[ALISON PIDGEON]
You are listening to the Grow a Group Practice podcast. Whether you were thinking about starting a group practice or in the beginning stages, or want to learn how to scale up your already existing group practice, you are in the right place. I’m Alison Pidgeon, your host, a serial entrepreneur with four businesses, one of which is a large group practice that I started in 2015. Each week, I feature a guest or topic that is relevant to group practice owners. Let’s get started.

Hi, welcome to the Grow a Group Practice podcast. I’m Alison Pidgeon your host. I love talking to group practice owners who are doing amazing things and today we are talking to two of them. So I have interviewed Jill Johnson-Young and Sherry Shockey-Pope. They both own a practice in California called Central Counseling Services. They started the business back in the 2009 recession and despite all of that, they have continuously grown the business. They now have another business that is kind of a sister business to their original practice. That is a nonprofit called CCS Wellness. They explain why they made that decision and how it kind of relates to their for-profit practice. They also do a lot to educate folks in our profession and provide them with internship opportunities.

Sherry is definitely a businesswoman through and through. She wrote a book about establishing a practice and they both have separate streams of income they developed. Jill Johnson-Young has developed her own kind of services around her work with grief and they were just so delightful to talk to and just really enjoyed their sense of humor and how passionate they are about what they do. So we kind of try to go through all of the different pieces of their business and how they grew to their business of the size it is now. And yes, if you’re looking at really wanting to scale up your business, this would be a great interview to listen to. It’s definitely something to aspire to. So I hope you enjoy this interview with Jill and Sherry. Jill and Sherry. Thank you so much for joining me today.
[SHERRY SHOCKEY-POPE]
Thank you for having us. I appreciate it, thanks.
[ALISON]
Can you take a minute to introduce yourselves and your practice?
[SHERRY]
Sure. My name is Sherry Shockey-Pope and I co-found Central Counseling Services with Jill Johnson-Young. We’ve been in business about 11 years. We serve about 1800 individual sessions with our 29 staff and we serve a variety of every concern except for eating disorders.
[ALISON]
Excellent. So you say 29 staff, is that 29 therapists or does that include everybody?
[SHERRY]
That concludes everybody? We have 26 therapists, oh, no, I’m sorry. 27 therapists and three support staff
[JILL JOHNSON-YOUNG]
So a total of total of 30 and we’re hiring right now.
[ALISON]
Nice, nice. So your practice is actually the same exact size as mine, so that’s exciting. So the reason that I wanted to have you on the podcast is because obviously you’ve built a very large practice and I know there’s many people who aspire to accomplish that. So I thought it would be cool if we could kind of get into the details of kind of how you started and how you scaled up and what kind of changed along the way for you, because I know I’ve had that experience. I think once I got to be between like 15 and 20 therapists it seemed like things changed quite a bit. So I’m curious too, to hear if that was a similar experience for both of you, but maybe we could just start talking about how did you start out. Were you thinking when you started, you were going to grow a practice this big or?
[SHERRY]
No.
[JILL]
We opened in the middle of a recession in this office with carpet that should go unnamed and it was just the two of us. Then we got excited and we have a part-time person to answer phones and things. Then it feels like it turned around in all of a sudden we’ve got two offices and contracts in places, some things, but Sherry is a master practice builder. So she should tell you how we did it.
[SHERRY]
I think part of the reason, Jill and I both have our backgrounds from Child Protective Services. So we came with a lot of experience of our kids not getting the help that we felt that they needed in the community. So our practice is very community-driven. So if someone comes to us and says I can’t find services for this population, or I can’t find services for these children, we’re like, okay, let’s build it. That’s kind of what we’ve done. So how we’ve gotten contracts is people have come to us, we’ve been in the community time and they’ve said, “Hey we have kids who are not adjusting well school. Can you come into this school and help with us?” And we’re like, “Sure.”

And part of it is we don’t always know exactly what we’re doing, but we’ll kind of figure it out on the way. And I think what I learned early on from being an agency person to a business person is that it’s just skills and we can learn those skills. If you can make it through graduate school, you can learn skills. So I may not know what they are right then, but I’ll figure it out. So that kind of how our business grew. We had people who said, we need these services and I would go into Jill’s office and plop on the couch and say, we have to figure this out. We would talk about it and kind of figure it out. We’d go, “Well, we need to hire some people. Let’s hire some people for this.” So we went from three of us to eight of us and then 12 of us, and it just kept kind of growing. Then it was like, well, we don’t have services in the south part of our county. Okay, let’s figure it out. And we just did it.
[ALISON]
Wow. That’s great.
[JILL]
It helps when you’re part of a community because you know people. So those contacts help us find the office in south county and it helped us realized that we could, if we couldn’t figure something out or didn’t have it right at the tip of our fingers, we knew somebody and we could use those contacts to build that too.
[ALISON]
That’s great. It sounds like your values are really around, like you said, supporting the community with the community needs and then you’re kind of building the business and response to that, which is cool. So was there a point at which you said like, have we gotten big enough? Are we getting too big? How much bigger are we going to get?
[JILL]
I don’t think Sherry has enough. I really truly don’t.
[SHERRY]
I think we’re in a position now where we do, I don’t know, I’m sort of driven by clients needs. I’m driven to help, to replicate what we’ve have in other places in our area. I don’t think I want to go out of state because then that involves a whole bunch of licensing stuff, but we live in a large community in Southern California and despite the number of therapists in the area, there’s still population chunks that are not being served well.
[JILL]
Or at all.
[SHERRY]
So I don’t think that we have that to serve everybody in Southern California, but I certainly think that we could be part of this solution. So as far as like moving out bigger, I think, yes, I think we could easily move out bigger and I think there comes a time and maybe this is what you are alluding to when you were getting your 15 therapists that you have to switch more to a strategic planning. And I think that’s where we are versus, oh, let’s just do this. Let’s do that. Which is where we were in the first say five or six years of our business. We just kind of did stuff on a whim. And with the bigger office and the bigger staff, you just can’t do things on a whim. There has to be a little more planning involved.
[JILL]
When we moved into our current Riverside office, it was smaller and we decided one day we needed more space. We negotiated it that week. We were putting holes in walls. Not long after that. Now it’s far more, okay, so we’ve got these communities that need services. We need to look and see where we need to be and what we need to do. So it is far more strategic now.
[ALISON]
And probably you’re doing things on a much bigger level. So it can’t be at the turn of a, it can’t be quick. It probably is like, oh, we have to open this 15-room office. So that’s going to take some planning.
[SHERRY]
Well, and part of, when we had COVID we had been looking for a building to buy and we can’t find a building in the area that we want to buy. So people, the real estate people say, “Well, just build one.” And I’m like, “I don’t think I want to just build one.” And now that we’re in telehealth, that kind of opens up a lot of different possibilities for us. So we may not need a physical structure in the same way we might have needed one before.
[JILL]
Or smaller one, that’s gotten identification for a community, but with far smaller facilities, because we are mostly telehealth.
[ALISON]
Yes. So when you were building up the practice, was there a point at which you said like, oh wow, we need kind of a different structure here or now we need to start hiring for leadership positions? Where was that point for you?
[SHERRY]
I think when we had about 10 to 12 therapists, we needed to start having leaders within that group. And I think that we are just now we’re like in year three of really leadership development. So we’ve selected some of our therapists to kind of step into that. We haven’t actually hired someone for a leadership role. We’ve hired them and they’ve been working with us. All of our people, and I think it’s really important still see clients, at least a few. So I think as we got to know them and we saw how they worked and we saw what they were doing with their clients and we sort of handpicked them for the leadership roles within our company.
[JILL]
Some of them really presented themselves, not by saying, look at me. It was just their skills were so evident that you are the one of the rock stars that we are going to have to move up and give more responsibility to. That’s been delightful to see.
[ALISON]
That’s exciting to see people go growing in different ways, taking on other responsibilities.
[JILL]
They’re the ones who nurture the staff that really speaks at least to me, that that’s who we need to move up with.
[ALISON]
So what is that position called and what are their responsibilities?
[SHERRY]
We use a really big fancy term, the leadership team. I think that, I don’t know, I think that we’ve identified people, I don’t know that we necessarily have labels in this same way that we would if we worked for the county. And I think that’s part of our hesitation of giving, because a lot of times you would get these fancy titles and you’re like, “Well, what do you actually do?” So we’re all part of that leadership team doing various work within our business. But I think that, I sometimes call them supervisors, but a lot of times I want them to feel that they have influence. So we just call basically all of us the leadership team.
[ALISON]
Okay. Nice. So what are their responsibilities?
[SHERRY]
They supervise staff, they review case charts, they handle client complaints. They provide —
[JILL]
Supervision for our students.
[SHERRY]
Yes.
[ALISON]
Nice.
[JILL]
One of them’s helping to build, three of them are helping to build a nonprofit and to do the leadership in that out in the community. So it’s not us.
[ALISON]
Great.
[SHERRY]
So what we were noticing and one of the reasons why we started our nonprofit is we couldn’t find enough therapists that were what we felt were well trained enough in trauma. Our center sees a lot of people who’ve had trauma experiences and we couldn’t find enough therapists so we decided to sort of grow our own and grow them from the students that we could put through the nonprofit. Then we can hand select the ones from there into associates, and then we can move them from associates to licensed therapists. That system seems to be working well for us right now. It’s still in the tweaking stages a little bit, but that seems to work well. We’ve had some really good staff come through that way.
[JILL]
And in fact, one of the leadership team wrote the entire nonprofit application.
[ALISON]
Wow. That’s great.
[JILL]
That says a lot.
[ALISON]
So obviously then the nonprofit is its own entity, the practice is its own entity, but they are kind of sister companies, you would say? So was there a particular reason why you chose the other entity to be nonprofit and not for profit?
[SHERRY]
We wanted to be able to go into hospitals and schools and things where other nonprofits, you don’t get an invitation into the table unless you’re a nonprofit. So we thought this would give us a good way. Well, in California also you can’t have students in a private practice. You have to be either in the agency or you have to be a nonprofit. So it made more sense for us just to create a nonprofit than to create an agency.
[ALISON]
Okay. Interesting.
[JILL]
And we already had contracts with a couple of nonprofits for who we were providing services. So it made sense to more consolidate those under one arm and separate out the other clients and the other services under the other arm.
[ALISON]
Okay. So then I think what I understood you were saying was you’re sort of training the people in the nonprofit and then they go on to become licensed and then they move over to the practice? Is that kind of it works.
[JILL]
Yep.
[ALISON]
Nice. That’s a great model.
[JILL]
It’s like having a minor league baseball team and they’re the Angels by the way, not the Dodgers.
[ALISON]
Yes, that’s great. So tell me about what are your, you said you’re planning still to hire. So what is your kind of goal for how big you want the practice to grow or sort of what’s the next face that you’re looking at with the practice?
[SHERRY]
I think for us, we’re looking at some underserved areas and so creating a group of say, six staff in a particular area would be our next goal to sort of not necessarily have satellite areas, but have a small enough unit. Again, because somewhat because of telehealth, but also have a smaller unit, which is certainly easier to manage and certainly easier to open financially. You don’t have to put as much down. It would be nice if we could buy those buildings, but they wouldn’t have to be as big as, like our office in Riverside has a classroom. Then it has 11 offices and it has a kitchen and it’s like 4,500 square feet. So that investment is significantly bigger than these other investments that we can do.
[JILL]
We’re also looking at strategically reaching out to specific underserved communities and looking at the skills that we have in our staff and what communities they feel connected to so we could reach out to those underserved communities better, and it is a more identified available agency for them.
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[ALISON]
Nice. So how do you figure out what population is not being served well in your community? Is that just through the process of kind of like networking and talking to other institutions and other healthcare providers or how do you figure that out?
[SHERRY]
It’s kind of a combination of some research. So we start with a listing of underserved areas. We also start with looking at research in general on who in our areas, zip code have the highest propensity of unemployment or poverty or both, or violence in the community. Also, we work with the victims of crime. We talk to other nonprofits in the area. I think reading the newspaper, you can find out where people meet things. Then talking to our clients. Our clients will come. I have clients that will drive 40 minutes to come see me because they can’t find a therapist in their area. I don’t know that I’d be that committed to coming to see me if I had to drive that far. But if I didn’t have that resource, then yes, I probably would do something to gather that resource.
[ALISON]
And I know you have mentioned having contracts a few times now since we’ve been talking. So can you tell me about that or how do you, do you take insurance or you’re self pay or how does that look?
[SHERRY]
We have a variety. So we have, we do take a few insurance companies, not all, but we take a few. Strategically, we’ve chosen some. We have contracts with nonprofits, so we serve cancer support survivors. So we have a contract with the city to provide that. We’ve also had with, we’re doing a pilot program right now with a school district for continuation school and we’re serving that population. That actually turned into two contracts because they also wanted us to help their teachers and work with reducing stress and mental health services. They liked what we did with the other contracts so they just, they didn’t even put it out to bid. They just said, can you do this and I’m like, Yes, I think so.” I’m like, “Jill, we need to hire some more people.”
[JILL]
And we need to find out who our staff wants to go over and you just make it work. Then we also have one for children who’ve been victims of crime and their families.
[ALISON]
Wow. That’s great. So how has that helped the business in terms of kind of, obviously you have those different streams of income, some insurance, some contracts. I’m sure you have some private pay, which is very common in your area. How does that work to kind of have all of those different streams of income?
[JILL]
Well, one of our biggest mistakes along the way of building our program is we got two heavily client-based in one particular insurance company. That insurance company, all of a sudden had a crisis of sorts where they stopped payment for everything. So for, was it three months? I was a very long time. They didn’t pay us. And I was like, oh, this is never going to happen again if we get through this crisis. And there moments that I thought, okay, I could put my house up the market. I mean, there was all sorts of things trying to make it work. So we decided after that crisis that we would diversify.

So we have a teaching arm where we teach classes to therapists and we teach classes to the public for various things. So we have that coming in. We have these additional contracts that come in and then we have our four or five, maybe six insurance companies. So we have these different streams because as you know cash flow is king. If you have one company holding up your whole entire business, they basically have you held hostage. And I was like, this is not happening again. It was hard. I looking at my people going, I might have to let somebody go. It happened to be at Christmas time and I was like, I’m not going to be screwed. I’m not going to be screwed.
[SHERRY]
It was tough and finally our office manager called and said, “Jill’s on her way and you better have security because she’s hot.” They had a courier bring a check and we, but it still took better part of a year to untangle everything that they had done. And I found out later we were not the only ones who experienced that. There were two other groups that I know of that had the same chunk of time where they just didn’t get paid.
[ALISON]
Wow. Wow.
[SHERRY]
And I don’t want to be hostage.
[ALISON]
So that’s really smart that you have those diverse streams of income. I’m curious about the contracts, because I think that is such a valuable way for practices to know that they’re going to have some income coming in from somebody else other than an individual client or an insurance company. Do you have any sort of advice for people who maybe you want to cultivate some contracts in their community? Like how did you kind of reach out to those folks? Was that just sort of …
[JILL]
That was community networking. They found, largely it was, they found us because we’ve been social workers in the community for so long. So it was, they were looking for it and somebody knew somebody who said it should be us. Since then it’s grown year over year on that word of mouth. But we also have looked at things like requests for bids from the county, because those are available to any agency, any group who wants to do it. There’s always bid out there that you can make.
[ALISON]
Right.
[SHERRY]
We got a very nice lucrative contract with Kaiser to train their social workers in suicide risk assessment. And they actually found us because they met us at a social work convention that we were attending a few years before. But then from there we’ve been able to contact, get the person’s name to contact someone in their Southern region and just say, “Hey, we’re doing this for your Northern region. We’d like to see if there’s something that we could do to provide services for you.” We’ve gotten a lot of nos and like anything else people will tell you no and it’s like, okay, I didn’t have it before I asked you and now I still don’t have it. No big deal.

I think part of it is that mindset and reaching out. So I ask people do you know someone who could do this and if they don’t know, then I ask somebody else and they’re, “I know someone who does this.” Then we ask them, so it is a bunch of networking. We got the school contract because my daughter talked to somebody at the school and said, “I think you guys need therapy.” And she’s like, “Yes, we all need therapy. I wish we could find someone.” And she said, “Oh, I can help you.”

So sometimes it’s luck. I think it’s luck, but then it’s also like showing up and telling people what you can do and then be willing to go, okay, let’s tweak this a little bit. How’s this working for you? Is this working for us? And I think like many of us, we went in initially kind of under distilling our services because we just didn’t know what the going rate was and what they were used to paying. But I know say in the last four to five years, we figure out what the going rate is by talking to a lot of people and then we go in for that rate or slightly higher and we’ve not been told no. So I think that’s a learning curve as well is like feeling like you’re good enough to provide services at a certain level and then going for it. And again, if they tell you, no, okay, you didn’t have it before that. So it’s no big deal.
[ALISON]
That’s very smart. I think there’s so much advantages to having those connections in the community and just saying like, “Hey, I have this idea. What if we provided these services for your population?” I’m always happily surprised how receptive people are to even just kind of discussing what that could look like.
[JILL]
It’s like, they don’t even realize that they have those options until you present them to them. Then the more face forward you can be, the more likely they are to hear you. If you’re out speaking somewhere on a podcast about X, Y, or Z subject, somebody knows somebody who knows something and when that topic comes up, they go back and grab you back. You’ve got to be out there to do it.
[ALISON]
Yep. Absolutely. I think, especially in an industry like mental health, where it’s such a personalized service, you really need to make those face to face connections. So I’m curious, you said you’ve been in business for, I think it was 11 years. Is that right?
[SHERRY]
About 12.
[ALISON]
Coming up on 12? Congratulations because not many businesses make it past even five years and you’ve made it almost 12, so that’s awesome. Do you have any advice for people who maybe are in the first couple of years of their group practice, maybe they’re really feeling the ups and downs of everything about being a business owner? What kind of advice would you give to them?
[JILL]
Part of it is we were very careful and we started not to overspend and not to get into debt. We’ve seen people open practices and hire a designer and spend thousands and thousands of dollars on what they could have recycled from their house and then start out in debt, which is not a good place to be. So we started out without having to worry about that. Then Sherry’s really good about identifying ways to recycle stuff you’ve already done. So you can use that for your face forward. She should probably talk more about that, because she actually wrote down everything she did as we were building the practice. So it’s an excellent way to look at how you start it without putting yourself in a bad spot.
[SHERRY]
Yes, I think I never wanted to take out a loan for starting our practice. So when we decided to do this, we both put in $5,000 and said, okay, this is the amount of money we have. So it was like, do we want to spend this on this or do I want to spend it on that? So we were careful on how we spent money and we’ve never, ever taken on a loan for anything major. I mean, if we buy a building, of course we’ll take a loan. But I think for us, at least for me anyway, it was mindset. Like there’s not an option to fail. In fact, except for when we had that major insurance problem and I was like, oh my gosh, are we going to fail, that was never an option.

It was sort of like these are opportunities to figure out a way to get from point A to point B. And I really, I know it sounds a little Pollyannish and I don’t mean it to sound that way, but the idea is that there’s always a solution to get to from pointing to point. If you want to get there, you know I focus on that particular problem and then we figured out, okay, how can we get there and what kind of steps can we take? And failure, isn’t an option. And I know there are days that I come home and I’m just, “Ugh, why did I do this to myself?” But it never, I think I look at it as a challenge, like, okay, what’s the universe going to give me today that I can figure out how to fix?

And I think that that for me has gone a long way. I’ve done tons of reading, I’ve read leadership books and business books and accounting books and a bunch of other things as well. But I think just having that, I don’t quit. I just don’t quit. And I never have that satisfaction of say, looking at the clients that come in and then having clients be discharged and you go, this is why we don’t quit because this service is really valuable to these people. That is better than any money ever.
[JILL]
And also looking at is this is a way that you can help your community and you can also give yourself some freedom. We were county employees and we now get to choose who we work with and we get to help our staff find that they’ve got skills and they’ve got areas of expertise they never knew that they even wanted. But because they’ve been given the freedom to try things and we support them when they want to put something else out there, it’s exciting to see that growth happening. That keeps you going on the tough days, because there are, but there’s absolutely, there’s no reason to quit. If you start off at a reasonable basis and you don’t overextend and you don’t compare yourself constantly to all the other groups that are online and everything’s perfect.

It’s that imposter syndrome that can get in the way and not comparing is really important. Because there are so many practice owners I talk to on the backside who are I can’t believe you guys make it look so easy. I’m like, yes, no, there were days it was absolutely not easy. Let me just tell you, there were nights that there was no sleep. But those ones who act like it’s never hard that’s because they’re not being honest with what it’s really like to own a practice. So dig in if this is what you want, then you just keep going and then you find a way to be grateful for the fact that you get to do some of the things you really love to do.
[ALISON]
That’s great advice. Thank you so much. Well we have to wrap up our time today, although I feel like there’s so many more things that we could talk about. Can you tell our audience what the best way is to get in touch with you, if they have questions or I know Sherry, you wrote a book that sounds very intriguing. So if you want to share that, that’d be great.
[JILL]
Cool book.
[SHERRY]
I wrote a book of how to build a practice and it was funny because Joe was just starting off his piece about the same time. We were at a conference together and we were having a conversation and he goes, you should just do it. Just do it. Don’t even think about it. Just do it. And I’m like, hmm, okay. So that’s kind of what I did. So it’s funny that we’re all 10 years later or so doing all these different things. But anyway, I could be reached at [email protected] and I will be more than happy to answer questions. I also have therapypracticeinabox.com. There’s a bunch of resources on there and blogs and how to get ahold of me as well. So either one of those is just fine.
[JILL]
And our practice is centralcounselingservices.com. We’re on Facebook for both of our practices as well as for our nonprofit.
[ALISON]
Awesome. What’s the name of the nonprofit?
[SHERRY]
CCS Education and Wellness.
[ALISON]
Okay. Awesome. Well thank you so much, Jill and Sherry. It has been great talking with you.
[SHERRY]
Thank you for having us. We appreciate it.
[JILL]
Thanks.
[ALISON]
Thank you so much to Brighter Vision for being a sponsor of this podcast. I have been a Brighter Vision customer since 2016 and have always been really happy with my service. The tech support is great. They’re quick to get back to me and make changes to my website. We’re actually in the process right now of kind of revamping my original website because it is now five years old. So they’ve also been great with that process as well. So definitely check out the special they have going on right now over at brightervision.com/Joe.

Thank you so much for listening. I hope you enjoyed that interview. I enjoyed them so much. I just really enjoyed their sense of humor and it’s amazing to hear about all the different things that they’re doing. If you are a group practice owner who is looking to get support and become a bigger practice like what Jill and Sherry have definitely considered joining Group Practice Boss. It’s our membership community for established group practice owners. You can find out all the details and also sign up at practiceofthepractice.com/grouppracticeboss. I’ll see you all next time.

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This podcast is designed to provide accurate and authoritative information in regards to the subject matter covered. This is given with the understanding that neither the host, Practice of the Practice, or the guests are providing legal, mental health, or other professional information. If you need a professional, you should find one.