Clinical Versus Business Decisions

Clinical Versus Business Decisions

Curt and Katie talk about how to make sure that you are making decisions that respect clinical and business principles AND meet the requirements for laws and ethics.

It’s time to reimagine therapy and what it means to be a therapist. To support you as a whole person and a therapist, your hosts, Curt Widhalm and Katie Vernoy talk about how to approach the role of therapist in the modern age.

In this episode we talk about:

  • Treatment strategies that are based on evidence-based practices, that may need extra information up front to avoid seeming coercive to families (i.e., required sessions, frequency or length of treatment)
  • The importance of defining the unit of treatment in the initial assessment
  • What needs to happen in the conversations with the clients
  • What is the treatment need?
  • How treatment orientation can impact business decisions
  • What limits you can set related to requirements for parents in treatment for children
  • Addressing treatment within the therapeutic alliance, in the treatment planning process, rather than holding to business parameters that go unaddressed clinically
  • Consciously discussing boundaries and compliance with treatment model, not allowing for clinical drift or an unacknowledged broken frame
  • The fear of challenging clients, fear of losing income
  • Looking at whether you can provide the level of treatment required
  • Whether we should be as flexible as our clients
  • Balancing our needs with the needs of our clients looking at both clinical and business reasons to determine how flexible to be
  • Bad clinical decisions that are based on business inflexibility
  • You don’t want business policies to overshadow the clinical decisions and clinical efficacy
  • Setting pricing strategies – doing bulk pricing or monthly pricing can get very complex and there are a lot of legal and ethical considerations
  • When we must sacrifice for our clients and when we can hold the boundaries
  • Separating assessment from treatment
  • Referring to treatment teams
  • The importance of good consultation to help talk through cases
  • The ethics codes do not require that you keep a client indefinitely
  • Ethical termination and referral options

Our Generous Sponsor:

Thanks again to our sponsor, SimplePractice!

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Relevant Episodes:

Managing Client Cancellations

Asking for Money

Ending Therapy

Resources mentioned:

We’ve pulled together resources mentioned in this episode and put together some handy-dandy links.

 Angela Caldwell, MFT at the Self-Injury Institute


Our Facebook Group – The Modern Therapists Group

Therapy Reimagined 2019: Sign up here to get notified when the details are released.

Our consultation services:

The Fifty-Minute Hour

Who we are:

Curt Widhalm is a Licensed Marriage & Family Therapist in private practice in the Los Angeles area. He is a Board Member at Large for the California Association of Marriage and Family Therapists, a Subject Matter Expert for the California Board of Behavioral Sciences, Adjunct Faculty at Pepperdine University, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making “dad jokes” and usually has a half-empty cup of coffee somewhere nearby. Learn more at:

Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant. As a helping professional for two decades, she’s navigated the ups and downs of our unique line of work. She’s run her own solo therapy practice, designed innovative clinical programs, built and managed large, thriving teams of service providers, and consulted hundreds of helping professionals on how to build meaningful AND sustainable practices. In her spare time, Katie is secretly siphoning off Curt’s youthful energy, so that she can take over the world. Learn more at:

A Quick Note:

Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We’re working on it.

Our guests are also only speaking for themselves and have their own opinions. We aren’t trying to take their voice, and no one speaks for us either. Mostly because they don’t want to, but hey.

Stay in Touch:

Our Facebook Group – The Modern Therapist’s Group


Voice Over by DW McCann

Music by Crystal Grooms Mangano

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