Multiple Income Streams Success Story #1: Supervision

In the past, I've written about increasing revenue using multiple forms of income (income not related to direct client hours). I offered five key questions to find areas where you might be able to enjoy adding some extra income to your private practice. In this series, I want to share the successes of private practitioners who have used these concepts to find areas that not only increase their income, but help reach their ideal clients and also fuel their passions. Amy Tatsumi, MA, LPC, found that she could garner additional income and give back to the psychotherapy community by providing supervision to others training in her field. Amy estimates that 25-30% of her income comes from supervision and consultation services.

“I believe that supervision and consultation are the biggest ways that I can give back as a therapist. Supporting clinicians in their journey to become sound, connected, and grounded psychotherapists has a powerful ripple effect. The supervisee, as well as all of their future clients, are impacted by the supervision process in their growth and development. In my private practice, I offer both individual and group clinical supervision and consultation for post graduate candidates and post license and seasoned practitioners in art therapy, counseling, and psychotherapy.”

To learn more about Amy and her services, visit amytatsumi.com 

You might find that the fee you can charge for supervision is similar to your hourly clinical rate. I recommend researching what the standard rates are for supervisors in your area. Be sure that you are meeting all the qualifications for supervising a particular discipline as requirements differ depending on the field (social work, professional counseling, psychology, marriage & family therapy) and on in which state you practice. It is common that supervisors meet requirements for a minimum number of years of licensure or have specialized training as a supervisor. It's also important to research and understand which groups of trainees you should or should not supervise.

Income from supervision can be accomplished in a few ways. I have found in my own practice that hiring interns to meet with clients has been a successful way of creating additional income for the practice. It allows your practice to see more clients than only having one provider. You can also provide direct supervision to clinicians from other agencies. There are many times when clinicians may not have access to the type  of supervisor necessary to meet the licensing requirements. They must then seek someone who can provide that. You can also provide supervision for other agencies themselves. Agencies may find that they have a need for someone to supervise employees for similar reasons that clinicians may seed outside supervision. Creating a relationship with an agency for supervision could be a consistent income stream. Consider all your options, then implement the style that works best for you.

If supervision isn't the income source you're looking for, don't worry; I'll be sharing other success stories and ideas for multiple avenues for revenue. I'd love to hear from you about areas where you have found the opportunity to generate income and, hopefully, some excitement for you.

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7 Factors That Affect Private Practice Income

Maintaining a successful therapy private practice takes a lot of time, effort, and skill. There are countless aspects of your business that require painstaking attention in order for things to run smoothly. It can be difficult to work so hard and still sometimes experience economic uncertainty, so it's important to analyze the causes of financial inconsistencies. Here are 7 factors that affect private practice income: 1) Client Retention Rates     

The ability to keep a client engaged in meaningful and helpful therapy is a learned skill that greatly impacts your private practice income. It doesn't get as much attention as generating new referrals, but in my experience it is equally important. While it would inappropriate to continue seeing an individual who no longer needs or desires therapy, keeping clients committed to the therapy process and attending sessions regularly not only helps them adequately work through their struggles and meet their goals, it also helps practitioners maintain their business. Conversely, clients who prematurely discontinue therapy put both themselves and their mental health professionals at a disadvantage.  

2) The Number of New Referrals   

Acquiring new clients is of course an excellent way to increase income, but it can be hard to predict the ebbs and flows of exactly when new individuals will seek your services, so it's not a guaranteed strategy. I have found that it's helpful to begin tracking the number of new referrals and then chart them so you can anticipate and prepare for business lulls in coming years.

3) Economic Climate        

The general state of the economy can greatly impact whether clients will go to sessions as often or are willing to pay out of pocket. For some individuals, therapy is considered a necessity, while others may be view it as a luxury. Your income as a practitioner is in part dependent on the current economy of your community and state.

4) Season/Time of Year     

The time of year can affect when current and/or potential clients ramp up their therapy time, as well as when they often take breaks. In my experience, the last two weeks of December is when everyone (clients and providers) take time off for the holidays. Just as with new referrals, tracking the dips in client numbers can help you save for those times when you will not be getting paid.  

5) Fee Collection

You may have a steady stream of clients, but your income can be significantly lowered if a number of them have outstanding financial balances. How much money do people owe you? Are you good at collecting your fees? If you work with insurance companies, are you able to get reimbursed in a timely manner? All of these play a major role in the financial stability of your private practice (click here for how to set high expectations and create firm financial policies).

6) Moving Office Location        

Relocation will almost certainly affect your private practice income. Depending on how far you move, it can take time to develop relationships, create a strong web presence, and acquire referral sources for therapy. Even if you are moving to another location in the same city, you may find that this may temporarily impact your client hours.

7) Leave of Absence/Taking a Vacation       

One of the biggest complaints I hear from private practitioners is that if they are sick and have to miss a few weeks, they are left without an income. Taking some time off from seeing clients means we are not getting paid; understandably, this can create financial concerns.  

These and other factors (some within your control, others not) can greatly affect how financially stable your practice will be. And as one of my goals is to help therapists experience income stability, I again strongly encourage you to pursue multiple income streams as a way of advancing professionally, serving your community, and also providing for your own needs.

Click here to access my webinar about how to develop multiple income streams.

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3 Things Potential Clients Really Want to Know

We've spent thousands and thousands of dollars on graduate education, continuing education, advanced clinical trainings and years in practicum and under supervision. We have invested a lot in our credentials, and all of the impressive acronyms behind our names. PhD, LCSW, LMFT, RPT, CSAC, LPC  -- and the list goes on.

In my twenty plus years of practice, I have realized that what we value as clinicians is not necessarily the same thing as what those who are considering our services value. In fact, there are some principle criteria that we as clinicians need to meet in order for an individual to choose us as his/her therapist. Of course, there are exceptions. There are clients who are savvy to the ins and outs of mental health credentials, trainings, and certifications and are seeking help from someone in a specific discipline or with specific training. However, as a general rule, potential clients want to  answer "yes" to these 3 questions before they select you as their clinician.

1) Do I like you?  

A sometimes overlooked step of gaining new clients is your approachability. You can have advanced degrees and training, but if someone does not feel drawn to you initially, it's very unlikely he/she will choose you. And remember that not everyone will necessarily favor your particular style, and that's ok! Just as you are looking for an ideal client, he/she is looking for an ideal therapist.

One way potential clients may determine if they like you is by what they see of your online presence. What can someone learn about your personality from your photo(s) and you online content? How do you present yourself? All these can play a significant role in whether or not someone takes the next step in seeking your services.

2) Can I trust you?  

Trust is a critical aspect of the therapy process, and people may want to get an idea of how trustworthy they perceive you to be before becoming a paying client (we don't share our innermost struggles with just anyone). Are you someone who can be trusted with another's vulnerabilities and pain? Would potential clients feel comfortable confiding in you? Do they feel like you are someone who would value and care about them? Do they believe that you are a competent provider?

When it comes to building trust with potential clients, once again a strong online presence can go a long way. By viewing the content you post on your blog and/or social media platforms, they can get a sense of your level of credibility and trustworthiness, and you can begin the process of fostering trust even before a client's first session.

3) Can you help me?

You as a therapist are there to serve, and individuals interested in you want to know that you have the skills to help them. Understandably, potential clients will be willing to emotionally and financially invest in therapy only if they believe it will truly benefit them. Can you use your training and experience to help them problem solve or develop coping skills? Does your professional expertise match their therapeutic needs? The answers to these questions influence whether or not someone will choose you.

An individual may not be able to fully know if you can help him/her until therapy actually begins. However, your online presence can still play a factor in introducing yourself, your approach, and your therapy style him/her. For example, media interviews can help potential clients see you as not just a provider, but as an expert in your speciality area. This type of exposure allows others to see your level of skill and competence (read here for more about how media interviews can benefit your practice).

How can you present yourself so that potential clients-

• like you
• trust you
• know you can help them

?

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Extra! Extra! Using a Newsletter to Build Your Private Practice

If there is anything you've taken from reading posts on Private Practice Toolbox, it likely has to do with the importance of having a strong online presence to educate and serve your community. There's a lot to consider: social media, blogging, podcasting, SEO, etc. But there's another aspect of building your practice that we haven't quite covered yet: newsletters.

Newsletters are a tool you may consider implementing for your practice. A newsletter is a letter you send out to your clients and readers updating them on what's happening with your practice (it's a good idea to send them out monthly; you don't want to overwhelm your audience with too much from you, but you also don't want them to forget about you). They can be an effective way to connect with your readers and offer some insight on topics related to your specialty, inform them of any upcoming events or seminars, and just overall keep in touch.

Newsletter or Blog Post?

If you're continually producing fresh content, there's often a question of where to place it. Does it work better for a newsletter or for a blog post? While there will be some overlap between the two, there are significant differences between what type of content is best for what medium. Anyone can read your blog or site, but your newsletter is much more tailored and specific, and only people who have subscribed will receive it. These are local users who have shown that they have a specific interest in what you have to say. So while your blog is perhaps more for the purpose of acquiring new clients, a newsletter is best fitted for engaging with current clients.

Another thing to keep in mind is that when you have information to share that you feel would be valuable for both potential and existing clients, sometimes a slight adjustment in wording or format between mediums can make your content fit both a blog post and a newsletter.

Building Your List

Email marketing is one of the most effective ways to attract and engage with clients and is the means through which you'll facilitate your newsletter. This is where you create a list of contacts to communicate with via email. But acquiring a list takes time and effort. Some therapists choose to gather emails at speaking events and conferences. Others may ask for permission to leave a sign-up sheet at physicians' offices or other public settings. Also, providing an opt-in on your website or blog is another way to generate contacts for your list. If you are taking the time to create content for newsletters, you want enough readers to make it worth your while, and building your email list is key.

Programs for Email Newsletters:

Although some do choose to send hard copies of their newsletters, most opt to use emails (hard copies quickly get expensive, and dealing with home addresses can be very inconvenient). But in order to be more efficient and professional, you'll want to use another email program than simply Gmail or Yahoo. Some well-known systems for email lists include Mailchimp and Constant Contact. These both have free trial periods and then have varying prices depending on your number of subscribers and the volume of emails you send out. Thankfully, email marketing programs for your newsletters are not very costly investments; Mailchimp allows users to send unlimited emails to 500 subscribers for only $10 per month. Take time to experiment with the different features and automations of these programs, and they can be an invaluable part of your newsletter campaign.

Newsletters are yet another way to reach out to your community and get the word out about your private practice. Consider the time investment necessary, the potential results (acquiring new clients, having more individuals come to your events, gaining more blog readers, etc.), and the costs, and then decide whether they would be a useful tool for your therapy practice.

What are YOUR experiences with newsletters?

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Therapist Turned Entrepreneur: Howard Spector, Founder and CEO of SimplePractice

I'm excited to introduce you to the kick off of a new series: Therapist Turned Entrepreneur and introduce to you a mental health professional who transformed his training into creating mental health related businesses. Howard Spector is a therapist turned entrepreneur and is the creator of TrackYourHours.com and more recently, SimplePractice management system. Here is his story:

Tell us about your background (college experience and degree, career beginnings, etc.). 

Wow, big question. I’ve had a number of careers as I tried to find the one that really fit. I attended USC for undergrad, and then after some years working in the entertainment industry found myself in Palo Alto while my wife was doing her medical residency at Stanford. I was always a bit of a technology geek and really connected with what was happening in Silicon Valley. We eventually ended up back in Los Angeles where I had some success with a number of technology companies. Then one day, I realized how disconnected I felt from the work I was doing and decided that I needed to reconnect with what was important to me, and also that a major career change was part of that. There was a particular school, Pacifica Graduate Institute, that I had always wanted to attend. Pacifica has a unique program where you basically live there for 3 days a month and are immersed in this wonderfully rich world of depth psychology. When I began school there, it felt like coming home. It was one of the most important experiences in my life, and I am very grateful for it.

With your business savvy and drive, you could have gone in many different directions. Why did you decide to apply your expertise to the mental health profession?

After graduating from Pacifica, I was doing my internship in California, and the Board of Behavioral Sciences (BBS) has very confusing rules for how you need to accrue, track, and report your 3000 hours of clinical experience. After fumbling around with a complex spreadsheet, I realized that this whole process would be better served by a web-based product. So I developed a product called TrackYourHours. It had all the BBS rules and forms built in, and it turned into a very sophisticated piece of software that was simple to use. It caught on quickly, and thousands and thousands of pre-license clinicians now use it. So that was where the entrepreneur in me really kicked in - I saw a need and filled it.

How did you come to develop the management system SimplePractice? 

I was getting close to completing my 3000 hours of training and started to look at practice management products to find one I would want to use. To be honest, I was very unimpressed by what was out there. Products were either outdated and just horrific to look at or too complex for me. I wanted something simple and intuitive. So I decided to build my own.

You’ve had tremendous success with your product. Explain some specific things you’ve been able to achieve with SimplePractice.

The most important thing for me is that our customers love our product for the reasons we set out to achieve - it’s simple and intuitive. I am also very proud of our team. We work insane hours to make sure we are adding the necessary features to our product so we can fulfill our promise to our customers. We are able to innovate very efficiently and are able to build out our product in ways that keeps new features well integrated and intuitive, as opposed to just slapping things on top of one another.

One of your main messages is the idea of “counselor as entrepreneur.” Why is it important for solo health practitioners to think of themselves as entrepreneurs? What are some ways that they can get into that mindset?

I don’t think this is limited to solo practitioners; it applies to anyone in any setting. I think the message that “you are an entrepreneur” provides the necessary reframe for this community. Being called to this special work is a gift, but that doesn’t mean this melding of art and science is not a business. It is very much a business, and one cannot survive and thrive by ignoring that. I want these health and wellness practitioners to embrace the business part of their practice and understand that as an entrepreneur/small business owner, there are things they can do to have greater success - and that that's ok.

One of our interests here at Private Practice Toolbox is helping counselors generate income in ways other than seeing clients. We’ve talked about speaking, writing, and teaching, but as of yet haven’t discussed software creation and development. Is there any specific advice or insight you can offer to tech-savvy clinicians thinking of venturing into that realm? 

The first thing that comes to mind is that developing software is a lot harder than it looks. There is so much detail work that has to be attended to, and there is no gray area; software is black and white. There are so many use cases for something as seemingly simple as recovering a lost password. For example, do you click on a ‘forgot password’ link and then send the user to a page to enter some information - what information? What if the user enters it wrong? Is there an error message? Where? What does it say? The list goes on…and on…and on.

I don't say this to be discouraging. I say it because based on my experience talking with customers, most don’t realize the work it takes to develop even mediocre software. So my advice is this: If you have an idea, by all means, pursue it. If it’s software-related, then find someone to work with who has experience developing software. And be prepared to spend money on good developers and designers. My mom has this great saying: “Cheap is expensive.” When it comes to developing software, especially software in the health market where there are significant security requirements needed to protect patient health information, don’t be cheap.

To recap: Follow your dreams and passions, and if that happens to be developing software, then understand the costs of time and money it takes to develop something valuable.

Not only do you have an innovative software program, but through your company blog, you are also involved in educating clinicians on how to best run their practice from a business standpoint. Why is it important for you to share your wisdom and skills?

Because I am incredibly passionate about this work. I have some insights into this field because I trained as a clinician, and I want this community to embrace the business side of their practice. The services clinicians provide are invaluable, and they should be well compensated for all the time they put into getting educated and trained. The more they think of themselves as entrepreneurs, and the more they can see the parallel between other industries and theirs, the more it will help them. I think I have more to offer than just a great software product, and if I can help clinicians, even ones that don't use SimplePractice, then that is awesome.

Howard Spector is the CEO and Founder of SimplePractice. He has years of experience creating and developing technology companies and was the creator of TrackYourHours.com. He has a MA in Psychology from Pacifica Graduate Institute and a BA from he University of Southern California. 

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Website: www.simplepractice.com

Blog: www.simplepractice.com/blog

Facebook: www.facebook.com/pages/SimplePractice/457351787631292

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