Episode Transcript
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(00:00):
(Transcribed by TurboScribe.ai. Go Unlimited to remove this message.) Hi, welcome to the Abundant Practice
Podcast.
I'm Allison from Abundance Practice Building.
I have a nearly diagnosable obsession with helping
therapists build sustainable, joy-filled private practices, just
like I've done for tens of thousands of
(00:21):
therapists across the world.
I'm excited to help you too.
If you want to fill your practice with
ideal clients, we have loads of free resources
and paid support.
Go to abundancepracticebuilding.com slash links.
All right, onto the show.
So I've talked about therapy notes on here
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I could talk about the features and the
(00:41):
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(01:02):
an included listing service that helps clients find
you, internal and external secure messaging, clinical outcome
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too.
(01:23):
Second, they are proudly independently owned.
Why should you care about that?
Because as soon as venture capital becomes involved,
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With over 100,000 therapists using their platform,
(01:45):
they've been able to stay incredibly successful and
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You can try two months free at therapynotes
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Welcome back to the Abundant Practice Podcast.
I'm your host, Allison Puryear, founder of Abundance
Practice Building.
I'm here with Nicole McCants.
Nicole is an expert in helping us scale
(02:07):
our practices so that we have other clinicians
working for us in a way that actually
works.
Y'all know when we talk about group
practice, I always want you to get guidance
because it is not just the logical next
step.
Nicole, thank you so much for being here.
You're gonna walk us through your five-step
model for how to scale your practice.
Can we start with how did you get
(02:28):
started in group practice?
What's kind of the origin of all of
this for you?
Sure, yes, and nice to be back, by
the way.
I think it was here like a year
ago.
Yeah, I do wanna share this because I
feel like people will relate.
I was in solo practice for 15 years
and loved it.
Like how lucky are we to do this
work?
I was so clear that this is why
(02:49):
I was on this planet.
And then fast forward 15 years of EMDR
and holding space for couples, I was burnt
out.
Not only burnt out, but I was sick
of hitting the ceiling in my income.
The only way I made money was sitting
in front of someone.
And then one day in 2026, I become
pregnant with twins.
My whole life is gonna double.
(03:09):
Like we need a bigger house, two cribs,
two high chairs.
Like how does that even work?
Oh my gosh, but I can't work more.
What do I do?
So guess what I did?
Nothing.
I did nothing because there was no mentor
to guide me.
Fast forward, I now have two-year-olds
and mommy is still working every night until
7 p.m. There was one night I
vividly remember their chubby little faces looking out
(03:31):
the window.
And I just burst into tears yet again.
I turned to my husband and I said,
I can't anymore, babe.
I'm just gonna do this.
I'm gonna start a group, but here's my
promise to you, Dan.
It will be systemized because I want to,
the whole point is to be home more.
And fast forward three years, I scaled to
55 therapists, multiple seven figures.
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But what I'm really proud of is it
was systemized.
And because it was systemized, a psychiatrist approached
me to buy it and I sold it
in 2022, which I never thought I would
do, but I did.
Yeah, and I think about the way that
most therapists go into starting a group practice
is not systemized.
(04:13):
They don't get any sort of training typically.
It's just like they add on therapists and
they can't scale like you did because none
of them are taking on 55 therapists without
a system.
That would be one of the circles of
hell, I'm sure, is named after that.
Yes, yes.
So let's talk through what the steps are
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to get to a place where you can
have a group practice where you're not working
significantly more than you were in solo practice,
where you're not being driven crazy by everything,
like everything that you're now juggling, because group
practice is not easier inherently in the way
that people think it is.
Yes, and I wanted to increase my income
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without seeing more clients.
That was my thing.
I'm a new mom, and it's funny, I
tracked a lot of new moms or parents
that are to be that are kind of
planning.
So I created a five-step scaling method
that got me to very rapid results in
our industry, but they work for everybody.
Like if you were to ask me, Allison,
would you have 55 people?
I would say, heck no.
I don't even know if I want that.
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But when it's systemized, it was kind of
like growing without me.
And I feel like when things are meant
to be, they have a life of their
own.
So step one, of course, is systemize.
Systemize your operations, build the container, my people,
before you fill it.
It's not just about posting to Indeed, because
if you do that, you will not be
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a CEO, you will be a CQA, a
Chief Question Answerer.
I know that you know that, right?
It's really overwhelming.
So what I mean by systemize is writing
it down, everything in your head, put in
a Google Drive, and then your next step,
I know this is a scary one, should
be hiring an admin.
You see, people in my business coaching program
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grow twice as fast when they have an
admin.
It's amazing.
And I think because they're offloading the overwhelm
and the minutia, so that's what systemizing means.
Like everything that you do, you're gonna write
down so somebody doesn't have to ask you
how to do that.
How do I send a receipt?
What's our no-show policy?
Like all the things.
How do I respond to a new client?
That's step one.
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Yeah, and is this a part-time admin
or is this a full-time admin?
Where do you start?
Definitely, okay, great question.
I think that people don't do it because
they think it needs to be full-time.
And it absolutely doesn't.
And so I'm so happy to answer this
because people think it's full-time and then
do nothing.
I would say casual or even a VA
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company.
So a VA company is great.
So when I say casual, it's like five
hours a week, whatever you need.
A lot of them, you actually bill per
the minute.
So just offload what you have and then
they can grow with you.
Perfect, okay, good.
So that's step one.
Step two is that this is where you
build your dream team.
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And I actually suggest that your first hire
should be a mini-me.
You see, you're gonna wanna offload the clients
eventually.
That's what I wanted to do.
And I made this mistake many years ago
in my 20s where I moved to Russia.
Long story, we'll talk about that in another
podcast.
I fell in love, moved to Russia, closed
my practice and gave all of my clients
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to somebody who is nothing like me.
So I think it's so important that they
match you in personality, in modality because your
brand, people expect a certain experience.
And so this person that I moved 50
clients to, guess what, not one of them
stayed because they were like, oh, you're nothing
like Nicole.
She's like a big personality.
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She's really direct and this person was not
like that.
So I would say like have your first
hire be a mini-me.
And one more piece around hiring, I actually
started with interns.
Yeah, and it depends where you live.
And in California, you can't even hire interns
but in Canada, we don't have to pay
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them.
So it was really nice for cashflow.
We're not allowed to pay them.
Like it's a hard, no, I didn't get
paid.
I don't know about you, but your practicum.
So these are practicum students that they get
paid in training and in course credit.
So that was really big for me for
growth because then it gave me cashflow.
Yeah, yeah.
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I think about like Tennessee, I don't think
they're allowed to pay their interns or their
practicum students or whatever.
So are these people who had graduated and
were getting their hours or these were people
still in school?
They're in school, they're students.
Not pre-licensed, yeah.
So pre-licensed, we pay 10% less,
typically 50% rather than 60.
But here's the thing, in what industry can
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you boost your profit margin by 10%
or make 100% of like gross profit,
right?
Not a lot of industries.
My husband used to own a cafe.
If it's low, it's low.
Like sandwich is a sandwich, you know what
I mean?
So we're very lucky.
Yeah, I would say across the board with
solo practices too.
Like we're just extremely lucky to have low
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overhead compared to every other type of business
I know.
Exactly, yeah.
Okay, so that's step two.
And then step three, what really helped me
was attracting clients with digital marketing.
I needed something that could bring in clients
when I was with my babies, when I
was sleeping.
And so I'm a big fan of Google
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ads.
Now I know this, people have a lot
of opinions about Google ads and I've seen
Google ads work and I've seen them not
work.
And they don't work if you do them
yourself.
Don't do that.
You're a therapist with a therapist brain.
But they do work if you work with
somebody who knows what they're doing, but also
it all comes down to your website.
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If your website doesn't convert, you have a
leaky bucket and you're wasting your money.
So the very first thing is don't do
anything until you're happy with a converting website.
Yeah, and I will say, I see niche
really impacting Google ads as well.
Yes.
Like as an eating disorder therapist, I have
hired multiple companies to try to do Google
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ads for my group practice.
But we're up against treatment centers who are
happy to pay $1,000 per click because
they're gonna make a ridiculous amount of money
for everybody that converts.
So it's also being mindful of like, if
you've got a typical therapist competition for Google
ads, you're probably just fine.
They'll probably work great if you have an
expert doing them.
(10:31):
Yeah.
If you're in substance abuse or eating disorders
or these things where you're against giant treatment
centers it can be a lot more difficult.
Yes.
And it boils down because we're bidding on
keywords.
So if you can ask yourself, okay, like
everybody is bidding on anxiety, depression, trauma.
So if you can offer as a group
practice, I wasn't niche.
It's hard to be niche with 55 people,
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but each person had a specialty.
We had an ADHD person, somebody specialized in
autism, et cetera.
So if we had those as keywords, that's
amazing.
So you wanna be strategic and work with
a company who's gonna tell you what keywords
work best where you live.
Yes.
Now, step four.
So, okay, the clients are coming in.
Oh my gosh, my website is working and
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the keywords are working, but now it's time
to convert the clients with consult calls.
They're not clients yet.
What really works for me, what I train
is a free bookable online, 20 minute consult
call.
And I've tested a consult call that is
15 minutes because I help people do private
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pay.
So there's consult calls.
And 20 minutes does better because you need
the last five minutes of the call to
pre-book four sessions, to get the credit
card, to go over the cancellation policy.
And having it bookable online is really key
because then people can book when you're sleeping.
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Because did you know, do you know when,
like pop quiz, do you know when most
people book therapy?
Oh, I'm guessing it's really late at night
or early morning just because that's when they're
up late, worrying, stressing.
So Jane did a study and they found
that after 7 p.m. because they're practice
management software.
So they can literally take all the data
after seven.
Usually, and my members just told me yesterday
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in coaching, like they're getting midnight, 1 a
.m., 2 a.m., yes, you got it.
And your admin is not there and they're
probably the bottleneck.
So I would have consult calls bookable online.
And are the consult calls with the therapist
they want to see, or is it with
somebody whose job that is?
Great question.
We tried both with the therapist they want
to see.
Because the thing is we're in the industry,
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we're of trust.
We tried it with the admin and guess
what?
They still wanted the consult call with the
therapist.
So here I am like, you know, we're
doubling up on consult calls.
Yeah, and also the show rate is much
higher when people book, research shows this too,
themselves rather than going through a contact form
and admin booking them.
(12:59):
Interesting, okay.
Yeah, a VA company found that.
So then you're going to be offering the
consult calls with your therapist.
They're getting booked, but wait, there's more.
There's one last step.
This is a step that is missed by
everybody.
Retain the client, but with follow-ups, follow
-ups.
So what that means is, you know that
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no-show yesterday, that canceled client, or remember
that one that just ghosted?
They came six times and like they went
on vacation, never saw them again.
Or that person that did have a consult,
but had to talk to their spouse about
couples counseling.
There's so many therapists that actually aren't following
up.
This is your admin, you know, that person
you hired for five hours, they're going to
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follow up and this can increase your bookings
by 20%.
Because some of them want to book.
They just got busy.
How many times in your life has that
happened?
Yes, a thousand times.
And especially if you work with people with
executive functioning issues.
Exactly, or depression, yes.
I see this a lot with therapists, where
they're like, well, it's on them.
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Like it's, the ball is in their court.
I want them to take responsibility for this.
I'm like, now is not the stage.
And you got it.
Now is the time.
They come to you for support, so support
them.
And that looks like following up.
Yes, that looks like being the guide.
Yeah.
Yeah.
And that is it.
(14:20):
So all of those things, don't skip a
step.
I teach people like the nitty gritty of
how to do it.
Let me know if you have any questions
we can dig in more to any of
them.
Yeah, well, what are the hiccups that come
up for people in your program in each?
You talked about the first one of like
hiring an admin feels very daunting for somebody
who's like, well, I don't have the extra
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money yet.
Why would I go pay somebody?
So I think that one is probably the
biggest hiccup there.
But what are some of the other ones
that happen for folks?
I think systemizing, and this is why I
give people all, I give them my manuals
because they're already written, you know, which saves
a lot of time.
But I think systemizing is boring.
Let's be honest.
Do you want to sit down?
Like, I don't.
(15:01):
So I find it's easier for people to
like customize, but I think that they want
to hire because that's where the money flows
in.
They want to skip the step.
And for me, my biggest thing that I
help people is like not to hire the
wrong people.
Have you ever hired the wrong person?
That's a lot.
It's a lot.
It is a lot, yeah.
So like what to look out for, you
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know?
I have like a six-step hiring model
where it's like go through all six steps
because I believe you want to only hire
your hell yeahs, those people during the interview
that you're super impressed with.
Yeah.
Yeah, absolutely.
Because these are, I mean, it's, I'm never
one to be like, oh, your workplace is
your family.
I don't want to say that because those
are always the most toxic places.
(15:45):
But you end up spending a lot of
time and energy.
You need to really genuinely trust and enjoy
everybody that you hire.
If I wouldn't send my friends or family,
like if I wouldn't book my mom with
you if you had your own practice, then
I'm not gonna hire you.
Yes, that's so funny.
(16:05):
I literally say at the end of the
interview, you should ask yourself, would I go
out for lunch with this person?
Are they warm enough that like this conversation
flows, they're high in EQ, but would I
book therapy with them?
If it's a no, then I would not
invite them in.
Because if you think about it, they have
a small window to build rapport very quickly
and book a consult.
And they need to be those, like the
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best therapists who get the busiest are able
to just flow and like show up so
warm and can hold space.
Well, and I'm wondering, how does that work
with people like interns or practicum students when
they, I probably wouldn't book with a practicum
student at this stage.
They're still learning.
How do you suss out who's got real
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potential?
Yeah, really good question.
I hire, I found lots of trial and
error, as you can imagine, how many interviews
I did with 55 people, I'm getting to
55, that I actually ended up hiring interns
that were older, a little bit more mature
in age.
I found those that were green in their
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career and green in age didn't get that
booked.
They just looked really young.
And we both know the photo and the
bio really makes a difference for booking.
So that made a difference.
But I will say there's some interns where
they can hold the space.
Like they've gone through, just because they didn't
read the books and they're not done their
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internship doesn't really mean that they're actually a
quality, they're like born to be a therapist.
You know what I mean?
Yeah.
So that was always in the back of
my head during the interview that like, okay,
can you hold the space?
And here's the big one.
The three big things that matter is, are
they confident?
It's confidence that comes with years, right?
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But this sense of confidence that I got
you, it does not have to be, I
know all the modalities in my head and
that confidence may not be there yet, but
this real sense that I got you and
people can feel that.
And I find those that do their own
therapy come with that.
Yeah, yeah.
I think about like I had a job
working at a residential treatment center in between
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undergrad and grad school that provided so much
confidence for me going forward.
I already saw there was so much I
didn't know, but I did know a lot.
I got to practice a lot.
Yes, exactly.
And that led to just confidence going out
into the job market that I wouldn't have
had otherwise.
Yes.
But, and I also think like dealing with
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their own crap, like I've dealt with my
issues.
I'm not, you know what I mean?
I can sit with yours.
Yeah.
That's so key.
We actually have that, funny enough.
We asked one of our lawyers in our
program, like, are we allowed to ask in
an interview, do you do therapy?
So you have to say it in a
certain way because you don't want them to
think you're asking if they have a disability.
That's not, do you never ask that entering
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an interview?
But you can ask like, what do you
do for your mental wellness to get a
sense if they've done their own work?
Because they'll be the best therapist.
Yeah, amazing.
And okay, so we've gone through a few.
What are some other hiccups people come across?
I think the biggest one actually isn't even
any of the steps.
It's mindset, as we know.
Yeah, I think that it's the imposter syndrome
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is real.
This sense that why should I be a
boss?
Like why would people want to work with
me?
So we work through that a lot.
And I think that just reminding therapists that
we are compassionate people.
All the research set out there on leadership
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says that the best bosses are the ones
that are compassionate and listening.
And people stay because of this sense of
belonging.
So I think so much of that, that
you're actually born, not everyone's born to be
a leader, but if you care about people
and you want to actually develop them and
create this culture, this like home where we
can all grow together, you will excel.
(19:58):
Yeah, and I'm curious like what middle management
looks like or what leadership looks like in
your practice before you sold it?
How did, or were you still the boss
of everything?
No goodness.
So the first hire should be an admin.
And I actually suggest that they're part-time.
So we said casual hours, eventually you'll work
(20:20):
them up to part-time.
I don't suggest hiring a full-time admin
ever.
And the reason is I lost admin and
it's just so overwhelming and stressful when they're
your right-hand person and they have all
the hours and then they leave.
So after that happened, I think you should,
rather than full-time hours, get two people
who work part-time.
(20:41):
They help each other with vacations and sick
days.
So that's step number one.
I ended up with six admin, of course,
because we were very big.
And then we had people overseeing like psych
assessments and different things.
But after that, you want a clinic manager.
That's going to be your next hire.
That person will, if anybody is sick, they're
overseeing the front desk, any issues with clients,
(21:04):
that's going with them.
They're really supporting it all.
And you begin to, this is where I
saw less clients and then stopped supervising a
little bit until I stopped supervising altogether.
And then my next person just below me
was operations.
They eventually helped with hiring.
They oversaw like the financials, just the growth
(21:24):
of the clinic.
And then I could just work on steering
the ship and working a little bit less
and enjoying more.
Yeah.
And what number of therapists working did you
hire those other positions of leadership?
I think it depends on if they're part
-time or full-time.
In Canada, contractors are really, really big.
(21:45):
In America, it's mostly W-2 employees.
And if you have a W-2 employee,
have them work full-time.
Why not?
Like they're just committed to your clinic.
So I would say, it really depends, but
like six to eight is when you might
need like, okay, another admin, but you're gonna
feel it.
You're gonna know like, okay, we need more
support here.
(22:06):
And then you're gonna bring on another one.
Got it.
And the best place to start actually, if
you love your admin, I wouldn't even post
to Indeed.
I would ask them who they hang out
with.
Birds of a feather flock together and then
hire their friends.
I think it's perfectly fine.
Hire the people they know.
Yeah.
Yeah, it's interesting.
Because when you have employees that really, really
(22:29):
care about doing a good job, and there
are so many people out there who really,
really care about doing a good job, it
makes your life a thousand times easier.
Yeah.
Because when they're just kind of like, oh,
I'm doing, you know, I'm phoning it in.
I'm doing like, kind of quiet quitting is
the way that I work.
Yes.
There is so much stress that then lands
on your shoulder.
Yes.
And you do become the question answerer because
(22:51):
there's always gonna be something that's not in
your standard operating procedure manual.
There's always gonna be some random thing.
And I would so much rather have somebody
who is gonna look for that answer elsewhere.
And like, they're resourceful.
They're gonna figure it out on their own.
I always hire based on personality, not on
experience.
Yes.
Oh my gosh.
When it comes to administrative roles.
Can we talk about that for a second?
(23:11):
Yeah, 100%.
Yeah.
So I have all these models.
That's why it's called the McCance method, all
these methods.
But the second step in our six-step
hiring method model is personality tasks.
We actually give them the big five.
Do you remember the big five?
So the big five, one of the five
is conscientiousness, like their work ethic, because that's
so important.
I truly believe that experience can be gained,
(23:35):
skills can be taught, but personality we both
know is pretty stable.
Yeah.
And if you are harder working, like if
you are more conscientious than the person you
hire, you are going to consistently be disappointed
and frustrated.
Amen.
Mm-hmm.
Totally.
I'm that person.
I'm very conscientious, so I needed somebody.
I don't want to be the smartest person
in the room.
(23:55):
I want to be so impressed in that
interview that I'm like, holy cow, you're going
to be the best.
Do not settle.
I've settled way too much, which, yeah.
Yeah.
And firing people is so painful for everyone
involved.
I would just love to save everybody from
having to fire people.
Exactly.
By that whole hire slow, fire fast.
I've never been able to fire fast, to
(24:16):
be honest with you.
I know I'm supposed to, but yeah, and
luckily I'm not in a position where I
have to do that now because my team
is rock solid of just badass people who
want to do a great job.
Exactly.
There's so much, I don't know if you
feel this, like similarities between dating and interviewing,
right?
Like you ever go on a date and
you're kind of talking yourself into, well, maybe
(24:38):
I'm falling in love with their potential.
Maybe they'll be better later on.
If there's any red flags, if people bring
this to coaching, I'm kind of like, if
you need to bring it here, it's probably
a no.
And then they just learn themselves, like, okay,
you know what?
That's true.
It's gotta be a hell yeah, because you
deserve only that.
Absolutely.
(24:58):
Yeah.
Oh, Nicole, okay.
Where can people find you?
What's your favorite way to introduce people to
your work?
Yes, well, two places.
If you love podcasts, I have a podcast,
The Business Savvy Therapist, and I also do
live trainings every single week.
So if you wanna come, hang out, and
I can teach you specifically the masterclass, how
(25:18):
to build a seven-figure group practice.
Amazing.
Thank you so much.
I'll give you both of those links.
Yeah.
Yeah, and we will put those in the
show notes to make it super easy.
Thank you for chatting.
I feel like we never get enough time
to talk.
Yeah, thanks for having me.
Yeah, I'm glad to have you.
Thank you so much.
Thanks.
If you're ready for a much easier practice,
(25:40):
Therapy Notes is the way to go.
Go to therapynotes.com and use the promo
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If you're listening, you probably need some support
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If you're a super newbie, grab our free
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Let's help all our colleagues build what they
(26:02):
want.