Therapy PracticeLab

There is an African proverb that says:

If you want to go fast, go alone. If you want to go far, go together.

Therapy PracticeLab, launched in 2015, was designed to allow therapists in private practice to participate in a creative, supportive Practice Circle where members utilize the power of having other innovative, amazing therapists completely in their corner. The groups focus on providing support for the multiple challenges of running a private practice as a small, purposeful, prosocial business. Here is one working motto for this group:

We are smarter than you are.

The premise is that “we” (a team of bright, vital human beings that includes you) are almost always smarter, more innovative, more flexible, and just plain bolder than any of us is in isolation. Once we acknowledge that we are, in fact, not competing for a small pie of business, we can freely share our best ideas with one another, realize a broader range of options when dealing with any practice challenge, and prevent the gross inefficiency that comes from “reinventing the wheel” with each business decision we make. We bring our respective strengths together and this will more than compensate for our relative weaknesses. And in those rare moments when we are competing (instead of collaborating) in the marketplace of behavioral health services, we as a team can outperform even the best individuals working in isolation.

Why join a Therapy PracticeLab group? Therapy PracticeLab offers a way to work with others without sacrificing our desire to remain independent from administrators or systems that constrain our practices. While some people gain support from group practices, others value their autonomy too much to join. Or they prefer to maintain control of their practices to ensure they can care for others and stay true to their values and ethics. Others do the math and decide the numbers just do not work for them to join a group. Still others, let’s be honest—you know who you are, are just too damn quirky to join a formal group practice. That desire to be autonomous can result in isolation, but it need not.

Get connected. Stay independent.

The health care environment is changing…so your practice is evolving. But is it going where you want it to go? My assumption is that the members of this group will all be caring, values-driven individuals, competent if not excellent in their roles as therapists. But being a good therapist will not keep your office open to do the work you value and that benefits others. You also need to have an entrepreneurial spirit and be business savvy to thrive in today’s health care environment. And getting your practice configured “right” is not enough — the environment is rapidly changing. Right today may be wrong tomorrow. What is needed is to maintain flexibility and to be adaptable to changing conditions.

Think of it this way. A short list of the proficiencies needed to operate a thriving private practice would include:

  • Knowing how to find referrals
  • Cultivating steady referral streams (even when your caseload becomes full, lest they dry up)
  • Communicating with other providers and interfacing with other aspects of the health care system
  • Scheduling effectively
  • Managing an office and paperwork
  • Managing electronic data and using an electronic records system
  • Coordinating intake appointments
  • Maintaining records and responding to records requests
  • Managing practice policies
  • Doing billing and activities related to getting paid
  • Hiring part-time employees or outsourcing some work tasks
  • Maintaining a website
  • Networking
  • Traditional and 21st century guerilla marketing….

Should I go on? This is not even half of the list. Sorry to stress you out. Do you have expertise in all these areas? I certainly hope not! Imagine how much time and attention that would require. You would practically need an MBA to do these tasks well. Notice how this list does not even include being a compassionate and effective therapist, maintaining some semblance of work/life balance, ensuring adequate self-care, and cultivating a spirit of continuous learning to keep the work fresh. THESE lattermost areas deserve your primary attention far more the business aspects. However, my experience is that most therapists are far better at attending ethics workshops, maintaining their clinical proficiencies, and ensuring their self-care. The business aspects of their practices, on the other hand, tend to be neglected. Having a team in your corner frees you from needing to have expertise in every domain and having a regular check-in on the state of your business will help it from becoming stale. You might even find, as I have, that the entrepreneurial aspects of running a practice can be rewarding and enjoyable.

About me. 2016 marked my tenth year running a successful, full-time private practice. It has been quite a ride. I look back and realize that I have made a lot of good decisions and that I have a better business and entrepreneurial mind than I realized back when I first made the leap from staff psychologist at the Boston VAMC, to group practice, and eventually into independent practice. I was fortunate to make good connections when I started in Portland and was able to cultivate a steady stream of referrals relatively early in my practice. Today, I receive many more referrals than I can accommodate and I am able to connect these referrals to a wide net of wonderful colleagues in the greater Portland area. It is fulfilling to be able to connect individuals in need with really good therapists who provide compassionate and effective care.

Truth be told, I also made a lot of mistakes. I learned from them also and, fortunately, none of them was too costly. My objective with this project is to facilitate the group to support its individual members, generate creative solutions to practice challenges, and to help us all remain flexible and adaptable. I plan to notice trends, anticipate their impact, and be proactive in planning. I hope that newer therapists can avoid many of the pitfalls I encountered, can thrive and be effective helpers and healers, and avoid discouragement. I hope that more seasoned therapists can remain effective, elevate their practice to a new level, adapt to changing conditions, avoid burnout, and thrive in the later years of their practice. I think that the wisdom and experience of seasoned clinicians combined with the flexible thinking, technical savvy, and energy of younger clinicians can make for a potent team. I am not sure that I am particularly wise, young, or energetic, but I have learned a few things and I will offer observations and strategies from my own experience into the mix as well.

Format. The groups will meet once per month for 75-90 minutes. Groups meet in my workshop space at 25 Middle St. in Portland, ME. We will use email, private social media, or other electronic communication between meetings, as needed. Groups will be capped at approximately eight to ten members. Additional members will be placed on a waitlist until existing members leave or until there are enough new members to form a new group.

Current Groups: The first series of groups ended in early 2017. Launched in 2015, two groups ran through 2016 and eventually consolidated into one group with members that remained active. Group members decided that the group had fulfilled its primary purposes for them and we agreed to discontinue. My current plan is to launch another group or two with new members in Fall 2017. The new series will, of course, incorporate all the feedback I received from the initial groups. If you are interested, please contact me.

I remain interested in the possibility of holding Therapy PracticeLab groups in locations outside Portland. If you are interested in participating in a group in far southern Maine or seacoast NH, on the midcoast (e.g., Brunswick, Augusta), in another local town, or via online versions of this group (Therapy PracticeLab v2.0….coming very soon) please give me some feedback here.

Cost. I plan to keep the fee for these early groups reasonable. Previous groups that started in 2015 were $50 per person, per month. Payment was made via PayPal subscription (meaning that it was be drawn from a credit card automatically each month). This system has worked very well for the ACT Study Groups I have been running for the past several years and it helps keep the tracking and paperwork easy for me, which permits me to waste less time and thus charge less. I will ask that new members give the group a loose commitment, say three months, to see if it meets your needs, before deciding to remain with the group or withdraw. But this is a request not a contract and members are free to withdraw and discontinue payment at any time, for any reason. Read payment FAQs.

Is the cost worth it? You will need to decide. However, it may be helpful to think of it this way: If this group generates just one new client that comes to therapy with you regularly for a short course of therapy, the cost of the PracticeLab will be covered for the year. Based on my experience running other professional groups, I think it is likely that your participation will generate numerous leads and referrals, not just one. Thus, the “return on investment” or ROI is significant. Yes, I know that this is a very business-y way of thinking about this, not typical for a therapist. Well, there is some value to this as long as it does not eclipse your primary values! It is also worth mentioning that the value of such a group extends beyond ROI. There are many intangible benefits, such as support and camaraderie, boosts in creativity and innovation, and improvements in work efficiency that are likely to result from working together.

Private practices ARE small businesses, albeit businesses with a strong social purpose. We cannot do the work we love if we cannot pay our rent, our health care costs, and meet our family’s financial needs. We need to think more like social entrepreneurs and less like charities. Getting by and surviving is not sufficient. It is time to appreciate running your business well as the next challenge and adventure. But why travel alone?

Interested? Ready to get started? Send me an email if you want to participate in a Therapy PracticeLab Practice Circle or if you have any questions.

Get connected. Stay independent.
Go fast
and go far.

Joel Guarna

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5 thoughts on “Therapy PracticeLab

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