Starting a private therapy practice means becoming a business owner, wearing all the hats, and being more than just a therapist.
It can feel stressful to suddenly have to step into a non-therapy role, especially if you never learned how or if you flat-out hate doing the necessary tasks that come with business ownership.
These things can become real struggles and roadblocks for therapists pursuing entrepreneurship, but there is also a solution—incorporating good support systems into your business operations.
In this episode, I talk with Amanda Landry, therapist, group practice owner, and co-moderator of My Private Practice Collective Facebook Group.
Top 3 reasons to listen to the entire episode:
Outsourcing is an important component of scaling a business, but there are good and bad ways to implement it, so it's important to approach it with the right mindset and plan. If you take care of the people taking care of you, you'll set yourself up for rapid growth and success.
More about Amanda:
Amanda Landry is a Licensed Mental Health Counselor, Certified Addictions Professional, National Certified Counselor, and private practice consultant. She’s the owner of a group practice, Caring Therapists, with several locations in Florida. Caring Therapists specializes in working with children through adults. They treat individuals, couples, and families.
Amanda is the author of Guided Journal for Women with Anxiety on sale on Amazon and wherever books are sold.
Amanda is trained in Cognitive Behavioral Therapy, Emotionally Focused Couples Counseling, Trauma-Focused CBT, and Eye Movement Desensitization and Reprocessing. Amanda specializes in treating anxiety and depression in teens and adults through holistic and evidence-based practice.
Amanda is the founder of My Private Practice Collective, an online community for therapists in private practice. She is a private practice consultant who helps solo and group practices build smart practices.
Check out Amanda's freebies to starting and growing a practice: myprivatepracticecollective.com/#freebies
Amanda's Website: myprivatepracticecollective.com
My Private Practice Collective Facebook Group: facebook.com/groups/myprivatepracticetribe
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Mentioned in this episode:
A Thanks to Our Sponsor, Owl Practice!
I would also like to thank Owl Practice for sponsoring this episode. Running your own practice is hard. With so many moving parts, it can sometimes feel overwhelming. That's where Owl Practice swoops in. Created specifically with mental health providers in mind, Owl offers a comprehensive HIPAA-compliant solution that helps you manage your practice in one convenient platform. Meet with your clients virtually through video therapy, which is fully integrated and built with security in mind. Manage client appointments and client records seamlessly. Streamline your claims process with Owl's integrated insurance and claims capabilities, and optimize your insurance billing flow. Use Owl to invoice and manage payments. Owl Payments ensures no sessions are left unpaid, and financial data is stored securely. Let Owl take you under its wing and handle the heavy lifting so you can focus on what you care about most, providing quality care to your clients. To discover everything Owl can do for your practice, start your exclusive 30-day, free trial. You can get started with Owl Practice using this link, owlpractice.com/atpp. That link is owlpractice.com/atpp. Get started with Owl Practice today.
Visit the website for Owl Practice here!
A Thanks to Our Sponsor, The Receptionist for iPad!
I would also like to thank The Receptionist for iPad for sponsoring this episode. As you prepare for the new year as a private practice owner, one area of your business where you might be able to level up your client experience is from the moment that they enter your office and check in with you. For many private practices, the client check-in process can be a bit awkward and confusing. Clients often enter into an empty waiting room. And chances are you're wrapping up a session with someone else, so there's no way of knowing when they arrive. With a visitor management system like The Receptionist for iPad, you can provide clients with a discreet and secure way to check in for their appointment while instantly being notified of their arrival. What's more, The Receptionist offers an iPad list check-in option where clients can scan a QR code to check in, which negates the need for you to buy an iPad and stand. Go to thereceptionist.com/privatepractice and sign up for a free 14-day trial. When you do, you'll get your first month free. And don't forget to ask about our iPad list check-in option.
PATRICK CASALE: Hey, everyone, you are listening to another episode of the All Things Private Practice Podcast. I'm your host, Patrick Casale, joined today by Amanda Landry. She has an LMHC. I get confused by all the acronyms and all of this since I am an LCMHC. In Florida, she is a group practice owner and a co-moderator of My Private Practice Collective Facebook group.
Today we're going to talk a little bit about being an entrepreneur, wearing all the hats, how having good support systems in your businesses are going to really help you flourish because so often I think we feel like everything is on our shoulders. And if we're not at our best, or if we can't show up, or if we're sick, then it can all come crumbling down without the right systems in place and the right support in place.
So, Amanda, thanks for coming on, and making the time, and really happy to have you here.
AMANDA LANDRY: Thanks for having me. I'm excited about being on the podcast. I am a listener and a follower. And so, I feel honored to be here today.
PATRICK CASALE: Thank you, that support means a lot. It's been a cool journey so far, and just love having people on, and just sharing their stories.
So, you own a group practice in Florida. I know you have… it's a pretty large-sized practice at this point in time. I can't remember how many clinicians you have. But can you talk a little bit about the fact, like, before we started recording, you were talking about your toddler, and like being a new mom, and like, all these responsibilities, and all these hats that you have to wear to keep things afloat. And I'm just curious about your story and your journey into this.
AMANDA LANDRY: So, I always tell people I never intended on having a group practice. I never even intended on going into private practice. I think I was like a lot of therapists when I graduated from grad school, it's like you just went and worked at an agency. And then, of course, what happens you get burnt out at your agency, and you're like, "Where do I go next?"
And so, you know, I started my solo practice by joining what was like a small group practice that was a renter, but it was a small group practice. And I realized, wow, I can do this and I would like to do this.
And over the past… this is my 10-year anniversary of being in private practice. I have grown from renting from somebody to a 40-person, five-location group practice, which if you would have told me that 10 years ago I'd never would have believed it.
PATRICK CASALE: Wow, that's impressive. And being a group practice owner myself, and having 15 therapists and two psychiatric providers, I know how much work goes into ensuring that the practice is running smoothly, and people are well taken care of, and the systems are in place. So, 45 locations, I mean, that's a major feat.
And do you feel like at this point in time that 40 soon becomes 50 becomes 60? Is that the kind of mindset that we're at?
AMANDA LANDRY: So, we're in a growth phase. I think I was nervous to say that before. Like, I didn't really tell… like I wasn't like, "Oh, we're going to go into our fifth location, we're going to go into our sixth location, we're going to have 10 locations." Like, I was nervous to say that. And now I'm very open about that like we're in a growth model.
Because I see what's happening in the industry. Couple things are happening. And there are a lot of solo practices where when I started there were not… I mean, there were solo practices, but there weren't that many. And there were even less group practices that were run by my contemporaries. It was really group practices who had been around forever, right?
And so, I know that I want to stay ahead of the curve, where I see a lot of practices being bought up by bigger companies and we don't want to get swallowed up. We want to stay competitive. And we know one way to stay competitive is to grow in a way that's strategic for our business.
PATRICK CASALE: Well said. Yeah, I think that we are in a new era of private practice ownership where I think COVID is the impetus maybe. People were sick of saying I'm going to go work and not be taken care of at an agency job and then you've got all these resources, and Facebook groups, and everything promoting self-practice, and private practice ownership, and taking a leap, and all that stuff. And you're seeing a lot of private practice owners, which I love. And you're right, you're seeing a lot of group practice owners better our colleagues. And there are a lot of practices that are being bought out by major corporations and major players in the industry.
So, tell me how you stay competitive? How do you stay ahead of the curve when you're thinking, I already see what's transpiring here and I need to be really intentional and strategic about how I move forward?
AMANDA LANDRY: You know, it's kind of funny, I would say one of the best ways that I gather a lot of information is Facebook groups. I see what other people are writing, what they're saying, what kind of referrals they're getting, what kind of questions they're asking. I try to connect, like you and I have connected, I've connected with many people that I'm sure listen to your podcast, or that are our colleagues, and talk to them about their practices, talk to them about where things are. So, I can hear. Like, I listen.
And I don't think I had put that together until you just asked but I listen a lot to what people are saying because that'll give you a lot of information. For instance, I'm seeing so many people ask for in-person session. Like, that's a big push lately. So, I realize, like, I think there will always be a market for virtual. But I realize for us in South Florida because so many people are asking for in-person, why not open a sixth location? Why? Because we know there are people asking for this. And it's not even just in my Facebook group, it's in all, like, I'm in tons of mom Facebook groups and local Facebook groups where people are like, "I want in person, I'm looking for in person."
And so, I think that's a big thing. And then, also, looking like at economic trends, what kinds of things are happening in our economy with other industries? What's being revolutionized? What's being bought up? Who's, you know, being laid off? And staying on top of that. I think as a business owner we have to do those things. I think we have to be clued in to what's happening outside of just our industry.
PATRICK CASALE: Yeah, great advice. And I think it sounds like you're saying you're doing market research by just simply connecting and being curious about what people are doing in our industry as well. And getting a sense of the trends, right? Like, in Florida, okay, we're seeing people want to go back into in-person sessions after two years of being more virtual-based. And in North Carolina, we're not really seeing that as much. I mean, it seems like hybrid is here to stay and telehealth is honestly taking over. And I think that just depends on your state and your demographic too. And it's important to really be aware of that because, otherwise, you're kind of going into this blindly and then floundering when, you know, the source of clientele, or referrals dries up, or the necessity or the supply and demand is no longer there. So, you're meeting a need by saying I'm opening a sixth location.
Now, tell me about like, opening your first and second locations, how much fear and anxiety was existing when you were like, "I'm going to start this group practice, open this location, and grow into a second." Tell me about that process for you.
AMANDA LANDRY: Every time I make a move, I always have some level of anxiety. Some of it is probably healthy because I think it's important to have some anxiety. Like, you're going to have to pay rent, right? Like, somebody's going to be knocking at the door. Like, you have to have some kind of emotion behind that to make sure you do the things you need to do in order to fill up your space.
And then, I have my own anxieties about doomsday and bad things happening. And that's the part I have to quiet down. I think when I opened up-Because that's the [CROSSTALK:
AMANDA LANDRY: That's the… completely.
PATRICK CASALE: …impostor syndrome every single clinician's going to quit on the same day, all of this stuff's going to happen and fall apart in one day.
AMANDA LANDRY: That's exactly where my brain goes. So, I have to quiet that down so I can be… For me, it's about being strategic in what we do. And so, when I opened my first location I remember feeling really excited. And then, for me the big step was when I went for my first location, we had a three-office suite to a six-office suite, and that I felt like this was big time. Like, this was a big deal.
And at that time, other group practice owners that I really respected were starting to hit numbers like 30,000 a month. Like, more than five years ago 30,000 a month was like a big deal in a group practice. Like, that was like you had really made it. Like, when I heard that my business coach hit 30,000 a month I was like, "Wow, like, they must be doing something so amazing." And so, to then push myself to go on a space that would be able to make that kind of revenue was really exciting. And since then we have certainly exceeded that and other group practices have exceeded that.
So, we all collectively I see have moved the needle forward, right? Where practices are making, like I remember when it was a big deal to say you made six figures in a year, which is still a big deal, no matter where you're at, but like to make six figures in one month? Like, that blew my mind. Like, sometimes I still can't believe those kinds of things have actually happened.
PATRICK CASALE: Right, absolutely. And it's a good reframe from starting point A to where you're currently at and going. And tell me a little bit about, you know, you have a larger group practice, you're growing, you're being really proactive and intentional. You also have a lot of responsibilities in your life and have a lot of different roles. So, how does that play a part?
AMANDA LANDRY: I was not prepared emotionally for the shift that was going to occur inside of me when I had a child. I don't think anybody could ever prepare you for that. And so, for anybody listening, wondering when they have children, maybe what that would look like, I don't think you can be prepared for that. And I think it looks different for everybody.
Prior to becoming a parent, I had seen a full caseload. And when I say a full caseload, I mean, I was seeing 25 or 30 clients a week for many years, and I actually enjoyed that. It didn't burn me out, it kind of gave me spirit in life. And, you know, I would take Friday's off and do my admin work. And that worked out really well for a long time. And even when I got pregnant, I kind of like chugged along, did my thing, we're all in the group practice, we're all seeing clients.
And then, I remember I was supposed to return from maternity leave. And there was something that I felt inside like that said, "I'm just not ready for this." Like, I was not ready. And at the same time, the group practice exploded. We were in the middle of COVID, we had hired a lot, we had promoted a clinical director, we had brought in an additional admin support. And so, while my baby was growing, my business was growing, and my time and effort was being really split between those two things, that there was no time or energy, let's even call it, left to see clients. And I don't think it would have been fair. I mean, I could have gone back and saw, you know, a handful of people, and really just done it that way. But for me, it was easier to make a clean break and say, I'm a mom, and I'm a business owner, and I'm always a therapist, I can't ever turn that off. But there was just a shift that occurred inside of me that really changed the role that I had within my business and just with my relationship with clients.
PATRICK CASALE: Yeah, that's really lovely to kind of think about it that way, that shift, and just realizing priorities are shifting and changing, and your energy is shifting and changing.
And that's probably a good segue into having the right support staff and systems in place to ensure that growth can continue despite maybe your inability to be as involved in a certain capacity or your role just simply changing because of life circumstance. So, you seemed pretty excited before we started recording to talk about that. Tell me a little bit about why that's so important and what you're seeing from therapists that you're connecting with, who are not able to do those things right now.
AMANDA LANDRY: Yeah, it's so interesting when I talk to a lot of people, especially, people in the solo practice level. I'm always surprised at like, how little admin support they have, right? So, if they're not answering the phones, answering emails, doing their social media, or if they're out sick, they don't have any support. And that's what's really hard about being a solo practitioner, which I think is why a lot of people are drawn to group practices lately because, with our group practice and many group practices, that's what's built-in. It's all of the admin support, somebody answering your phone, somebody booking your intake, somebody, you know, calling if a credit card gets declined or open supervision group.
So, for me, I think I realized I needed a lot of support and then I also wanted to provide support to the people who worked for me. And so, I knew we needed two levels of support in my practice. We needed the administrative support. I've always had somebody doing billing, credentialing, and answering my phones, even as a solo practitioner, just because I know I'm the kind of person I need support. Like, that's really important to me.
And then, I also knew I needed help clinically. I mean, I had been answering all of the phone calls, I had been answering all of the emergency services. And the other clinicians in my practice if I wasn't there, they were doing it but we needed a streamlined process.
So, I promoted a clinical director and hired to director of operations to oversee the different locations that we had. And that shifted a lot because now the clinicians had somewhere to go, with somebody who had the time, and could create that versus like catching me… I remember therapists just like, catch me between sessions in office, I wasn't even like, decompressed from my session, someone's like, "Hey, I have this client, and can you answer this, and can you answer that." Now, they had somebody who would be fully present with that. And then I could be fully present with my admin team and the time that I had. And so, it just shifted the rules that everybody had.
PATRICK CASALE: Yeah, I love that because I think that it makes things flow a lot more smoothly, both on the client experience side and on the clinical side, so that clients aren't getting like disjointed information when they call or email in, they're being scheduled, you know, with consistency, they're being discussed, and communicated to with consistency. It also ensures that you have that tiered level of support so that you don't have to be responsible for everything, you don't have to be responsible for every conversation that's going on inside the practice.
And I like what you said about having admin support in solo practice. And I know a lot of you listening that are just starting are like, where am I ever going to get the money to have admin support starting off? And that is a valid question and concern, but you are going to make more money in private practice than you did at an agency job, that's just a fact. Starting to reinvest and to outsourcing, to have the admin support because one thing I see in my Facebook group and all over the place is just like, "I don't have time to call clients back, I don't want to call clients back, my systems are so disorganized that it causes me extra layers of stress."
And we so often don't realize like, if I had a virtual assistant, or a scheduler, or a biller, or whoever, who took this off of me, where I didn't have to call Blue Cross four hours a week and deal with claim denials, and rejections, where I didn't have to spend an hour getting people scheduled and onboarded, you're actually giving yourself more time to make the money doing the things that you love to do. And that's why I think outsourcing is so crucial.
And we oftentimes only look at the short-term investment of like, but that's money coming out that I don't necessarily have coming in. But if you stop thinking about it in that way, and realize this is actually going to buy me time because one hour of your time on the phone with Blue Cross is not the same investment as it is doing one hour of clinical work with a session that you're getting paid for. So, being able to allocate what's important and having those systems in place is really crucial.
AMANDA LANDRY: I think that's probably one of the hardest lessons that I learned in being a business owner is what my hour was worth and what tasks I was doing was worth. That was a really big shift that I made, like, when I was the coachee, when I was getting coaching because I was, and again, I had always had an admin, but there were just some things I was doing that I needed to hand off.
I was thinking about it, when I first started, I think the first invoice or the first few invoices that I had sent over to my virtual assistant was like for $100 for the month. You know, I had found somebody local, which I felt very lucky to do and it was great. It really was not even comparatively that much money. And now we pay her way more than that. And she's worth like her weight in gold. And I had just always found that so helpful. But I still struggled with other things, even personally, like I was doing a lot of things, like a lot of things around the house that I could outsource much easier.
And that was a big shift that I had to make. Like, I didn't grow up in a family, like, we certainly did not have a maid growing up at all. I didn't grow up with money. And so, there were certain things I was kind of uncomfortable doing or uncomfortable experiencing, and I realized if I wanted to take my business to the next level that I would really have to let go of those things. And that I would really have to outsource them and pay for them, and I would make more money in the long run or the business would make more money. It's not even just for me to make more money, it's for the business to make more money, for me to do the things that I'm good at.
I'm a good strategic thinker. My clinical director often jokes like, we don't need you back in the office seeing clients, we can hire for that. What we need you to do is forge relationships and do the business planning, and to you know, get us offices, and to do that bigger picture stuff.
And so, at every stage, just the same with the anxiety, there's things I had to let go of, and I still miss my clients. Like, I don't think I acknowledge that probably as much as I could. Like, I miss seeing clients, I miss that clinical work, I still read and do podcasts, and try to stay connected in that way. But it has been a big shift to let go of that and to mourn that side, but on the flip side, to celebrate the successes that I've had in the whole group practice's side.
PATRICK CASALE: That's really well said. And I mean, it's a good way to kind of take a step back and to experience grief of transitioning out of potentially working as a clinical professional and therapist, but also the recognition that you're helping grow, you're helping create jobs and opportunities for people in your community, and by really using your strengths to your advantage, and really being intentional with your time.
I've had to do that too. Like, I didn't have many clients prior to throat surgery in my therapy practice, and post throat surgery I have zero now. And that was not intentional. But losing my ability to speak for long amounts of time has been challenging. So, it kind of forced me out of that capacity and that role. But it allows me to just have more time to focus on, like you said, growing community relationships, connecting, so that the practice can continue to stay successful, continue to get referrals coming in consistently. We want to ensure that our clinicians are well taken care of. So, that's priority number one for me in that business.
And I think that having good admin support, a good clinical director, good team leads on staff, really, really important because I can step away and not be anxious that my phone's going to be blowing up, or my email, or that something's going to come crumbling down. I trust the people that are in place. And that took a long time, not just to trust them, to hire the right people who get the vision, who are committed to it. But also, for my own control issue to be like, I can do this job, I can do this role, you know, I should be the one to do it.
And we stress that a lot is like, you may be good at something, but that doesn't mean you should be the one to do it. And your time can be better spent elsewhere, knowing that it can help lead to growth for so many different levels because you're not focusing on the little details every single day.entrepreneur, [INDISCERNIBLE:
AMANDA LANDRY: And that's important to me to both at my level and my clinicians level, which is why we try to be very efficient and effective in our group practice and the systems that we have because I want my clinicians to feel like they can come in, see their client right there, maybe go to a meeting, you know, once a month, come to supervision if they want to and that's it. Like, they don't necessarily have to do a lot of other things. So, I want them to also feel that. I don't want them to feel like okay, they're a part of a group practice yet they have to make phone calls, and they have to market, and they have to do all of these other things.
So, that has been I think a big part of our success as a group practice is that people can come in, they're joining something that is functional and something that is supportive, and that they can also have their work-life balance, and then we play at the top end of things. So, that has also been very helpful. Though we have a lot of expenses. I'm a very, like, fiscally responsible kind of entrepreneur where I'm not, like, putting out, like, large amounts of money for things that don't make sense for the business. I'm also very strategic. And I think that has been very helpful, then to be able to really put our money where we need it which in this past year has been in a lot of admin support.
We actually just did an overhaul of our whole leadership team, people got promotions, they were allotted more hours to work in their admin role. And so, that has been a really big shift and exciting because we've up-leveled the whole practice.
PATRICK CASALE: It's great to hear. I love that. And it makes so much more sense to operate that way. And you know, my perspective too, like, my group practice, I really try to prioritize people over profit. I want them to have work-life balance that we often preach in this profession but don't practice. And I really want them to just be able to show up and see clients, and not have to deal with the million other details. If they had to do that, why are they working for me? Go work for yourself because there's really no difference at that point in time. So, just really trying to change the way that these group practice structures are run too, in terms of how we treat the people who work for us. And I think that we both do that really well.
For everyone that's listening, do you have just any tips or advice if you want to create this level of growth and you're having multiple responsibilities and life happens, it's just the reality, just things that could be helpful for them to hear?
AMANDA LANDRY: Yeah, I think like our whole theme has like been getting support. And that's both personally and professionally. Like, on the personal end, like, are you seeing a therapist? Have you absolutely been in therapy over these past few years? Like, what other kind of support do you need? Whether it's family support if you don't necessarily have family support? Can you have like hired help, like people who can help you within your home and within your responsibilities? Friends? And then, at the professional level, like, do you have colleagues you can go to and get support from? Are you in a supervision group? Are you getting coaching from somebody? Are you doing things that are really connecting you to other people?
And then, from like a group practice, like, do you have enough admin support? Do you have a clinical director if you have a medium to large-sized group practice or you're thinking about that? Do you have enough people answering your phones? Where are you getting your support from? Because it's really, really, really hard to do on your own, for both personally and professionally. We all need support and assessing that, and I'm always assessing how much support I have, personally and professionally, and where we can kind of plug those holes.
PATRICK CASALE: Yeah, I love that. That's great advice. And that, you know, support comes in so many ways and can be obtained in so many different capacities too. And it is important both personally and professionally. I do think having your own therapist, having your own coach or mentor, mastermind group, a group of colleagues, just people you can bounce ideas off of, then again, the admin support, there's so many ways to have it. And it's really helpful, it will make your life a lot less stressful. Being an entrepreneur is stressful, I'm never going to sugarcoat that, but it's also unbelievably rewarding. And I wouldn't trade it for the world.
And I like to joke that my worst day as an entrepreneur is a million times better than my best day at my agency job. And I stand by that statement 100%. But that does mean you have to take care of yourself and really put the pieces in place to allow yourself to be successful too. So, really great advice, Amanda, I appreciate that. Can you please tell the audience where they can find more of what you're offering these days and how to find you?
AMANDA LANDRY: So, the easiest place to find me is in my Facebook group, My Private Practice Collective. We are, I was just looking, today 18,700 people which again is another thing that blows my mind. Never intended to have a Facebook group that large. So, you there, or if you're not on Facebook, myprivatepracticecollective.com. And if you're interested in learning about my group practice, we are Caring Therapists of Broward.
PATRICK CASALE: All of that information will be in the show notes so that you have easy access to it. And I just want to say, again, thank you for all the wisdom today and sharing these resources and these tips. This is really, really helpful for the audience to hear.
AMANDA LANDRY: Thank you so much for having me. I can't wait to share this with my audience.
PATRICK CASALE: For everyone listening to the All Things Private Practice Podcast, there's new episodes coming out every single Sunday on all major platforms. Like, download, subscribe, and share. Doubt yourself, do it anyway, we'll see you next week.