[JOE]:
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This is the Practice of the Practice podcast with Joe Sanok, session number 498.

I am Joe Sanok, your host. And if you’re new to this podcast, I am so glad that you’re here. You know, podcasting is such a fun way to be able to share your thoughts, interview really cool people, get messages out into the world that maybe you haven’t been able to get out into the world in as broad a scope as you can with a podcast. We have a bunch of tools for free over at podcastlaunchschool.com, a whole nine-part email course for you over there that you can sign up for if you’re interested in considering whether or not a podcast might be for you. But the reason I bring that up is Nancy Ryan, who is one of the people we’re interviewing today – or I’m interviewing today – she came to Slow Down School, she’s someone that I really respected her work for a long time, she was part of a mastermind group, just a kind, wonderful person that helps therapists that are specifically working with couples. And so we’re talking about being a confident couples therapist today. She and her friend, Dana, have put together a number of really cool programs to help people around being a couples therapist, and they’re going to just share a whole bunch of tips today. So without any further ado, here is Dana and Nancy. Here are Dana and Nancy.

________________________________________

[JOE]:
Today on the Practice of the Practice podcast, we have Dana McNeil and Nancy Ryan, Dana and Nancy are licensed Marriage and Family Therapists and founders of thriving group practices specializing in couples therapy and utilizing an evidence-based type of couples therapy, which is known as Gottman Method. Dana and Nancy’s practices both work with all types of relationship issues, parents of special needs children, sex addiction therapy, LGBTQ plus, as well as a number of individual and family issues. Recently, Dana and Nancy have come together to create Confident Couples Therapist, a program focused on bringing training, education and support to couples therapists throughout the nation. Their mission is focused on helping therapists become confident in working with couples and building a successful cash-pay practice. Dana and Nancy, welcome to the Practice of the Practice podcast.

[NANCY]:
Hi, Joe. This is Nancy.

[DANA]:
It’s nice to be here.

[NANCY]:
Hey Joe, we’re talking over each other. Yeah, good to be here.

[JOE]:
I’ll make sure that I kind of ask you guys individual questions or let you jump in too. So, let’s start with Nancy cuz, you know, Nancy, you and I have known each other for a while, you came to Slow Down School and you flew in a little bit early so we got to hang out for a whole day together just kind of getting set up. So that was… was that just a year ago or was that…?

[NANCY]:
Two years.

[JOE]:
Yeah. So what’s happened over the last two years? You had a thriving practice and now you’re doing this couples work, like, bring me up to speed just from a personal standpoint. What’s going on?

[NANCY]:
Yeah. So, so exciting. When you and I started working together, it was kind of like, hey, I want to run a group practice. And so I learned a lot from you in doing that, and it’s been very successful. Right now, I have nine clinicians and two locations, and we’ve been thriving, even in this COVID time, and it’s all hundred percent cash pay. And so that’s been really exciting and…

[JOE]:
Well, let me just pause you right there. Because I think a lot of people are like, wait a minute, you have a group practice, and you’re thriving during COVID, and you’re cash pay, like, what systems did you set up before the pandemic that for you feels like it gave you the momentum to be able to be successful, even in the midst of this global pandemic?

[NANCY]:
Yeah. So a lot of it was, you know, putting the marketing, a good website with good SEO, Google ads, I had all that together, as well as getting coaching and training on how to build a group practice. And I had a couple clinicians that I’ve… so, October 2018 was when I hired my first clinician, and so I built a lot of the infrastructure and a couple years before that, I had done a lot of speaking and community marketing. So my reputation was known. I was getting some overflow calls. And then from there, it’s all just a matter of getting, like, my marketing is pretty automatic now. I’ve got a couple of systems, I’ve got someone that handles the phone, I’ve got another personal assistant that works with me and just getting those pieces together, making sure that I’ve got enough clients coming in and then once that happens, bringing on more clinicians.

[JOE]:
Mm. So in less than two years, you’ve been able to build this multi-site group practice, it’s pretty automated, like, what kind of mindsets did you have to deconstruct? Because when I see people in Next Level Practice – our membership community – and they’re ready to kind of go to that next level for a group practice and they want to expand, they often have that kind of like bootstrapping mentality, and I’m hearing you say, I have assistants during this, I have automations. Like, that doesn’t just happen overnight. You have to kind of deconstruct a lot of things, oftentimes. For you, what did that look like?

[NANCY]:
What a good question. There’s a lot of money mindset that has to be handled because as you grow, obviously, the amount of money that’s coming in, the rates that I’m charging, the confidence that I have to have as a clinician, and as a leader, all those mindsets had to really be developed.

[JOE]:
Yeah. And Dana, tell us a little bit about your practice, and kind of when did it develop? And where are you at now?

[DANA]:
So I have a group practice in San Diego that I started in February of last year. And we just moved into a new space that we remodeled. So we have five offices, and I have six clinicians that work for me.

[JOE]:
Wow. And are you a hundred percent private pay or do you take insurance as well?

[DANA]:
Absolutely. Yeah, we specialize in couples therapy, we practice the Gottman method. We do see individuals but seventy-five percent of our practice is couples and we are all cash pay.

[JOE]:
Okay, and what kind of trends, over especially the last year, you know, we’ve got this pandemic, all these things happening – what have you noticed as trends of people coming into your practice, what they’re looking for as couples?

[DANA]:
There’s a myriad of couples, there’s the things that we know that couples fight about that we, you know, we don’t co-parent well, we don’t manage conflict well, we don’t know how to acknowledge when I’m getting defensive, or I’m starting to shut down, we sweep problems under the rug. But what I’m seeing as a clinician, which is an important trend for all of us therapists to be aware of is that there’s a rise in clients investigating and experimenting with open and poly relationships. And so having an awareness of how to deal with the dynamics of that, how to not have judgment if you are not in support of that or you don’t think it’s a good option for clients. Like, really just meeting our clients where they’re at; not having judgment, being open to, there’s a lot of, you know, millennial clients that embrace the idea of therapy, they’re my favorite clients, they’ve grown up saying, we should come to therapy, we need to get tools, we’re in a relationship, there’s no shame in the fact that we don’t have healthy communication. And so there’s this surge of like, younger clients that are coming to couples therapy, and it’s super exciting, because they’re totally buying into therapy, but you’ve got to meet them where they’re at. And they don’t want to be put in a box. They don’t want to be defined. They don’t want to be told what a relationship looks like. They just want to come in and get tools. So it’s an exciting time but if you’re not a therapist that wants to work outside of the mold, then it’s probably something you should brush up on.

[JOE]:
Yeah, and I definitely want to get into some of those tools for therapists in this interview. How did the two of you come together into kind of this new offering that you’re helping therapists that work with couples?

[NANCY]:
Dana and I met in a mastermind and we were both one… so to become a certified Gottman therapist, you have to submit four videotapes of you doing specific interventions, and we were both stuck on the last one. And so we went, hey, let’s call and coach each other. And so during that time, we’ve developed a friendship, we’ve both become certified Gottman therapists, and as we’ve been talking every week and training our clinicians, we’ve really realized that there’s something that we do with couples that makes us really good that we’ve had to start teaching our clinicians, and we both started noticing the places that our clinicians get stuck and some of the coaching that we needed to give. And so there was this, wait a minute, if you are wanting to be a couples therapist, you can go get EFT, or Terry Real’s program, or PACT, or Gottman, but what about all the soft skills that are needed to handle couples effectively in the room. So we began talking about that.

[JOE]:
And what are some of those soft skills that you’ve noticed people need to know?

[DANA]:
Do you want me to take that, Nan?

[NANCY]:
Yeah, go ahead.

[DANA]:
One of the things that… we were just brainstorming one day, she came down to visit me because she lives in Sacramento which is up the other end of the state, and we were just kind of talking about the things that you have to attend to in the room. That there’s, like, micro-expressions that are happening as one partner is talking about their frustration or their pain. And the other partner might just have like a raised eyebrow, or they’re not turning towards them physically, they’re looking out the window, or there’s a tear that’s rolling down their face, it’s just this little minuscule, like, they’re in pain too. And it’s so often that the couples have tuned out with each other that they don’t even notice those expressions anymore. And so we have to come into the space and say, hey, you know, that sounds like you’re in a lot of pain, client one. But client two, I just noticed a tear roll down your face, did your partner see that? Like, do we want to talk about what’s happening in the room and getting them to physically turn towards each other and start to make it a didactic relationship that we facilitate. So sometimes we’re the voice for the partner. And we speak the pain that we can feel kind of in the room, because we’ve been with them for so long as a couple that we know their dynamics, and we know their personalities. And so just us stating something that maybe they haven’t been able to say in the past frees up this space for the other partner to turn to them and say, is that true? Do you really feel like that? Yeah, I do feel like that. And then it’s just, there’s like a lot of moments like that as a couples therapist that can really open up a relationship.

[NANCY]:
Yeah, and let me add to that as well. One of the things that I hate to hear when couples come in is, you know, we’ve tried a couple of therapists, but what we kind of did was just, you know, we understood each other’s feelings, which is very important, what Dana’s talking about, but there’s more, or we just fought in the session, and went home, and it made it worse. And so handling conflict in the room and being able to be a presence that interrupts their cycles and not get flooded, and not be afraid of whatever anger’s coming up, and managing that conflict, and interrupting them, and teaching them different ways to process a conflict is something that a lot of clinicians are fearful of.

[DANA]:
Yeah, I always refer to Nancy as you have to have a little bit of swagger in the room, right? I mean, the reality is, is that the majority of us therapists are female, let’s just put that out there in the room. And some of us don’t do well with male anger. Well, guess what? Probably half of your couple might be a male, and there’s probably going to be some anger. And so how are you going to keep your business in check, so that you can show that you have control in the room? Like I’m fond of saying, sometimes I have a couple of five-year-olds show up here, and I’m the Kindergarten Cop, and I have to still keep them liking me, but also manage the conflict and me take the control back so that everybody knows that I’m in charge in the room. That is a specific dance, and it does require some swagger.

[JOE]:
Yeah, cuz it’s like if someone comes to couples counseling, and there’s not someone that’s calling you out on things, as well as calling you into things, it’s like, well, what are we coming and talking about if we’re just kind of rehashing everything? Versus, hey, here’s a different way to think about this, or do you see what you just did in that conversation? And to have that person that kind of owns the direction of it can be so helpful.

[NANCY]:
Yeah.

[JOE]:
Yeah. I just muted Dana with that fire, whatever’s going on there.

[NANCY]:
California is on fire.

[JOE]:
Man, seriously, like, so much in the world is on fire right now. So Nancy, tell me a little bit about as you work with your own clinicians, and then as you and Dana started to work with people that you’re consulting with, what does that look like? What are kind of some trends and maybe some phases you hear people go through, or see people go through?

[NANCY]:
Yeah, there’s… while a new couples therapist, or somebody that’s wanting to go in that direction is learning, they’re learning a theory. So that’s kind of all in the back of their mind. And then they’re learning all these different ways to manage the couples in the room, and that takes a little bit of time to get all that together. And so being able to kind of coach that where it’s not like, you’ve got an intervention that you’re thinking of, or a couple interventions that you’re thinking of, and a couple sits down and you got to be able to, you have to be able to notice that there’s frost in the room, or the couple needs to be talking about something else and go off-script. So many of our new clinicians will go, well, I wanted to do this intervention, and I pulled it out and it didn’t go very well. And I’m like, well, what was in the room? So it’s a dance, it’s kind of like you’ve got a tool belt and you got to be able to handle what’s in the room, what needs to be talked about, how to handle that, and then perhaps pull out that intervention, but not to stay on script. And so young couples therapists – young in the fact that they’re just doing it – have a hard time negotiating that. So it’s continual coaching until they get that.

[JOE]:
Yeah, yeah. And Dana, what have you found to be kind of helpful with the people that you’re training and consulting with?

[DANA]:
I think getting them out of the mentality that I’m going to use the same skills I use for individuals because it is a completely different world. You are not just mirroring, and like reflecting, and doing great listening, and saying, well, I think you have the answers, what do you think you should do? It’s very directive. And so for some new clinicians, it feels uncomfortable to be that directive force. One of my clinicians came to me the other day and said, you know, I’m really struggling with telling them some of the things that I see that are going on in their relationship, and I said, why? That’s why they’re paying you money. And she said, well, what if they get mad,? And I said, then they get upset, and we deal with the emotion that’s in the room. And so getting comfortable with thinking that you have an idea about the dynamic, speaking the dynamic out loud, and then offering tools about how they might work through that conflict, or the perpetual issue that they have going on in their relationship is not something we’re used to doing as individual therapists. We do a lot of psychoeducation, we do some coping skills, we teach them ways to cognitively think about it differently. But this is a lot of behavior change, and it’s modeling, and it’s just a very directive approach to therapy that most of us are not comfortable with, or just not familiar with.

[JOE]:
Yeah, I’d love to pull back the curtain a little bit in regards to kind of this big idea that you guys are launching. So it’s Confident Couples Therapist, and a lot of people maybe want to have multiple streams of income, they want to do passive income, but they just don’t know how to do it. They try all sorts of different things, they might create it and then it’s just crickets, and other folks, you know, we’ll launch a podcast, maybe they’re going through Podcast Launch School so they’re walking through our process – for you, what were the steps where you said, okay, we feel like we’re really good at working with couples, we’re also good at helping other clinicians, and we think we might be able to help other practices, like, what did that look like in regards to actually launching a big idea, figuring out your ideal person, starting to market it, like, tell us about the big idea launch?

[NANCY]:
Yeah, this was when we started talking more and more about what we were training our clinicians to do, the idea that there’s a bridge there that needs to be filled. So we put out some surveys, Dana did a lot with a lot of our colleagues, and we talked to all our clinicians, like, what’s your biggest concern? And so we started hearing handling conflict in the room, or feeling like the relationship, success or not, is all on our shoulders. And so we started hearing a lot of the pieces that were missing for people that have couples in the rooms and don’t know what to do with them. And then as we started going on, we started hearing a lot more about, wow, you guys have cash pay practices. And couples are a niche that work really well with cash pay practices. And so these two things started going hand in hand with, you’ve got to be really good because we have a huge word of mouth referral now, like, from therapists and from, you know, it’s like, if you’re a couple, you got to go to the Relationship Therapy Center up in Northern California. And so you’ve got to have good clinicians to build that and then you’ve got to know what you’re doing to build the business. And so both of those things started launching, and we’re getting asked questions on both and we’ll have to kind of see how it fleshes out where the need is the greatest,

[DANA]:
But you have to be able to keep all of those plates spinning, and that’s the really difficult part if you want to start your own either group practice or do some kind of, you know, extra moneymaker because you have your core business that you have to keep moving. And you’ve got this other business that hasn’t maybe taken off yet or hasn’t found its legs yet. And then you’ve got the business of your business, and you probably still have clients that you’re seeing. And so having some kind of organizational system, some kind of accountability, maybe even like a mentor that’s already gone through this before – all of those things are super helpful for us.

[NANCY]:
Mm hmm.

[JOE]:
And so where did you put your energy first? Was it in social media, building the website? Like, what were some of the first things that you did to launch this?

[NANCY]:
I flew down to San Diego and we spent, like, six to eight hours on a Friday and Saturday together and just hammered it out in what is our idea? Who are we speaking to? How do we offer this? And so we ended up building the structure of a ninety-minute webinar, that’s going to be happening in October, that will cover all of what we’re talking about. And from there, put the structure together for a six-month group plan that will hit all of these. And so we put the outline together, and then began building our messaging and copy and then put a website together. And we meet weekly now just to continue to stay on track, and we’re really good accountability partners.

[DANA]:
I also had a business coach that we would kind of meet with as well. And so whenever we were working on a specific part of the new business, we’d run it past her. So we’d schedule a meeting, and she’d sit and listen with us. And I’m like, okay, here’s what we’re thinking, we’re a little bit foggy on this part, what’s your recommendations or what have other clients done? And then so that was really helpful, too, because Nancy and I would come together, okay, here’s our concept. Here’s what we know, we’re clear on, what’s some areas that we can get some help? And I think, knowing that you’re not supposed to do everything on your own, and that you should have resources – you should have a web person, you should have business coaches, you should have mentors, you should have people that you can reach out to – you’re not supposed to know how to do everything. And I think so many of us clinicians think, I’m supposed to do my own website, I’m supposed to do my own marketing, I should do all my social media, my own accounting. No, you need to build a good team so that you can hand some of this stuff off, so that you have the space to brainstorm and create, like Nancy and I were able to do.

[JOE]:
Yeah, I think that’s so essential, to have people that are as good or better than you in these areas. And honestly, you think about a copywriter, or you think about someone that does design, none of them are charging a clinical rate. And so even if you’re at $150 an hour, it’s more effective for you to spend an extra forty-five minutes doing a couples session than it is to go learn how to do Canva and do a whole bunch of the actual design side, you know, you can find people so much cheaper than that to do all this work for you. And so when you do that, let’s say you find someone at $30 an hour, and you’re $150 an hour, you just in that one hour bought yourself five hours of design time.

[NANCY]:
Absolutely. Yeah.

[DANA]:
I mean, Nancy knows this amazing lady that created our logo in what, like, a half a day, and it would have taken Nancy and I like twelve years.

[JOE]:
And it wouldn’t have been as good as the logo you ended up with.

[DANA]:
Right. Exactly.

[JOE]:
So I guess as people are listening to this, and say they’re into trauma, or they’re into kids, or like they have a specialty area, what would you encourage them to do to start to think about their own big idea?

[DANA]:
There’s that book, you know, Start With The Why. Why are you doing it? Who’s your audience? What is it doing for them? What void does it fill that you see is happening in your world, in the population that you work with? Is there a lack of material there? Or is there not… you’re not connecting with like-minded people, and you want to create a group where you can all come together and brainstorm. Nancy and I almost always feel like unicorns when we go to any kind of organization, or mentoring group, or mastermind because there’s this philosophy that you have to take insurance. And so we’re always like, should I feel ashamed about the fact that I don’t take insurance? Or should I, like, be proud of myself? Because I get mixed messages in the world that we work in as therapists. And so, you know, just kind of, what is your goal? What do you want this to turn into? And then kind of start fleshing it out from there, I would think.

[NANCY]:
Yeah, absolutely. And I’ll add to that, too. It’s kind of, I mean, I’ve had many, many ideas over the last couple years on how to move on. But when we finally saw a real need, like, because, I mean, we could create something and there’ll be no need, but once we found out that there was a need for this, and we saw that in our own practice, that was the key in moving forward.

[JOE]:
It’s so awesome. I think that really focusing in on that need and that pain and going beyond just your individual sessions, that you have something to share that’s so much bigger than yourselves. So the last question I always ask is, if every private practitioner in the world were listening right now, what would you want them to know? And Dana, I’ll have you go first.

[DANA]:
Well, I have a request for them. So Nancy had alluded to earlier that we often, and this is a trend as a couples therapist, that we get clients that say, hey, you’re like our third couples therapist that we’ve been on. And I think the reason for that is so many of us, particularly those that are starting a private practice, we say that we can do everything, or we think that because we like couples that we’re good with couples, and my plea, and my request would be if you’re not good with couples, please refer out. Because there are those that understand that it’s a specialty and that it takes specific training and a different mindset. And it actually isn’t doing much for the therapy world when we keep just seeing clients that we don’t know how to handle. And so please find the referrals in your area that specialize in couples therapy, and please refer them out.

[JOE]:
So good. And Nancy, what about you?

[NANCY]:
Yeah, one of the things that I found in going to school and networking with other therapists is so many therapists think so small, and I really would love for our therapy world – and with all the coaching and you and all the other coaches that have been developing over the last decade – we don’t have to do that. We have so much skill, and so much talent, that we need to be able to make a living at this, and not feel guilty for making a living at this, and give our skills to the world. And instead of someone that might have been trained in a six-week program, and they’re out there because they have the confidence.

[JOE]:
Mmm, that’s so awesome. Well, the two of you put together an ebook that is for my audience. Will you tell us a little bit about that ebook, and how they can access it?

[DANA]:
Go for it , Nan.

[NANCY]:
Yeah. What that ebook does is it will give you three conflict-busting techniques for working with couples. And so that you have an idea, that’s the number one concern that we heard. If you go to confidentcouplestherapist.com/freeguide, it’s there for you. It’s a beautifully made ebook and I’m sure it will give you a lot of tips.

[JOE]:
Oh, that’s so awesome.

[DANA]:
Yeah. A lot of what to do with your attitude, and how to approach conflict and just a lot of the scary stuff. So we just wanted to give you something to start helping you soothe some of those fears that you might have.

[JOE]:
Well, Dana and Nancy, thank you so much for the work that you’re doing with couples therapists, and thanks so much for being on the Practice of the Practice podcast.

[NANCY]:
Thanks so much for having us, Joe. I’ve got to come see you again.

[JOE]:
Yes, absolutely.

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[JOE]:
Well, thank you so much for listening today. What’s the action going to be that you take from this? So often, we listen to podcasts and, you know, there’s a certain time when you really want to just push yourself to be able to get some things done. So I want you to take some action items from this as well. Also, thanks to TherapyNotes for being one of our sponsors. You’re amazing. Make sure you use promo code JOE at checkout to get that deal, and it’s a great way for you to just become more professional, have your notes in order. It’s something that so many people struggle with and you just don’t have to. So, TherapyNotes makes it so easy. Thanks so much for letting me into your ears and into your brain. Have a great day.

Special thanks to the band Silence is Sexy for your intro music; we really like it. This podcast is designed to provide accurate, authoritative information in regard to the subject matter covered. It is given with the understanding that neither the host, the publisher, or the guests are rendering legal, accounting, clinical or other professional information. If you want a professional, you should find one.