The Sky is Falling: How Therapists Can Protect Our Industry, Patient-Centered Care, and Our Businesses, An Interview with Dr. Ajita Robinson
Curt and Katie interview Dr. Ajita Robinson about innovation within the mental health industry that could threaten therapists in private practice. We chat about Value Based Care in insurance, insurance credentialing companies, and big tech disruptors. We also talk with Dr. Ajita (an income strategist) about ways that therapists can diversify their income leveraging both their license AND their knowledge, to try to mitigate these risks to our businesses.
Click here to scroll to the podcast transcript.Transcript
An Interview with Dr. Ajita Robinson
Dr. Ajita Robinson is known as The Experts’ Therapist. She is a Grief & Trauma therapist, Award-winning and Bestselling Author of The Gift of Grief: A Practical Guide on Navigating Loss, TEDx speaker, International Speaker, and Income Strategist. She has been seen in places such as Good Morning Washington, Headspace, Wall Street Journal, HuffPost, Washington Post, CNBC, Business Insider, Bustle, Essence Wellness House, and Therapy for Black Girls.
Dr. Robinson is a Licensed Clinical Professional Counselor, Trauma and Grief Expert, first-generation trauma, and poverty disruptor. She is the Founder and Executive Director of Friends in Transition Counseling Services, a trauma-centered mental health practice located in Bethesda, MD. She is also the CEO of Legacy Wellness Group, a conglomerate of enterprises dedicated to promoting generational wealth, education, and healing.
After serving as a grief and trauma expert for over a decade, Dr. Ajita Robinson began to leverage her years of clinical experience and her previous career as a corporate consultant to launch a mental health practice and scale it to 8-figures. She is a first-generation trauma and poverty disruptor who helps mental health entrepreneurs create living legacies and financial freedom while helping communities heal.
In this podcast episode, we talk about how therapists can protect our profession
With the changes to our industry, we thought it would be important to talk with Dr. Ajita Robinson, an income strategist and insurance expert, about how therapists can weather the storm.
What are the threats to the mental health industry?
“One of the big challenges that I’m seeing is that we’re not thinking long term about how to protect the industry, how to protect the integrity of what it is that we do, while also innovating. We have to move and keep forward with technology, we have to optimize our practices. But we also have to protect the thing that we do better than anyone else, which is actually patient-centered care… But more than anything [we have] to innovate from the inside out, as opposed to what’s currently happening as the outside industries with tech and software and AI coming in and really shaping what’s happening next. We’re going to lose control of that pretty quickly.” – Dr. Ajita Robinson
- Big tech companies innovating in our space, with a focus on efficiency
- Value-based insurance billing
- Credentialing and billing services (like Alma and Headway) moving us out of direct communication with insurance companies
How can therapists leverage their skills for alternative revenue streams?
- Understanding what other types of services can therapists provide
- Clarifying when we’re leveraging our knowledge versus leveraging our license
- Identifying problems that we’re best situated to solve
- Entering the self-help industry
How can therapists get started when they are ready to leverage alternative revenue?
“I’m always looking at: am I leveraging my knowledge or my clinical license? Because if I’m not leveraging my license, then why put it at risk by having the services under the same company as my clinical practice?” – Dr. Ajita Robinson
- Identifying the problem you solve rather than the transformation you want to provide
- Understanding what your target client has already tried
- Knowing what the barriers are for them to solve their problem
- Clarifying who is the customer and who is the consumer
- Contracting with schools, cities, etc. is possible for therapists to increase income
- Accessing resources and experts to help you do what you need to do
- Distinguishing when to start a separate business
Resources for Modern Therapists mentioned in this Podcast Episode:
We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance!
Dr. Ajita Robinson’s book: The Gift Of Grief: A Practical Guide On Grief And Loss
Facebook: facebook.com/drajita
Instagram: instagram.com/dr.ajitarobinson
LinkedIn: linkedin.com/ajitarobinson
Facebook group: Purposeful & Profitable Therapist Community
Purposeful and Profitable Summit in July
Our Linktree: https://linktr.ee/therapyreimagined
Relevant Episodes of MTSG Podcast:
Private Practice Planning for the Future of Mental Healthcare: An interview with Maureen Werrbach
Is AI Smart for Your Therapy Practice?
Who we are:
Curt Widhalm, LMFT
Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, 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: http://www.curtwidhalm.com
Katie Vernoy, LMFT
Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also a former President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt’s youthful energy, so that she can take over the world. Learn more at: http://www.katievernoy.com
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 with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:
Consultation services with Curt Widhalm or Katie Vernoy:
Connect with the Modern Therapist Community:
Our Facebook Group – The Modern Therapists Group
Modern Therapist’s Survival Guide Creative Credits:
Voice Over by DW McCann https://www.facebook.com/McCannDW/
Music by Crystal Grooms Mangano https://groomsymusic.com/
Transcript for this episode of the Modern Therapist’s Survival Guide podcast (Autogenerated):
Transcripts do not include advertisements just a reference to the advertising break (as such timing does not account for advertisements).
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Announcer 0:00
You’re listening to the Modern Therapist’s Survival Guide, where therapists live, breathe, and practice as human beings. To support you as a whole person and a therapist, here are your hosts, Curt Widhalm, and Katie Vernoy.
Curt Widhalm 0:15
Welcome back modern therapists, this is the Modern Therapist’s Survival Guide. I’m Curt Widhalm, with Katie Vernoy. And this is the podcast for therapists about the things that we do in our practices, the things that we do to support our profession. And just knowing the things that are coming up in our field, the things that are happening in our field. And we are joined today by Dr. Ajita Robinson, author, therapist, speaker, all around cool person who is going to hopefully take some of that anxiety of what’s coming up in our field and help us understand what’s going on. So thank you so much for joining us today.
Dr. Ajita Robinson 0:52
Thank you for having me, and no pressure, right.
Katie Vernoy 0:57
We are so excited to have you here. I have been following your stuff. And I just love what you’re putting out into the world. But instead of me gushing, let’s go with you doing a little bit of a self introduction, the question we ask all our folks first is who are you? And what are you putting out into the world?
Dr. Ajita Robinson 1:14
Again, thank you so much for having me. I’m equally a fan. I’m a grief and trauma therapist, so a Licensed Clinical Professional Counselor. I sit here in Maryland, and we serve the DC, Maryland, Virginia area. But specifically what I do outside of clinical practice when it comes to therapists is really helping them leverage their brilliance beyond direct practice. And so yes, I help with building private practices. But my jam is really as an income strategist to help us identify ways to serve beyond the couch to even generate what I call pajama profits, which is passive income. So the diversification piece, is the thing that I absolutely love to do.
Curt Widhalm 1:50
I know that a lot of the conversations that we end up having had with you is just about kind of where the mental healthcare field is. After the pandemic, everybody’s burnt out. We are, as a field, already a very precarious place before the pandemic, we’ve done maybe too good of a job as a field being like, hey, therapy like but the workforce issues are just bearing down on us. What do you see is what’s coming ahead as far as what therapists are facing in kind of this future landscape right now?
Dr. Ajita Robinson 2:23
I think one of the challenges that we’re facing is the way that our field has been kind of really really like hot kids on the market, right so the pandemic really highlighted that everyone has mental health challenges, right, at some point. What we’re seeing from a tech perspective is that tech companies are like, wait a minute, there’s a lot of money to be made here. But they it requires therapists to get on board, right? Because we still are the skills, right? We’re the technicians. And so one of the challenges, the big challenges that I’m seeing is that we’re not thinking long term about how to protect the industry, how to protect the integrity of what it is that we do, while also innovating. We have to move and keep forward with technology, we have to optimize our practices. But we also have to protect the thing that we do better than anyone else, which is actually patient centered care in a way that allows us to remain viable, right, that we can’t be replaced by large tech companies that talk about our inefficiencies and administration. We have to really get a grapple on bringing that back in house, so to speak, so that we actually can compete in a way that allows us to protect our patients, to protect our field, but more than anything to innovate from the inside out, as opposed to what’s currently happening as the outside industries with tech and software and AI coming in and really shaping what’s happening next, we’re going to lose control of that pretty quickly. And I’m not normally a doomsdayer.
Katie Vernoy 3:50
One of the things because we had our friend Maureen on and she was talking about kind of value based insurance billing. And I know you also have been an expert in insurance. And this is another piece that I think is something that we want to get a handle on. Can you tell us a little bit about what that is and how you think that might affect therapy practices.
Dr. Ajita Robinson 4:08
This is a big one, because value based models as we as we know, in general, in the insurance industry, a lot of the regulations trickle down to mental health, but they’re really meant to regulate our counterparts in more the medical model, right. But we are part of healthcare so we get the impact of that. And so value based kind of billing and value based care, that healthcare model really focuses on patient outcomes. And so it really is driven towards instead of billing for procedures, and we know that we are CPT code and procedural based fee for service based billing model. Well, it really is flipping that and saying, Hey, we’re no longer going to bill based on fee for service we’re going to bill based on outcomes. And in mental health that makes it really tricky to bill based on the outcomes that patients are having when we mostly deal in chronic illnesses. And so, how many of our clients come for preventative care, and we’re able to preventatively kind of mitigate whatever’s happening for them. The reality is, is that what’s happening for them often requires some length of care. And if we’re only paid based on how efficient we are in resolving the problem, then that can leave us with doing solution based care with clients that have long term and cumulative trauma. And we know from a patient care perspective that actually is counter intuitive to the work that we’re actually doing. Does that work in physical therapy? Maybe. Not so much in mental health. So once again, because we’re not involved in policy development, this value based care really requires us to increase our documentation, increase our assessment and measurement of outcomes, right, in ways that may feel dishonouring to the work that we actually do. Right? So how do we measure in a quantitative way the outcomes of a client’s increased awareness, right? How do we measure self esteem in a quantitative perspective? Yes, we could give them, you know, an ASI or something of that nature. But we know that we’re measuring quality of life, which isn’t as easy to captur. But that’s what our reimbursement rates will be based on if they really switch to this model. And everything tells us this is coming down the pipeline that’s been in play in other industries, but that it’s being kind of globalized to the healthcare industry, in general. And I think that, again, requires us to innovate and advocate in very real ways.
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Curt Widhalm 6:26
Not only are you mentioning the kinds of things of like measuring quality of life improvements, but there’s so much of our work that is also based on keeping people from getting worse, that is potentially keeping people out of emergency rooms and this kind of stuff. Are you seeing any of the discussion focusing on our role in the broader systems of this as part of this advocacy effort?
Dr. Ajita Robinson 6:52
There should be, but again, we have the least representation, unfortunately, when it comes to the Center for Medicare Services, which is where this is coming down from right. The preventative care, again, that model is grounded in the medical model. And so for us, it really, really imposes an issue of when we’re coming in, and we’re trying to do preventative care. Oftentimes, if we’re meeting clients in that space, where we’re preventing suicidality, we’re preventing, you know, anxiety from getting worse, we’re presenting some of the things we know that can, you know, exacerbate things that are on the biological and the physiological side, it often doesn’t meet medical necessity. And so we have another issue of how do we then get paid for preventative services, because we don’t currently have preventative diagnosis codes that the insurance industry pays for, right? Because those are generally our z codes. They don’t generally pay us for those. And so we are really stuck in between a rock and a hard place. Because the things that would allow us to provide preventative care are currently not covered. Right, and the way that we document and assess that, again, it’s a circular issue doesn’t meet medical necessity, it’s a non covered service, but it’s needed to prevent, or at least to build some coping mechanisms and to reduce risk, to improve functioning before it gets exacerbated. Insurance company doesn’t value currently, the way that things are written. Those codes that would allow us to do that, in a preventative way, aren’t reimbursable codes, because they don’t meet medical necessity, the way that the criteria is set up. And so this is where advocacy comes into play. The other thing that I’ll say regarding this is there’s in this value based model, there’s a big push for collaboration. And they’re encouraging interdisciplinary collaboration. And this is great for our counterparts on the medical side, because they’re able to bill for those interdisciplinary collaboration, collaborative calls, and those interdisciplinary team meetings. We are not considered eligible billers for those codes, although we’re more most likely to initiate the interdisciplinary collaboration, but we’re currently also not reimbursed. So this is an opportunity, again, for advocacy, for educating up the chain. And for really thinking intentionally about why we have to really make a stance about we do something unique. No, this can’t be just encapsulated into the medical model, because we know that our counterparts often in OBGYN and pediatrics and the other MDs aren’t trained to recognize it in a preventative way, or even intervene in the way that we are trying to do. And so this really is when I talk about protecting our field from the inside out. This is what I’m talking about. It is pervasive, and it is so necessary.
Katie Vernoy 9:30
Even in thinking about how value based billing is going to impact, you know, individual practitioners. There’s also, you know, like the Headways and the Almas and the folks that are already capitalizing on insurance billing in a fee for service model. I mean, it seems like the way we make money is really at risk, at least for those taking insurance.
Dr. Ajita Robinson 9:54
100% and I have tried to continue this conversation about the dangers really of us partnering with these organizations without getting a cease and desist because their unique selling position to the insurance company is that we lack the the skill set and the administrative capacity to manage our own credentialing and billing. And so it’s an incentive for the insurance company to not have to deal with us. And so they have them as a middleman. So they reduce their call volumes for from uninformed providers. That is their unique selling position, right is that it costs them less money to have a company like Headway or Alma intervene so that they don’t have to interact with us. Which leaves us from being unable to truly advocate for what we’re doing. Because now instead of being able to see the data that really speaks to how effective we are, it now gets rolled up in an aggregate way in Headway’s and Alma’s reporting about their value that they’re bringing to these organizations. And so we’re really cutting off our face, right, we’re cutting our nose off as far as protecting our industry. And the thing that again, we do better than anyone else, these companies would not be viable if we wouldn’t sign up for the services. Right. And so I know that, you know, I own a credentialing and billing company. So that’s a conflict of interest. So I’m glad you asked me this question. And I didn’t volunteer, right.
Katie Vernoy 11:20
It’s interesting, because we’re looking at insurance. And I think a lot of clinicians are are in network or signed up for one of these services. That seems to be at risk, at least as far as what we’re talking about. There’s a lot of folks that then will decide they don’t want to be therapists anymore. And so they go and do coaching, or they do courses or do other things. And that’s a perfectly viable option, right. But the thing that I’ve been hearing, when I listen to your webinars or I, I look at your programs is that you’re also talking about diversifying income as a therapist. What to therapists get wrong when they’re starting to think about diversifying their income?
Dr. Ajita Robinson 12:04
So I think one of the big things that we get wrong is really in our mindset of thinking about how do we leverage our clinical skill sets in ways outside of one on one work, right? So we understand we can do group therapy, we can even understand oftentimes, and we can do coaching, right? But I think in not really being clear about how transferable our skills are, we lock ourselves into only doing direct service. Whether coaching feels very much like direct service, right in a lot of ways. So we don’t think about being able to consult, right. And whatever it is that we decide that we’re going to whether it’s speaking, being a thought leader in the media, creating a course or partnering with schools, right to consult on crisis intervention, or whatever it might be, oftentimes, because we’re not clear about how transferable our skills are, we then aren’t thinking clearly about what problems those skills equip us to solve. And so when we’re in one on one therapy, we understand how to screen a client out most of us right understand when a client’s not a good fit. But when we come to partnering with the school, we often think about being a referral source or even coming in and providing services to the students or to the staff. But we don’t think about what does it look like to function at a higher level, such as being a consultant for social emotional learning, right? A consultant for professional development, or a consultant and a professional development trainer right? On how do we recognize suicidality and you know, anxiety and distress in a classroom setting? Those are things that we recognize because we’re working with the kids who are coming in, that are anxious, or the parents who are trying to help support their children. But then we don’t really think about how do we then switch that when we’re talking to a different audience, of educators, or of you know, principals or leaders who are responsible for developing programming for children that may be experiencing anxiety. And so I think part of it is our lens, right? We’re trained, often at the micro level, and that we struggle with shifting to looking at it at a macro level, and we have the skill set to do it. It’s often again, shifting our vantage point. And so that’s what I spend a lot of time doing is shifting the mindset, and really helping clinicians think about the possibilities about how they can take their knowledge and their skills. And when are we leveraging our knowledge, right? So the things that you learn as a clinician versus when you’re leveraging your license? Because if we’re leveraging our knowledge, that opens us up to be able to being able to practice without restriction because we’re not leveraging our license. Right. And so those are some nuances that I think clinicians struggle with when they’re thinking about diversifying.
Curt Widhalm 14:36
You know, I see so much of how we introduce clinicians in the field is to focus so much on what you can’t do and all of the laws and ethics that restricts people, but this is something where we become so kind of paralyzed by this idea of what we can’t do that I imagined that there’s just a lot of All right, take a breath breathe. You do. You are intelligent. You did go through grad school. But you’re smart. Let’s just talk about this in a way. And I’m glad to hear you’re not just using words like scaling up and all of that kind of stuff that we hear from a lot of coaches and that kind of stuff. But in giving people just that permission, I’m refreshed to hear you talking about it in this way. So I don’t know that I have a question here, other than just kind of like, this is giving permission to think in new ways rather than just being like, yeah, go out and do it.
Dr. Ajita Robinson 15:27
And I think that’s so important. So thank you. Thank you for that, Curt. I think we have to remove the limits. One of the things that I think helps remind us of this is I ask this question, how many people do you know, that need to be in therapy that aren’t going? They’re never coming to therapy, right? But do they need access to information that might help them just better understand what they’re experiencing, better understand, even their children, right? Every now and again, right? As someone who grew up with cumulative childhood trauma, I have to check in with a friend who did it, to ask them whether or not my 16 year old is like messing with me, right? Like this is normal, right? Or she messing with me because my little filter gets off every now and again. But again, the reality is, is that everyone isn’t coming to therapy. But the self help industry is a multi billion dollar industry. What does that tell us? That people are still looking for resources on their own to help get some insight, to get some skills, to get some alleviate some suffering. And so who’s best equipped to help them on that journey? We have this magic that happens in one on one therapy, or group therapy, or however your survey, they get stuck there. And then people who can’t get on your calendar, don’t get access to your brilliance, to the skills and the tools, right, and the tips and the insight that could free them up on their journey because everyone doesn’t need therapy. They may just need words to describe what they’re experiencing so that they know that it’s not just them. That’s what I hear repeatedly when, you know, people all around the country, via me about my book, a book that I thought wasn’t enough, because it wasn’t for my colleagues. It was for people who don’t have a Master’s in Counseling or mental health, it was for the everyday person that needed to name grief, especially grief that wasn’t about dying. Right. And I think that’s important. I think sometimes we minimize how gifted even we are, and the fact that we save and change lives every single day, because we’ve been doing it, it’s just what we do. But it’s amazing for people that don’t have access to it right, and that we still are in a place where everyone doesn’t have access to get health care, right. And then I think the last thing that I like to remind clinicians of is we’re outnumbered y’all, we are outnumbered, like, literally, there aren’t enough of us for all the people who want therapy, there aren’t enough of us to actually serve everyone. And so our commitment to reducing the stigma of mental health means we got to get out of the way. And we have to figure out ways to leverage what it is that we do when people can get up close and personal with us. For the folks who we can’t get access to, they can’t get access to us. And so that’s what drives me. When I think about like, Should I do that? Is there still room? Absolutely, we’re out numbered right. And so I think that heart to still serve motivates a lot of us to to fight down this thought of we haven’t done enough or we don’t know enough, or I don’t know how to do that. Because we’re still so committed to helping as many people as we can. And so other things other than direct practice is one way that we can do that.
Katie Vernoy 18:33
So if we’re looking at getting started with diversifying income, you’ve got a lot of other ideas that I hadn’t heard other folks talking about, what are some things that folks can think about when they’re getting ready to diversify their income?
Dr. Ajita Robinson 18:46
So I get this question a lot. And I love it. And oftentimes people come and they say, oh, Ajita, I want to do X, Y, and Z. And I always ask them why. Right? Because my background, I come from corporate. And so my job was product launches and product development, the income strategy for Fortune 500 companies, right, selling dog food, or widgets, or whatever it was. And I get to do that same thing for mental health professionals. But we always started with, what problem are you solving? And who has that problem? What we often do is that we think about the transformation we want people to have, and then we build the product. But people aren’t buying products when they’re in a space of transformation. They’re buying products when they’re in a place of pain. And so we often will create things that’s a multivitamin. How many of us take those regularly, as opposed to we never run out of painkillers because we know what it feels like to have that migraine or to have that backache or whatever it is. And so people buy products that solve problems that they already know they have. And as therapists we’re like, I want to just get you to that point, because it’ll change your life. And that feels out of reach for people. They don’t even think that’s possible yet. And so I always ask them, what problem do they have now that you can help them solve? So what’s motivating you? Right? And then the next question next to that, but well, before we get to what you actually packages in, whether it’s a course or a group or retreat, is what are they already tried? And this is important because people will already have some distance between a course, if they’ve tried to course, and it didn’t work, right. So if you try a self paced course, with parents, and what parents desire most is community. And what they have the least of is time, a self paced course does not go well with parents, right. But you get them in a community with other parents that can normalize and validate their, their their pain points and their experiences. And they can vent about these kids. You’re cooking with grease, right? And so I always say, let’s start over with instead of leading with, I want to create a course or I want to create a workbook, who are you serving? What problem are you solving? And what are the barriers to giving them transformation? That should almost always help us figure out how we serve them, right? How we deliver what the solution is. And so those are the things that I find most clinicians, when they diversify their services, they start at the end, and they don’t think intentionally about what the problem is, and who has that problem. Can I add one more piece, this, this really lights it up. Okay, the next thing that I really would love clinicians, and just, you know, anyone, right clinicians to understand when they’re developing products or services is to understand the difference between their customer and their consumer. Their customer is who buys what you’re selling, the consumer is who uses it. And we understand this example, innately, because we might work with kids, and they’re the consumer, they, they receive the therapy services, but the parent is normally who pays, they’re the customer. So we know when we’re marketing our services, we at least have to talk to the parent about what’s happening with the child. And the same is true when we want to launch a book or a course, we have to understand that there are differences between who’s buying and who’s using the service. And we have to be nuanced in talking to both of them, and talking to them about the right thing, because we know, in the same example, with parents and kids, the parent can come in and ask for services. And then we meet with that child, they have completely different thoughts about what the problems are, right. And so we want to take the same thing into consideration when we’re developing products, especially, because otherwise you will have the consumer locked in, but who’s paying for it, right. And so we want to make sure that those are in alignment.
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Katie Vernoy 22:25
One thing I want to make sure you also add in because this was something that that blew my mind in a webinar that I watched, that you did, is sometimes the customers are the government or cities or schools or that kind of stuff. Can you talk about what that looks like, because I think that’s an avenue a lot of therapists don’t think about, and the products and services that you can provide to those customers can make you some really good money.
Dr. Ajita Robinson 22:52
You are correct, because we scaled to seven figures the first time, we scaled four to seven figures the first time and that’s actually what helped us get to eight was absolutely through contracting. And so your state, your local and your federal government are always the biggest spenders, even in times of economic easing. And the really cool thing is, is that many of us are already situated to provide the services, we just may not have our registration, we’re not in the the procurement site for our state as a vendor. Many of us qualify for small business certifications that would give us an advantage. A really, really cool thing that we’ve been able to do is to add continued education that we provide, we have a continuous contract with the state substance abuse facility, where the facility pays us for we come in, and we’re the dedicated CE provider. We also provide supervision of supervisor of the supervisor. For them, we have a similar contract with the Department of Defense, y’all it’s like, big deal, right for a course that I actually created for first responders. So it was a great course on grief. And I did one on vicarious trauma. And someone from that, you know, from an agency under the Department of Defense saw it and said, Hey, would you all do one of those for us, and we’d like it to be a part of our onboarding. So everyone that gets onboarded in this certain unit for Department of Defense gets that training. It happens to be a unit of federal LIOs law enforcement officers. And so that really scaled our practice in a whole new way. And we haven’t had to recreate this course. It’s an evergreen course that we created an optimized once. We created it once and then optimized it and so we’ve had that contract, and it’s a multi six figure contract. We have a couple of training contracts with the FBI, and we’ve done you know, state universities, right. So these are things that we have the skill set to do. I think we’re just doing it on a smaller scale. That has been phenomenal, right? in growing our business. I talk a lot about the revenue piece. But it also has allowed us to grow a benefit package right. And so we’re one of very few private practices or privately held companies around our size that has a pension plan. And we were able to do that through the administrative fees that you can build in, they call them fringe benefits when you’re in contracting, right? That you can build it into salary, your team, it’s how I salary my clinical director and how I salary you know, my first executive assistant was through contracting, right and certifications. And so these are ways that we can grow our business exponentially and really help retain your team, right, because if we think about why people leave, they may leave to start their own practice. But many times they leave because they need better benefits, right for their families, and outside of working for the government, how many companies don’t offer pensions? And so being able to structure things so that there’s opportunities for growth. It also helps you reduce burnout among your team, when you diversify what their day looks like. Right? So getting them trained to do things outside of direct practice, allows you to stabilize their income and give them some of their time back as well. And so that’s been just one way that we’ve scaled our practice to eight figures and helped others do the same.
Katie Vernoy 26:02
I think a lot of folks are pretty overwhelmed by contracting. Do you have some ideas about how they might get started with contracting?
Dr. Ajita Robinson 26:09
Absolutely. So I always recommend if you can partner with a grant writer, most of us aren’t trying to write grants. Always utilize your resources. Most of us either at the county or at the state level, there are small business centers. So my we have a Women’s Business Center, we have a small business center. They are there to help you navigate these processes. And so they have people that literally will walk you through the process. And then the third thing that I would say regarding that is start as a subcontractor. We understand subcontracting, right. And we bring in contractors, we work with people in a fractional way, because we can’t afford a full time marketer. So we contract a part of their services. And so our first contract, we weren’t primary, we didn’t go after it by ourself, we partnered with someone that had experience contracting, and we had expertise in the actual service delivery. And so for us, it literally was delivering groups to parents, right, that high conflict, co parents on communication and conflict resolution, that was something we were already doing in family therapy, right, in those mediation sessions that we’re trying to do. And so we just went and partnered with a nonprofit in the area that was doing the supervised visits. They had the facility, they had the people, they didn’t have the capacity, they didn’t have anyone on staff trained to actually lead the sessions. And so we learned as much as possible under that particular contract. And then eventually, we became primary. And so seek those partnerships out. I think, oftentimes, we don’t go after opportunities, because we’re only counting our individual capacity, when we really need to partner with other people, right. And so collectively, you may not have what you need individually, but find someone that has the competency that you don’t have. The last thing I’ll say regarding that is that there’s a lot of administration when it comes to contracts. So find someone like an accountant that has specialization and experience in the reporting aspects. And so we hired someone to do the administrative and the reporting pieces that we didn’t know how to do. And so we learned alongside right, that process. And so now we have dedicated people to do it. And so I want to be very clear, we didn’t start off as primary contractors, right, we had to learn and grow our way into that.
Curt Widhalm 28:17
At what point does it make sense to separate out into different business entities on these kinds of things? Because if you’re going from alright, I’m seeing my 15-20 clients a week and then contracting with the FBI and Department of Defense. One of those things is not like the other.
Dr. Ajita Robinson 28:37
Yeah, so what I’m always looking at, am I leveraging my knowledge or my clinical license? Because if I’m not leveraging my license, then why put it at risk by having the services under the same company as my clinical practice? So that’s one that I want to kind of my factors that I’m looking at. The other one is, does the engaging in whatever the behavior is or the activity is create additional risk to my practice? Right. And so for me, it’s about risk. And the risk could be to the my license, because I want to protect that. But the other risk could be financially, right. And so does it create a, create additional financial risk? And the larger the contracts we got that we weren’t leveraging our clinical licenses because we were doing psycho education. That was our degree, not the license, right? The more it made sense to separate the two. We did start off altogether there because again, we had one contract, and there was no additional risk there. But when we had to secure additional insurance policies and additional liability policies that were outside of what our malpractice, we could even get on that side of the business, it absolutely made sense. And then from a tax perspective, right, and so it made sense to separate them out because it was going to push us to a completely different tax liability perspective, and not from an evasive perspective. It just made sense because we were doing completely different things right and the way we needed to hire on the consulting side of the business, if we had kept them under the clinical side, we’d have been forced to make them employees because of the way that model works. And so we needed to separate the liability of having contractors, and being adhering to labor laws and things of that nature and separating them out made that cleaner. And so those are things that took we took into consideration after consulting with our accountants and our attorneys. So please have those folks on board as well.
Curt Widhalm 30:20
Where can people find you?
Dr. Ajita Robinson 30:22
I am Dr. Ajita on all platforms. I’m on Instagram, I’m on Facebook, my TikTok is suspicious, so I would recommend the first two. I have a Facebook group the Purposeful & Profitable Therapist Community. And so those are that’s really where I hang my hat where you can find all kinds of things and all types of information. That’s where I am.
Katie Vernoy 30:43
And you kind of just barely touched the surface and kind of mentioned it in passing, what are the things that you do? How do you support folks? What might our modern therapists want to connect with you about?
Dr. Ajita Robinson 30:55
So anything to diversify income. So whether you’re wanting to host your own event, or start your own courses or speaking and consulting, so anything diversifying beyond the couch, that’s really where my specialization is. We actually have a summit coming up the Purposeful + Profitable Therapist Summit that’s focusing specifically on diversifying income. We do it every year in July and so the next one’s coming up July 13 and 14th. I have on my website, I have a ton of downloads that help you really think through what it looks like to diversify your income. And so we have some checklists and a workbook there.
Curt Widhalm 31:29
And we’ll include links to those in our show notes. You can find those over at mtsgpodcast.com. And follow us on our social media, join our Facebook group, the Modern Therapists Group, and until next time, I’m Curt Widhalm, with Katie Vernoy and Dr. Ajita Robinson.
… 31:43
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