fixing anything.
Yeah.
Or even for the people who like, you
can understand the dynamics really well, theoretically, but
bringing that into your life has been hard.
(20:13):
Yeah.
Yeah.
Yeah.
Yeah.
So it sounds like, okay, we've got your
niche.
We've got some clarity on how to communicate
it.
(20:36):
You're buying a house.
I mean, God freaking willing.
You're buying a house.
You've got this job that you can leave
at work, which is great.
Yeah.
Um, and you have as many clients as
(20:57):
you want with more calling.
You're in a great position.
I hope I think so, but yeah, it
feels tenuous all the time.
It feels overwhelming.
I think.
Okay.
Yeah.
Yeah.
Yeah.
I can see why.
I mean, it's a lot of work.
How many clients are you seeing in those
two days?
(21:18):
Um, I haven't started.
I mean, that job starts in the last
week of March.
And so like, I'm in kind of like
this period of between job jobs.
Um, so I have probably like 12 ish
to 14 people that I could see weekly.
Um, and so I'm not sure exactly.
(21:41):
I, yeah, how I'm going to work that.
Um, I'm going to do math real quick.
So you said 12 to 14.
So I'm going to go for 13.
(22:11):
That might be more than.
So to make the same amount of money
that you're making per week, um, at 200
obsession.
And I know you said somewhere lower than
that, but we're just going to go with
200 for math sake right now.
If you were to charge 300, you would
only need to see nine people.
(22:33):
Oh, so just from a math perspective, just
something to think about.
Um, because I don't know if those are
eight hour days at Kaiser, even though it's
not an ongoing caseload and even though you
leave it at work, it's heavy.
Yeah.
Yeah.
(22:54):
Yeah.
I don't, yeah.
I don't know anybody that's hurting 300.
I do know a lot of people that
are in like the two 25 to 50
range, but, but yeah, some folks at 300,
I know a lot of folks actually at
300.
That's what I think of is like, because
of the people I know, like that's the
same, but yeah, I mean, if two 50
feels better, I can do that math.
(23:16):
Um, it's 10.4
clients.
I always round up.
So like 11 clients.
So that'd be two fewer.
Huh?
So that like, that would be like a
gross annual of like, what did you say?
(23:37):
Like, Oh, that I just did it by
week, but how many weeks do you take
off in a year?
Uh, maybe three, three to four.
I'm having a hard time with backwards math
on the one side.
We'll do four.
Cause that one's easier.
52, 48.
(23:57):
So that would be one 24, 124,800.
Um, making the same amount.
Like if you were, if you're, if you
had 13 people at $200 per session, like
you do now-ish, um, two 50 with
11 clients.
Yeah.
Yeah.
Yeah.
Yeah.
My husband is always trying to get me
(24:18):
to raise my fee.
I'm like, why don't you ask your boss
for a raise?
Yeah.
And there are a million ways to raise
your fee.
You could raise it just for new people.
You could raise it like over time for
current clients.
Like there are a number of ways to
do it in the under special circumstances in
the, um, what to say when course there
are some different ways outlined.
(24:40):
Um, so there's, yeah, there's a way I
promise something to consider just from a workload
perspective.
I don't want you to get burned out.
Um, and I want you to have as
much time with your family as you want.
So, yeah, I never, it's so funny.
Like I never expected to be in this
position like that.
I think that's like the grief that I
(25:01):
probably have to work on when my therapy
is like, I always like, I, it's interesting.
Like I went into grad school knowing that
I wanted to do private practice and like,
I didn't feel like I had the same
like money stuff that a lot of people
have.
Like, I never had that feeling of like,
I'm not doing this to make money.
Like I knew how much I paid my
therapist and I was like, Oh, well that's
(25:23):
how much I can make too.
Um, and so I never had the feeling
that I was obligated to like work in
community mental health or anything like that.
Um, and yet now here I am in
this weird place with money.
Yeah.
Yeah.
I just got here a different way.
Yeah.
Yeah.
And I think if, um, how many people
(25:43):
a day, like let's say if you're going
to see like 13 people over two days,
then you're looking at six or seven.
Yeah.
The other thing that I do, which is
going to sound like I'm again, a burnout
case, um, is I see people every other
Saturday.
Um, so, um, so I probably wouldn't do
(26:05):
like six to seven straight on Monday and
Tuesday.
I would see a couple of those people
on Saturday.
Um, yeah.
Okay.
It sounds like, yeah, it sounds, I hear
myself.
I hear myself.
That's all that matters.
And I think like, if you sat down
with the math of $250 per session with,
(26:28):
I don't know what kind of caseload you
would want, if that was all you were
doing, how many clients would you want to
see?
Yeah.
Um, I'm not sure.
I mean, like on a day, like I
feel like four is like a really nice
number.
Yeah.
Five, five feels like a busy day and
(26:49):
six is like too many usually.
So, yeah.
So I think it's, it's doing the math
to see like, what would, what would it
look like financially?
Does it, would it make sense?
Um, once you, you know, once you bought
the house, um, I don't know how long
(27:10):
you want to stay in this job.
If it's more like getting the proof of
a W-2 and moving on or what,
but doing the math to see if you,
if you went at this full throttle, yeah.
Like what could you make?
What could you let go?
Like Saturdays?
Could you let go of Saturdays and just
trust that the clients who can see you
(27:32):
will see you?
Yeah.
Yeah.
You raise a lot of good points.
Yeah.
It's just a lot.
And I'm, yeah, I want you in this
career.
As long as you want to be in
this I don't want you burned out and
leaving.
I know.
Yeah.
That was a big part of why I
(27:53):
went down this path.
I was like, oddly I was in like,
I owned a fitness business with my brother
and I was like, I don't know where
I can do this forever.
Like I can't do like heavy lifting as
a career when I'm in my fifties.
I guess I could, but I didn't see
it.
And so I was like, Oh, I can
sit on a couch until I'm 75.
If I want to.
There we go.
(28:14):
And then you're in it and you're like,
it's a little different than just sitting on
a couch.
Yeah.
Yeah.
Yeah.
Different kind of heaviness, right?
Yeah.
Not weights, just emotions.
Yeah.
Yeah.
All right.
Well, keep me updated.
I want to hear about it in the
party and yeah.
Yeah.
Yeah.
I was so excited to get this time
and I appreciate it a lot.
(28:36):
Nice meeting you.
Okay.
All right.
Take care.
Bye.
Popular Podcasts
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations.
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
The Nikki Glaser Podcast
Every week comedian and infamous roaster Nikki Glaser provides a fun, fast-paced, and brutally honest look into current pop-culture and her own personal life.