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What if you hate private practice?

Curt and Katie chat about the realities of private practice and why it isn’t the idyllic career path it’s often made out to be. We dig into reasons therapists may dislike private practice, like financial instability, isolation, lack of accountability, and ethical concerns. We also share ways therapists can navigate these hurdles and find fulfillment in their work.

Transcript

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In this podcast episode we talk through what makes owning a private practice hard

We have seen both overly effusive (“living my best life”) and hopeless (“I will never be successful in private practice”) feedback about being in private practice. But what is it really like? AND if you don’t like private practice is that okay? We decided to dig into what makes being a private practitioner challenging.

Doesn’t everyone LOVE private practice?

“There’s this mythology about what private practice looks like…it puts forward this idea that we all love it, that it’s amazing, and if you don’t love it, you’re doing it wrong, and there’s something wrong with you.” – Katie Vernoy, LMFT

  • There are a lot of reasons people choose private practice as their job
  • Private practice is hard
  • Private practice isn’t for everyone

Financial Instability is unavoidable in private practice

  • Private practice income can be unpredictable, often lacking benefits and paid time off
  • Therapists may need outside financial support to mitigate these challenges
  • Starting a private practice easily can rely on financial or able-bodied privilege
  • Charging high fees and navigating ethical dilemmas can challenge therapists’ sense of fulfillment and values.

Owning a Private Practice comes with Business Challenges

  • With limited business training in grad school, therapists often struggle with marketing, setting up systems, and attracting clients.
  • Therapists can overthink how they set up their practice, causing delays and inefficiency

“[Marketing is] a very different skill set than sitting and talking with clients…than what you have gone to grad school for. And that is part of that entrepreneurial part that is…you go out and you network, and you do the hustle and you sign up for insurance companies or whatever else it is that you do that does require kind of more specific job/task orientation kinds of things that are outside of [delivering therapy]…I fully acknowledge that that is something new and different, and it’s not for everybody.” – Curt Widhalm, LMFT

Many Private Practice Clinicians experience isolation

  • Private practice can feel lonely
  • Networking, consultation groups, and in-person connections are essential for combating isolation.

Private practice can be boring or monotonous

  • If you are tightly niched or work only with the worried well, you may encounter little clinical challenge
  • If you are only doing one to one work, you may desire more diversity of tasks to stay interested (like teaching, podcasting, etc.)

If you own your own business, figure out how to deal with accountability issues

  • Without structured oversight, therapists may face difficulties staying organized or motivated, which can lead to burnout
  • Depending on who you talk with, you might convince yourself that no one is caught up on notes or paying their taxes on time – which isn’t accurate.

What can therapists do to make private practice better?

  • Network and nurture social and professional support
  • Get systems set up (and make them as simple as possible) to streamline your work
  • Think about diversifying what you do, to keep yourself engaged with the work

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!

Relevant Episodes of MTSG Podcast:

Thriving Over Surviving: Growing a Practice without Burn Out, An Interview with Megan Gunnell, LMSW

How Therapists Can Manage a Sedentary Job: An interview with Celina Caovan, DPT

Building Your Treatment Team in Private Practice: Essential Networking Skills for Therapists

Why Therapists Shouldn’t Be Taught Business in Grad School

The Dividing Line Between Coaching and Therapy

Are Therapy and Coaching All That Different?

The Brand Called You

Topic: Business

Topic: Marketing and Branding

Topic: Money

 

Who we are:

Picture of Curt Widhalm, LMFT, co-host of the Modern Therapist's Survival Guide podcast; a nice young man with a glorious beard.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

Picture of Katie Vernoy, LMFT, co-host of the Modern Therapist's Survival Guide podcastKatie 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:

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Consultation services with Curt Widhalm or Katie Vernoy:

The Fifty-Minute Hour

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).

… 0:00
(Opening Advertisement)

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 to modern therapists. This is the Modern Therapist’s Survival Guide. I’m Curt Widhalm with Katie Vernoy. This is a podcast for therapists about things that go on in our field, the people who make it up, the things that we run into as therapists. And this episode is for those people who have maybe dabbled in some private practice sort of stuff and found out that they didn’t like it, or those who are considering going into private practice and have a lot of maybe healthy qualms about, is this right for me? Well, there’s many people who talk about private practice being the greatest thing ever and being free of all of the horrible things that go on in community mental health and all of the demands of meeting contract payers and all of that kind of stuff, that private practice is not necessarily something that everybody enjoys, nor is it necessarily always the answer. And so Katie and I have accumulated through some of our observations of our our friends, our colleagues, and also some of the Facebook group commentary around why don’t people like doing private practice? And if you’re making it through the end of the episode, what are some of the things that can be done at each of these steps that might help to be able to address it. So we at least are starting this off with a list of 13 reasons why people don’t like private practice, but Katie, you’re the one who kind of accumulated these first I’m going to let you run most of this episode.

Katie Vernoy 1:47
My first place to start before we get into 13 Reasons Why, there is an entrepreneurial tendency to say: being a business owner is amazing, and I’m living the dream, and I’m passionate about what I do, and this is awesome, and I get to see, you know, 12 clients a week and do yoga, and do all this stuff. And there’s this mythology about what private practice looks like. We’ve talked about this in other episodes, but it puts forward this idea that we all love it, that it’s amazing, and if you don’t love it, you’re doing it wrong, and there’s something wrong with you. And so the reason I brought this to you, Curt, because I feel like this is probably going to have a million links in the show notes to other episodes where we’ve talked about pieces of this.

Curt Widhalm 2:35
Is it possible just to link to the entire back catalog of Modern Therapist’s Survival Guide?

Katie Vernoy 2:41
Potentially, potentially, and we’ll hopefully be able to share for our Throwback Thursday an episode that is especially relevant to this. But I feel like it is really important to remind all of us that being a business owner, being a therapist that has a private practice is a job. It can be a calling too, I’m not going to argue that we have a lot of meaning in this, but it is a job. And so some of the reasons that came up there, as well as the conversations you and I have had, and the experiences we’ve had over the years, are reasons why most people don’t like having a business or struggle to be a therapist. I want to start with hope. I think a lot of these things are addressable if private practice is actually your path. But I also want to acknowledge private practice isn’t for everybody.

Curt Widhalm 3:34
You and I, we come from different generations. You’re Gen X, I’m millennial, and I think that this is something that particularly my generation seems to have been hit with growing up: is turned your passion into a career, into a job. And I have largely come to the conclusion that that is just terrible advice…for a couple of reasons. Whether it be being in private practice, whether it be why you’re in this field in the first place, or any field at all, is that first and foremost, is that allows employers to use your passion against you, especially when it comes to things like wages and that kind of stuff, because you’re doing it because you love it. You’re in it for the outcomes, not the incomes and all of that other BS that just kind of leads to being exploited. Maybe your advice should be, pick like your fifth or sixth biggest passion, use that as kind of your reason, so that way you’re not expecting all of your fulfillment to come out of everything that you do, day in and day out. Off the top of my head, I can’t think of any field where anybody is expected to love every single aspect out of what they do. You know professional athletes, there’s still a lot of practice that goes in. There’s a, if you’re a A list celebrity, you might hate going on press junket tours and social media and dealing with that kind of stuff when really your passion might be acting. And so as it applies to things like private practice, there are a lot of aspects around still running a business that you might not be passionate about every single little thing that you do. Just to kind of reiterating: It’s terrible advice that, all right, if your passion should be private practice, that you have to love every single little aspect out of it.

Katie Vernoy 5:23
Definitely a millennial statement, but I think it’s just an entrepreneur statement that monetize your passions. I found that that advice is harmful to me, because then I spend all of my time worrying about making money, and all the anti capitalists are like, yes, we’ve monetized our lives. This is horrible, and it’s really bad for my mental health, because then I can never turn off, because if I’m doing something that I love, I have to think about how to make money from it. So that’s I don’t want to belabor at that point too far.

Curt Widhalm 5:55
And then one more thing is it also takes the fun out of it when it becomes something that you are seeking out money for.

Katie Vernoy 6:03
Yeah, yeah. Becomes a job. So, moving into the first and least surprising reason that folks do not love private practice: financial instability. It’s a business. You have to put yourself out there and charge a certain amount of money, and make money, and you can’t, especially initially predict how well you’re going to be at getting clients, keeping clients. There’s things to work on with that, but in any business, it’s really hard when your money is going up and down and all over the place, and you’re expected to live like other folks who have a W-2 salary or consistent hourly wage.

Curt Widhalm 6:47
Way back when Katie and I were coming up with the idea of doing a podcast and the various things that we do together, I had commented to you that I think that the number one way to make money in this field is to marry somebody who already has money. And it very much speaks to this financial instability, and a lot of the commentary that I see online that at least initially starting out a private practice, many people do have the benefit of having a spouse with a stable job that does allow for some of that financial risk taking. And that’s a privilege that a lot of people who come into this part of the field have in order to be successful. I know that at least when I first dove into private practice, that that was a privilege that I had that allowed for me to really be able to craft things in the way that I wanted them to be. I don’t know that I would have been able to do it if I didn’t have a spouse who had that stable job at the same time. And I think that this is where we’ve had a number of episodes in the past where it’s you don’t necessarily have to dive head first into only doing private practice, and it’s something that you can ramp up and find kind of a balance of, once you’ve reached a certain level of stability or predictability, that you can jump in, but that financial instability, especially in the first year, but even the first couple of years, until you get used to kind of the seasonal aspects, the summer slump, the holiday slumps that can end up happening, where you get into kind of a, alright, I know that I have to put aside some money, so that way I have regular income, or the regular ability to pay bills when there is kind of seasonal aspects of things. I also remember back during the Great Recession, when a lot of, you know, people cut therapy as, you know, a luxury at the time, because people were losing their jobs. That that wasn’t just seasonal. That was for a couple of years there where a lot of people in private practice were facing some of that instability as well.

… 8:58
(Advertisement Break)

Katie Vernoy 9:01
We have several episodes that go into managing your money, budgeting that type of stuff, so I’ll link to those in the show notes. Over at mtsgpodcast.com. I want to acknowledge that getting to a place of relative financial stability, especially when starting out at private practice, you mentioned the privilege of having a second income. Probably with that income comes another one of our reasons why folks are nervous or don’t like private practice is they don’t have benefits, they don’t have paid time off. Those types of things. All of this kind of flows together, and I want to acknowledge that there’s also an able bodied privilege in being able to work a full time job and start a private practice to meet the financial needs. I was able to do that for both of the reasons. I was more able bodied when I started my private practice. I also had a second income and I had a full time job that paid me well, so I had a lot of things where I could build up my private practice slowly, design it the way I wanted it to, all of those things. And I hear a lot, especially in groups where there’s clinicians who have chronic illnesses or disabilities, but that’s just not possible. You can’t see a bazillion clients a week. You can’t do it. So I don’t know that there’s a way around that. And I want to try to support folks who want to be in private practice, because I think it can be a good career for folks who have medical concerns. It’s looking at, how does that work, so that you can have enough income as well as the benefits that you need. So these are real issues, and I think this episode, we’re already, you know, ways in, and we’ve only gotten to the first couple of reasons, but this is, I think this is the biggest thing for folks to really think about is the finances and being a business owner doesn’t work for everyone, and so weighing how you take care of yourself and potentially advocacy for medical benefits, not being connected to your job, for example, like those types of things, may make it more approachable for folks that don’t have the financial or able bodied privilege. And I go back to it may not be possible for everyone, and so I think we should leave that there, because we have a lot of episodes where we go into this deeper, but that piece alone, I think, is a big thing to consider. And potentially the biggest reason why folks get out of private practice is not being able to finance their lives. The second reason, or third reason, I guess, is what we are at now, being a business owner isn’t taught in grad school. We’ve talked about why we think maybe it shouldn’t be taught in grad school, or it should we have that episode over in the show notes. And I think that there are businesses that are much harder to create than therapy private practices, and there’s really simple ways to be able to do it, and so not everybody’s cut out to be a business owner, and I think that folks are making it harder than it needs to be sometimes to create a therapy business. Am I does that sound kind of sense Curt? Because I I feel like there are a lot of systems or processes or things that are kind of plug and play that people sell, that make it almost seamless. You could start your private practice in a weekend.

Curt Widhalm 12:19
Couple of things come to mind as you’re talking about that. Number one is for people entering into our field, we get a lot of education about things, and there’s a lot of knowing about things that helps us to feel competent about delivering therapy, but when it jumps into actually making financial risk by starting a business, that sometimes those feelings that come up end up becoming paralyzing because we don’t know.

Katie Vernoy 12:47
Absolutely.

Curt Widhalm 12:48
But the other piece that comes up with this is, you know, the Betty Crocker cake mix things that if you bake at all, they’re really simple baking things where you just have to add the mix in with some water and a couple of eggs and then put it the oven. Those were originally designed to be even simpler than that, but what Betty Crocker had found out when they were first making them is that if they were too simple, people didn’t feel that they were contributing anything at all and weren’t actually using them. So I’m also wondering if it’s where, if things are too simple, then it just feels like I should be doing something more to make this happen. There has to be something more to make this happen. Why am I not seeing the results right away? I know that you’re a wonderful systems person. You’ve encouraged me to add some systems my practice that have benefited out. But when people are building a practice and not getting clients right away, it comes back to some of that money sorts of things, too. Where you can have all of those systems in place and still not be seeing enough clients to feel that it’s worthwhile right up front.

Katie Vernoy 14:01
And that leads to another of the reasons, which is having to hustle, having to market, and doing something that feels really foreign to a lot of therapists. It’s putting themselves out there, it’s selling, and I’m not gonna lie, that one’s pretty darn hard.

Curt Widhalm 14:18
It is, and it’s a very different skill set than sitting and talking with clients, and I think that it’s part of our podcast that we’ve largely started to shy away from is really, you know, going out and marketing, and we haven’t had a lot of business coaches on in recent years, and kind of by intention. But we feel that that’s either covered in some of our previous episodes or in some of the coaching workshops and stuff that other people put out there. But it is very much a different skill set than what you have gone to grad school for. And that is part of that entrepreneurial part that is just kind of how you end up getting to do what you got into this field to do. You know, it’s part of the trade off of, all right, rather than sitting in budgeting meetings for an agency, you go out and you network, and you do the hustle and you sign up for insurance companies or whatever else it is that you do that does require kind of more specific job/task orientation, kinds of things that are outside of the All right, delivering therapy, pieces of things, and, yeah, I fully acknowledge that that is something new and different, and it’s not for everybody.

Katie Vernoy 15:46
A lot of what I’ve seen are marketing strategies that are focused on extroverts and being able to get out there in a big way. I know we have episodes that talk about a lot of different strategies, including SEO and Google AdWords and different things. So there’s making some decisions there, and I think decision fatigue can be very huge, because that’s how entrepreneurs burn out, is decision fatigue, versus having a lack of control over what happens in your workplace like employees do. But it also seems like it’s there’s a moral kind of assessment of people that are tooting their own horn, or talking about the services they do, or marketing directly to other folks. And so it feels like when someone hates marketing and another one of the reasons feels isolated in private practice, they kind of sit with that and don’t recognize that networking and consultation groups and collaborative teams and all of that stuff solve both problems in a lot of ways. You spend a lot of time with colleagues. You you’re networking with them, you refer to each other. There’s there’s momentum that happens. And so when, when each of these things are seen as individual things to solve, I think it becomes even more overwhelming for folks to address any of it. And obviously, when we’re in isolation, there’s the loneliness, and that’s one of the things that a lot of people have mentioned. But there’s also this lack of grounding in what the profession is doing, and so if you’re only getting your socialization through Facebook groups, you’re getting a very, a subset of clinicians that are more tech savvy, potentially, or keyboard warriors in some cases, and so you don’t necessarily get a good, a fully rounded social support or professional social support network that can provide both potentially clients, but also collegiality and calling you on your stuff when you’re getting off base with your clients, or yourself.

Curt Widhalm 18:08
So really, it’s get out there and see what’s really happening and working around you. And the field is changing. Katie and I grew our practices well before the pandemic, and since the pandemic hit and telehealth has become a large part of people’s business models, and the job landscape has largely transformed into some part of jobs, if not it being complete parts of jobs, being entirely virtual.

Katie Vernoy 18:38
Yeah.

Curt Widhalm 18:38
Ends up being where the career landscape is that that is still very much a subset of all of not only our profession, but all of society. And getting outside of those voices that are the most vocal in the virtual spaces, and I will say, including podcasts like ours…

Katie Vernoy 19:00
Yes.

Curt Widhalm 19:01
Something…

Katie Vernoy 19:02
Fair enough.

Curt Widhalm 19:02
…that helps to be able to give you some different perspectives on what’s out there. People ask me what kinds of podcasts I listen to, and I really have listened to less and less over the years, because part of where my fulfillment ends up coming is hanging out with my friends. Some of them, most of them happen to be therapists. And guess what? That’s networking, and it’s support. And just because it’s not going out and meeting brand new people all the time doesn’t mean that it’s not networking. It’s still, hey, here’s what’s going on in my business, or hey, here’s challenges. Are you facing them too? That helps to kind of keep it even more collegial and supportive. That is an additional piece of this, rather than going out and throwing business cards at people who are running down the street, or trying to get them to scan QR codes from my phone that let them know about my business. That there is still trying to what you were saying, trying to hit some of these things, getting more than one egg in a basket sort of thing, kind of being able to not have every single thing be: Okay, now I’ve got one check mark done.

Katie Vernoy 20:20
Yeah, yeah, yeah.

… 20:24
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Katie Vernoy 20:24
Another related concern that we’ve already started talking about is feeling very alone with your cases. We have a whole episode on creating treatment teams in private practice, so we don’t need to go into that here, but there’s also part of that is effective networking, and so I’ll leave that there, but I feel like private practice if you have high acuity cases, can feel isolating and dangerous if you don’t have a team around you, either built or, like, internally built, like within a group practice, or externally built, like developing your own treatment team. Or another concern that was brought up is not being clinically challenged. And so you get the low acuity cases, and you see a ton of those cases, and they’re well paid, they’re, you know, you’re living the dream of having this low acuity, high financially rewarding private practice, but you can get bored. It can seem monotonous. There can be a lot of, I don’t know, just feeling unfulfilled that happens in private practice if you get it too refined and too easy.

Curt Widhalm 21:37
I can’t speak to that personally, because my practice has gone on, I’ve leaned into taking on higher risk, higher needs clients, and I love it. And that has come hand in hand with having a supportive team built around me, and being part of consultation groups that also work with this. So kind of checking off a lot of these boxes at the same time. That if I had a caseload that was entirely, you know, in that worried well sort of column, I’m just even trying to imagine that. I don’t know that I have ever been at risk of that, but especially not lately. You can set challenges for yourself, like in private practice, there’s very few guidelines as far as what you have to do. It’s only the limits of your imagination. And so if you want higher risk clients, be part of consultation groups that help support you to work with higher challenge clients. Get trainings on working with somewhere between that higher acuity of care, like the only limitation on this is your mind.

Katie Vernoy 22:52
Yes, and your emotional capacity, your spoons. I think for me, I worked with such high acuity in agency work that I’ve been a little bit shyer about taking in clients with higher risk. I’ve had them. I’ve had a lot of clients with higher risk, and some of them, I knew when I accepted them. Some of them, those things came up later. And sometimes it just really stresses me out, because I feel I just worry about my clients a lot. And so all of this goes to other types of ways that you can take care of yourself, but I probably lean more towards the private practice gets a bit monotonous. It gets a bit boring at times. And I’m mostly okay with that, as long as I’ve built up other things to make my life more interesting, like a podcast, and, for a while, a conference and other types of consulting and those types of things. So, I’ve built out other opportunities to, professional opportunities to be able to keep my interest and my and develop meaning. I know that there’s been times in my life, I’ve also had big personal goals that have helped with making me feel like I’ve got meaning and purpose in my life that was separate from my job that I had created for myself. You’ve taught, which I think is another thing that you really love and have been able to incorporate in to keep the monotony, or the, you know, the boringness, out. So, I think there’s a lot of ways to to push back against that monotony or boring nature, and you have to be willing to step out. Because I think some folks will get burnt out or bored with private practice and do one on one coaching and wonder why they don’t feel any better. And we have a whole episode on that, so I won’t go beyond that. The other thing that you just said that was, I think, pretty interesting, is that there’s no real limits on private practice except your imagination. And you and I both are on the California Association of Marriage and Family Therapists ethics committee. We’re not speaking for them. This is not part of that. And, you’re a law and ethics expert overall, so we know that there are legal and ethical boundaries to what we can do in private practice. But it does feel like there’s not a lot of accountability. And this is one that was not in anything I read. It’s just something I’ve seen: if you don’t have accountability, and the systems are not in place, or you’re feeling overwhelmed, or life happens and there’s nothing outside to that you feel to keep yourself on track. For some folks, that means pretty unruly practices; getting behind on progress notes, not billing. I’ve seen people who forgot to bill their insurance billing for months in, you know, in the coaching that I’ve done, it can get pretty overwhelming. And then when you’re behind or you’re not, things are kind of in disarray. There’s nobody that’s really outside looking at you. So you start, I’ve seen this anyway, you start getting this external like you become your your own boss, yelling at yourself. And there’s that, the mental load of carrying that and the shame that builds up around it. And so to me, I think that is a vicious cycle that happens within private practice where I’ve now stopped doing the things that I know I’m supposed to be doing. Nobody’s watching me. I’m not getting in trouble if there’s not that external motivation, and I’m and I’m just feeling really bad all the time and feel less like doing the things I need to do. And so private practice just feels really horrible.

Curt Widhalm 26:27
And I think that there’s also a larger piece of this in our field altogether, which is, once you get licensed, and you get through your first couple of years and you can start supervising, there’s overall very little as far as guidance, as far as clear cut career progression. It’s get licensed, there’s a bunch of hoops to get through for that. Before that, there’s get through your graduate school. There’s a bunch of hoops to get through to that. Get to a couple of years plus licensure you can supervise and then practice for 40 years until you retire. Once you hit that two years in, you’ve hit kind of the top of your licensure for many aspects of the field. There’s, there’s very few things where it’s okay get to five years and then do this, or get to 10 years and do this. But kind of in a very similar way with what you’re talking about when it comes to private practice, is that when there’s nobody making you do things, if there’s not the gamification where it’s you must do this, then it’s very easy to just fall into, well, I’ll do the things that I like to do until I have to do that. And usually that’s when a licensing board, an ethics committee, the IRS, your state tax board, somebody who’s got some teeth will make you do something. It’s self discipline, in a way, to do the things that you don’t have to do when nobody’s looking that really makes it to where, yeah, you have to do that. And that’s not something that everybody naturally has, and it’s something that it does take being accountable to other people and talk about, oh yeah, this is stuff that I have to do. This is me paying not only my quarterly taxes, but my monthly taxes, and knowing that other people are doing this too, that kind of helps to instill some of that self motivation to doing it, to be able to get there.

Katie Vernoy 28:25
There’s a lot of support and authenticity that I find in some of the Facebook groups that I, therapist’s Facebook groups that I’m a part of. And then there’s this other element of having the folks around you in this: I’m a mess. Nothing’s working. It’s so hard. I’m super behind on my notes. I haven’t paid my taxes. It’s normal. Nobody’s nobody’s doing this that that puts you into this bubble of venting and normalizing failure. And I believe there are a lot of us who are doing what we need to do, and some of us do it naturally, organically. We we have it within us. Some of us need accountability partners or body double or something to get some of this stuff done, or delegating and having a bookkeeper and an accountant and those types of things as you’ve moved along, making sure that you’re paying what you need to pay, or doing what you need to do. And so I feel like there’s this need to really put forward: Who am I spending my time with? How am I taking care of myself? Because when I was spending time around a lot of entrepreneur type folks, not therapists necessarily, who everything was amazing and wonderful in it, and then living the dream, I felt less than and I felt like I wasn’t doing a good job, and it felt really overwhelming, and I felt like I was going to fail. When I spend time around folks who are super authentic. And this is really hard, and it’s going to be the biggest challenge in your life. And I. I I’ve not done a note in 27 years. You know, whatever it is, I feel like I’ve also gotten to a place where I’ve lowered my own standards and given myself some compassion, but potentially also set myself up for that very negative internal monolog of, I can’t do it, I can’t do it. I can’t do it. Nobody can do this. You know, I’m done.

Curt Widhalm 30:22
In our Brand Called You workshop, we talk about the people that you surround yourself with tend to be the ones that are a reflection of who you are, or that you become a reflection of the people that you surround yourself with.

Katie Vernoy 30:36
Sure.

Curt Widhalm 30:37
And I think especially in online spaces like Facebook groups, where some of these less than functional behaviors end up getting reinforced, can be something that does normalize those behaviors that you’re talking about. And it’s never easy to face: Hey, here’s a space where I’m showing up less than. But if it is something that does reflect better on the kind of business owner that you are, the kind of therapist that you are, hang out with better people.

Katie Vernoy 31:14
Better friends.

Curt Widhalm 31:15
Find better friends. But that’s also the benefit out of networking. If you’re five notes behind, rather than 400 behind, you’re putting yourself into a less unethical position.

Katie Vernoy 31:33
Sure.

Curt Widhalm 31:34
But I think that that’s, again, one of those things where networking and part of the smarminess out of it, that some people don’t like that hustle piece of it is networking isn’t just about going out and selling yourself and selling your business and saying, hey, send clients to me. It’s also going out and making genuine connections with people that look at Hey, what does it take to actually run a business? Well, what are the new requirements that are coming up for jobs and businesses and that kind of stuff that helps to keep you more on track. And then it becomes easier, rather than needing to feel like you’re doing everything all at once.

Katie Vernoy 32:16
So we’re getting very, very short on time, and there’s just a couple more things that I think I can mention and direct folksto our back catalog. Many people put forward this notion, and this is a big one that I’m feeling, is it’s a sedentary job, and it’s has huge impacts on people’s bodies. We have an episode with my physical therapist, so I’ll link to that in the show notes. And I think that there are things and maybe this is something that we can revisit for an episode. There are things that I’m doing to try to optimize that a little bit. We’ll see if it’s interesting enough for a whole episode or maybe a partial, partial episode, but, but that’s one, competence issues, folks who feel like they’re not competent and but feel like they have to take all the clients. So there’s, there’s some differences there, because you’re making the business decisions. And the last one, which we’ve kind of talked about, but I want to just put a, you know, kind of a little button on this one, having moral or other qualms around charging a high fee. And when you are able to command a high fee and feel comfortable to charge it, that can help with a lot of the concerns that we’re talking about, and that practice isn’t necessarily right for everyone because of why they’re big that why they became a therapist, and what they want to do with being a therapist. So I guess we just have come back around to it all depends on your own personal situation. There’s not one answer, and private practice isn’t for everyone.

Curt Widhalm 33:51
Yeah, when I was first looking at this list, before we started recording today, I commented to Katie that this is something where it’s not a yes or a no thing. There’s a lot of different factors that go into it, and it has to be kind of a very personalized decision. Some of them are going to come from a place of privilege. I acknowledge that it’s it’s not equal for everybody, and that’s part of the reality of where we’re, where we’re at as a society, as a profession. And until that changes, you have to look at all of these 13 Reasons, and probably more that we’re not even thinking about, and say, Is this the right decision for me? And some of it is going to be around competency, competency to run a business. Some of it is going to be really just about the nuts and bolts of financial things. I have a very good friend that I have been friends with since grad school, who by all means is privileged in just about every single way. And I asked him recently, why don’t you want to run, you know, your own thing. Why, why not go out and start something? And he confided in me some aspects that made sense for him to remain an employee, where he’s able to practice at the top of his license. And it makes sense for him. You know, this doesn’t have to be for everybody. You don’t get a plaque that says you made it in private practice. You get, you know, a dog park named after you. You can go and make success wherever it is that you want to be. Yeah, we’ve come up with a bunch of ways to address some of these things in either a one by one way, or being able to knock a few of them out together, and that’s still not going to be for everybody, and that’s okay. Like go and and find the best fulfillment that you can. If your job in a group practice or an agency somewhere is you can get 100% satisfaction out of 80% of satisfaction. Get 100% of 80% because if you get 3% out of 100% satisfaction for private practice, you’re not doing better. You’re doing much, much worse.

Katie Vernoy 36:13
Private practice is hard, but if it’s too hard, you don’t have to do it.

Curt Widhalm 36:20
Yes, we’d love to hear more of your commentary. Let us know on our social media or in our Facebook group, the Modern Therapist Group, if you have further thoughts on this. If you think that there’s stuff that we’re missing, we’d love to hear that kind of feedback. And you can check out our show notes over at mtsgpodcast.com We’ll link to all of our back catalog and that and until next time, I’m Curt Widhalm with Katie Vernoy.

… 36:49
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