Building a diverse and successful associate practice in 2025 with Dr Esther Cole

Welcome to the Business of Psychology podcast. Today I'm joined by Dr Esther Cole, the clinical director and founder of Lifespan Psychology, which is a proudly diverse and thriving associate practice. She's here today to talk to us about what it takes to build a thriving associate practice, particularly in the more challenging context we find ourselves in in 2025. This is a must listen if you are somebody that is thinking about building your team and expanding your impact through associate work. Esther is also an impressive psychologist in her own right. In 2020 she won the BPS Early Career Award for a book that she initiated and co-edited on pediatric acquired brain injury. Esther has a great passion for helping people who may not always feel confident to come forward for therapy and may not always be well served by the therapy on offer, and that's part of the reason that she set up her podcast ‘Breaking Through Therapy’, which I think is amazing.

Full show notes and a transcript of this episode are available at The Business of Psychology

References:

10x Is Easier than 2x: How World-Class Entrepreneurs Achieve More by Doing Less by Dan Sullivan and Dr. Benjamin Hardy 

We Should All Be Millionaires: A Woman’s Guide to Earning More, Building Wealth, and Gaining Economic Power by Rachel Rodgers 

Links for Esther:

Breaking Through Therapy Podcast: www.lifespanpsychology.co.uk/podcast

BOSS: www.lifespanpsychology.co.uk/coaching

Website: www.lifespanpsychology.co.uk

LinkedIn: Dr Esther Cole

Instagram: @lifespan_psychology

Facebook: Lifespan Psychology - The Diverse Practice

Links for Rosie:

Substack: substack.com/@drrosie

Rosie on Instagram:

@rosiegilderthorp

@thepregnancypsychologist

The highlights

• Esther tells us about her podcast, Breaking Through Therapy 01:20
• Esther tells us about herself and her career, and how she came to set up an associate practice 02:39
• Esther talks about the most common mistakes she’s come across in associate practice 16:12 
• I ask Esther how we can encourage dedication from our associates 20:29
• We discuss recruitment and how to find the right people for your practice 26:42
• We talk about the skills you have to develop as a manager 34:10
• I remind people to listen to the Breaking Through Therapy podcast 44:29

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SPEAKERS

Rosie Gilderthorp, Esther Cole

Hello and welcome to the Business of Psychology podcast. Today I'm joined by Dr Esther Cole. Esther is the clinical director and founder of Lifespan Psychology, which is a proudly diverse and thriving associate practice. So she's here today to talk to us about what it takes to build a thriving associate practice, particularly in the more challenging context we find ourselves in in 2025. So this is a must listen if you are somebody that is thinking about building your team and expanding your impact through associate work. But Esther is also an impressive psychologist in her own right. In 2020 she won the BPS Early Career Award for a book that she initiated and co-edited on pediatric acquired brain injury. Esther has a great passion for helping people who may not always feel confident to come forward for therapy and may not always be well served by the therapy on offer. And that's part of the reason that she set up her podcast ‘Breaking Through Therapy’, which I think is amazing. So today we're talking about lots of things, but hello, welcome, Esther, let's get started by talking about your amazing podcast, ‘Breaking Through Therapy’.

Oh, thank you so much Rosie. Yes. So the podcast is a passion project. It's called ‘Breaking Through Therapy’. It's where you come on the show with your former therapist, discuss the breakthroughs, challenges, and the highs and lows of therapy. I really think it's actually, I if I had to define it in a nutshell, it would be a post-traumatic growth podcast because all the amazing guests we've had on the show have talked about recovery from everything from like addictions, sexual assault, trauma, heart conditions, physical health conditions. The most recent episode is going to be released on long covid, so how you cope with the monster of fatigue in long covid. So it's a post-traumatic growth podcast, I would say, and I hope you've been enjoying listening to it.

Yeah, I really have. And I don't think that there's much else like it out there. And actually, when I look at your career and the things that you've done, I could say that about a lot of things. I think that's why you've got that award actually, that you seem to be really interested in working with the people and in the areas where maybe they're not that well served already. So, tell us a little bit about you and your career.

So I have wanted to be a psychologist, I think since I was 14. I think at the time it was maybe writer and a counselor. So I'm really happy, like my inner child got what she wanted in the end. So, yes, I do think I have my dream job. I absolutely love what I do, and I worked in NHS for 12 years, predominantly with older adults, but felt that I had a lot more to give, not just in terms of sort of neuropsychological assessment, but also I wanted to offer a lot more therapy and wanted to work across a lifespan. And so when I had two children of my own, I decided to work privately. But by 2019 before the pandemic, I was diagnosed with a chronic kidney condition, and I thought, I was given five years actually until dialysis, so I had been like a ticking time bomb waiting for that day, which hasn't come, I'm pleased to say. But in the meantime, what I did was I built a team around me, because literally from my hospital bed, I was getting referrals, and I couldn't, I thought I wouldn't be able to work as a psychologist for many years again. And so around the time of covid, I was expecting our third child, had this chronic kidney condition and I onboarded my first two associates and, yeah, it was just, it's amazing. I now have 16, there's 16 of us and it's just been fantastic because I've worked virtually for all these years predominantly, I occasionally go into clinic, but the work-life balance, it's easier to work from home and just having this incredible team around me. We've won two awards as well. So we've won the Prestige Award twice in 2022 and 2024. And that's for psychological therapy specialist provider of the year and I think because we're the diverse practice, I think that's probably what's maybe unique about us. So we are from all around the globe. We're from, so my grandparents were born in Jamaica, so we're from Caribbean, West Africa, Tahiti, Hong Kong, Philippines, Europe, UK, we're from everywhere. And I just wanted psychology to represent, be represented, from many different perspectives and from kind of all voices to be heard, if that's ever possible. I know we will have blind spots and our privileges and biases that won't always allow us to see things from more perspectives, but that's where I'd like to say we are.

The way that your practice is now, and you know, I've had the good fortune of talking to you a few times about how your practice runs, it's really, it sounds really intentional and like that's a real strength of the team that you've built, that you've been quite intentional about it. But how did you, from your hospital bed, did you have this vision of what you wanted to create then, or was it a bit more like scrambling around and then kind of creating the vision as you went?

Oh, I definitely think I was in survival mode. I talked a bit about post-traumatic growth earlier, and I think this is a prime example of it. I definitely had hit rock bottom in lockdown. I was, I had given birth, I had a three and a 6-year-old and had this kidney condition and I had to homeschool two children, me and my husband, and then we had no sleep at night and we're in the lockdown. And I had to make it up as I went along. And so the reason that I've developed this new coaching network and community called BOSS, is because I had to make mistakes and work things out as I went along the way. And if I was fortunate, I'd bump into some amazing people who could help me along the way. But it was a, there was a lot of guesswork and, you know, our doctorates don’t prepare us for the business of psychology!

Not at all. And actually…

I just made it up as I went along.

Associate practice is very, very difficult to get right and, you know, certainly my experience, and I'm sure yours as well, is that often you might meet people that have been doing it for a long time, but it's never actually worked for them. So yeah, when I get under the hood sometimes of people's businesses that have been established for a long time and they're thriving in terms of they're helping loads of people, they've got loads of associates, but actually often those people are not able to pay themselves properly. And when I say properly, I mean anything you would recognise as decent compensation for the level of work that they're doing. And that's not sustainable. You know, that leads to burnout. It leads to overwork, it leads to resentment and feeling undervalued by both your associates and your clients. And that's a really tricky hole to get out of. And so, you know, I was really happy when I saw your network pop up and you emailed me about it because actually. I know that you've built a model that does work and helping people to get to that faster and ideally not building these beasts that break them in the first place is something that I think we're both really passionate about, because that's where good care comes from, I think.

And that's a brilliant point you make. It's getting more and more tricky to make any sort of profit or to make ends meet or to make the fees work. We are really struggling against, you know, insurance fees that have been capped, and just the economic climate and people not feeling they can afford to self-fund for therapy. And then we've had large global companies come and suck up a lot of the online work and undercut us, particularly as clinical psychologists, so I am here, so the BOSS stands for Business Owner Support Squad. And what I've been doing for over a year is supporting people at different stages of building an associate practice. And we can, we have group coaching sessions and we have one-to-one coaching sessions. And I really enjoy helping people to thrive and like, make those numbers work because they can work for you, but there's many different components to it and you know, there are, there are many different costs as you know, to running an associate practice. Everything from the admin to the accounting, to the software, to the marketing, to your own time. And yes, you can burn out very easily if you don't get the balance and, and the formula, right.

Yeah. And I think a lot of getting it right comes down to that intentionality. And for you, I wonder, because your business success, I mean, our stories are different, but they have some real similarities, don't they? My business became a lot more successful when the shit hit the fan, and I had to make things work in very constrained circumstances with no time, no support, and you know what, on paper looks like a nightmare. And you know, yours sounds even worse actually. But I think sometimes when we have those big constraints, we find the creative ways of working that are smarter, not just harder, and you have that intention because it's right in front of you. I have to make this work under these circumstances. So I do wonder if that kind of pressure cooker is part of the reason that you were able to create such an intentional business which had to work.

And I think you're right. You know, every hour is spoken for as a parent, within your day. And the stay at home mum is just a really unfortunate term. That's not what we're doing when we're staying at home. We have a million hats that we wear as parents, and whether it's a nurse or the taxi driver or providing the nursery or the being the chef, or being the doctor, being all, you know, and you know, you've shared your journey raising children who are neurodiverse and the extra challenges that you might face. So you are constantly, you know, advocating for your family and their needs and having to find space for yourself amongst that. So I set up parent and carer BOSS as well because I was aware that obviously we need to find the creative ways that you've spoken about. We need to support each other along that journey of raising a family and managing a business and managing a team of associates. But yes, you do have to get a lot clever. So in terms of time management, so each unit of time, each hour, it has to work for you and your family. It has to work for your business. So, I'm much better at saying, what is that going to cost me in that hour and what am I going to make in that hour? Because before I could easily make a loss in that hour, in that unit of time and not use it very wisely.

And I think there's something about physical health challenges as well, where it's like, okay, I don't have infinite energy, so I can't work late into the evening. I can't say, oh, don't worry, I'll just, you know, work every time the kids nap or whatever. That's, it's not an option. I'm sure it wasn't an option for you when you were going through such a difficult time with your physical health. But I think in a way, the silver lining of that is probably that it means that you can carry those good boundaries forward into hopefully a time where you are feeling better, but you're still hopefully not tempted to do what many people just get into the habit of doing and overworking all the time, making no space for rest.

And, you know, it's really fascinating. I haven't finished it yet, but I've started reading a book, 10 X Is Easier Than 2 X.

Oh, I've read that one. Yeah, it's a good one.

Yeah. You'll know the authors. So, and there's just something about taking that, that step back, that huge step back and really thinking, you know, rather than working twice as hard, doing double what I can, like you say, working into the small hours of the night, who can I bring in or what can I do? What can I automate or what can I streamline or what can I… what's going to give more power in the system for me to scale this all up? Who are the right people to have around me? How do I create that time for rest and holiday and breaks while still earning an income? And I think that's where that book is actually really quite helpful, I think.

It is. And you know, just to say for anybody that you know, reads that book, I really recommend it and I listen to it on audio book actually, and I found it a really good one for my power walks. I walk in circles, learning stuff and all my neighbors think I'm insane, but I do it all the time and that's the best way for me to learn. I found it really, really valuable for helping me to think about if I want to make a really big impact, if I'm not happy with the impact that my practice makes at the moment, and I want it to be a much bigger thing, and I do have this real calling actually to change the mental health system, which sounds so grandiose and I'm aware I'm not going to get there, but this book is all about set a goal that actually you don't think is achievable. The point is not we're going to go and achieve the goal. The point is to get into the mindset of what would need to be different for that goal to happen, and then maybe you'll achieve 10% of it, but you'll get somewhere. Whereas when we are just thinking about making micro improvements all the time and setting realistic goals, which we've all been trained to do, then we tend to just work harder at what we're already doing. And that won't, that won't bring the big changes, if that's where you want to go. But I did find, and I don't know how far through you are at the moment, when I got towards the end of the book, I started to get a bit annoyed about all of the examples being, oh, old white men really, and then not really referencing the privileges that they had and so I read, the next book I read was recommended to me by Claire Plumley, friend of the podcast, as an antidote to it and it, but on similar themes. And that's Rachel Rogers' book, We Should All Be Millionaires by Rachel Rogers. I really recommend it. If there's part of your mind that resists the 10 X Is Easier Than 2 X concept, and we will all probably have a bit of our mind that goes, ah, that's all right for you, but I couldn't do it, she writes from, you know, a really different position, but she provides loads of practical implementation tips, like even kind of templated emails and stuff like that at the end of her book which really help you to visualise how this looks, how this might look in my life, so I found those two together really helpful. But anyway, getting off my soapbox about books, what I really wanted to ask you about was the mistakes that people make when they're building a team. Because we've both seen a lot of people making mistakes building associate practices. What are the most common mistakes that you've come across?

Okay, so I don't want to be judgemental in terms of saying that it's a mistake, because there'll be people who kind of maybe have this way of managing their practice and it works for them, or, you know, it depends on the context of a lot of other things, but one thing that people maybe lose sight of is how much time and investment goes into onboarding a new member of a team. So actually taking that time out to be with them, to teach them how your practice works, help them to learn the software, induct them, help them register with insurance companies, all the things that you need to do in the beginning to make a really good working relationship, it is almost a bit like having an employee still. I think people may underestimate the time and effort and energy that goes into onboarding a new member of the team and haven't costed that. So we do take a marketing fee, it's only small, but it's nominal really just to, so that we know that the person's serious about committing to working with us, and it's the cost that you might be, might be associated with, like, putting them on the website or making social media posts, a bit of time for your onboarding and having that one-to-one meeting with them or paying for your administrator to have the one-to-one meetings with them. So I think onboarding's probably one of the big costs that people haven't really factored in. Other mistakes? Probably charging too low a fee. Overall to all new clients, and insurance companies where they could be asking for a higher fee, but also asking for too lower commission from their associates or too lower cut if they're taking the fee up front, because you've got all the invoicing costs if you're invoicing for them, the cost of your administrator to chase, the cost of getting them the new client, whatever marketing costs have been associated with that, the cost of bookkeeping that, the cost of the software that they're using. So I think really the mistakes tend to be around how much things cost. And then in the end, you might as well just seen the client yourself, you know?

Yeah. I think there's a real resistance in a lot of people that I've coached to actually knowing those numbers. And when you're a solo practice, I still think it's important to know those numbers, because that's what helps you make the decision to outsource certain things, often. When you look at, okay, how many hours do I actually spend faffing with this and what does that cost me? I think that's really important to know. But when you are bringing in associates, it is so important because this is exactly how people build massive practices and then pay themselves minimum wage. Because I worked out in my practice what the monetary cost per associate per month was. And I couldn't believe it. I could not believe it. And you know, I can share what mine was, each associate of mine costs £250 a month, and I never would've anticipated that if I hadn't sat down with my spreadsheet, I would've estimated it more like 50 quid probably.

Sure, that makes sense. Yes. And so it's really important to have a certain number of clients that each associate sees. So I know it's the dream scenario that your associate would only work for you and you know, they don't work anywhere else and they've got all the hours that you need them for. It's not always the case. Often they work in other places, they also work for themselves part-time. So you may be in the beginning struggling to get the hours you need and the availability you need, but that actually costs you more. So I think that's a really big one. If you've got an associate who's only available half a day a week, you're going to spend time obviously seeing if a client will fit that availability that's going to cost you time and money, and then when they say no, they don't, you're going to find someone else. And so I think the more availability the associate has, the more kind of dedicated they are to your practice, the more business sense it makes because you'll have fewer costs, I think. So the 250 should go down per month.

How can we encourage that dedication from our associates? Because it seems like you do have a really nice, kind of cohesive team ethos. How have you managed that?

I think I've really attracted people who, quite a few of my associates have actually emailed me to work with me because they like the diverse practice ethos. They like the philosophy around it being a diverse practice. My values of diversity, equality, and inclusion, I know it's not flavour of the month anymore, DEI, but it'll always be a priority for me because I think, you know, from all we, our tagline is basically, all ages, all stages, all backgrounds. We're here for everybody and anybody and want everyone to feel included regardless of race, religion, background, sexual orientation, I don't think there's that many people maybe just screaming that from the rooftops, but for us, this is really, really important and I think we've attracted like-minded associates who are also big on those values. And then I do throw in quite a lot of perks, so like, the more clients an associate can see, the more perks they get in our practice, for example. And I think that works quite well.

So what would be an example of a perk that works?

So we, I provide sort of cash back on, so if you see, if you have 20 appointments a month, you get cash back that you can use towards your supervision or your CPD. So the more 20 appointments they have per month, the more 80, like £80 is the figure. So they get that towards supervision, either with me or someone else or CPD that they can put that towards. I also offer an employee assistance program where they can have free counseling, 24 hour legal advice and helpline. We've got like a wellness app. I offer spa spa days and wellness days, and I rarely get to see them, so they always know that lunch or dinner or a spa day will be on me. So those are some of the things that we throw in.

I love that, and I think it does need to be more than just a referral generation system. I think very often associate practices, all they're really doing for people is giving them clients. And while we know that actually acquiring those clients is a huge amount of work, often our associates are not aware of that. And they start to think, I could just make more money if I did this on my own. And, you know, sometimes that's even true because, you know, there might be a lot of demand in a particular area. So there has to be another reason that they want to work with you. And I think those strong values that are so clearly infused through your practice, that's probably the sticky stuff. And then the perks just delights people and makes them really happy to, you know, to see you whenever they see you. Yeah, so I think that's really good to share with people.

We also offer CPD days. I was doing them every month, but the availability of everybody doesn't always align, so we do it every two months, and then sometimes I'll bring a fellow boss on. So we had the wonderful Diane Everett come and talk to us about autism and ADHD assessments, and then we record it so anyone who couldn't make it could watch the recording. And they've really responded well to that, having that CPD available to them. And, I try and like tailor the CPD to what it is that they want, but they don't always express an interest, so I kind of just go with what I think is going to be useful. And I also do a monthly newsletter as well.

Yeah, I think all of that stuff, it's that nurture, isn't it? And you know, helping people to develop and become, you know, better clinically and more fulfilled professionally, I think all of that, that's the reasons that we enjoy staying in any job role that we've had. So I think really the most important message for people to take from this is have a vision for what you want to create, and it has to be more than, I just want a bit of extra money, because there are easier ways to make extra money, I would say.

Oh, yeah. Yeah. I agree with you. And like you said, there's nurturing that goes on and I've got to make sure that I’m, I meet with them regularly, I'm on top of what they're kind of professional and personal, professional development needs are, and yeah, that I'm guiding them really, actually providing a bit more than just, like you say, just the referral and that hands-off referral, stream.

Yeah, and all of that costs money, but in terms of your time and also resources and so that's the bit that you have to price into the commission that you're taking. And I don't know about you, but sometimes it can be a bit triggering when you see in professional groups, people being very critical of services that take a higher commission when really the context is so important. Like yeah, of course I think it's unethical to take 50% from somebody's fee if you're not really giving them anything. And we've probably all had those experiences where it is just a referral engine that's taking a massive fee, but a service like yours is providing so much value to those associates that your percentage seems cheap, really.

And I don't take 50%! I probably could increase my percentage at some point, but no, I'd rather have a team that stay with me, and take a lower cut. And so I've had, you know, I've been blessed with team members have stayed for up to four years, so yeah, I'm quite happy. I think the balance seems to be working really well for us and I think the least amount of time I've had an associate’s a year at the moment. That's my track record, for the current group of associates. But that's not to say that I was there in the beginning because I definitely wasn't, I hadn't gotten the formula right and people would leave within six months or, you know, and it, yeah, you get better at working out who's the right fit for your company or your organisation and what's going to be motivating them to stay and what's going to work well for you as well.

Yeah. So I suppose there's two sides to it, isn't there? There's recruiting the right people, which can be really challenging. And then there's that ongoing management, which we weren't trained for. And I think, I always have so much admiration for people who become managers in the NHS because I left before that point. So I really had no management experience at all, and I really, it's a skill that I really admire and have tried to learn about over the years, but doesn't come particularly naturally, I don't think. So let's try and, you know, give some tips for both of those things. So firstly, starting with the recruitment, how do you find the right people? Have you got any sort of nuggets of gold to share on that one?

Yeah. I've helped people, so if you wanted to have, anyone listening wants to have a one-to-one coaching session with me, or come and join the BOSS group, please get in touch. But there are ways, and I think Indeed was the, Indeed Jobs was the first place I actually found my first associates, and then another way that people are not necessarily aware of was the universities are often quite keen to have jobs advertised. So I tend to approach universities around this time of year for the current trainees. And then the first year of newly qualified psychologists. Now some people might be listening thinking, oh gosh, I don't want a newly qualified psychologist, I work with people who've got at least three years experience. Well, I've got a whole mix, so not everybody is newly qualified, but I do really like, obviously supporting people. some people might say I'm stealing from the NHS. They tend to still be in the NHS at that point in their careers. But yeah, I think, so the universities and Indeed are probably two avenues people haven't tried, but LinkedIn's great. And then your website as well will attract people if you put a job advert on the website. And yeah, I think those are sort of the main, the main ways. And I think word of mouth, I've had people recommend associates to me and have had people hear about us through word of mouth and have approached me as well, so always let your network know you're looking as well, and they might know somebody in your local area or somebody who want, wants to work remotely if you have remote work, and they'll recommend people. But I think maybe we're all a bit too shy of actually asking for what it is we need. Don't you find psychologists are a bit reserved and saying, I need referrals or I need associates. Like, just say what you need and somebody out there might actually be able to plug you in with something.

Yeah, and actually that's something that I've learned to get a bit better at, being honest about what I need for the practice. And again, I think there's a bit of a mindset shift that needs to happen before you expand out into associate work. We have to stop thinking about the practice as you and start thinking about it as its own entity that requires nurture, and when you do that, I find it a lot easier to spot, okay, well, the practice requires somebody that can work at least five hours a week for us, the practice requires this level of commitment and this, and it doesn't feel so difficult because it's not me, it's the practice, and I'm running the practice rather than it being, you know, an enmeshed part of me.

Yeah, yeah, that's really helpful. It's that step back again, isn't it? That perspective.

So, because I found the first time I used Indeed I got like 250 applications within like two seconds. Oh, it was so overwhelming. And you know when, I follow somebody on Substack who talks a lot about nervous system overload, and it, it really, I honestly, I had to shut my laptop and run away from it. I didn't have a good reaction to this at all because I was like, how am I ever going to be able to sift through those people? It felt like I was saying no to like 249 people, which didn't feel comfortable at all. It was awful. And what I learned from that experience was to put out really quite a discriminating job advert, which would let people know, this is what I'm looking for. Like really give people a sense of this is the values of the practice, this is the commitment that we need. If you align with this completely, apply. If you don't exactly, if there's something about it which isn't going to work for you, then maybe at a future stage, but not now please. I found that so hard, but it's made a difference.

Yeah, you've gotta be really tightly specified on what you're asking because you will get people randomly applying, hoping that they will… oh, this happened to me so many times, I need somebody normally for southwest London and somebody who lives two hours away will apply who's got no intention of traveling, and then I can't say no. And if they're listening, my associate will know who that is, because I couldn't say no to her! So I end up trying to build around her and she, she won't mind me saying this because I can't, I can't always say no, but I let her know it was going to be slow. Like, I don't work in that area, so if I'm going to find you work, it's going to take a few months. So I think it's just about taking that pressure off yourself and like you say, knowing exactly what it is you need, your company needs rather, and being able to say no, it's not the right fit. And the right fit is always, always a good phrase I think to use because it's not personal, is it? It's not the right fit.

Yeah, I met some wonderful people. The last round of interviews I did, I met people that I honestly feel like our souls are slightly connected. Like I really, I had so much in common with, like obviously something about the advert had magnetized people who really do share those values. But quite a few of them just didn't meet the requirements for the kind of work that we get. And so I was like, oh gosh, I might actually work out trying to get some of the type of referrals that would be right for you, but I have to say no now because I'm not in a position where I can say, yes, I'm going to really commit to getting that sort of work in, we just don't have it right now. That is so hard. I don't think, I don't think for me that will ever be easy, but I have sort of learned it's necessary.

Yeah, but then exactly, I mean, you've just, you've got a gold mine there Rosie, of just all, how many associates did you manage to like potentially have in the bag there? Because you could be, you could be like a recruitment agent for all of us. You could recommend all of us. You could always, that's the point, isn't it? If you wanted to, just like with the referrals that we can't see, you say, you know what? I don't work in addictions, but I know somebody who's amazing who does. The same for you. And whether or not you take a referral fee for offering that as a service, that could be something you could do. There's always ways of monetizing things. We're not always comfortable doing that. But recruitment consultants, consultants do it all the time, don't they? They say, you know, we could pay you £300 if you find somebody for this job. You know, it's possible. There's a lot of, that's a lot of interest you got in your role.

Yeah, I suppose that's a really good point actually, and I think we do need to, as business owners, be smart about the skills that we have that maybe we take for granted. That actually could be valuable to someone else. And how we can be paid for doing things which maybe don't feel like work. Maybe they feel really enjoyable to us. So thank you, that's really good food for thought. And thinking about the management side of things, because I don't know if other people have a phobia of management, but I really did, and it was the part of my MBA which I found the most challenging, but also the most useful to me because I really had no clue about this. So can you say a little bit about the skills that you've had to develop as a manager and what you think is really important?

This is really, really interesting and I'm sure there'll be a lot of occupational psychology and coaching psychology papers on this. But from my own personal experience, I started off using my psychology skills because that's all I had, right? And a lot of that was be nice to people and, and like, imagine what it is they might need, like mentalize, you know, kind of what would I feel like being inducted into this company? What would I need if I were you? So that mentalization, that empathy and those listening skills and that, so I very much approached it as a psychologist first of all. And then the management side of things, I suppose it comes with like, the more of the leadership and the boundaries and the, you know, what does your company need and what do you need to, you know, performance isn't great or. If it's not, if they're not a good fit for your team, how do you work on improving that or let, letting somebody go, letting somebody know that they're not a good fit? So the sort of, the harshest stuff around boundaries and management had to come with time, I think of just… it isn't easy, but I think it's probably easier than maybe being a manager in the NHS where you don't really have control over who you're managing or what your targets are or what your outcomes are. As I really do think as a business owner, you have a lot more say in, or how that all goes. And so it's probably an easiest, easier type of management than I would say like the NHS or or another organisation. It's your, it's your baby, isn't it? So ultimately you need to do what's right and yeah, compassion, but not too much, I suppose, and leaning into your leadership skills and things like that.

Yeah. I think I always feel for NHS management that the difficult bit is that they are squeezed in the middle. So they've got the needs of the people that they're managing that they usually feel very connected to really care for, but then there's also the kind of needs of the executive. And certainly my experience of the NHS is, those people are really far removed, it's very rare, you don't get to know the inner workings of their mind and why they're saying that they want to make this change that you know the people that you're managing are going to hate. You are not really privy to the inner workings of why they're doing that. And actually, I just contributed to a chapter on leadership for a book being edited by Amber Rowe and this is what my contribution was. It was actually learning through the MBA how the economics of healthcare work. I can now see why some of the, I still don't agree with them, some of the decisions that were being made when I worked in the NHS were made. I still don't really like them, but I do understand them and I think if management can communicate that understanding in a way that's digestible to their teams, it's much easier either to get buy-in and, you know, we find a way to make this policy work for us as a team, or actually to advocate against the policy. Because what I notice is often we know that the impact of a policy will be bad for our clients or for the people that you know, we are working with. But because we haven't got that piece of the puzzle where we can make the counter case on an economic level, for the organisation or for, you know, the economics of healthcare in general, we are not invited to the table because they think that we're just naive single issue advocates. And it's like actually we are all intelligent enough to understand enough about economics and organisational finance to make a good case for why these things that don't feel comfortable to us probably aren't also the best and most savvy financial decisions, which, you know, they've turned out not to be.

Absolutely because, you know, we save on sort of child mental health and we think about the future of our children and the new generations. You're not really saving long term, are you? It's a false economy to save now when you are going to have more costs in the future, whether that be, you know, God forbid, you know, costs in prisons or costs of unemployment, or costs of mental and physical health. You know, real severe, mental and physical health issues further down the line. So I think preventative medicine and preventative care on child mental health, money should always be spent there, but it's just cut and cut, isn't it?

Yeah. And you've got to learn to speak the language of the executive, the commissioners, whoever it is, making those decisions at the top of an organisation in order to advocate properly, and I think that's where there's often a gap in knowledge for mental health professionals because we just weren't taught about it. And it's not rocket science. And we all, many of us instinctively do know, it's just you don't know how to frame it in the right way to be heard. So, yeah, I mean, I think we went on that digression because we were talking about the difference between NHS management and managing our own practices. And I think the wonderful thing about independent practice is that you have this agility, you get to decide what is important in this practice and if that changes because you learn something different, then you get to change it and then trickle that down to the people that are working for you. So yeah, that's a real delight, I think, in independent practice.

Yeah, and that's what we're here for, isn't it for you, Wendy Kendall, myself, coaching to offer people support in management if they're really struggling, and the groups and the networks, You can always thrash these ideas out and, and troubleshoot. There's a Facebook group I've set up now as well for BOSS. So any issues you might be having, just give us a shout out in that group.

Yeah, because I think often people feel ashamed that they can't figure this out on their own. And actually, like with so many things, we're not really supposed to try and do all of these things on our own. It's okay for there to be a hive mind, and even when you're in a position of coaching other people, you know, there are things that I will come to you for advice for, you will come to me about other things. You know, might talk to Wendy about other stuff. Like, we all need, we need this collective sharing of expertise and experience because absolutely nobody has got it all sewn up. No one.

No. And that's what's so difficult about social media. Everything looks so perfect and glossy. That's why sometimes I don't even post because I'm thinking this is not authentic. Like I'm not going to post this most perfect picture of me when actually, no, it’s not been a great week or it's not been a great day. I want to show you how it really is. So yeah, I'd like to hopefully be posting, I try to be authentic in what I post anyway, but I think that's the problem with the day and age, isn't it, of how perfect everything looks.

It is. And there's only so much you can do to counteract it. So, you know, I think when we met at the Christmas party, actually, people were saying to me things like, oh, you've always got it so together, you're always so confident. And I was like, oh my goodness, I've actually tried really hard to make my social media not give that message because you know, I'm not confident 99% of the time. And you know, things feel very chaotic a lot of the time. And I just really want to normalise that because I've had the good fortune of meeting lots of successful people, you know, yourself included, and nobody is feeling like they've got it all sewn up, everybody feels like their life is chaos, that it just does not exist, this image of, you know, serenity and feeling a hundred percent fulfilled and aligned at all times. Actually, when we are growing as people, things are breaking and being rebuilt all the time, you know, personally, professionally, in business, that's the nature of the beast. And so yeah, social media really frustrates me and it demotivates me. You know, when I hear things like that, it makes me not want to post as well and think, I just don't, I don't believe in the messages that are being put out here. But yeah, that's probably a whole different topic for a whole different day.

But I think honestly though, with what you project out there, we have confidence in you, if that makes sense. Like you might not be feeling 99% confident or confident 99% of the time, but we have confidence in you. And even like listening to your podcast, the first I listened to, I think was interrupted by your children. I loved that. That made me feel so connected to you because I just really felt like I was in the room with you, and that's exactly the sort of thing that would happen with my children. And it really humanised the whole experience and made me feel like, actually, yeah, I could do a podcast because Rosie had had children in the background, that was fine. And it was actually great, you know, so I don't think it's necessary that you have to be, you are seen as confident all the time, but I think we're confident in you, if that makes sense. So hope that's a nice…

Oh, I love that.

…nice reframe.

It really is. So well, before we finish up, I just wanted to remind people to go and listen to your podcast, Breaking Through Therapy. It's a really unique and interesting listen, there's so much out there which is the same and this is something bringing something really different, which I think will hopefully encourage people to feel confident to access therapy that might not have felt confident to do that before. But also as a professional, I think there's loads of lessons to learn from it. I love listening to other people's journey in therapy and taking what I can from that as a professional. So thank you for bringing that to the world, and I just want to give a proper big plug for it, because I’d really like everybody to go and listen.

Thank you so, so much. It's so hard, you get hidden under a rock with the search engines these days and AI, but it's so powerful and very passionate about people hearing the real stories of real people who've been to therapy and coming on the show with their former therapist. Nobody's doing that with, you know, having that bird's eye view of how therapy works and what the breakthroughs are and the post-traumatic growth. I think Esther Perel has done it a bit, but she's part of that dynamic, so for me it's different to bringing actually the client and therapist on the show together, if that makes sense and having independent hosts. So I hope you all like listening and do gimme some feedback on it, and rate the show and subscribe, that'd be great. Thanks Rosie.

Yeah, no problem. Yeah, you're all on your podcast apps now, so search for it. So it's a really good one to listen to. So thank you so much for being with us today, Esther. I feel like we've covered a lot and there'll be lots of people that want to go and look up the BOSS Network too, so I'll make sure that all of those links are in the show notes.

Thank you so much. It's been amazing. I could talk to you all day.