Yeah, I did.  I broke one of those BIG rules I’ve always talked about and written about.

But I broke it exchange to satisfy a bigger rule, I think.  I guess you can be the judge.

You know I have always liked, no loved, to do my own billing, accounting, and insurance work.  It allowed me to feel in control of the financial aspect of my business, and also helped me to know just enough about where the business was going, how it was getting their, and what I needed to be doing about it.

Not anymore.

With the expansion of A New Direction Counseling, billing became more than just a few hours on a Friday morning.  It became a constant worry and frustration.  And even with all that anxiety, I still wasn’t sure if all the claims were being paid, especially for my associates, as the process started to develop new wrinkles – wrinkles that I was not effectively tracking or managing.

The stressed continued to build, and the concern for my associates only worsened.  The decision eventually became a time for dollars issue.  Yes, doing my own billing was inexpensive, only about a one session copay per month.  But I was spending way too much time on it, and not being as effective as I should be.

Having someone else (still Carepaths) take charge of the billing is expensive, more like several clients full session fees per month, but the difference is in the time.  Now, instead of spending 3-4 hours every Friday working on billing, and several hours throughout the week, sometimes on Saturday or Sunday; now I have the freedom to do what is needed, and what I am good at, during that time.  Now I can see 3-4 clients on a Friday morning, which would easily cover the cost of Carepaths billing.  Or I can take the time to exercise, chat with my peers, plan a marketing blitz.  I can have the time to work on what I am good in, rather than spending a lot more time doing what I am not as good.

Yeah, it may be more expensive; but in the comparison of where my time is being spent, it is well worth it.

That’s one of the most enjoyable parts about private practice – we get to choose where we spend out time.  We get to determine the areas that we are best qualified in (and hopefully #1 is being fully present with your clients!) and focus there, while we make smart business decisions in other areas.  It is an opportunity to check back in with our selves and our business to make sure we are growing in the right direction, and prune back where we are not.

So, did I break my own rule?  Perhaps.  But I like to think in breaking that rule, I made a fairly intelligent business decision, and just as importantly, a good decision for my own mental health, and the financial health of my associates?

What do you think?

Feel free to contact me if you want to know more about Carepaths, or any other aspect of managing your own private practice!

I think I owe you an apology, or at least an explanation.  I know I said I wouldn’t be writing as much here, but I really didn’t expect to stop for so long.  Even all the experts say it is important to be ‘fully present and consistent’, whether it’s in counseling or in sharing our ideas through a website.  I certainly have not been fully present here.  Of course, I have tons of excuses – all of them having to do with the expansion of A New Direction Counseling; buying furniture, working on associate contracts, doing billing, blah, blah, blah.  I can tell you this, taking time away from this site has certainly been freeing – it has freed me up to do quite a bit for my office, but I do feel like I have not been giving enough here, and for that, I am sorry.

I’m still not sure where this website will go – I still have the passion to help more therapists start their own private practice, just not sure if I have the motivation to maintain a website about it.  What I do know is this, I was fortunate to attend an amazing conference last week, I am was inspired to share it with you.  This is the synopsis that I posted at www.ANewDirectionCounseling.com yesterday.

Big Names in Leadership

There are a lot of great ideas in leadership out there these days – how to help your community, your work, your family, your world.  I was fortunate to hear from some of the top leaders in the world through the Chick-fil-A sponsored Leadercast last week.  I didn’t know such a thing existed.  But now that I do, I will certainly be attending every year.  If you have any interest in improving your life, leading your community, or changing the world, or anything in between, this event would be time and money well spent.

Here are just a few of the things I heard when I attended with a group I am consulting:

Andy Stanley, author of Next Generation Leader and 19 other books, talked quite a bit about simplifying life and leadership.  ”Complexity is the enemy of clarify” – “Growth creates complexity which requires simplicity.”  He offered quite a bit on how to simplify life and leadership, including his three simple questions: 1. What are we doing; 2. Why are we doing it; 3.  How do I fit in.  If your looking for a spiritual take on the art of leadership, check out his work.

John C. Maxwell, one of the most well known thought-leaders in business, management, and leadership; and author of 60 books on the topic shared his ‘leadership math’: Add Value to people every day, Subtract your personal ‘leadership landmines’, Multiply your strengths by developing them, and Divide your weaknesses by delegating them.  An awesomely engaging speaker, my favorite take-away from his time; “We’re always looking for a leader to solve our problems – BE the leader.”  True in government, work, and life.  We can all be leaders if we choose.

Four-time Olympic Gold Medalist shared about the importance of her vision-board – the list of her goals she creates at the beginning of each year – and how those two simple acts, writing down those goals and attending to them each day, were vitally important to her success as an Olympian.  Goal-setting, it works for Olympians, it can work for you.

Dr. Henry Cloud was a personal favorite, as I think he was one of the only other “shrinks” (his word, not mine) in the room – I am pretty sure that was the case at my site.  He and co-author John Townsend have written quite a few books on Boundaries, and he spoke to the idea of boundaries for leaders – how the idea that “if everything is important, then nothing is important” leads us to focus on what is needed and necessary, rather than all the other clutter we may pack into our minds.

Mike “Coach K.” Krzyzewski and Condoleeza Rice were both engaging, inspiring, and insightful speakers, while Jack Welch, former CEO of GE and #1 International best-sell author of books like Winning, kept us on the edge of our seats with his time-tested wisdom, like when he practically screamed, “You’ve got to love what you’re doing or you’re never going to win!”

But for me, the most inspiring part of the day was hearing the far-too-brief comments of LCDR Rorke Denver, Navy SEAL, star of Act of Valor, and author of Damn Few.  His passionate reading of what it means to be “king” from the pages of Steven Pressfield’s Gates of Fire was hard to describe – emotional, proud, patriotic.  It was the perfect ending to a great experience.

Take some time to look up some of these people – if you are reading these pages, it is safe to assume you want to learn more about improving your self, your work, your community, or your world.  The ideas listed above are some great places to start.  May 9, 2014 would be a great place to continue.

“Calm is contagious.”

“You can replace the word ‘calm’ with just about any other word…  especially ‘stupid’, ‘stupid’ is 100% contagious.”  - Rorke Denver

How we behave and what we think is passed on to those around us.  It’s infectious.  How do you effect others?  How do you allow others to effect you?

That’s what I love about this business – it can be as fluid, or as concrete, as you want to make it.

I was just having that conversation with a peer a few weeks ago.  Both of us know plenty of people in similar fields who are struggling with the changes in the health care industry, insurance reimbursement, state and federal budgets, and various decisions about how certain clients/customers should be treated.

In private practice, you can choose to change with the times.  There are almost always options available.  On the other hand, in large agencies, dependent on one stream of government money, change can be devestating.

But before I go off in a philosophical tyrade, this article is about the changes here that I promised to share with you – and it’s about an apology.  An apology for slacking off in checking in here.

I’ve spent the past month and a half in a space sharing agreement.  It lead to another realization I already knew - I don’t play well with others.  It wasn’t really about that, but more about not enjoying having a schedule dictated to me by anyone but my clients.  It’s one thing to agree to meet with a client at 830am because it fits their needs, but it’s a completely other issue when that is the only time I can meet each week because that is the only time I can share the office.

We made it work for a while, an I am very appreciative for the opportunity, because it certainly motivated me to change the situation quickly.

And that is what these pictures are all about – the future of our offices – just one more way private practice allows you to be flexible, but make fun, exciting, and anxiety-inducing choices in your personal and professional life.

We will have PLENTY of room in the new space – so if you, or anyone you know, are interested in becoming a part of the practice, or starting your own practice with a little bit of added support, give me a call or email!

More to come, but for now, you can see I have some painting to do.

Here we go.

The move is complete – at least for now.  I am in an office sharing situation while I
begin the process of looking for a larger home for my business.  With that, comes the opportunity to work with
more therapists in the practice.

While serving the local community and providing the best
clinical service in our niche, the business goal is to help good new therapists
become great and great therapists to become great business people.

So who wants to be a part of it?

We’ve been having this conversation for quite a while, so
now I am extending an offer for you to be a bigger part of it.  If you would like to work in me in this new
practice, let’s talk some more.

Do newly licensed counselors, therapists, or social workers
belong in private practice?

Better yet, should brand new graduates, fresh out of the
halls of academia, look towards private practice as their first job
post-graduation?

Anyone had that debate lately?

It’s a discussion that has quite a few varied opinions.

You will hear quite a bit that “it’s good for you to start
out in agency mental health” from those of us who started our careers
there.  It’s good for you to “cut your
teeth” in the community mental health world.
I’ve heard you “have to learn where you DON’T want to work,” from those
of us who started out in places where we didn’t want to work.

But do these opportunities teach you how to be a better
therapist?  I’m not so sure.

They definitely teach you where you don’t want to continue
your career (unless you are happy there, at which point you might want to stop
reading), but do they make you BETTER at helping others?  They teach you to work with a variety of
clients, sometimes outside your area of expertise.  They may even teach you how to cope with the intricacies
of non-clinical personalities in management, marketing, and front-office staff.

But does all that make you a better helping professional?

Again, I’m not sure.

I know my path helped me to be better – the time and
experience in community mental health, then corporate mental health, then
agency mental health helped me to be better at reading, understanding, and
helping people.  It also taught me
stress, burnout, and a 10-day stay in the hospital (ok, that was a clinical
management job).

But is it necessary these days to start out that way?  Do you have to look burnout in the face to be
an effective, “seasoned”, therapist?

What do you think?
This is one of those questions where I really want to know your opinion.

One of the goals for the changes in A New Direction
Counseling is to bring newly graduated therapists in to the practice to help
them access the benefits of the National Health Service Corps program  – but, does that help them to be a better therapist
moving forward?

More importantly, how will it help the clients that they work
with?

It was a lot of fun writing about the anxiety of years past – especially when it is so far in the past, and I was imaging YOU going through it, and not me…

It’s easy to talk about anxiety and coach people through it when you’re not the one going through it!

But here it is again.  Sleepless nights, queasy stomach, and that gnawing feeling that I should be working on something…  whether it’s 2pm or 2am, I should always be working, right?  That’s what I’ve been preaching here all this time, right?

Wrong.

Here’s the cool thing.  We all know that anxiety is GOOD for you – at least when you manage it in a healthy way and use it as motivation to figure things out.  Anxiety is that part of your brain and body telling you to do something, to take action,
even that action might just be figuring out that you don’t have to do anything.  Maybe just putting the plan on paper is enough
to cure your anxiety.

I know that’s what worked for me this week.

Right now, it’s pretty simple – pack up the old office this month, move to new office, take care of all the change of address things that need to be changed.

Not too hard, right?  It’s the after-move stuff, planning for a bigger office, that freaks me out.  But that can wait.  That doesn’t need to happen for a little while.  I have enough to freak out about in the next few weeks, I don’t need to worry about the things that need to happen after this month.  Really, with a schedule like I have tomorrow, I don’t need to worry about much until later
this week.

Sometimes, the key is to take it one day at a time.  Maybe even one hour, or one session, at a time.

What has you freaked out these days?  Is it the big goals coming up next year (can you believe it is almost time for next year goal planning already?!   I can’t wait!) or the goals that haven’t been finished this year?  What are you doing about those freak-out topics?

I find it kind of funny – not “ha ha” funny, more like “oh wow” funny; ironic funny, I think….

Here I have been writing for over two years about going into your own practice, leaving community mental health and co-op practices to go into business for yourself.

And here I am preparing to set up a group practice to encourage therapists to come work with me…

I feel like I have some explaining to do.

It really starts with that National Health Service Corps contract I’ve been talking about for a while – the one where I put in 2-3 years of service under the contract, and they pay off my student loans.  For me to be awarded the contract, my
practice had to be approved – quite a bit of work.  And now that my service is about up, I thought it would be a waste to let the practice contact expire without someone else being able to take advantage of it.

I felt kind of lame telling interns that they should pursue the contract, but not having any place I would really encourage them to go work.  So, like I’ve said, it was time to put my money where my mouth was, and open up a place for those interns to have
a NHSC contract, and a decent place to work.

But what makes “a decent place to work?”

Because, let’s face it, my altruism only goes so far, and in the end I would like to have a bit of a return on my investment.  I’d like to earn a little extra money for taking the risk of bringing in therapists, putting up a building, and providing supervision – I know, that makes me evil, but I’m OK with that.

There is part of me that wants to make sure that those beginning therapists, and even those who may not be beginning therapists, have the best possible place to work, so that they can do their best possible work.

So what does that look like?

A fair fee split? Salary?  One of those nice Keurig coffee makers in every office? How about a billing system that works and gets you paid on a regular basis?

Maybe it’s a place that give you the ability to focus only on counseling and therapy, and not have to worry about marketing, insurance authorizations, and accounting?

What makes a group practice a perfect place to work?  How should I go about setting up a great place to work, and not become one of those places I warned you about?

These are the questions keeping me up at night…

I’ve been writing about the wonders of private practice on this website for around two years now.  I’ve shared with you my passion for working in private practice, the freedom and opportunity it brings to our lives, and the ways I have gone about building a
successful and authentic private practice.

I think it is time for a change.

Things around here have been pointing in that direction for a little while now.

I’ll tell you a bit about some of the things that have come up – almost serendipitously, and then we can talk about where things are going for this website.

I’ve been sharing for quite a while about the benefits of the National Health Service Corps Loan Repayment Program.  But I’ve been somewhat frustrated with the places I’ve had to send interns and new therapists to work in order to receive
the benefits of that program.

I’ve been dreaming about buying a place to fix up for an office, or relocating to a new office with a bit more room.  I figured that since I was planning on being in practice, in this location, for the next 20 or so years, it made sense to move into a more permanent location, perhaps one that would be a long term investment.

I approached a local wellness center/medical complex/fitness center to offer to speak to their members about mental health and wellness in relationship to mental/emotional health.  Before I knew, the conversation turned into bigger partnership opportunities and an offer of office space – we realized our goals and ideas for our community were a great fit, and that there were a lot of benefits to having my office there.

So it looks like I will be moving.  Soon.

With that, it is time to put my money where my mouth is, and open up more opportunities for therapists wanting to get a start in private practice, not just talk about it.  So I will be expanding my office to offer more opportunities to other therapists.

It all starts November 1.  Let’s face it, it starts now, it started weeks ago – the planning and pondering.

But that means I am not sure what will happen with this site.  It’s going to take some time and focus to make this happen.  I will
probably keep writing – I thought it would be fun to share how the change and transition works out, maybe there is something I can share with you for your benefit, maybe you will have something to share with me.

Right now, the plan is to keep the writing as regular as it has been – every Tuesday morning.  But I’m not sure how much longer it will keep going – I guess we will just have to wait and see.  It’s all pretty fluid right now, but you can count on this, it looks like I will have plenty to write about here.

…or with what pays the bills?

This was a fun discussion over the weekend with my younger brother-in-law as he looks to make big decisions in his young career.  Through that chat, I realized how much this concept relates to the rest of us.

Go with your heart:

Help those who need help regardless of ability to pay.

Dedicate your days to “the good of the client”, no matter how many hours per week you have to dedicate.

Don’t worry so much about when, how, or how much you get paid.

Go with what pays the bills:

Climb the ladder of corporate mental health until you earn that magic salary.

Hope that CMHS stays around long enough for you to have a full career.

Become and evil, greedy, “only think about money” capitalist pig.

But can you have the best of both worlds?

I think so – that’s why I am in private practice.

What do you think – can you have the best of both of these moral, ethical, and business worlds?

If you are going to run a business, if you are going to run a private practice, you have to be comfortable with money.  If you want to keep your business open for years to come, helping more and more people, you need to generate a PROFIT from
your business.  If you want to continue to grow your business, to help more people in more effective and generous ways,
you are going to have to generate MONEY to be able to do this.  In order to generate money – in order to make
a profit, you are going to have to learn to ask for it.  It will not fall out of the sky.

How do you feel about money?  Do you embrace it as a resource to help you, your family, your business,
and your client; or do you shy away from it?

What would you do if you had all the money you needed?

Would you take more vacation time so that you were more refreshed, relaxed, and re-energized when you met with your clients?

Would you offer a more comfortable and calming atmosphere for your clients in your office and waiting area so that they came to session relaxed and ready to do the difficult work involved in therapy?

Would you invest more in your own personal growth and development as a helping profession and as a person so that you could be a greater asset to your community?

What would you do?  How would that feel?  What would it look like?

How can you get there?

It starts with being comfortable with money.

Money is not good or bad.  Money IS.  We place subjective judgments – good, bad, right, wrong – upon it.
Money is a resource, just like time.  What we choose to do with it is positive or negative.

What are your attitudes towards money?  Were you taught that it is the root of all evil and to be avoided, or are you ready to embrace it as a resource to help yourself, your family, your clients, and your community?

Are you comfortable asking your clients to pay you a fair and honest rate for your services?    Or do you struggle to ask for their co pay, much less your full fee?

Being in private practice is considerably different than working for anyone else, or for a community mental health center.  One of the biggest differences is how you relate to money, and how it relates to you.
How would you rate your relationship with money?  If you are not happy with your relationship, what are you going to do about it?