Turning a practice into a service with Dr Melanie Lee

Today I am delighted to be talking to Dr Melanie Lee from Trust Psychology and Trust Pain Management about how she realised she needed to create something bigger than her and the process of turning a private practice into a psychology service. 

The highlights

• I welcome Mel to the podcast and she tells us about the two services that she runs, who she helps, and how she helps them 00:39
• We discuss the support and collaboration that having a team of associates provides, and Mel’s associate model 02:47
• Mel mentions a number of Business of Psychology podcasts that have helped her (see links below) 10:23
• We talk about how there are different ways of running a business, and that it’s an ongoing process 20:41
• We discuss the importance of networking 23:03
• Mel tells us how her business evolved 27:18
• Mel talks about knowing if she was financially ready 34:09
• I mention that Sally Farrant is adding an associate model into her pricing class for Psychology Business School 37:58
• Mel shares her reflections on her personal journey, and an exciting new international collaboration 45:32
• Mel tells us where people can find her if they want to connect 55:59

Links:

Where to find Mel:

https://www.trustpsychology.co.uk

https://www.trust-pain-management.co.uk

LinkedIn: 

Dr Melanie Lee 

Trust Psychology 

Trust Pain Management 

Podcasts mentioned in this episode:

Business of Psychology:

• Why every psychologist and therapist needs a specialism
• Psychologists and therapists still need mindset work. Getting to know your values and dealing with your mind
• Creating a purposeful practice part 2 with Michaela Thomas
• Using Youtube to Reach more people with Dr Clare Roberts 
• Social entrepreneurship. Making the change you want to see with Dr Asha Patel from Innovating Minds
• Case Management: A creative and flexible way to work for psychologists with Dr Shabnam Berry-Khan
• How to set your fees in your psychology private practice with “pricing queen” Sally Farrant

Notice That Podcast

https://www.beyondhealingcenter.com

 **********

Do you sometimes wake up at 2 am worried that you’ve made a terrible error that will bring professional ruin upon you and disgrace your family?

I’m laughing now but when I first set up in private practice I was completely terrified that I had “missed” something big when setting up insurance or data protection.

Even now, three years in, I sometimes catch myself wondering if I have really covered all the bases.

It is hard, no impossible, to think creatively and have the impact you should be having in your practice if you aren’t confident that you have a secure business. BUT it can be overwhelming to figure out exactly what you need to prioritise before those clients start coming in.

I’ve created a free checklist (plus resources list) to take the thinking out of it. Tick off every box and you can see your clients confident in the knowledge that you have everything in place for your security and theirs.

Download it now from the new link:

https://psychologybusinessschool.com/client-checklist

TRANSCRIPT

SPEAKERS

Rosie Gilderthorp, Melanie Lee

Welcome to the Business of Psychology podcast, the show that helps you to reach more people, help more people and build the life you want to live by doing more than therapy. Today, I'm delighted to be talking to Dr. Melanie Lee from Trust Psychology and Trust Pain Management, about how she realised she needed to create something bigger than her, and the process of turning a private practice into a psychology service. So hi, Melanie, welcome to the podcast.

Thank you so much, Rosie. It's great to be here. Do feel free to call me Mel as well.

Yeah, I will now. So first, Mel, can you tell me a bit about the two services that you run? Like, who do you help? And how do you help them?

Yes, sure. So, Trust Psychology and Trust Pain Management are both based in the northeast of England. Our office, which I'm sitting in today, is in Jesmond in the centre of Newcastle, but we operate across the region. And now of course, with zoom opportunities, even in a wider geographical stretch to that as well. But we exist really to offer a trustworthy responsive service to clients and to the referrers with particular client need, particularly in the medical legal area, so case managers and solicitors often refer to us, particularly now for our new pain management service, where we have a multi and interdisciplinary team of psychology, occupational therapy, and physiotherapy working together on a collaborative team treatment plan sort of formulated together and informed by the same principles. So we've, we've grown, it used to be just me at the start in 2016. And now we have unbelievably, I was just counting everybody up earlier, 16 Associates, including different professional backgrounds. Now, of course, not everyone's full time or doing this for the their sole employment or income, people have a range of other things as well. But it's our real kind of core vision is to be able to keep people safe in connection and look at psychological trauma driven, formulation driven services that particularly focus on chronic pain, that's our area of specialty.

And I love the fact that it is a multi disciplinary service. Because I think so often when we do our formulation, it doesn't involve just you know, seeing a psychologist in a silo, we can see that all of these other intervention to be really helpful. But it's quite rare in the independent sector anyway, to find a service with all of that under one roof.

Yeah, absolutely. There are a few people doing it at different points in the country, or with a different focus, perhaps, than pain specifically. But it really came out of reflections both on how it felt for me in private practice, to be doing something, really, as you've spoken about many times with some of your other guests as well, you do this for a grander, sort of a greater purpose and a vision of what you want to offer the world that you feel you've got more opportunity to innovate and achieve in the private setting. But what struck me quite quickly is I really missed my colleagues. And I missed having a team around me. And of course, thinking about just diversity of opinion and highlighting your blind spots. But I've been incredibly lucky to have connections with people that are maybe a few steps ahead of me doing other private things. So learning as well about the benefits of outsourcing that you've spoken about a lot before. And really honing where your skills are best placed, as opposed to trying to do everything yourself. So it came out of a real need to have people to talk to, to get excited with the the greatest moments which have kind of surprised me, or when I get feedback from a referrer or client around what one of our associates or team members have done. And the pride of the collective enthusiasm is just fantastic. I really enjoy that side of it.

I can really relate to that. I think sometimes when you're sitting on your own in a room, it can feel really terrifying. Especially if you get some complexity come your way or there's a client who's really difficult for you emotionally, then you just don't have that colleague connection to back you up and to feel supported.

Oh, absolutely like that. I think from, there was a real part of me, I sometimes speak in parts because I'm really interested in IFS at the moment, internal family systems. So the, there was an absolute part of me that did this for the support of aspect as well in the collaboration. But what's brilliant is if you really look at what the evidence base says for psychological therapies and particularly for approaches like chronic pain, that we're really doing a disservice to our clients if we're not able to give them that holistic, multidisciplinary or interdisciplinary, all really working together approach to be able to establish not just what the client needs, but make sure you're on the same thread throughout. Because what all of us have been part of teams, where it's much more linear. You see, particularly in my old service, in the NHS, sort of seeing a consultant anaesthetist first perhaps, getting a medication review, going on the waiting list for physiotherapy, and then psychology. And we would all come together for the pain management programme, but to be able to offer, and this is where we started, when I spoke to my, my colleagues, initially, we just got in a room and had some coffee and said, like, if we could do this in the way that we wished to set it up, how would it look? And we came quite quickly to the realisation that it would be three of us in the room together with the client at the same time, offering a very held containing experience. Also keeping in mind not to be too overwhelming, that as well. So lots of different factors to consider. But just starting to talk about it generates that level of interest, and I've been amazed at the amount of people said, Yeah, Mel, count me in, I'm there, even before we fully fleshed out what it really looks like, of course, all of that work is still ongoing. It's an ongoing process.

Yeah, I think I can, I can see why people would jump at the chance. Because so much of the time, when we're working in, you know, either the NHS or other public services, you feel like you're compromising on what would be best practice. You know, sometimes you feel like you're not even able to follow NICE guidelines, let alone what you might think would be best practice. And so the opportunity to create something which ticks all of your professional boxes, where you can go home at the end of the day and think I gave the absolute best that we can give to that person. I think that'd be extremely alluring to lots of people, I can totally see why people jumped on board with you straightaway for that one.

Oh, absolutely. It's, it's not just that kind of supportive nature for you as a professional and the absolute reality of we need to be held to do the best possible job for our clients, just like parents need to be held in order to support their children. It all goes back to that, those core attachment and understanding of those ideas, but to feel, again, having feedback for some some colleagues that there's something like warm and fuzzy that happens when we all connect together, that we're doing something that absolutely embodies our values. But the more we've been doing this together, the more we're able to really articulate what is underneath that. So I might have said to you before, when we were talking about my emphasis on process over content, which is the single most greatest lesson I learned from my doctoral training, and the role of the therapeutic relationship, but just the, the how of what is happening, not just the what. So that always drew me to the relational approaches, and trying to think about how we really integrate. The thing that I think's missing in a lot of healthcare, you know, this when you're a client or a user of services yourself, is that lack of integration throughout. Who's holding you, especially at times of great distress, or in times of pain and agony. So we've come up and it's been lovely, again, to have a team collective idea around our values, like what are our values, so to be able to come back to trust and to be able to come back to core safety. So we've got these phrases that we keep talking about in the team, which is, trust the process, attend to the relationship, and think about how we can really integrate and be value driven, like so many of the acceptance and commitment therapy principles, which is not my core therapeutic model, but a number of my team members really embrace as well.

Yeah, I love that because I think often that is the piece that can go missing, really sadly. But from some of the services that I've worked in, I had to reflect on this as part of my MBA course that I'm doing with Warwick uni. And I had to reflect on leadership in these departments. And I was like, actually I think one of the fundamental problems is that when I go on these trusts websites that I worked for, I don't recognise the values. They were never spoken about. They were never part of that service really, it wasn't I couldn't see them in the work that we'd done in the way that we'd done it, which is really sad, but I think not uncommon for bigger organisations to lose their values in that way. Whereas the opportunity in independent practice of building something with the values right at the core of it, and not letting go of those, I think is fantastic.

Oh, absolutely. And I really valued your podcast episode when you invited us all to go into, particularly thinking about our niches, but thinking about those values, and I really appreciated your attention to this is going to be painful guys, actually, because I found that having been named our values which are trust, given our name, integrity, and responsiveness, as well as the underlying kindness and compassion that is there as well. That by having those core values named, what that allows you to do is every decision that you make not only clinically decision wise, but business decisions to the direction we go, how we respond to this particular issue with an associate, with a client, with a referrer, based on those values, and it means that it's likely in time that most team members or associates within our service will make a similar decision, or will do things that are driving towards that greater shared vision, because we're, we're doing our best to embody, which I think is so crucial when you're working in the area of physical health and trauma in particular. So something that I often talk about, and I was trying to think, where I got this from, and I honestly can't remember, it was something a supervisor said to me, as a third year clinical trainee. But if you imagine an upside down triangle, I use this a lot in my sort of supervision as well, with process on one corner, formulation on the other, and technique or strategy at the at the base there, then, unless you've got the attention to the trust in the process, and I'm not just talking like lip service to therapeutic alliance, I'm talking about really doing the rupture repair work that we know has to be done and using therapist core self and awareness of you, in order to negotiate that relationship, which is an ongoing thing, then once that's established, then you can look at the formulation. Are we on the same page? Do we have a similar understanding of what we're trying to do here? What is your need at this point in your life? And as you know, for a lot of people, the work is just that; process formulation, process formulation. And then and only then does the technique or strategy come into play so that the idea that you can do protocol driven treatment, or treatment that is following a set, you can absolutely have a thread of a treatment plan. That's that's, of course very important. But moment to moment attunement is so critical. And what frustrates me is the lip service that is often paid to the kind of technique or strategy. And that even that model by itself has really helped us as a team, work out what order we need to do things in, because until we know each other well and trust one another, and then think about are we on the same page, then we can talk about how we're going to do it, how we're going to deliver it. And I see that everywhere, people thinking that they're doing the most useful thing, but then wondering why they're getting into stuck points. So the idea of doing a kind of formulation driven, which I think psychologists are fantastic at, you know, we don't get it right all the time of course, we've got our blind spots, but particularly in business and the marketing strategies, you hear mindset being thrown out all over the place. And I'm, I've actually reached out I think Michaela's episode with you the other day when she just said, I reached out to these people. I've done it a bit myself now, so thank you, Michaela. And I'm going to be interviewed for a business podcast, like reaching out to say, look, you need to talk to psychologists, if you're talking about principles to do with mindset, and self regulation, we know that we just keep it protected in the sort of therapy realm. And there's so much greater application, even thinking about...

And it's so interesting that you kind of started out by think, it sounds like you kind of started out by thinking how do we want to approach this for clients and making sure that you and your team were working from the same page. Because of course there are clinicians who wouldn't want to work in that way, but they wouldn't be the right ones to work with you, which is a painful truth but a reality. So making sure that you're all on the same page in your approach to clients, but in doing that, it's also formed your approach to the whole business. And right away, you know, from the high level stuff down to the marketing plan, which is absolutely what I've seen happening in my business too, really important.

And I think all of your reflections and conversations about that have really spurred sort of me as a listener of your podcast on to as well. And because then if you're embodying things, it feels authentic, doesn't it? And so much of the time we we deny that or we step into the, what we view as the professional mode. So your conversation with, was it Claire, about the YouTube experience?

Oh, yeah, that was fantastic.

That idea that we just need to start and go, and even people, there's been fantastic episodes with Asha from Innovating Minds about, and Asha and I connected at the end of a webinar that she ran recently. And it is just taking that extra step, isn't it to say, let's just try it and see and trust, the fundamental training that we have, and the fact that we do do this day in day out, that you know, if it takes what is it that that concept of 10,000 hours to become an expert in something. And if you count out the amount of hours post our qual... even pre with our assistant roles as well, then we're there. We do know about this. So it's okay to go and share that. The key idea with marketing that really stuck with me, because of course, we don't know anything about business, we're clinicians aren't we? That that actually marketing, particularly from an ethical point of view is about sharing what you can offer, and telling people about it. It's It's so different to I think how it can be perceived in other setting, and I think that's true, when you get a lot of the conversations that happen, say in the Facebook pages that we're all part of, what to do with client cancellations, or DNAs, or what to do in all of these ethical dilemmas, then going back to those core values and those principles is is fundamental, isn't it? It just gives you that held contained space.

Absolutely. And almost a route map for any anything you could encounter.

Absolutely, yeah. It's almost, you're almost formulating yourself, aren't you based on these core principles, this is what our formulation would actually suggest we do. And it's been fantastic to have a team to be able to pick up the phone to and just run it by them as well with what would you do? Like, do you think this is okay, if I do this? And I absolutely invite and welcome everyone that joins our team to do that at every single stage with me, I'm always on the end of the phone, I have lots of conversations with people just get like your your held and your you're welcome here, because if you're not safe, and I have had some feedback from from people in the team about what that feels like in relation to other services that they've been in, because I myself was an associate when I got up and running, and to be more than just a sort of a provider or a number where you're just sent a referral, and assumed to be getting on with it and just talk about the nuances of what does it mean, to charge this? So what's going to happen with the collection of the money? Or what's going to, what's that going to mean if you've got something going on in your personal life, to have other people that can step in or offer that support? It means that people have got longevity then, we've got haven't we that prevention of burnout that we all worry about, particularly in private practice I think,

Yeah, exactly. It sounds like a real team, rather than I think some sometimes an associate model can be built where it's, you know, I'm the main practitioner, and I'm just going to use associates when I'm too busy. And that's not a team. Whereas with your model, it's an associate model, but it sounds very much like you work together and and see yourselves as a team, which feels quite different, I think.

Oh, thank you, Rosie. I think that's such an important point, that it's very tempting to look at what other services do and I certainly did that early on, like, how do you do an associate model? Is it a referral fee, and then they have to take care of everything themselves? Is it a percentage, and we do certain things, but not other things. And of course, those the whole spectrum of oper... different options within that. And I think one thing I would say to people listening is it can be very tempting to think, how should I do this or what's the right way to do it? Rather than going back to those values and thinking about, okay, what do you want to do? What does your service need, and you've spoken to this with systems as well actually even template systems like I use BrightUp and Tresorit and then monday.com for the project management side of things. And each of them needs a slight tweak or an adaptation and doing what we're doing with this multi and interdisciplinary working, we might even need another more case management based software, to think about everything being integrated. And thinking about really how you can use technology to do that. And there are so many ways that you can, again, use your formulation driven ideas to dictate what it is that your service needs, and not to be apologetic about that. I think I'm just learning to keep focused on our direction of travel, and be aware of what others are doing and invite conversations, but not to get too concerned by it. Of course, so much easier said than done absolutely.

It's so hard to let go of that idea that there's a right way of running a business. And I think if I could, you know, if I could leave listeners with one message it'd be there isn't a right way, there might be a way that works better for you, but you know, there are people running really successful practices that look totally different from each other all across the country. And that's great. Because it means that we're serving a diverse group of clients, if we're if we're providing completely diverse services,

I think something you were relating to earlier, just before we started recording as well, is about the ongoing process, that nothing is a finished product anyway. And it can be very scary, or you can be quite hesitant to make the first step, or take the first step until you've got it all sorted. And we haven't not got it sorted by any stretch of the imagination whatsoever. I um, I had the real great fortune of having some sessions with a business coach just before Christmas, which was actually funded through our local council in Newcastle. And City, and City Life, I should really name that because it was absolutely fantastic. Tracy Clarkson, from Lark Partners, was able to offer me eight hours of her time with my team later on, as well as sort of senior collective team, to talk about business development. And that was only through some of these emails that you get connected. And so many of those emails you might delete or pass on, but really want to make people aware how much support there is out there. I think Asha has spoken about this before as well. We've just applied for grants to help us develop our website, because that's been a real sticking point for me. It's not anywhere near where I want it to be. And we, our recruitment of associates is happening, at such as such a rate that to keep that up to date is a real challenge in the midst of clinical work and everything else that we're doing. But now we've got the opportunity with this, potentially granted, fingers crossed, that we can again, go back and think to the team like this is what we're thinking about what we want to say on it. Are there other factors? Or can we future proof it for potential webinars or subscription services in the future? There's, it's, there really is a lot of support and help out there if you know where to look for it.

Yeah, there absolutely is. And I think often we we don't engage in our local business community enough, so we don't find out about it. But this is another reason I'm always going on about go to networking events.

Yeah, I don't know if you're part of the Federation of Small Businesses, FSB, I've only recently heard about it, and it was through a LinkedIn contact, I've joined. And that's a fabulous resource in terms of free web, I mean, you have to pay your membership, but again, the networking, already, there may be avenues for sort of partnerships or referral opportunities. And just feeling you're giving something back to your local business community in terms of what we can offer as a psychological and chronic pain aware service, especially when you've got things like long COVID having such a huge impact on the the employment sector and the working life adults moving forward. So those collaborations and partnerships can really come out of left field if you just keep your eyes open to them.

Absolutely. And it was only through going to some really corporate and weird sounding business meetings that I learned about the social enterprise community and realised that I was in fact running a social enterprise. And then once I embrace that, then you know, I'm now on lots of mailing lists, where I'll find out about little pots of funding that can do things like get your website up and running and, and really help accelerate your mission. So I couldn't emphasise more to people being visible at networking events is yes, it's great for marketing, but it's also great for just the development of your ideas and your business. And yeah, getting that support that is out there, and we might as well access it.

Definitely and something that the business coach Tracy really emphasised for me that I hadn't thought about at all really, from the marketing perspective. And again, that's still something we need to work so much more on that we're just scratching the surface of what's possible, people do not know we exist, a lot of our referrals are still through word of mouth. So I'm sure that by the time we really get ourselves in a position that we know what our strategy is, and we're implementing it. And again, that's frustrating, it takes time, you have to divide your time between home and family. And it's okay. Like, it's, it's lovely when my some of my team say to me remember the slow burn Mel like we're getting there, it's happening. But Tracy really encouraged me at these networking events to really ask the questions of your kind of core referrers as well, what is it, you know, we might assume what it is that a case manager needs. And also Shabnam's service, when she's doing the psychologically driven case management is just fabulous, isn't it, just being able to consider those gaps in the market around what it is, that has happened up to date that people just assume will continue. And I've had that experience with some of my cases. And in that there's there's things that have the medical legal framework encourages or puts into place, that actually we wouldn't think is very safe psychologically or is going against some of our core values and principles, but were in the system, so how do we reflect on that with others that are working within it? And that those moments to reflect and step back and to, you know, in time I'm really keen for our team to have regular case reviews, when we think together about what did we learn positively and in terms of improvement for cases, and share formulations, and because you've got that opportunity, if you set up your your associate model, where it is a collective that is much more team focused, then you can be thinking about things like the GDPR protection and the decisions you have to make about what's shared and what's not shared within the team versus in individual cases. And all of those things, come back to really deciding from an associate model kind of where, where you're starting from and where you want to get to, because I have to reflect on the fact that what we've got now is maybe not exactly fit for purpose. And we're still evolving it as we go. But as we said earlier, yeah we have...

Well I was going to ask you about the evolution of it, because I know from talking to you before this, that you, you didn't start out with the same vision that you've got now. And things kind of organically started to evolve. So can you tell me a bit about that process?

Yeah, absolutely. If I think back, it was probably 201/2016 I started my private practice part time. And I'm incredibly lucky that my my other half the lovely Dave Lee, Dr. Sleep, he was already doing some of this work and was very encouraging to me and incredibly supportive. So he had a number of contacts and suggestions about kind of how to get known and where to get started. But then, what I was able to do is just start generating those sort of referral links. And then like we said, I missed people, I miss the the, the ability to have those conversations with colleagues and share. I missed being excited with people, Rosie, like, there's nothing greater than being at one of our meetings and us kind of all talking about the fact that we're passionate about the mind/body connection, and then getting excited about it. So I was lucky enough to be able to go full time in private practice about 2017 that just coordinated with some life events that were happening, Dave and I got married and it was just the perfect timing to, to move from being... because I had some part time cases, or in during cases that I was doing in part time hours, to then just to have a greater number of flexible days. And Trust Psychology was sort of born there. And it's it's fascinating looking back, because when I thought about the name, I knew intuitively I didn't want it to be my name or something about where I was located, I just there's something about that just didn't sit with me. And I just wrote down a load of words that I associated with what I do and psychology. And Trust just stood out to me. And I'm so delighted I picked that because now thinking about the, the evolution to Trust Pain Management and how that fits with our core ethos of what we're trying to offer, people seem to get it quite quickly. It's got kind of multiple meanings attached to it. And now I know that that kind of intuitive instinct was that the the kind of the early seeds growing in terms of the culture and ethos of what we've created. And I have to say it's just moments of conversations that you don't expect. So I've got a fabulous colleague in Vicki Gilman who runs Social Return case management in the northeast, and she's a lovely friend who's championed me from the word go. And she said to me a while ago, sort of Mel I can tell you're going to make this work, like, I can see that you're going to make a success of this, so just for another person to have that faith in you, and then she said, you do know with your pain experience, there's a real lack of that, you know, there's a real need for a team approach for this multidisciplinary, interdisciplinary, working. And if you had a team rather than us going to individual services, that would be fabulous, it would be cost effective. But again, that absolutely fits with the formulation driven approach, because you're not you, the, the associates on my team today are people more often than not that I've worked with considered for a considerable amount of time before now. So I know we know each other, we know how each other work. And people have got different circumstances and can give certain amounts of time to what we're doing. But starting from that basis means that we've, we've again, that the trust bit’s kind of already being worked on, and then we can talk about the formulation, and then the tech technique and the strategy of it. So Vicki said about that. So getting, getting then just those moments of reflecting back going, I can't do that, like y'know with that imposter syndrome. How on earth would you even begin to do a team like what, what do I need to do? And you can get absolutely overwhelmed by those early stages. But you just start with conversations. So I had a chat with Dave and I'm like, who would I really love to work with? And then people's names just just jumped into my head, picked up the phone, let's have a chat and a coffee. Let's just think about it. And it's evolved from there. People come on, just take one case to start with. I sort of share how I've done it up till now. We work on it together. That was manageable, and and then approaching the physiotherapist and occupational therapy colleagues and doing it having a similar conversations. What I did not expect then, was that people would find us, like it's been word of mouth. I've, I have a part of my website that talks about the we're open to kind of associate inquiries. But other other than the people that I've approached directly, I think a huge proportion of the people in the team now have found us or heard about us. So have, and I honestly didn't expect that to happen, I thought they'll probably be two or three of us for a while, we'll see how it how it evolves. But yeah, here's probably a lovely opportunity just to do a shout out to the lovely dream team. So...

Yeah, please do.

Yeah, no, I just want to really say my deep gratitude, and thanks to first of all, our senior management team, which is a concept that's just evolved since COVID, because we've had these additional times to think together and use zoom to connect more frequently than we would do. So Alan and Catherine and Sonia, and then our physios Chris and Jenny, our occupational therapist, Margaret, our clinical psychologist and counselling psychologists. So I'm glancing down here to make sure I don't forget anybody. It's so important. Hannah B, Christy, Leslie and Sarah, Jenna, Hannah W. James, Lois, Zoe, Mike and Amanda, and those who have contributed along the way that maybe have other things going on in their lives right now, were Liz, Rob, Kathy, Suzanne, and Kev, thank you all so much for being part of what we're doing together. And I, you know, really enjoying working with you and looking forward to a kind of where it's going to go next.

Oh, that's so lovely. And I guess it sounds like it wasn't too difficult for you to find your dream team. But one of the other things which I know really holds people back when they're thinking about building something bigger than than just them is knowing how did you know that you were financially ready to do it?

That's a good question. And the answer is I didn't. I didn't know I was financially ready. But what you can do is thinking about the associate model, and the choices and options that you have. There is always, depending again if whether you take a referral fee or whether you do a percentage, and thinking about what I wanted an Associate's experience of working with us to be, and not only to have opportunities and to be part of something that and to you know, have access to CPD or have access to training things that we might not have been able to do in certain roles when funding is restricted especially in current times is the way that we offered it in terms of we, we provide the the administrative support and the internal supervision, keeping, of course, that clinical guidance, if people need to go and get separate formal supervision elsewhere or talk about things completely separate, we've got those arrangements as well. But working out a model whereby the the money that comes into the service is then going to be more than the fee that's paid the associate. So you've got that window, which then goes back into the company, make sure it's profitable, make sure it's sustainable. And then thinking really clearly about what the flow of that money is, as well. So very often, as people will know, with medical legal cases, there can be months when you're not paid for those. So having a system where people are paid in lieu, or paid for, you know, I will guarantee that you if if a client DNAs that you as our associate will get paid for that session, and it's up to me, it's on my shoulders to chase up that money afterwards, and making sure that there's enough funds in the company that you have that cushion space and wiggle room. And I think the honest answer is it's never enough. Like I worry a lot about it, there's a lot of work I've had to do personally in private therapy and with mentors about where we are financially. And, again, the business coach was really helpful when I have these doubts, about saying but Mel, something's working because you're earning money. So you, there are things that you can control and there are things that you can't control, so try and put as much cushion and thought behind it. But what has been so useful, coming back to the core idea of trust within the service as well, is that conversations are always possible. So I've, over time being more and more transparent with the team, and especially now my senior management team that knows everything about what's happening in the business and where we're at, when snapshots and what we need to do, so to have other people's opinions on where we should be investing and where we should be holding things back, takes a lot of the responsibility off my shoulders. Now clearly how you set the business up in terms of limited companies and partnerships. So a social enterprises, has legal and financial and tax implications, and that needs to be thought about. But this this, and it will all come back on my shoulders. It's for certain aspects of those. But I'm okay with that for now. Like I, you know, I have to be able to manage those risks and talk about that at home and have, you know, having contingencies is also an excellent idea. But there's so much about trusting the process as well. And your episode with Sally, the pricing queen is just brilliant. Like being able to, I've, my prices are still not quite where we want them to be. So to be able to think about what you want to be able to offer an associate. And then think kind of what do I need to charge then to be able to make that workable?

Yes. And I think that's the piece of the puzzle that we often miss out if we don't have somebody like Sally, saying, no, you've got to think about every little thing that went wrong, like just then you mentioned oh, you know, it's sometimes it's difficult to get paid for DNAs. But we want to pay our associates for that, I was like, oh, yeah, that's something I would not have thought of, but would cause a real financial problem, because sometimes it's taking that time, isn't it, to make the spreadsheet of the worst case scenarios? And actually, Sally teaches a class in Psychology Business School about pricing and she's adding in for this round, the first time, she's adding in an associate model for us. So yeah, so she's actually presenting it tomorrow, so I haven't seen it yet. But I think that's going to be a spreadsheet, which basically, you know, takes us through how to do like a cash flow for an associate. And it that sounds really, really powerful. Empowering.

Yeah. And I can absolutely say I haven't got it right yet. Like, there are things that we have spent more on than we should have, or I regret spending it on. And you just have to look at that and learn but also know that to truly grow and invest, then there, you're not going to be able to sit at a comfortable level, that there might be times when you're spending a huge amount out that's eye watering, especially when you talk about subscriptions, and monthly monthly commitments to things. But one of our philosophies, if you think about the trust, again, is trying to take some of that anxiety away from associates but being clearly transparent about if there's ever going to be any issues that are a struggle for us, we will tell you as soon as possible. And I've been really surprised the amount of people have come to, come forward and said, Mel, we want this to work, so do whatever you need to do to keep that sustainable, even if that means we need to come up with differences to what we originally agreed, although that's not been necessary to date, but to still have that discussion is so supportive and confirming, because you can't know what's going to happen, like COVID, some of our regular contracts just changed in terms of what, what we were able to provide or thinking about. And I, we'd just taken on this beautiful new office. And then all of my kind of room higher projections went out the window, because we couldn't use the rooms. So you just adjust, don't you, you roll with it. And this models therapy, it comes back to exactly what we've said before. And you've done such a fabulous job in the Do More Than Therapy community about kind of greater reach and all of the things that we can do. But Hands up, I adore one to one therapy, I would spend as much time as I can doing that, and the the kind of the marriage of the art and science that happens there. So to think about the fact that you've got to roll with it, you've got to keep attending to that attunement and relationship the whole way through your therapy, you cannot predict everything. But as long as you're flexible and adapt, then you're more likely to to be in a position as as you go along that you don't panic or react too quickly to things, which I've done, and I've regretted it. And I think actually that that is not the responsiveness of our service value, that was a more reactive. So even if it's a sleep on it before you make the ultimate decision, send an email, check in with someone, they can be really helpful things to keep in mind.

I really like that analogy, because I think so many times in business, I've done something less than ideal, like just like you were saying, you know, maybe I've spent 1000 pounds on a course, which actually was the wrong course, and not something I needed. Or, you know, I actually I did it on an Instagram creators course. And it was all about taking amazing photos. What have I spent my money on? That's a mistake.

That will come in handy at some point, I'm sure.

The amount that I beat myself up about that at the time, because it was quite early on in business, and I did not have that money to spare. And it felt like what a colossal mistake. But actually, it's just one of those instances where Okay, that was a bit of a rupture, I'm going to repair this and get back on track.

Absolutely. It's the same philosophy. And I really like it, particularly Catherine, who was the first person to join my team as our full time administrator. And this is another point actually, Catherine and I knew each other before, we talked anything about sort of what I was trying to do with psychology, and it was just me and her for a good year and a bit. And Cath... we knew each other through our book club and being mums at the same school. And it just so happened, it worked out brilliantly, she wanted to do some working from home. So don't always jump straight on the internet or Google or find people out there, you know, see who's local, see who you've already got connections with that you might find the ideal person right there.

I love that. And I do think when I think of the most successful business owners, I know, that is what they've done at the beginning. But I think possibly the reason a lot of people don't do that is this embarrassment we have about talking about what we do. And I know, I think I shared on the podcast before that when I set up my business, I tried to not use my name anywhere. And like the idea of the other mums knowing that I did this. But actually, it's not until you overcome that, that you get any success with your business, you've got to be able to talk about it, you've kind of got to enjoy talking about it and being passionate about what you do in front of the people you know. And so actually doing that reaching out to your network, and for something like that, you know, I'm looking for admin or social media support or any of that it's a really great way of getting out of your comfort zone.

And actually going back to my some of the team members about what we've talked about, you know, we might be developing the website soon. And people know people don't they? Somebody knew somebody who was sort of really good branding expert, or people have other connections that you can't know about until you just put it out there. But when you know someone and you're developing those relationships, one of the things that we worked on really quickly was about sharing those mistakes as well. Like, let's just put it out there. So Catherine and I have loads of conversations about uh-oh, another booboo by me, sorry. And by having that transparency, it then takes all of the defensiveness or personal responsibility away and we just say, Okay, what was it about that moment that led to that? It was probably a systems issue, to be fair, like we've repeated something and then use the wrong information the second time, so that, but that I think, particularly for associates or team members, there can be a huge fear about coming forward and saying, I'm not sure how to do this, or you've asked me to write this report, but did you want me to include that bit or this bit? So to have open conversations, provide templates and say, this is what we're looking for, but of course you're gonna have your clinical clinical autonomy regarding the fact that you're an independent individual practitioner, but come to us and I, and I try and model that myself with making mistakes. And it's not easy. There's certain things you feel deeply ashamed or embarrassed about. And that's why all of the personal therapy journey work is so important. So, which part of me is holding that, let's just let that step back and relax a bit. So actually, we can come forward and say, this is a, this is a process. This is a journey.

Yeah, because I was going to say, actually, because I know we're getting short on time, so we've got to wrap up a little bit, but it just sounds like for you, and for me, and I think for anybody running a business and expanding it, it's a real journey of self development as well as business development, you can't do one without the other. And I was just wondering if you had any reflections on your kind of personal journey?

Yes. And actually, this is a really good point to reflect on right now. Because there's, there's, I say that because I've got some really exciting news about an international collaboration that we've just developed. And that literally happened last week. And it came out of my personal sort of development journey. So it's going back to that idea of find your joy, find what your purpose is and what your mission and vision are. And this idea that, you know, we don't need to tolerate pain, we really have so many things that we know about now. And I, I've trained in cognitive analytic therapy, and EMDR, and CBT. And I know, parts of ACT and parts of CFT. And all of us are doing this all the time we're integrating. But one of the things that my personal experience taught me is I'm really frustrated that there's a lack of kind of integration, you know, you can, you don't want to be these kind of, you're an integrative therapist, but you don't want to be pulling things with no clear formulation. So I said, you know, what I need, I really need an overarching model, or framework that will bring all of this together. And for those of your listeners that are EMDR trained might know about the Notice That podcast, which is Melissa Benintendi, Jen Savage, and Bridger Falkentein, across in Missouri, actually, in Springfield, Missouri, in the States, they've been doing this amazing podcast, around EMDR principles and bringing in attachment. And then just about a month ago, on one of their podcasts, they said, we've developed this amazing model, which is called somatic integration processing, it's case conceptualization, or that's, we're probably more call it the kind of formulation type model, where we're bringing together attachment theory EMDR, and the polyvagal theory. And I just went What? This this is, this is the, this is the model. This is the framework. This sounds incredible. So I reached out to them. And by sheer chance, honestly, this is complete serendipity, they had online zoom training in their model last week. And because of the time difference, it took a lot of negotiation at home, and thanks be to Dave, he's amazing, that allowed me to spend that time speaking to them on zoom and attending their training. But now we've got this incredible framework, that I cannot wait, this is so hot off the press, I've not even spoken to my whole team about it yet, but the idea that we can integrate these incredible models that are evidence based, based in neuroscience, that then off they've they've developed this absolutely beautiful, kind of concise model that just speaks to my heart, about the integration. They even bring in Maslow's hierarchy of needs on top, so you're, you're doing your right brain left brain, whole body integration, whilst being so aware of the relational dynamics in the room at the time. I'll have to put, I'm going to get so passionate about this. It's, I'm going to, it's something that I'm so excited about, and we're going to work together a kind of across, across the water and develop this for the pain service because this is the missing part. And that's not even thinking about nutrition and the hormone sort of elements of the work. But this is, this is the exciting bit of practice, isn't it? This is like this, there's no way I would have ever had the time to do this in another role. You have to make this happen.

That's exactly what I was thinking. I was I love this for lots of reasons like firstly, it's really exciting model, and and I use EMDR, so I'll definitely be looking at that podcast was it Notice That? Is that what the podcast is called?

It's Notice That yes, and they've also got a new one called Evidence Based Therapists launching soon and they do Beyond Trauma, which is an sort of psychoeducation podcast for clients as well. Check out beyondhealingcentre.com.

Brilliant. I'll link to that in the show notes for anybody that wants to check it out. That sounds amazing. And but it's also just such a good example of where independent practice shines right. You've, you've built a job for yourself where you've got time to explore those collaborations. But also, may I say, you have the balls to reach out and make that connection.

This is where I think your your podcast has been so permission giving for that. And Michaela talked about it didn't she about reaching out to the Instagram kind of influencer. And there are times when you think people won't be interested in me or that. But actually, if you've, what that experience has taught me is find your people. And just embrace that you're an absolute geek in this stuff, of talking about it. I tried to talk to my some of my sort of personal friends about some of these ideas the other night when we were sort of connecting, and, you know, their eyes glazed over after five minutes, because they're not into that. But that's cool.

Yeah, that's wonderful. And it reminds me, I did some trauma training for other hypnobirthing teachers. And I was really worried I was like, Oh, you know that it's quite sciency. Because I wanted to go a bit into a kind of sciency side of things, because I've been asked, I get a lot of questions about that. And I was like, oh, but have I gone too far. But no, of course, they're all massive geeks about birth, and I love teaching it and it just feels right doesn't it when you connect with people who really share your passion on a subject, then it's easy and fun too.

I think the other key bit that the personal development journey's taught me as well is embrace who you are. Like you are the best version of you that anybody, that anybody can be. And we all go through doubts, and anxieties, but I did this amazing embodiment training a few years back, where I got a real felt sense of my energy and my kind of enthusiasm. And that's something I've been very apologetic for over the years. I'm always the person with the biggest gob in training, I ask hundreds of questions, I like talking. And I've, I've really had to learn within our team, what aspects of that part of me are really useful and what aspects actually do I need to step back and let other people take on board, but really allow me to be my excited, passionate self, when it's when it's conversations like you and I are having right now, when it's trying to generate energy. And when it comes down to actually getting things done, I'm not always the best person, but I know who is in the team. So that kind of authentic self takes a lot of years. Obviously, it's an ongoing development, isn't it, but something that's just let us all kind of sink in to who we are.

And that kind of, I think that's a beautiful note to finish on. Because I think so many, especially women are brought up with a bit of a sense of you have to be an all rounder, if you can't do it all, there's something wrong with you. And actually, it's a reality for any of us. We all have strengths. And we all have areas which are just not our strength. And for me, I do some consulting work with some other psychologists, In Mind Consulting we're calling ourselves now, and one of the other psychologists I work with, Kat, is hugely details focused, she can see things that I cannot see, because I'm all about the big picture. I'm the person that's going to get really excited about the idea and the concepts and I love doing outlines of things, but I can't see spelling mistakes. And I can't like just the idea of like googling for a reference. It just makes my soul shrivel. But a few years ago, I hated that about myself. And it's only really recently that I've come to the like, actually, I shine at some stuff. And it's not that, and what I need is to find colleagues who can fill the gaps and I can fill theirs.

And I totally hear you Rosie that that, and completely agree with you. But it also speaks to the idea to be curious doesn't it about those sides of ourselves. And a supervisor actually could have been one of the personal therapy experiences I had said to me why pain Mel? You know really own why it is that this is something that you've been drawn to. Look at your own history, consider. And again to be embraced that means that you're not apologising for what it is that you're interested in. There's something connecting about for some reason, and a really fantastic recommendation I've only just come across recently is Period Queen by Lucy Peach. Check it out, ladies and gentlemen because it's it's fantastic in terms of our hormonal changes at different points in our cycle. And I think, again, understanding the influence of the hormonal system, the role of nutrition in the... and Dave will always be talking about the role of sleep as well, these courses, understanding your circadian rhythms, like the information is out there. But being able to embrace where you are and why you made that decision at that point in time, is always got another meaning or explanation behind it if we know where to look. And that's what that, the sematic integration and processing model really emphasises is just look at what you're what you're experiencing through particular lenses, the attachment lens, or the hormonal lens, or the AIP for the EMDR perspective, or the kind of nervous system lens. And this, there's so much more there, that makes sense. You know, all behaviour is communication.

It's so fascinating. I feel like I could just talk to you all day. I really wish we could. We might have to do a part two at some point. But yeah, it's been a real pleasure. Where can people find you if they want to connect with you and find out more about you?

Oh thank you very much. Yes, LinkedIn is a good place. We're still developing our pages. But I'm at Dr. Melanie Lee on LinkedIn. And other members of our senior team, Dr. Alan Bowman are there, Sonia Porritt's there. We've got Trust Pain Management as a page there as well. But our websites which are under development, so they will be flashy and exciting very soon, www.trustpsychology.co.uk and www.trust-pain-management.co.uk. They're the best places.

So I'll put all of those links in the show notes so that people can find you really easily. I think a lot of people are going to want to see what you're up to. So thank you so much for joining us now and I'll speak to you soon.

Thanks, Rosie, really appreciate the invitation. Thank you so much.

Before you go, I just wanted to check something out with you. Because I don't know if this is just me. But do you sometimes wake up at two o'clock in the morning, worried that you've made a terrible error that's going to bring professional ruin upon you and disgrace your family? I'm laughing now. But when I first set up in private practice, I was completely terrified that I'd missed something really big when I was setting up my insurance or data protection practices. Even now, three years in, I sometimes catch myself wondering if I've really covered all the bases properly. And it's hard, no actually it's impossible to think creatively and have the impact you should be having in your practice, if you aren't confident that you have a secure business underneath you. But it can be really overwhelming to figure out exactly what you need to prioritise before those clients start coming in. So I've created a free checklist plus resources list to take the thinking out of it. Tick off every box and you can see your clients confident in the knowledge that you have everything in place for your security and theirs. You can download it now from psychologist.drrosie.co.uk/client-checklist, and the link is in the show notes.

Thank you for listening to this week's episode of the Business of Psychology podcast. If you share my passion for doing more than therapy, then make sure you come over and join my free Do More Than Therapy Facebook community where you can work on getting your big ideas off the ground with like minded psychologists and therapists. I'd also love it if you could leave the show a five star review wherever you listen to your podcasts. It will help more of the people who need it to find it. See you next week for more tips and inspirational stories to help you do more than therapy.