April 21, 2025 • 27 mins
My live Ask Allison recording sessions are a great way to get free, conversational support. Today’s podcast episode—sponsored by our friends at TherapyNotes®—features a clip from one of those sessions, recorded back in March. In it, we cover topics like launching a private practice while still contracting with a group, how to start out on a tight budget, raising your rates, and managing imposter syndrome.
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Episode Transcript
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(00:10):
(Transcribed by TurboScribe.ai. Go Unlimited to remove this message.) Hey, our Live Ask Allison's are an opportunity
for you to get free live conversational support
from me.
You're hearing an excerpt from one we did
recently.
I'll give you details on how you can
join our next Live Ask Allison at the
end of the episode.
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(00:31):
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(00:52):
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Well hi y'all.
Today is just like full open Q&A,
whatever you need.
Like we can go all over the map
from mindset to scaling to how to get
(01:57):
your first client to whatever.
So who would like to start us off?
I can.
Okay, great.
We'll go you and then we'll go Holly.
Okay.
So I was just listening to the podcast
you recently did about whether to take insurance
or not or just keep taking insurance.
(02:18):
But it felt a little motivational interviewing, like
a little bit.
You know what I mean?
Like it's okay, keep taking insurance.
And you had mentioned something about the confidence
to market yourself and how it's important for
therapists to be able to work through that
if that's a little bit of a stumbling
block or holding us back.
(02:39):
And I was wondering some advice about that.
Yeah.
So this fear of being seen, it's a
pretty big deal.
And when we're starting our practices, we often
feel like the imposter syndrome is really strong.
And so then it makes it really hard
to feel like, great, let me put myself
out there when I've got both these things
going on.
I'm not sure I even know how to
(03:00):
do therapy or have ever helped anybody anyway.
We can get really insecure when we're starting
our practice or when it's plateaued and we
need to build.
And so part of it is acknowledging the
imposter syndrome for what it is, which in
my mind is like, it's you doing something
new, period.
(03:20):
Every time I do something new, I get
imposter syndrome every single time.
At this point, because I like doing lots
of new things, I'm like, oh, here it
is.
It's just because I'm doing something new instead
of letting it take me down with it.
The fear of being seen is sometimes rooted
in that.
And sometimes it's rooted in like, what if
what I say I think is right, but
it's not right.
And everybody tells me how wrong it is.
(03:41):
And I am.
And that's less imposter syndrome and more like,
what if I'm actually wrong, which is scary
and hard.
And that could be anything.
That can be the way you do therapy,
but it could also be like the way
you look.
What if I do videos and everybody tells
me you look stupid in some way, you
(04:02):
know, and all of our insecurities are going
to come up.
They're just going to, um, when we're doing
this hard thing.
So part of the thing that makes putting
ourselves out there feel worth it is when
it works and we get clients.
But if we keep holding ourselves back and
we don't just do the damn thing, then
we don't get the opportunity to have that
(04:22):
positive reinforcement for it.
So long story short, the advice is do
the thing that feels least scary consistently.
So like, if that's networking, it's like find
the least scary people to network with like
old coworkers that you've got along with.
You don't need to go to like the
scary psychiatrist or the scary PCP go to
(04:44):
the people that feel like, oh, I can
have an easy conversation with these people.
And that's most therapists really.
Not everybody's going to be a great fit,
but I would say too, there's clarity gets
in the way of marketing.
So if you don't have an extremely clear
niche, then it's really hard to create content.
(05:05):
So of those things, like which one are
you struggling with the most or something else?
Yeah.
Um, I think, you know, the niche is
one, and also I know it sounds weird,
but also like believing that it will work.
You know, there's this sense of like, what
if I try all these things and I
fail and I don't get any good results
(05:28):
from doing all these scary things.
Yeah, that's fair.
Here's the thing though.
People don't usually fail private practice if they
keep trying.
Right now it's taking people a longer time
to get full than it has in a
really long time right now feels like, I
don't know if anybody was in practice.
Adam, I think you might've been in practice
in 2020.
(05:48):
But right now, these last few months have
felt like April and May of 2020, when
there was this collective breath holding and clients
weren't reaching out and therapists were freaking out
and then the damn broke.
I don't know why everybody just broke at
the same time.
I think we all just need to exhale.
It's not like anything really changed in June,
(06:10):
but that was probably the busiest summer.
Many people have had in private practice.
And I think for a variety of reasons
that I can speculate on, there are a
lot of reasons people are holding their breath
and not spending any money right now.
On therapy, I think there are some people
who are also just kind of afraid of
being cracked open when they feel vulnerable and
scared.
And I think that there will be a
(06:32):
similar exhale.
It might not be quite the intense one
that we had in 2020, but what I'm
seeing is some people getting like they're working,
they're doing the right things.
And because it's not happening as quickly as
it has for their friends who started practices
two years ago, they're like, maybe this isn't
for me and I should just stay in
my job.
And that's the last thing I would rather
(06:53):
you work slow and steady.
You don't have to go super hard, but
like slow and steady to get where you
want to go.
Because if you keep doing like whatever marketing
strategies you're doing and you're doing them the
right ways, you will get full.
It'll happen.
Thank you so much.
Yeah, absolutely.
Thanks for starting us off.
I see Holly, you were next.
(07:15):
I'm realizing that my ideal client has shifted
from when I first developed my ideal client.
So my niche is anxious, overwhelmed millennials who
struggle with their self-worth.
Um, I think even more niched down is
(07:40):
that that comes from their religious upbringing, not
necessarily trauma in like a big way from,
you know, like a cult or something, but
just purity culture and women's roles in society
and things like that.
So that one more layer of specificity.
(08:00):
Um, and so I'm wondering how I should
incorporate that into my marketing.
I feel like I don't want to redo
my entire website because I just did my
entire website.
Well, I moved it from Wix to Squarespace
and did some revamping of it, but I
(08:22):
don't know, should I add it as an
extra specialty?
Like right now I have anxiety, self-worth
and EMDR specialty pages.
Like, should I add a religious or spiritual
trauma?
The problem with that is that, um, my
ideal client doesn't label it as trauma.
(08:45):
So I don't want to use that word.
Another thing I've been playing with is like
religious or spiritual deconstruction, possibly, or since my
ideal client does have this like religious upbringing
component, should I redo how I present my
marketing on my website and obviously other everywhere
(09:08):
else too?
Well, everything else is the same about your
niche, right?
This is just a layer underneath.
So I think you can keep the vast
majority of your website up because what they're
looking for is the same, like it's the
self-worth stuff.
They're not necessarily, if they're not identifying it
as trauma, they're not yet making that connection
probably of like, I need to divest from
(09:31):
some things that I was taught in order
to be able to feel like wholly human.
And so I think in that case, you
could do a specialty page and maybe it
also depends on your ideal client.
Are they still wanting to be of the
faith they were raised in, just like a
different denomination or flavor or what have you?
Or are they like, I want nothing to
(09:52):
do with religion.
I'm like, where are they with that?
They want to figure out how to continue
incorporating faith into their life, but figuring out
what they want to bring forward and what
they need to leave behind.
Got it.
Okay.
So then the deconstruction and the word divesting
(10:13):
probably aren't the ones to use either.
Okay.
What you could do is on your homepage,
you could either do one paragraph or you
could do like a couple sentences on a
couple of paragraphs that already exists on your
website that say something like many of my
clients realized that some of the messages they
were given in their religious upbringing no longer
fit.
They're still people of faith or they're exploring
(10:36):
their faith, but they find that some of
their self-worth is rooted in this idea
that they were supposed to play these specific
roles, which don't feel aligned for them.
Okay.
Yeah.
So just adding that layer of specificity to,
I think, probably my homepage, but as well
as my anxiety and self-worth pages.
(11:00):
I'm just finishing up a blog about EMDR
where I do weave in the religious upbringing
stuff into how I'm explaining it.
So probably adding that to my EMDR page
as well.
And then not necessarily, I guess, maybe I
need to decide for myself if I want
to like separate it out as its own
(11:22):
specialty or just keep it as part of
the history and cultural context of my ideal
client.
Do you think it, or how would, how
would I decide if I want to have
add another specialty?
I think it's like, is your ideal client
(11:44):
looking for that?
Is that what they would search up?
Is that something they've already identified is causing
some of their turmoil?
Or is that something they come to and
exploring things more deeply with you?
My ideal client already knows that that's part
of the problem.
Then I would definitely have a specialty page
(12:05):
about it.
Okay.
Yeah.
Yeah.
And I think like that distinction, I like
your confidence and saying like, you're really clear.
Cause what we often do is hedge and
we're like, well, my ideal client knows, but
there are all these people who don't know.
So I'm not, I don't know if I
should, right.
If your ideal client has a clear perspective,
I want you to mark it to that
clear perspective.
So awesome.
(12:27):
Yeah.
So I would do a specialty page and
I would link to it when you mentioned
these folks in your homepage so that you've
got those links throughout your website that go
from, go from page to page, each other,
you know, make it a little spider web
makes Google happy.
Okay.
I have not done that.
So I will do that.
Yeah.
So you can do that with your self
-worth pages too.
And you can also do it between your
(12:48):
specialty pages of like, sometimes this impacts self
-worth on your religion page and vice versa.
So.
Okay.
Yeah.
That's helpful.
Thank you.
Absolutely.
Good to see you.
You too.
All right.
We'll go Evelyn and then Sarah.
Hi.
Hi.
So it's my first time here.
I'm so excited.
I've listened to so many, so many talks
(13:10):
and like, like episodes, but I don't know
exactly what to ask, I guess, because I'm
stuck.
So I just want to describe it really
quickly.
So I'm in group private practice right now.
I'm a contractor and I want to build
my own thing, private practice.
And I'm kind of like in the middle.
I did a lot of research on like
(13:30):
how to start.
Like I've done it, created spreadsheets and everything.
And I don't have any new clients coming
in for a long time now.
Group private practice is like not doing anything
at all.
And I'm, I'm only teletherapy.
So I don't even use their office.
So I, and I don't have like that
chunk of money that I calculated to start,
you know, kind of like just like, like
(13:52):
take off.
Right.
So, and I have some clients who might
transfer, but it's only like three.
So I don't know, like, am I gonna,
do I just sit and try to save
money, which is like minimally coming?
It's coming like almost nothing.
Cause I only have like five clients, which
(14:12):
is ridiculous.
Like, so I don't know.
I don't know any ideas or how to
just proceed or not proceed.
Are you, have you signed anything that says
you won't start your own practice while you're
working at the group practice?
Uh, I don't think so.
It's been so long.
It's been like 2017.
(14:33):
Okay.
She's fine.
My, my boss is, is fine.
Okay.
Well, and you're a contractor.
So legally you're supposed to be able to
have another job.
So, um, they can't actually limit you from
that actually.
So what I would do is start your
own practice on the side while maintaining your
group practice.
If they're not feeding you clients into the
(14:53):
group practice right now, you've got the time
and energy hopefully to be able to start
your own thing without significant investment.
Yeah.
Isn't that going to be like a conflict
of interest?
Because I didn't tell her that I'm starting.
I will obviously have that conversation one-on
-one once I'm ready to launch.
Cause that's the right thing to do, but
(15:14):
not yet.
So, so it's just like, if, if she
sees like, oh, my new website, if I
get the money to launch a website, but
like, it's just, I don't know, it can
get messy or I don't even know.
Well, I mean, as a contractor, and this
is, this is a thing where so many
group practice owners, they want employees, but they
(15:34):
don't want to pay the taxes on employees.
So they hire contractors instead.
And then they get all up in arms
when a contractor behaves as a contractor does,
which is to have multiple gigs.
So, I mean, you can have a really
frank conversation with her and say, I'm not
able to get enough clients through the group
right now to sustain me.
So I'm going to be starting my own
practice on the side.
(15:54):
Mm-hmm.
And you can just have a really open
conversation about that, or you can just start,
you don't owe her an explanation of what
you're doing.
That's not the nature of your legal relationship.
It might feel better interpersonally to be talking
about it, but you don't legally owe that
to her.
(16:16):
So, yeah, I would start your own thing
on the side.
I would really market well.
You said, if you could get enough money
to get a website together, you can do
it for $20 a month on Squarespace.
Squarespace.
Yeah, I heard that you recommended that.
So I'm really looking into that.
But I know I need to have simple
practice.
Then I need a physical address.
Then I need so many things that are
(16:36):
mandatory, like liability insurance.
And together, it just turns out, I don't
know, $700 at least, which from the top,
I don't have that.
Right, right.
So I did not grow up with a
ton of money.
So right now, what I always do is
I look at like, okay, well, what's my
(16:56):
mind now goes to, okay, well, what's the
optimized situation for, say, having a landscaper come
and fix the yard or something.
But then I go to what is the
I'm broke version look like?
So the I'm broke version, like, let's say
you do have a virtual practice.
So you don't need a physical address.
You use one of the EHR systems that
(17:19):
is not as expensive, or you do paper
and pen.
You don't have to use an EHR.
As long as it's behind two locks, like
a door and a filing cabinet that are
both locked, you're good to go.
So you can be old school from a
from a records perspective.
I do strongly recommend a practice management system
once you have a few clients because things
(17:39):
become chaos quickly.
But you can start off and get to
a point where you can afford to do
that.
Yeah, you need to pay liability insurance.
But as a sole proprietor, that's going to
be a lot less expensive than if you
were an LLC, you don't need to be
an LLC right now.
So there are all these like, if you
absolutely had to start now, how could you
do it the most bare bones way?
(18:01):
And if you're keeping your group practice job,
then you're able to continue to have at
least the income you've got from them.
And then every single dime that you make
from your own practice, I want you to
sock away, like don't spend it on anything
except overhead and then savings so that you
can eventually make that shift over.
Okay, thank you so much.
(18:23):
Absolutely.
Thank you so much for these ideas.
Thank you.
All right, Sarah.
Hey, thanks.
So I am new to private practice.
I launched my practice about three months ago
after 15 plus years running treatment centers and
so needed to make a change.
(18:44):
And I'm loving it.
And it's all the things of starting now.
And so I have kind of a two
part question.
So I am private pay, fully virtual in
North Carolina, eating disorders therapist.
Love it.
Hello.
It's my twin.
Hi.
Within that, the population I love most are
the clients who have gone to treatment, done
(19:06):
the things they could teach you DBT.
They know all the skills.
They need more.
They would be in that bucket that many
folks might call chronic or severe and enduring.
That is who I love to work with.
And so I know the eating disorders therapist.
I know people I am struggling to figure
out how best to kind of market that
specific nitric in front of those particular clients.
(19:27):
And then I think in parallel to that,
many of those clients have sunk a lot
of financial resources into treatment.
And so as a cash pay therapist, I'm
trying to figure out how to either think
about what some sort of reduced rate model
looks like, or if that's not really the
way to best reach those people and serve
them.
And so I think I'm trying to figure
out how to best reach that particular niche
(19:47):
in my niche and be financially successful for
myself as well as financially achievable for clients,
which feels like a big question.
I'm curious for your thoughts.
Yeah.
Yeah.
OK.
So the fact that you work with the
more chronic, the harder clients, we'll just call
them the harder clients because they are.
Most of us in the eating disorder world,
we would like to stay more in the
(20:08):
disordered eating and mildly, but I don't need
to go to treatment population.
You are who we all want to know.
OK.
So I want to be really clear that
you're not stepping on any toes networking with
other eating disorder therapists and saying, I love
the ones nobody else likes to work with.
Like, I want the folks who've been to
(20:29):
treatment four times.
I want the ones who can tell you
about Marsha Lanahan's entire life story and how
to do DBT backwards and forwards, but can't
seem to make it happen in their lives.
Like, those are my people.
Talk to all the treatment centers because they
have their frequent flyers.
They have the ones that maybe they've only
been here once, but they've been everywhere else
(20:49):
twice.
And they really want them to land with
somebody who isn't intimidated by their struggle.
OK.
So a so much of what's going to
bring people into you is going to be
networking.
OK.
And you got to be super explicit about
loving the hard ones.
OK.
In your website copy, I want you to
be so like you've been to therapy.
(21:11):
You've been to treatment.
You could teach me how to do therapy.
I have no doubt.
And your life still sucks.
And it's this is still driving you.
But lucky for you, I know how to
help you get where you want to go.
And so it's instilling confidence instead of them
seeing like yet another therapist.
It's helping them trust you before they even
(21:34):
take the step.
OK.
You're going to get so full, Sarah.
I'm going to get so full.
And for the financial piece, let's talk about
that, because that's very real.
And if they can continue to pay these
treatment centers, they can pay you.
OK.
And so it's not sacrificing your financial well
-being for people who would find some way
(21:55):
to make it work if they had to
go back into residential.
OK.
Because you're going to keep them having to
go back into residential.
Ideally, like that's the goal.
So keeping your private pay model, I will
say if for those of you who are
interested in like sliding scale, a model that
is new to me that I've learned through
(22:16):
some of my students is the green bottle
model.
Where is that?
And it's interesting.
It's basically like if you offer sliding scale,
it has three different.
I don't know why it's called the green
bottle model, but three different green bottles.
And it's basically like, you know, if you
can go on vacation once a year, if
you can do X, Y and Z, like
you're in this bottle over here.
On the other side is like there's no
(22:37):
way you could grab a coffee from Starbucks
on your way to somewhere like that's just
not able to happen.
You're often worried about making your rent or
your mortgage.
You don't have a car or if you
do, it's breaking down a lot.
Like it's the people who actually really, really
need sliding scale.
And I think the beauty of that model
is that when you show that to a
(22:57):
client, they realize, well, yeah, I do get
a Starbucks every morning.
You know, I do X, Y and Z.
I do have hobbies that I can afford
to pay for that.
If this is my priority for a time,
I can pay for therapy out of pocket.
So it kind of helps them see that,
well, it might not be comfortable and there
(23:18):
will be sacrifices.
They can pay your fee.
That is one way to make it work.
But this is, you know, this is a
population who's likely relying heavily on parents, on
partners, on other people in their lives who
are helping support them.
And so everybody in the whole situation wants
this as resolved as it can be.
And if you can show them through your
(23:41):
confidence and through your competence that you can
make that happen, then they're happy to pay
you.
Residential is way more expensive than you are.
Okay.
That's helpful.
Thank you.
Absolutely.
Yeah.
Yeah.
All right.
Who's next?
I do have one quick question, Allison.
Yeah, of course.
(24:02):
So I have considered going up on my
rates a little bit.
I'm currently at 160 across the board for
all of our therapists.
And my therapists don't mind me setting the
rate.
I've thought about going up to 175.
I wish I had done that when I
increased last time, but I didn't.
So I've wanted to honor that.
(24:23):
The problem that I'm running into is this
kind of, it's not my scarcity mindset as
much as the scarcity mindset of potential clients
because of the climate that we're in politically
and all of that where everything's more expensive.
And I don't know if this is the
(24:43):
right time because I'm not personally scared to
go up on rates as much as I
want to make sure that it makes sense
for the environment that we're in.
You know what I mean?
Yeah.
And so to me, my thought is like,
I appreciate you wanting to be very accommodating
of clients, but everything is more expensive for
(25:04):
all of your therapists and for you too.
So if y'all can make a little
bit more, because typically the people who can
afford 160 out of pocket can afford 175.
And if therapy is a priority, which often
if you're paying 160, it's a priority, then
that extra $15 is doable.
But I don't want you to sacrifice your
(25:26):
therapist's financial wellbeing and your financial wellbeing because
things are crazy economically.
So yeah.
Matter of fact, I'm not sure how to
even figure that out because if people really
are kind of struggling to even get the
160 and then we bump it to 175,
I'm afraid of potentially losing a few, which
(25:49):
I wouldn't mind if it was just me,
but I'm also considering the other people involved
in this.
Yeah.
Well, you could do something like, because since
it's private pay, like these folks are, you
can do what you want.
It's your practice, right?
So you can say, you know, we're raising
our rates to 175.
If this creates significant financial hardship for you,
(26:11):
let's set up a time to talk.
And then if they're like, I'm barely making
160 work, you can be like, no problem.
We'll keep you at 160.
Yeah.
That's cool.
You don't have to unilaterally raise everyone.
It's your practice.
You can do what you want.
So, but there are people who are like,
I mean, it's fine.
Yeah.
(26:31):
175, I can do that.
And so we don't want to make assumptions
about them that are going to make it
harder for you.
We've literally had some clients that have said,
I don't know why you don't charge more.
Right.
Yeah.
So I think it's safe.
I think it's safe to go up.
And then if really it will cause hardship,
do have them have a conversation with you
about it.
Don't just be like, email me and let
(26:52):
me know, but say like, let's schedule a
time to talk on the phone.
Because the people who were like, well, it'd
be nice to not have my rate changed.
Aren't going to hop on the phone with
you.
They'll just pay the 175.
Right.
But the people who were like, oh God,
I don't want to lose my therapy.
They'll hop on the phone with you.
So, all right.
I appreciate that.
(27:13):
Yeah, absolutely.
We'll wrap it up then.
Thanks for being here.
I hope that you got some good value
and I will talk with y'all later.
Thanks for listening in on a live Ask
Allison sponsored by our friends at TherapyNotes.
If you'd like to join us for the
next one, send an email to help at
abundancepracticebuilding.com and we'll send you the link.
(27:37):
If you're listening, you probably need some support
building your practice.
If you're a super newbie, grab our free
checklist using the link in the show notes.
I'd love for you to follow, rate and
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Let's help all our colleagues build what they
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(Transcribed by TurboScribe.ai. Go Unlimited to remove this message.) Hey, our Live Ask Allison's are an opportunity
for you to get free live conversational support
from me.
You're hearing an excerpt from one we did
recently.
I'll give you details on how you can
join our next Live Ask Allison at the
end of the episode.
So I've talked about therapy notes on here
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I could talk about the features and the
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(00:31):
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(00:52):
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Second, they are proudly independently owned.
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Why should you care about that?
Because as soon as venture capital becomes involved,
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they've been able to stay incredibly successful and
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they don't have to sacrifice your experience to
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You can try two months free at therapynotes
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Well hi y'all.
Today is just like full open Q&A,
whatever you need.
Like we can go all over the map
from mindset to scaling to how to get
(01:57):
your first client to whatever.
So who would like to start us off?
I can.
Okay, great.
We'll go you and then we'll go Holly.
Okay.
So I was just listening to the podcast
you recently did about whether to take insurance
or not or just keep taking insurance.
(02:18):
But it felt a little motivational interviewing, like
a little bit.
You know what I mean?
Like it's okay, keep taking insurance.
And you had mentioned something about the confidence
to market yourself and how it's important for
therapists to be able to work through that
if that's a little bit of a stumbling
block or holding us back.
(02:39):
And I was wondering some advice about that.
Yeah.
So this fear of being seen, it's a
pretty big deal.
And when we're starting our practices, we often
feel like the imposter syndrome is really strong.
And so then it makes it really hard
to feel like, great, let me put myself
out there when I've got both these things
going on.
I'm not sure I even know how to
(03:00):
do therapy or have ever helped anybody anyway.
We can get really insecure when we're starting
our practice or when it's plateaued and we
need to build.
And so part of it is acknowledging the
imposter syndrome for what it is, which in
my mind is like, it's you doing something
new, period.
(03:20):
Every time I do something new, I get
imposter syndrome every single time.
At this point, because I like doing lots
of new things, I'm like, oh, here it
is.
It's just because I'm doing something new instead
of letting it take me down with it.
The fear of being seen is sometimes rooted
in that.
And sometimes it's rooted in like, what if
what I say I think is right, but
it's not right.
And everybody tells me how wrong it is.
(03:41):
And I am.
And that's less imposter syndrome and more like,
what if I'm actually wrong, which is scary
and hard.
And that could be anything.
That can be the way you do therapy,
but it could also be like the way
you look.
What if I do videos and everybody tells
me you look stupid in some way, you
(04:02):
know, and all of our insecurities are going
to come up.
They're just going to, um, when we're doing
this hard thing.
So part of the thing that makes putting
ourselves out there feel worth it is when
it works and we get clients.
But if we keep holding ourselves back and
we don't just do the damn thing, then
we don't get the opportunity to have that
(04:22):
positive reinforcement for it.
So long story short, the advice is do
the thing that feels least scary consistently.
So like, if that's networking, it's like find
the least scary people to network with like
old coworkers that you've got along with.
You don't need to go to like the
scary psychiatrist or the scary PCP go to
(04:44):
the people that feel like, oh, I can
have an easy conversation with these people.
And that's most therapists really.
Not everybody's going to be a great fit,
but I would say too, there's clarity gets
in the way of marketing.
So if you don't have an extremely clear
niche, then it's really hard to create content.
(05:05):
So of those things, like which one are
you struggling with the most or something else?
Yeah.
Um, I think, you know, the niche is
one, and also I know it sounds weird,
but also like believing that it will work.
You know, there's this sense of like, what
if I try all these things and I
fail and I don't get any good results
(05:28):
from doing all these scary things.
Yeah, that's fair.
Here's the thing though.
People don't usually fail private practice if they
keep trying.
Right now it's taking people a longer time
to get full than it has in a
really long time right now feels like, I
don't know if anybody was in practice.
Adam, I think you might've been in practice
in 2020.
(05:48):
But right now, these last few months have
felt like April and May of 2020, when
there was this collective breath holding and clients
weren't reaching out and therapists were freaking out
and then the damn broke.
I don't know why everybody just broke at
the same time.
I think we all just need to exhale.
It's not like anything really changed in June,
(06:10):
but that was probably the busiest summer.
Many people have had in private practice.
And I think for a variety of reasons
that I can speculate on, there are a
lot of reasons people are holding their breath
and not spending any money right now.
On therapy, I think there are some people
who are also just kind of afraid of
being cracked open when they feel vulnerable and
scared.
And I think that there will be a
(06:32):
similar exhale.
It might not be quite the intense one
that we had in 2020, but what I'm
seeing is some people getting like they're working,
they're doing the right things.
And because it's not happening as quickly as
it has for their friends who started practices
two years ago, they're like, maybe this isn't
for me and I should just stay in
my job.
And that's the last thing I would rather
(06:53):
you work slow and steady.
You don't have to go super hard, but
like slow and steady to get where you
want to go.
Because if you keep doing like whatever marketing
strategies you're doing and you're doing them the
right ways, you will get full.
It'll happen.
Thank you so much.
Yeah, absolutely.
Thanks for starting us off.
I see Holly, you were next.
(07:15):
I'm realizing that my ideal client has shifted
from when I first developed my ideal client.
So my niche is anxious, overwhelmed millennials who
struggle with their self-worth.
Um, I think even more niched down is
(07:40):
that that comes from their religious upbringing, not
necessarily trauma in like a big way from,
you know, like a cult or something, but
just purity culture and women's roles in society
and things like that.
So that one more layer of specificity.
(08:00):
Um, and so I'm wondering how I should
incorporate that into my marketing.
I feel like I don't want to redo
my entire website because I just did my
entire website.
Well, I moved it from Wix to Squarespace
and did some revamping of it, but I
(08:22):
don't know, should I add it as an
extra specialty?
Like right now I have anxiety, self-worth
and EMDR specialty pages.
Like, should I add a religious or spiritual
trauma?
The problem with that is that, um, my
ideal client doesn't label it as trauma.
(08:45):
So I don't want to use that word.
Another thing I've been playing with is like
religious or spiritual deconstruction, possibly, or since my
ideal client does have this like religious upbringing
component, should I redo how I present my
marketing on my website and obviously other everywhere
(09:08):
else too?
Well, everything else is the same about your
niche, right?
This is just a layer underneath.
So I think you can keep the vast
majority of your website up because what they're
looking for is the same, like it's the
self-worth stuff.
They're not necessarily, if they're not identifying it
as trauma, they're not yet making that connection
probably of like, I need to divest from
(09:31):
some things that I was taught in order
to be able to feel like wholly human.
And so I think in that case, you
could do a specialty page and maybe it
also depends on your ideal client.
Are they still wanting to be of the
faith they were raised in, just like a
different denomination or flavor or what have you?
Or are they like, I want nothing to
(09:52):
do with religion.
I'm like, where are they with that?
They want to figure out how to continue
incorporating faith into their life, but figuring out
what they want to bring forward and what
they need to leave behind.
Got it.
Okay.
So then the deconstruction and the word divesting
(10:13):
probably aren't the ones to use either.
Okay.
What you could do is on your homepage,
you could either do one paragraph or you
could do like a couple sentences on a
couple of paragraphs that already exists on your
website that say something like many of my
clients realized that some of the messages they
were given in their religious upbringing no longer
fit.
They're still people of faith or they're exploring
(10:36):
their faith, but they find that some of
their self-worth is rooted in this idea
that they were supposed to play these specific
roles, which don't feel aligned for them.
Okay.
Yeah.
So just adding that layer of specificity to,
I think, probably my homepage, but as well
as my anxiety and self-worth pages.
(11:00):
I'm just finishing up a blog about EMDR
where I do weave in the religious upbringing
stuff into how I'm explaining it.
So probably adding that to my EMDR page
as well.
And then not necessarily, I guess, maybe I
need to decide for myself if I want
to like separate it out as its own
(11:22):
specialty or just keep it as part of
the history and cultural context of my ideal
client.
Do you think it, or how would, how
would I decide if I want to have
add another specialty?
I think it's like, is your ideal client
(11:44):
looking for that?
Is that what they would search up?
Is that something they've already identified is causing
some of their turmoil?
Or is that something they come to and
exploring things more deeply with you?
My ideal client already knows that that's part
of the problem.
Then I would definitely have a specialty page
(12:05):
about it.
Okay.
Yeah.
Yeah.
And I think like that distinction, I like
your confidence and saying like, you're really clear.
Cause what we often do is hedge and
we're like, well, my ideal client knows, but
there are all these people who don't know.
So I'm not, I don't know if I
should, right.
If your ideal client has a clear perspective,
I want you to mark it to that
clear perspective.
So awesome.
(12:27):
Yeah.
So I would do a specialty page and
I would link to it when you mentioned
these folks in your homepage so that you've
got those links throughout your website that go
from, go from page to page, each other,
you know, make it a little spider web
makes Google happy.
Okay.
I have not done that.
So I will do that.
Yeah.
So you can do that with your self
-worth pages too.
And you can also do it between your
(12:48):
specialty pages of like, sometimes this impacts self
-worth on your religion page and vice versa.
So.
Okay.
Yeah.
That's helpful.
Thank you.
Absolutely.
Good to see you.
You too.
All right.
We'll go Evelyn and then Sarah.
Hi.
Hi.
So it's my first time here.
I'm so excited.
I've listened to so many, so many talks
(13:10):
and like, like episodes, but I don't know
exactly what to ask, I guess, because I'm
stuck.
So I just want to describe it really
quickly.
So I'm in group private practice right now.
I'm a contractor and I want to build
my own thing, private practice.
And I'm kind of like in the middle.
I did a lot of research on like
(13:30):
how to start.
Like I've done it, created spreadsheets and everything.
And I don't have any new clients coming
in for a long time now.
Group private practice is like not doing anything
at all.
And I'm, I'm only teletherapy.
So I don't even use their office.
So I, and I don't have like that
chunk of money that I calculated to start,
you know, kind of like just like, like
(13:52):
take off.
Right.
So, and I have some clients who might
transfer, but it's only like three.
So I don't know, like, am I gonna,
do I just sit and try to save
money, which is like minimally coming?
It's coming like almost nothing.
Cause I only have like five clients, which
(14:12):
is ridiculous.
Like, so I don't know.
I don't know any ideas or how to
just proceed or not proceed.
Are you, have you signed anything that says
you won't start your own practice while you're
working at the group practice?
Uh, I don't think so.
It's been so long.
It's been like 2017.
(14:33):
Okay.
She's fine.
My, my boss is, is fine.
Okay.
Well, and you're a contractor.
So legally you're supposed to be able to
have another job.
So, um, they can't actually limit you from
that actually.
So what I would do is start your
own practice on the side while maintaining your
group practice.
If they're not feeding you clients into the
(14:53):
group practice right now, you've got the time
and energy hopefully to be able to start
your own thing without significant investment.
Yeah.
Isn't that going to be like a conflict
of interest?
Because I didn't tell her that I'm starting.
I will obviously have that conversation one-on
-one once I'm ready to launch.
Cause that's the right thing to do, but
(15:14):
not yet.
So, so it's just like, if, if she
sees like, oh, my new website, if I
get the money to launch a website, but
like, it's just, I don't know, it can
get messy or I don't even know.
Well, I mean, as a contractor, and this
is, this is a thing where so many
group practice owners, they want employees, but they
(15:34):
don't want to pay the taxes on employees.
So they hire contractors instead.
And then they get all up in arms
when a contractor behaves as a contractor does,
which is to have multiple gigs.
So, I mean, you can have a really
frank conversation with her and say, I'm not
able to get enough clients through the group
right now to sustain me.
So I'm going to be starting my own
practice on the side.
(15:54):
Mm-hmm.
And you can just have a really open
conversation about that, or you can just start,
you don't owe her an explanation of what
you're doing.
That's not the nature of your legal relationship.
It might feel better interpersonally to be talking
about it, but you don't legally owe that
to her.
(16:16):
So, yeah, I would start your own thing
on the side.
I would really market well.
You said, if you could get enough money
to get a website together, you can do
it for $20 a month on Squarespace.
Squarespace.
Yeah, I heard that you recommended that.
So I'm really looking into that.
But I know I need to have simple
practice.
Then I need a physical address.
Then I need so many things that are
(16:36):
mandatory, like liability insurance.
And together, it just turns out, I don't
know, $700 at least, which from the top,
I don't have that.
Right, right.
So I did not grow up with a
ton of money.
So right now, what I always do is
I look at like, okay, well, what's my
(16:56):
mind now goes to, okay, well, what's the
optimized situation for, say, having a landscaper come
and fix the yard or something.
But then I go to what is the
I'm broke version look like?
So the I'm broke version, like, let's say
you do have a virtual practice.
So you don't need a physical address.
You use one of the EHR systems that
(17:19):
is not as expensive, or you do paper
and pen.
You don't have to use an EHR.
As long as it's behind two locks, like
a door and a filing cabinet that are
both locked, you're good to go.
So you can be old school from a
from a records perspective.
I do strongly recommend a practice management system
once you have a few clients because things
(17:39):
become chaos quickly.
But you can start off and get to
a point where you can afford to do
that.
Yeah, you need to pay liability insurance.
But as a sole proprietor, that's going to
be a lot less expensive than if you
were an LLC, you don't need to be
an LLC right now.
So there are all these like, if you
absolutely had to start now, how could you
do it the most bare bones way?
(18:01):
And if you're keeping your group practice job,
then you're able to continue to have at
least the income you've got from them.
And then every single dime that you make
from your own practice, I want you to
sock away, like don't spend it on anything
except overhead and then savings so that you
can eventually make that shift over.
Okay, thank you so much.
(18:23):
Absolutely.
Thank you so much for these ideas.
Thank you.
All right, Sarah.
Hey, thanks.
So I am new to private practice.
I launched my practice about three months ago
after 15 plus years running treatment centers and
so needed to make a change.
(18:44):
And I'm loving it.
And it's all the things of starting now.
And so I have kind of a two
part question.
So I am private pay, fully virtual in
North Carolina, eating disorders therapist.
Love it.
Hello.
It's my twin.
Hi.
Within that, the population I love most are
the clients who have gone to treatment, done
(19:06):
the things they could teach you DBT.
They know all the skills.
They need more.
They would be in that bucket that many
folks might call chronic or severe and enduring.
That is who I love to work with.
And so I know the eating disorders therapist.
I know people I am struggling to figure
out how best to kind of market that
specific nitric in front of those particular clients.
(19:27):
And then I think in parallel to that,
many of those clients have sunk a lot
of financial resources into treatment.
And so as a cash pay therapist, I'm
trying to figure out how to either think
about what some sort of reduced rate model
looks like, or if that's not really the
way to best reach those people and serve
them.
And so I think I'm trying to figure
out how to best reach that particular niche
(19:47):
in my niche and be financially successful for
myself as well as financially achievable for clients,
which feels like a big question.
I'm curious for your thoughts.
Yeah.
Yeah.
OK.
So the fact that you work with the
more chronic, the harder clients, we'll just call
them the harder clients because they are.
Most of us in the eating disorder world,
we would like to stay more in the
(20:08):
disordered eating and mildly, but I don't need
to go to treatment population.
You are who we all want to know.
OK.
So I want to be really clear that
you're not stepping on any toes networking with
other eating disorder therapists and saying, I love
the ones nobody else likes to work with.
Like, I want the folks who've been to
(20:29):
treatment four times.
I want the ones who can tell you
about Marsha Lanahan's entire life story and how
to do DBT backwards and forwards, but can't
seem to make it happen in their lives.
Like, those are my people.
Talk to all the treatment centers because they
have their frequent flyers.
They have the ones that maybe they've only
been here once, but they've been everywhere else
(20:49):
twice.
And they really want them to land with
somebody who isn't intimidated by their struggle.
OK.
So a so much of what's going to
bring people into you is going to be
networking.
OK.
And you got to be super explicit about
loving the hard ones.
OK.
In your website copy, I want you to
be so like you've been to therapy.
(21:11):
You've been to treatment.
You could teach me how to do therapy.
I have no doubt.
And your life still sucks.
And it's this is still driving you.
But lucky for you, I know how to
help you get where you want to go.
And so it's instilling confidence instead of them
seeing like yet another therapist.
It's helping them trust you before they even
(21:34):
take the step.
OK.
You're going to get so full, Sarah.
I'm going to get so full.
And for the financial piece, let's talk about
that, because that's very real.
And if they can continue to pay these
treatment centers, they can pay you.
OK.
And so it's not sacrificing your financial well
-being for people who would find some way
(21:55):
to make it work if they had to
go back into residential.
OK.
Because you're going to keep them having to
go back into residential.
Ideally, like that's the goal.
So keeping your private pay model, I will
say if for those of you who are
interested in like sliding scale, a model that
is new to me that I've learned through
(22:16):
some of my students is the green bottle
model.
Where is that?
And it's interesting.
It's basically like if you offer sliding scale,
it has three different.
I don't know why it's called the green
bottle model, but three different green bottles.
And it's basically like, you know, if you
can go on vacation once a year, if
you can do X, Y and Z, like
you're in this bottle over here.
On the other side is like there's no
(22:37):
way you could grab a coffee from Starbucks
on your way to somewhere like that's just
not able to happen.
You're often worried about making your rent or
your mortgage.
You don't have a car or if you
do, it's breaking down a lot.
Like it's the people who actually really, really
need sliding scale.
And I think the beauty of that model
is that when you show that to a
(22:57):
client, they realize, well, yeah, I do get
a Starbucks every morning.
You know, I do X, Y and Z.
I do have hobbies that I can afford
to pay for that.
If this is my priority for a time,
I can pay for therapy out of pocket.
So it kind of helps them see that,
well, it might not be comfortable and there
(23:18):
will be sacrifices.
They can pay your fee.
That is one way to make it work.
But this is, you know, this is a
population who's likely relying heavily on parents, on
partners, on other people in their lives who
are helping support them.
And so everybody in the whole situation wants
this as resolved as it can be.
And if you can show them through your
(23:41):
confidence and through your competence that you can
make that happen, then they're happy to pay
you.
Residential is way more expensive than you are.
Okay.
That's helpful.
Thank you.
Absolutely.
Yeah.
Yeah.
All right.
Who's next?
I do have one quick question, Allison.
Yeah, of course.
(24:02):
So I have considered going up on my
rates a little bit.
I'm currently at 160 across the board for
all of our therapists.
And my therapists don't mind me setting the
rate.
I've thought about going up to 175.
I wish I had done that when I
increased last time, but I didn't.
So I've wanted to honor that.
(24:23):
The problem that I'm running into is this
kind of, it's not my scarcity mindset as
much as the scarcity mindset of potential clients
because of the climate that we're in politically
and all of that where everything's more expensive.
And I don't know if this is the
(24:43):
right time because I'm not personally scared to
go up on rates as much as I
want to make sure that it makes sense
for the environment that we're in.
You know what I mean?
Yeah.
And so to me, my thought is like,
I appreciate you wanting to be very accommodating
of clients, but everything is more expensive for
(25:04):
all of your therapists and for you too.
So if y'all can make a little
bit more, because typically the people who can
afford 160 out of pocket can afford 175.
And if therapy is a priority, which often
if you're paying 160, it's a priority, then
that extra $15 is doable.
But I don't want you to sacrifice your
(25:26):
therapist's financial wellbeing and your financial wellbeing because
things are crazy economically.
So yeah.
Matter of fact, I'm not sure how to
even figure that out because if people really
are kind of struggling to even get the
160 and then we bump it to 175,
I'm afraid of potentially losing a few, which
(25:49):
I wouldn't mind if it was just me,
but I'm also considering the other people involved
in this.
Yeah.
Well, you could do something like, because since
it's private pay, like these folks are, you
can do what you want.
It's your practice, right?
So you can say, you know, we're raising
our rates to 175.
If this creates significant financial hardship for you,
(26:11):
let's set up a time to talk.
And then if they're like, I'm barely making
160 work, you can be like, no problem.
We'll keep you at 160.
Yeah.
That's cool.
You don't have to unilaterally raise everyone.
It's your practice.
You can do what you want.
So, but there are people who are like,
I mean, it's fine.
Yeah.
(26:31):
175, I can do that.
And so we don't want to make assumptions
about them that are going to make it
harder for you.
We've literally had some clients that have said,
I don't know why you don't charge more.
Right.
Yeah.
So I think it's safe.
I think it's safe to go up.
And then if really it will cause hardship,
do have them have a conversation with you
about it.
Don't just be like, email me and let
(26:52):
me know, but say like, let's schedule a
time to talk on the phone.
Because the people who were like, well, it'd
be nice to not have my rate changed.
Aren't going to hop on the phone with
you.
They'll just pay the 175.
Right.
But the people who were like, oh God,
I don't want to lose my therapy.
They'll hop on the phone with you.
So, all right.
I appreciate that.
(27:13):
Yeah, absolutely.
We'll wrap it up then.
Thanks for being here.
I hope that you got some good value
and I will talk with y'all later.
Thanks for listening in on a live Ask
Allison sponsored by our friends at TherapyNotes.
If you'd like to join us for the
next one, send an email to help at
abundancepracticebuilding.com and we'll send you the link.
(27:37):
If you're listening, you probably need some support
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