6 Things I Learned from 'Breaking Up' With Managed Care

6 Lessons Learned From Breaking Up with Managed CareIt was a scary step to resign from all insurance panels! I wasn't aware of any therapists who had built a fee-for-service practice in my area. The things I learned in the process of were better than I had expected. When my practice Wasatch Family Therapy transitioned from managed care panels to a private pay model over a decade ago, I anticipated a few things would happen; I knew that this business decision would help allow me more control over the type and length of therapy, that I would have less paperwork, and I would get paid at the time of service. However, there were some unexpected lessons I learned as well. Here are 6 things I learned from breaking up with managed care:

I Learned:

  •  the value of my perceived value.     

When potential clients learned that I employed a private pay model, they seemed to perceive me as a more competent provider. "You must be really good if you don't have to be on insurance panels." My clinical skills hadn't changed, but my perceived value went up because of how I presented my services. It's surprising how much the way we clinicians value and present ourselves affect how others see us.

  • that I felt more alive in my clinical work.    

The stress of constant paper work and phone calls that was part of being on managed care panels unfortunately led me to resent the work I was doing. However, after transitioning to a private pay model, I could refocus my energy on the reason I went into the mental health profession. Since I no longer felt drained by jumping through hoops for insurance companies, I was able to rediscover my passion and love of doing clinical therapy.

  • that I deserved to be compensated well.

The work we do is vitally important, and it's not selfish to desire income stability for yourself as a mental health professional. Resigning from managed care helped reaffirm to me that I do deserve to be well compensated for my clinical services.

  • that I had more time and energy for family and other passions.   

The income stability, decreased stress, and increased time that a private pay model afforded me meant that I could invest more in my hobbies and in my relationships. I've been able to pursue many of my passions, including songwriting and getting my PhD, and I've cherished the relationships that I've been able to nurture and devote more time to.

  • how to present my fees with confidence.  

Understandably, a mental health professional transitioning from managed care to private pay may feel some hesitation about talking about his/her service fees. I initially felt this reluctance as well. Few people are confident in talking about money! But, as time went on I learned to overcome this challenge and present my fees and talk about a fee-for-service model with ease (click here for more about how to create and assertively implement a financial policy for your clients).

  • how to generously refer to colleagues. 

It can be difficult for many clinicians to refer potential clients to other providers. We may feel somewhat of a scarcity mentality, and that if we don't decide to do therapy work with a certain individual there may not be any other clients who want our services. I realized that even if I didn't see a client for therapy, I could still serve him/her by providing referral options. For example, I could identify sliding scale fee clinics in the area or email names of therapists who were on an insurance panel or were in some way a better fit. By doing this, not only was I helping individuals find the care they needed, but I was also helping other colleagues in my community by providing them with more business. Referring to outside sources has been an incredibly important aspect of working with a fee-for-service practice, as Wasatch Family Therapy currently refers at least 50% of our inquiries to other providers in the community.

timthumbClick here for access to the full webinar "How to Break Up With Managed Care and Build a Thriving Private Pay Model."

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The Power of Online Presence: Facebook Brings Australian Parenting Expert Elly Taylor International Opportunities

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Discover how some very successful mental health professionals use blogging, social media, and other technologies as powerful tools for their therapy practices.

Elly Taylor, AARC, is an Australian Relationship Counsellor, Parenthood Researcher and advocate for emotional health. She teaches parents and professionals about the eight stages of early parenthood following pregnancy so families can bed down solid foundations for psychological, emotional and relational growth. You can learn more about Elly’s work at www.ellytaylor.com.

When and how did you first start putting time and effort into maintaining a strong online presence?

With two teenagers at home, "Facebook" was a dirty word in our house a few years ago! Then, after my book Becoming Us was published here by Harper Collins in Australia, I met up with a very successful author friend who was giving me tips on marketing and how social media had made all the difference for her. I squirmed awkwardly in my seat and said something like “I really want my book to spread through word of mouth." She looked at me straight and said “Elly, these days that’s called social media.” So I reluctantly hopped on Facebook and found it completely overwhelming! Until I found there were groups. I love groups; part of my job is leading them. After a few months of participating in conversations in a couple of different groups about birthing, I received my first invitation to present my research in the United States... through a Facebook message!

Please describe what social platforms you currently use. 

I would use more if I could get off Facebook! I’m on LinkedIn and will be more active on there when I start my group for Family Focused Perinatal Professionals early next year. I’m also on Twitter, but don’t find it as warm and fuzzy as Facebook. I like seeing people’s kid pics. I did start a couple of Pinterest boards, but I’m worried I will get completely lost in there and weeks will pass and I’ll forget to eat…

About how much time do you devote to your online presence? How do you balance it with your other work responsibilities? 

Far too much at the moment! The plan for next year is to spend two days face-to-face with clients, one in my office and one via Skype for interstate and overseas clients. That leaves three days for writing and social media-ing. And the weekend to recover from my online hangover!

What kinds of things do you use to inspire your content creation; what do you write about?

I try to write about the stuff that’s unspoken, and with expecting and new parents, there’s plenty to cover! I write about the ways parenthood changes life and love and how to work with the changes and support your partner to do the same so you both grow together through them. So many relationships come undone through lack of awareness. In this information age, that shouldn’t be happening.

I also have found in my research that so many aspects of our culture set new families up for failure, that there’s a huge information gap between therapy and birth professionals, and therefore such a massive gap between expectation and reality for parents. I’ll be starting my regular blog soon, one for professionals to cross-pollinate their expertise and one for parents so they get the benefits of that. I’d like to do what I can to help cross the divide.

How do you best balance personal and professional in your online activities? Please give examples.

I have two FB accounts, one in my professional name and one in my married name, which is private. I don’t share family stuff on my professional page, although I know many who do and I’m probably being over-cautious. I do share some stories from my own life my talk for the Parenting 2.0 conference in Dublin is a good example!), but I check with my hubby that he’s OK with that beforehand…or maybe just afterwards!

What is some tangible evidence that your online presence has grown your business?

All my speaking invitations in the US and UK have come through social media contacts. My Facebook friends were also the ones who encouraged me to develop trainings based on the content in my book. I’ll be rolling out Becoming Us webinar trainings next year so that birth, health and therapy professionals have ideas, direction, and support to work with the expecting and new parents in their care.

What other ways has your strong online presence helped you?

Oh gosh, in lots of ways! If I have an idea I’m not sure about (logo, tag lines, etc), I’ll run it by my online friends. I’ve asked for feedback on my book and website and taken it all on board so when I finally launch my webinar series early next year, it’s been given a really thorough test run first.

A lovely birth professional friend referred to me as a “Parenthood Tour Guide” the other day, and then another one said she thought of me as “The Family Whisperer." I was so touched and thrilled! I love the support and validation I receive through Facebook groups; so many wonderful, engaged, enlightened souls who are all there to lift and help each other. I remember in the years before I got on social media, I was often lacking the support and collaboration I needed to get my work off the ground. I teared up just yesterday when a FB friend offered to be an administrator for a FB group I’m starting up next year and another offered to do a video testimonial for my book.

What have been some of the biggest challenges you’ve encountered creating and maintaining your online presence?

Trying not to get sucked into the Facebook vortex and get other stuff done, like actually develop the content! I get so carried away by seeing everyone's pictures and news and cute videos. I made the mistake of announced the Becoming Us training courses just the other day at the same time I was supposed to be picking up my daughter from school.

How have you overcome those challenges?

I keep telling myself I’m going to get an egg timer…

What tips or resources can you recommend to help therapists who are new to the online world of blogging, social media, SEO, etc.?

Start slowly, observe at first to see what others are doing while you get your bearings, take your time, and build your confidence. See what ignites your passion – that’s where your best writing will come from. See where the gaps are. When I first got on FB and joined a bunch of birth professional groups, I noticed that fathers (and partners) were often left out of the conversations completely. I feel strongly that from an adult attachment perspective, including and supporting dads/partners during pregnancy, birth and early parenthood has major long-term benefits for the whole family. That's where I began my journey, and it was worked out well so far!


Elly Taylor, AARC

Australian Relationship Counsellor, Parenthood Researcher Facebook Page: www.facebook.com/BecomingUs Website: www.ellytaylor.com LinkedIn: linkedin.com/in/ellytaylor

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4 Ways to Make Your Website Mobile-Friendly

4 ways to make your website mobile friendly - Private Practice Toolbox

More and more people are using their phones to search the internet.  By optimizing your online content for mobile devices, your clients can more efficiently access the information and services your therapy practice provides.  

It has been said that 2014 is the year of the mobile.  People are increasingly accessing online material from their phone, so it’s important that providers are aware that their content is being viewed through multiple channels.  But there are unique challenges that come along with this trend:  a website or blog can appear dramatically different on an iPhone or Android than on a computer screen.  Different features can get warped or skewed on a mobile device.  Thankfully, there are ways to make online content more efficient and accessible for cell-phone users.

Here are 4 ways to optimize your website and online content for mobile devices:

1)  Make a Separate Mobile Site

If you own a smartphone, you are probably familiar with how certain sites offer a version specific for phones.  For example, Facebook has a separate application (a cell-phone app) for mobile users.  It has slight modifications to make it easier to use than the normal site would be from such a small screen, but the general capability is still there.  Creating a separate mobile site will certainly require some tech-savvy skills, so as your therapy practice develops, you may want to consider hiring a web-developer to help you navigate some of the trickier aspects of web design.

2)  Simplify

The mobile version of your site should be very, very simple.  Clean, white space will help viewers not get overwhelmed by too many features.  Not everyone on the main version of your site should be displayed for cell phones users.  Using drop-down menus can help eliminate unnecessary distractions.

3)  Emphasize Prominent Information

Once you’ve decided what to cut out, you need to decide what elements of your original site to keep for your mobile site.  The name of your therapy practice, contact information, and a photo or logo should be very clearly displayed.  If someone has to hunt to find key information, he/she will likely exit your site very soon.  Emphasize your most important message in a clear and concise way.

4)  Provide Links to the Full Site

Although someone may first come across your online content while using a phone, users are more likely to fully interact and take advantage of services through the original site.  Remember that the mobile version is meant to serve as a mini format of your main website or blog.  The full site is the main attraction and ultimately where you want your viewers to go. Make sure to provide a link to redirect viewers to your full site.  

Do you have a mobile version of your website or blog?

How can you use these tips to make your online content more accessible for mobile users?

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1)  Photo (c) Canstock Photo ID:  13124395

2)  "9 Tips for Optimizing Your Website for Mobile Users"


8 Steps to Launching or Relaunching a Psychotherapy Practice

Launch (3)In this guest post, Miranda Palmer LMFT and Kelly Higdon share eight ways to thrive in the current private practice climate. The process of building a successful private practice has changed considerably over the last twenty years. Most therapists we speak with who have been in practice for a few decades started by getting their credentials from an insurance companies. Reimbursement rates were relatively high for the cost of living from the 80s into the early 90s. Things flowed. Maybe they had a listing in the phone book, but back then there was no need for websites, Facebook pages, or Twitter accounts!

Fast forward to now: the financial picture for therapists in private practice has drastically changed, as we are in a time of low or stagnate reimbursement rates combined with an increase in cost of doing business and living.

The old model is simply that, old. It doesn’t work for today, and thus we find experienced therapists with a full practice that isn’t profitable enough to prepare for retirement, and new therapists often feel lost when they ask their mentors for direction and get answers that don’t resonate with the current economy.

We want to simplify the steps required for launching and successfully running a private practice in 2014. Whether you are starting out fresh, have moved to a new city, or need to make some significant changes in your business foundation, these steps will help you get things on track!

1) Develop a clear vision of your life

We tell our clients to do this regularly. We help them reassess and ask them to be accountable for the choices they make that lead them toward or away from that vision becoming a reality. This is your road map. When you begin with a plan for your life, your business can be formed to support that plan. So before you come up with an awesome group therapy curriculum or some other great idea, write down a super clear vision for your work AND home life.

2) Take that vision and break it down into pieces

Having a simple vision, with no basis in reality, can be difficult. How much money do you need to make that vision come to life? What would it take for you to go home at that time each day? Are you preparing for quarterly taxes? Are you realistic about how many clients you can see regularly while avoiding burnout? Are you leaving time for networking and marketing your practice? Leaving time for going to trainings? For being sick? Are you leaving enough time to return client phone calls and be available for crisis situations?

This is where people can get stuck in magical math. If I see 20 clients at $100/hr, that is $2,000 per week for 50 weeks – that’s six figures! YET there are expenses, taxes, real life stuff that happens. Be honest with your capabilities and your needs. Also, be open to the idea of reaching your goals in different ways. You might discover that face-to-face sessions is only a part of the plan. Now go crunch numbers, write down the schedule, and look at the specific pieces that are needed to fully form your vision.

3) Develop a business plan based on your vision and those realistic pieces

Every therapist in private practice needs a written business plan. He/she must know exactly how the fee was developed, how many sliding or pro bono slots there are, how much money is put toward retirement, etc. There is also a bit of research to be done here. Surprised? Sure, people need mental health services, but who and where are they, and what are the holes in the market in your area? Have a clear idea of who you want serve and how you plan to serve them. Write it down; be accountable to yourself.

4) Develop a sustainable plan to let your community know who you are

Notice I didn’t say develop a sustainable plan to let people know your business exists. People decide to work with therapists they know, like, and trust. Being authentic in how you present your private practice to the public doesn’t have to mean complete self-disclosure. Maintain professional boundaries, but don’t be afraid to let your personality shine!

The beauty of our current world is that people can advocate for themselves by choosing a provider who they believe is prepared to help them heal. If a potential client doesn’t get a chance to hear your “voice” and how you practice, how can he/she determine if you are a good fit? How hard is it for you to choose a therapist for yourself? Can you imagine how much more difficult it would be without an advanced degree and a deep knowledge of psychological theory?  Make sure to clearly communicate what unique things you can offer as a therapist.

Be aware of your insecurities and how you demonstrate those to the world. Now is the time to believe in yourself and honestly take stock in what you bring to the table. It is not prideful to share your craft with others. It is necessary in order to build relationships and instill hope in members of your community.

5) Develop and maintain clear business boundaries

Your business is your service to your clients. You may think that the things you are doing on a daily basis are serving your clients, but you need to be honest with yourself. If your business is struggling, it will impact your clinical work. What would happen if your clients talked to one another? Do more assertive clients pay a different fee than passive clients? Do clients with poor money management skills pay less than a client who has better budgeting skills?

Stick to your plan. Go back, and if you start to waver, remember #1 – why you are doing this in the first place? What is the life you are seeking to create? Who are the clients you are seeking to transform? When you break those boundaries, you are holding yourself back from the dreams you have for yourself and from helping your community in a profound way.

6) Streamline your business processes

The best way to do great clinical work is to free yourself up to do great clinical work. Whether this means transitioning to a paperless office to reduce late cancellations or no shows and decrease unpaid balances, or outsourcing your insurance billing so you never have to sit on hold with insurance companies again, find a way to make the business process work efficiently. If you feel like you can’t afford to streamline your process, you need to look at return on investment and/or whether you have set a fee that fully integrates business and overhead costs.

7) Streamline your marketing process

It takes more energy to start from a stopped position. The start of launching or re-launching your practice takes a LOT of energy, gusto, and enthusiasm. Know that it won’t always be as hard as it is in the beginning. Watch what works for growing your practice most effortlessly, and make a way to continue the bare minimum even when you are full with clients to keep things flowing. Maybe that is blogging once a month, speaking a few times a year, or monthly lunch dates with new contacts in your area. If you don’t have time to do some minimal tasks to keep things moving, you need to reassess if you are being honest with yourself about the time it takes to run a business.

Your marketing must align with who you are and your core values. If you don’t want to write a blog, don’t. If you don’t want to speak, don’t. BUT, do something and analyze if it works. If it isn’t working, then tweak it until it works, or let it go and move on to other options. Just because your neighbor gets referrals from Psychology Today doesn’t mean that is what YOU should do. You must only do what is best for your business, not necessarily what is best for others.

8) Celebrate your accomplishments!

Be good to yourself; kind to yourself. There is a lot to learn when starting a private practice. Know that everyone has a learning curve, and seek out a supportive community. However, no matter how awesome your community is, you will be struggling to stay energized and enjoy private practice if you are being unkind to you. Start from the inside out! And don’t be afraid to celebrate all the great accomplishments you’ve made in your private practice.

Miranda PalmerMiranda Palmer is a Licensed Marriage Family Therapists who is passionate about teaching and empowering other static.squarespaceclinical counselors to successfully run a private practice. Visit her site www.zynnyme.com to learn more. 

Kelly Higdon wants to make a difference by sharing her expertise to help clients and business owners reach their full potential. Check out her Business School Bootcamp to learn more.   


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How Your Therapy Skills Can Help Build Your Online Presence (Part 1)

canstockphoto9611721 This is the first post of a 2 part series of how to best utilize social media to engage your readers.  

Developing and maintaining a strong online presence to engage readers employs the same skills you use as a therapist: the ability to foster trust, build rapport, and serve your community.  

The internet allows you to expand your therapy outreach in a way that exceeds the bounds of what you could do from a traditional office setting.  Here are some specific points to consider when building an online presence.

Your Therapy Skills in Practice

Some clinical counselors new to social media aren’t always confident about how to approach the task of building an online presence and effectively building a social media following, but you already have many of the skills you need.  Your training has taught you to help others feel comfortable, address their specific concerns, and provide professional insight to respond to their needs.  Building your online presence is simply translating those therapy skills to a larger venue.

Don’t be scared or overwhelmed by the technology side of things; by starting small, asking questions, and perhaps even learning a bit through trial-and-error, you will gain the experience you need to create a thriving online presence.

Content Creation vs. Content Curation

We’ve talked about the importance of creating quality content to frequently post to your blog and social media platforms.  But just as important is curating material that already exists; that is researching, finding, and presenting content that is relevant to your current focus or professional study.  Your goal is to connecting with both the general public and other professionals in the field in an effort to serve, educate, and inspire.

Some may wonder how much original content they should produce, and how much existing material they should repurpose.  I generally try to obey the 40/ 60 rule; about 40% of the media I share through my social platforms is my own, where 60% is material I’ve found that I feel could best serve my community of clients.

“Why am I not getting new clients?”

I have talked to therapists who wonder why they haven’t seen a significant growth in their practice after they began to devote time to their online presence.  But social media is a long-term strategy, and the results are usually not immediate.  You need to build a collection of quality articles, podcasts, media contributions, etc. that prove you serve as a reliable resource in the field.  It won’t happen overnight, but if you consistently create and curate quality material, you will be able to better serve your community, establish yourself as a trusted professional, educate the public about relevant topics pertaining to mental health, and also grow your business in order to meet your own needs.  So keep plugging away; you’ll get there!

Stay tuned for an upcoming post about the logistics of using different platforms (Twitter, Facebook, etc.) to further engage your readers.  

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