Over the last year, I’ve had more than one conversation with art therapist Amy Maricle about the business of private practice. And, every conversation has had the same thread running through it – personal integrity.
When she offered to write this guest post on building the business you want, I knew that was just her language for personal integrity.
Actually, I don’t think she even thinks about it in terms of “integrity,” but I do.
And, I think, what Amy and I both know is that in the ways your values line up with your actual practice . . . .
That alignment is both what sets your practice apart from your colleagues and also what allows you to practice and grow your business effortlessly.
(If you are interested in writing a guest post, check out the guidelines here.)
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A Guest Post by Amy Maricle
Redefining the Business of a Therapist
After my son was born, returning to an assistant clinical director position that demanded 45+ hours a week, a 45-minute commute, and on-call duties seemed unrealistic.
I wanted to do something that was equally challenging, stimulating, and dynamic, but without the commute, and with a more flexible schedule.
I had vaguely considered private practice in the past, but had somewhat dismissed it because I couldn’t see myself sitting in my office all day with a stream of clients rotating on and off my couch.
Still, returning to my old job was not an option, so I got to wondering if there was a way to structure a private practice that would allow me to do the kind of varied, multifaceted work I love.
Luckily for me, I came upon some great resources, including Tamara’s blog, and began to envision how I might create my own brand of private practice.
Business Is Not a Dirty Word
It turned out I had a lot of misconceptions about private practice.
One of the most basic ones was that private practice should not be run like a “business.”
Isn’t the purpose of a business to make the maximum profit for the minimum cost, as often as possible?
That seems at odds with what a therapist should be doing, doesn’t it?
Most likely, you and I chose this field for the same reason – because we believe in people’s ability to change and grow and we love being a part of that.
You could have studied any number of subjects to earn triple your salary.
But you didn’t.
Being a therapist pays you back in ways that few other professions would.
Because therapists want to help people, and not gouge them for their money, that means that they can’t be running a business, right?
But I am here to argue that there is more than one way to run a business.
Business is not a dirty word. Nor is money or payment,or bill.
Did you cringe when I said any of that?
I still do a bit.
Somehow we were taught, whether in grad school, by our parents, or our culture at large, that therapists are altruistic and therefore should care about the clients, not the money.
Why can’t we think of ourselves of being in the business of caring?
We deserve to get paid fairly for the very heart-centered, caring, and important work that we do with people every day.
We don’t seem to have these hangups about massage therapists, nutritionists, acupuncturists, or other helping professionals so why do we think about ourselves this way?
Let’s Be Honest: Like it Or Not, You’re in Business
People like Tamara have proven by example that you can care tremendously about your clients while also caring for yourself, your work life, and your financial stability.
Pretending to yourself or your clients that it’s not a business is not a sound way to take care of yourself, your clients, or your financial life.
Getting honest with myself about the fact that I am running a business has helped me deal more effectively with finances with clients.
I used to ask for payment very awkwardly at the end of session, which often led to running over, missing my bathroom and note breaks, or forgetting to ask for payment all together!
Were you as awkward with payments as I was?
Create Your Kind of Private Practice
The more I learn about private practice, the more I realize that getting down to the business of my business is a great form a self-care.
Admitting that I am running a business and feeling comfortable with that has freed me to imagine and create MY kind of private practice.
We all know that great self-care is one of the elements that makes for an effective, ethical therapist who avoids burnout and gives her best to her clients.
What else would you add to your private practice if you had no fear?
In the Business of Helping People
I have always been a therapist who partners with people to seek wellness in a creative, body-oriented, and strengths-based approach.
But now, I am also incorporating my other passions into my business through an art therapy consultation group and art workshops.
These endeavors provide me with multiple income streams, a wider array of services to offer folks in my community, and a way to stay invigorated and interested in my work.
I have no idea what other endeavors I may undertake, what parts will succeed, and which will fall away, but I know that I am in the business of helping people one way or another.
What about You?
What has helped you create the vision for your private practice?
Do you offer any kinds of services besides therapy?
Be brave.
Share an idea you have had for another service you might provide.
Is it a group or an educational class to supplement your therapy services?
A consulting role you might play?
Private Practice from the Inside Out is an amazing, positive, and energetic group.
Why not take advantage of it’s power and bat some ideas around with others right here?
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About the Author: Amy Johnson Maricle, LMHC, ATR-BC is an art therapist and blogger in Foxboro, MA. She has a private practice focusing empowering girls and women to put themselves first, overcome anxiety and depression, set good boundaries in relationships, and find creative self-care outlets.
Amy,
I loved your comments and yes I agree with them all 🙂 How did you shift from the awkwardness to being okay with it? For me, I think it just happened over time, I don’t know what shifted so I’d be interested to see what happened for you.
I’ve been doing trainings for several years for other therapists in sandtray therapy and I LOVE it. It keeps me on my toes and gives more credibility to with my private practice clients. It’s really a win-win for sure. Thanks again!
HI Amy!
I think all the sand tray training you have been doing is great, and I can totally see how it creates balance in your work (great self-care) and also inspires confidence from your clients.
I am curious, do you do much sand tray with adults? Whenever I have done it in trainings, and once in a session, I found it so powerful. I’m a big advocate of using expressive arts with adults.
In regards to getting more comfortable with money – I am a gal who loves to have a structure – a base of safety that I know is there, and then I can depart from it and improvise, always knowing it’s there if I need it. Given that, Tamara gave me some simple language to use about payment that has helped me tremendously, I feel calm and confident when I do it. No awkwardness, just, let’s get the payment and next appointment out of the way first they don’t interrupt us at the end. I wonder if that’s similar or different to what you do?
Cheers,
Amy
Amy (and Amy:) – I’m getting ready to share that language with ALL of you guys. Just waiting for my geek to get back in town and set it up for you:) Stay tuned. I promise it’s coming!
Amy,
Yes, I LOVE sandtray with adults. If you sign up for my email you can get a free webinar that talks about sandtray with adults and stuff (just FYI). I love expressive arts with both my kiddos and adults as well. It gets all that underneath stuff that you may not get with just talk therapy.
As for what I do with the payment info, I do take it at the end of the session and it doesn’t seem to be weird. I have figured out to stand in that place that I’m worth it and also I think about how when I go get a massage or my haircut, its not weird for me and its EXPECTED because I received a service. I think that once I figured out that I provided a service and its a business then it become less awkward.
I also like to have a base of income so I do testing and have some contracts for that with the state and other agencies in addition to training and seeing clients.
It was great to connect with you. Great post btw:)
Awesome post, Amy! Thanks for sharing your insights with us. It really helps to hear other’s stories, along the journey, to gain clarity. You have a great gift, and your clients are blessed to work with you. It is a privilege to learn along side, from the East Coast to the West. This is very relevant information about finding perspective, and I am grateful to you for sharing here today, on Tamara’s blog.
HI Patricia:
Thank you so much for reading, commenting, and for your kind words. Perspective is a funny thing, isn’t it? I wonder how yours has changed over the years and what assumptions you have found to be untrue?
🙂 Amy
Hey, Patricia – I noticed that you don’t have a little photo of you that shows up with your comments here (and on other blogs, too). They are called “gravatars. Here’s a link to a quick tutorial that shows you how to set up your own gravatar http://www.allthingsprivatepractice.com/how-a-tiny-picture-of-you-can-help-drive-traffic-to-your-website-or-blog/ . (Don’t worry! It’s so easy that even I could do it and it’s absolutely FREE!)
Amy, I love that you are blogging about this “should-ing” that we do to ourselves! It was exactly what kept me stuck and struggling . . . thinking I needed to accept insurance, play with managed care, and create a practice that looked like every other therapist’s business that I knew. I limped along for 5 long years trying to stay afloat with that model guiding my path.
Lyn Grodski was the first one that I ever heard talking about the business of psychotherapy and offering services that were a bit outside of the traditional box. I remember feeling like someone had opened a window for me to be more of who I am and to share more of my gifts with the world!
Don’t get me wrong – I love, love, LOVE a good day of trauma and doom and gloom! But, I also love teaching and mentoring and collaborating and supporting and gluing and pasting and creating new things and playing with old ideas and . . . and . . . and . . . and more!
Your call to be BRAVE is right on target. Be BRAVE! Be MORE . . . MORE of WHO YOU ARE! It’s the right call for therapists (and coaches) who are wanting to grow a strong and vibrant practice. It’s the call I needed to flip a switch on my struggling little practice in Irving, Texas and grow it into a thriving word-of-mouth business today.
(Sending out a special “thank you” to Lyn Grodski right now for planting that seed that allowed me show up with a better version . . . a more authentic version of ME!)
HI Tamara:
Thank you again for inviting me to post about this. I talk about risk taking all the time, both with clients and colleagues.
It is amazing how when you “open the door” a whole host of things turn into possibilities that weren’t before. Authenticity has always been really important to me, as you point out, and I feel like I am figuring out how to be more and more authentically me all the time in terms of the services I provide and the way that I think about helping others.
Thanks for your ongoing encouragement, Tamara, and this whole community!
Amy
You’re so welcome, Amy! It’s my pleasure to help you and others see the host of possibilities that await you. Did you ever here that (Buddhist, I think) saying “When the student is ready, the teacher appears?” I may be “seeing” possibilities a little differently than you, Amy, because much like the teach and the student, it has been my experience that the opportunities appear when the therapist is ready! So glad that you and others here, too, are ready to see the many ways to grow your practice! (And, thanks for taking me along on your journeys!!! I am honored!)
WOW!!! Who is spying on me (jokingly said)
” I used to ask for payment very awkwardly at the end of session, which often led to running over, missing my bathroom and note breaks, or forgetting to ask for payment all together!
Were you as awkward with payments as I was?”
I AM GUILTY – I mean, I plead the fifth..lol
What works for me is as far as being creative is infusing – “life wellness” with various life stages and helping my patients think outside the box (their comfort area) – to live today while working toward a better/brighter future. (also let me not forget to say-“I like to use humor”) While working in clinical arena it was not accepted with warmth by the powers that were. In my private practice it is welcomed by my patients. (sort of takes of the edge)
Thank-You Amy for your wonderful words and to you as well Tamara for posting another great piece.
Good morning, Neal! Welcome back!
Is there anyone who wasn’t awkward and boundary-less at the beginning of their career in mental health? Please! Speak up if that’s you! I would run over by a full 30 minutes . . . ! After all, I didn’t have another client for another 3 days! Ha! Ohhhh, those were painful times!
And, Neal, I’m with you on using that humor – something they NEVER mentioned in my graduate program. I know I’m doing great therapy when there’s laughter going on in the office! And, at least for me, that’s not a reflection on the client so much as a reflection on me not taking myself too seriously.
Thanks Dr. Neal for your comment. I agree with you and Tamara about the power of humor. Again for me this goes back to finding ways of having good boundaries but also showing up in a very real way in the room. I feel like the older I get the better I get at this. (A parallel to life itself and the way we grow more comfortable with who we are over time, I suppose.)
I hear this in your comment, Dr. Neal.
Cheers,
Amy
I’ve always colored outside the box and offered services (supervision, consultation, coaching, training) to clients and other professionals in addition to clinical services. I had a thriving child therapy practice and play therapy training center in MO for several years until a few months ago when my husband’s employer relocated him to TX. I’m starting the journey all over again by taking the seeds I planted in MO and transplanting them in TX. The opportunities that are coming my way are endless and I am now able to pick and choose the ones that fulfill me and interest me the most.
Amy, thanks for your
HI Pam:
Wow – the ability to “pick and choose” your opportunities! I hope I get to that point too. Cheers to you!
Amy
Amy, all of us get to “pick and choose” our opportunities already. It’s just some of us are too scared to consider playing big, playing boldly, embracing all of who we are and what we have to bring to the table. And, when we do that . . . play small because of our fear . . . we see with “little” eyes from dark and rigid corners. The visibility is more confined . . . The opportunities are so often hidden . . . And all of who we are cannot stand up, stretch, and reach our fullest potential.
And, if you’ll notice, Amy . . . In the places that you have chosen to pick and choose . . . Where you focus . . . Where you put your time . . . How you spend your energy and your resources, you are finding opportunities . . . Close to home and online, too. Just sayin’ . . . .
Come on, you guys! LET’S PLAY BIG! (And, if you don’t know how, then take a big breath and hire me! Let me show you how!!!)
Jill, that’s a great way to build your credibility in your community and add an extra stream of income, too! I love that you are investing in you and your future by getting this training.
If you’ve already begun, then you’ve realized that while the skills for being a good counselor and those for being a good clinical supervisor do overlap, there are also some distinct differences, too. Not all great counselors make great clinical supervisors! Is Georgia one of the states that has additional requirements to be a clinical supervisor?
Tamara –
It’s true – I am directing my energies very purposefully. I just had never put it in such confident language I guess. I know this will come with time.
Thanks for all you do!
Amy
Amy Johnson Maricle, you were meant to PLAY BIG. We ALL were!
Hi, Amy! Thanks so much for taking time to share your thinking about receiving payment for your professional services. I think it’s so helpful for therapists who struggle with money issues to hear how other therapists process the tasks of setting fees, seeking reimbursement, etc. – especially when you no longer seem to struggle with those things. I love your image of “standing in that place” of worth!
And, thank you for sharing some of the ways that you have diversified your income – through testing and training. You didn’t mention . . . what is it that you are contracting for with other agencies?
And, by the way – congrats on the beautiful website for Southern Sandplay Institute! It looks great!
im working through the training necessary to provide clinical supervision to play therapists and professional Counselors to build my practice. The hurdles right now are financial but I only have a few trainings to go!
HI Jill:
That sounds so great. It’s nice to “meet” you. I am familiar with your name and face from this online community. I love doing supervision. It is so satisfying to get to play a mentoring and teaching role. It helps you realize how much you know – and how much you don’t!
Cheers,
Amy
Thanks for the post, Amy! I am running a “typical” private therapy practice, but I long to do something out of the box. I have so many ideas running around in my head, but unfortunately, not many actually come to life. I see other people successfully creating programs, books, resources and other services. I know it’s possible! Finding time to put my ideas into action is one part, but addressing the fear of failure is another. Thanks for the encouragement to keep striving for a business that I love.
Nicole:
You have such clear, tangible, approachable, helpful ideas. I have no doubt that once you decide what it is you feel most passionate about offering that people will eat it up! Every time I share one of your posts my friends all comment on how much they value the information.
Your kind words mean a lot.
Amy
Amy, thank you for this! I am just starting out with the therapy portion of my business (been coaching for about a year) and I keep feeling restricted by comparing myself to what I see around me. I keep worrying I’m doing something wrong by putting my crazy self out there and not being this super professional, clinical person! But I know that is what my clients want because I work with creative people; MY people. So I really appreciate any reminder that I can get to keep building what I want, not what others do.
I’ve been thinking on what sorts of groups or workshops I might be able to offer. It’s funny, before I saw your art journaling link, I was just thinking a journaling workshop might be a good idea! I’m trying to get in touch with what my clients might really want or need – and what sort of workshop I might attend as a client. Still working on it, though.
Thank you!!
HI Lauren:
By the looks of your website, you at least SEEM really clear. You have a very fun, creative vibe going on and I can see exactly where you fit in for artsy folk (and those who love them.)
Reading your comments made me think of what I have been telling people as I mull this all over – I just sort of sat up one day – (a very short while ago!) and said to myself, “I have a BUSINESS! I can do whatever I want. (Within reason, as long as it’s ethical and I have good boundaries, etc.) But I can do what I want. What do I want more of in my work life?” Suddenly the doors burst open.
I totally get feeling unsure while you look around. What helps me is looking around ONLINE. I find so many good, sound, professional, ethical, but also artistic, creative, fun, soul-filled folks who are doing good,interesting work. I have always had jobs with tons of variety. I did not want that to stop.
I connected with your post about creativity and vulnerability. I love the connection between risk taking and growth, connection.
Cheers and thank YOU for introducing me to you.
Amy
Hi, Lauren! You’ll be much more successful in private practice if you keep flaunting your own artsy self rather than cloning yourself into a Stepford-like therapist. Twelve months into private practice it’s likely that you’re still just getting your “sea legs.” Be BRAVE. Be BOLD. Be YOU! I love your very focused niche on counseling creatives. There’s a huge need and you are already ahead of the game by speaking their language!
Thank you so much for your thoughts, Amy and Tamara! I really need that extra boost sometimes. It can be both exciting and scary navigating the world of private practice. I’m constantly wondering if I’m doing it right. But I’m learning that if I’m following my heart, I’m probably doing it right!
I wrote this down from Amy “What do I want more of in my work life?” I am definitely going to investigate that question. I suspect it comes in the form of “variety” as well, which I was leaning towards, but then I heard from someone recently that new practitioners shouldn’t do much more than try to fill their practices. I became unsure. Again – just have to follow my heart!
And Tamara, I wrote this down, “Be BRAVE, Be BOLD, Be YOU!” Totally. YES!!
Thank you both for being awesome!
Lauren
Lauren, WHAT DOES THAT MEAN??!!!! “. . . New practitioners shouldn’t do much more than try to fill their practice?!?!??!?!!!” REALLY?! Who says that? And, what’s that about?!!
Tamara,
It was in reference to a “multiple streams of income” conversation. I can’t quite remember who said it – I have so many resources on advice for private practice! The person said something like “I wouldn’t recommend brand new practitioners focus on things outside of filling their practice.” I’m not sure where that came from, but it definitely left me unsure that I should try to expand my horizons so quickly. I think that left me a bit stuck, though. After this conversation though, I’m doing my best now to just listen to myself and find what various things I would like to do. 🙂
Thank you! <3
Thanks, Lauren for clarifying this. The context helps. I do think that for most therapists starting out in private practice, getting that income to flow as quickly as possible is crucial. And, for most of us, it’s all we can do to focus on getting paying clients in the door. That’s hard to do that in the beginning if you haven’t already gotten seen, gotten known, gotten liked and trusted. It takes a lot of work.
If the choice point is to get paying clients in the door or build a second stream of income, I think it is wise to prioritize where you are going to put your limited resources – time, attention, money, etc. – because for most of us, those things are not unlimited. Within that context, for any given therapist, I think it may be true that to focus on a second stream can be a deal breaker.
However, if you’ve already developed a solid stream of income (or just happen to have unlimited resources!), then by all means consider adding a second (and, perhaps, passive?) stream of income!
HI Lauren:
I went through this exact same process, actually. I basically waited until something naturally came up that I wanted to develop and then I put the time in and went for it. When I was initially trying to get my feet wet with everything involved in getting clients in and getting the basics of having my own practice, it would have been too much for me.
I think if you take an honest look at where you are spending your time and how comfortable you feel with the private practice piece, then you will get a sense of whether or not you are “ready” to start developing a second income stream. I also think having an idea already helps a lot!
Good luck and let us know how it goes!
Amy
Lauren- I checked out your website because it sounded really neat and realized we’re both in Towson! What are the odds? We should meet up and consult sometime. Your work looks really neat!
Tamara and Amy- As always, thanks for helping us stoke our creativity! Love these ideas and the thoughts shared in the comments.
Hi, Katie! I love that social media allows us to make connections around the world and in our own backyard, too! Happy to share a platform for you and Lauren to meet and to share Amy’s work with you, too!
Katie,
Yes, I would love to meet with you some time! Your website is fab, too – I’ve actually been thinking about offering some walking sessions myself. I’d love to chat with you about how that is working for you.
HI Katie:
It IS so great that the internet connects us this way! I am finding that the online portion of my business is a funny thing. There’s a real balance between how much time I spend online trying to reach out to others, and the time I spend in person with folks, whether colleagues or clients. On the one hand, it can sometimes feel a little less focused than I would like and it seems like all I get is crickets, but on the other hand, I have begun to develop real relationships with folks. One of my other favorite people I have met online calls me one of her “internet humans.” HA!
Nice to meet another real “internet human!” Your photos on your website are lovely and give me a good sense of you, as well as your text. It’s a nice, clean, easy to navigate site. I hope you and Lauren connect up and become face-to-face humans!
Cheers,
Amy
“Internet humans!” I’m so stealing that one!
Amy, Thanks for taking the time to check out my site. It is a work in progress as I’m still in my first six months of private practice! Feels like a real continuing education. This site has been a wonderful resource and support during this start-up period!
Thank you, Katie! Your voice will help make Private Practice from the Inside Out even stronger! I look forward to chatting with you here! Let me know if you don’t find what you are looking for!
Wow! The idea that my practice is MY BUSINESS and the need to design it as I wish, literally just revolutionized my thinking! I’m just getting started and have been a bit fearful about niche-ing as much as I feel that I should. But now I’m prepared to take the leap!
Oh, Jessica! I love hearing this from you!
May I quote you on this?
Your ideal clients never needed a clone of the therapists up and down the street!
Your ideal clients need YOU!
Hope you’ll drop back in often to share your journey with us!
Happy to celebrate your successes with you and support you through the challenges, too.
Let me know when I can help!
Thanks so much, Amy, for taking time to share your insights with our community here and in your own online community, too!
You know . . . your Art Journey: Soulful.Creative.Self-Discovery. All in One Little Journal is a perfect example of “building the business that you want!”
Thanks for the link, Tamara, and for folks who are not in the New England area, I am GULP, going to be offering an ONLINE Art Journaling 101 workshop. Folks can pre-register now while I have it in the production stages. It’s scary to do something with videos and online, scarier to put it out there and advertise before it’s done, but I know it will be good and it’s thrilling too!
http://foxboroarttherapy.com/art-journaling-101-online/
Cheers,
Amy