[JOE SANOK]
This is the Practice of the Practice podcast with Joe Sanok, session number 679.

Well, I am so excited about this series that Alison and Whitney are doing; session 672, why start a group practice in 2022, 673 we’re going to be talking about how it’s easy to start a group practice, s step by step guide, in 674, Alison is going to be interviewing someone from Group Practice Launch and giving real behind the scenes look. 675, same thing, except it’s Whitney. They’re going to be doing all sorts of interviews with people from Group Practice Launch to get some real life stories of people that have launched group practices. Then session 680, which is going to be on the 3rd of March, group practice story time where Alison and Whitney are going to talk all about different things that have gone on in group practice.

I’m just really excited that the two of them are putting on this series because leveling up oftentimes means going beyond starting a practice where you only make money when you show up. And having a group practice is one of those great ways to add another stream of income. There’s lots of other ways. It can be doing a podcast, can be doing e-courses, offering other sorts of consulting. But a group practice really is that low-hanging fruit for most people. So without any further ado here is that series with Alison and Whitney all about starting a group practice.
[WHITNEY]
Well today on the podcast, I have my friend Nate Page with me. How are you doing today?
[NATE PAGE]
I’m doing great. Excited to be here.
[WHITNEY]
Awesome. Well, I want to introduce you here to my friends. Nate Page is a group therapist who helps other therapists. He facilitates four different ongoing online process-oriented groups for therapists all over the world. He now as is a large group therapy conference every six months. He runs virtual retreat programs for helping professionals to learn more about him. You can go to grouptherapycentral.com. All right, well, wonderful. I love having you here on the show and today we are going to talk all about starting a group practice. How do you feel about having your group practice?
[NATE]
Well, I was nervous and for a number of years when I listened to podcasts and people talking about group practice, if I wanted to do it. For there was a long time when I thought, no, that’s not for me. But in hindsight now that I’m four or five months into it, I really like it.. It really lines up well with my skillset and my values. So I’d love to open up and unpack any part of my story. That would be helpful for you Whitney or the listeners here today.
[WHITNEY]
Yep. Looking forward to it. Well, why don’t we just start with what drew you into being a therapist and how did you start your practice? Tell us a little bit about your solo practice.
[NATE]
Yes, so I did a counseling psychology program and my spouse actually, she was two years ahead of me, we met in her first year of the program. So we have one of those that I think are fairly common. Our resume is essentially identical, the same school, the same internship, the same postdoc, same last name. I really got into group therapy in my doctoral training and joined the American Group Psychotherapy Association and found my professional home there. So I’m a certified group therapist, so I love individual therapy, but group therapy is really home for me.

There’s something about it that’s very special and meaningful. I did my whole training in college counseling settings, so really throughout my graduate program and then internship and postdoc. Then I worked there for four and a half years and landed my dream job actually at a counseling center here in Minnesota, that was a fantastic gig and for a few years was ideal. Burnout is really what started to settle in. Then it became a golden handcuff job where, it was the best counseling center job there, was in my mind, but it was not sustainable.
[WHITNEY]
Until you found out you could have your own.
[NATE]
Right. I got to have a front row seat to my spouse during those four and a half years that I was working and her journey. I built the website for her, listening to Joe Sanok talk about that. I helped her understand what private pay would be like and she ended up doing quite well, only filled up to two days a week. So I got to witness that. I took way too long I think getting out of my position at the counseling center. It was about a year and a half when I started my solo practice to where I finally jumped ship. That was January 1st, 2021, so about a year ago, a little over a year ago. It was a great switch. Financially it was much better than college counseling. I used to joke in my interviews on internship and postdoc and even for my job. People would say, well, why do you want to do college counseling? I would say, oh, I’m in it for the money. People would laugh because they immediately saw the irony in that or the humor in that.
[WHITNEY]
That’s right. So now I’m curious, what’s your wife doing now?
[NATE]
So we started, we’re in practice together.
[WHITNEY]
Okay, cool.
[NATE]
Northfield Dynamic Therapy is what it’s called, because our town here is Northfield, Minnesota.
[WHITNEY]
Can you share a little bit, how, so you started your practice and, did you all join forces right then, or that was later? How did that work?
[NATE]
We joined forces. She was working for a group practice and she was the only clinician there that was private pay. The rest were doing insurance. That group practice was dissolving and the clinicians were leaving or doing other things. So the timing worked out really well. That was about six months after I started my solo practice that we joined forces. We were together for about a year before I left my full-time job. She works Tuesday, Thursdays. I started working Monday, Wednesday, Fridays, and that was middle of pandemic times and we have four young children. So that worked out quite well. We didn’t see each other very much but we could cover the kids whenever we needed to. I guess we had a group right from the beginning with the two of us.

My first time, full time in private practice, after leaving my job was January 1st, 2021 and over the next six months I was trying to recover from burnout; was one of the big things I talked about that with Joe quite a bit. And Whitney on your podcast, you had a really good episode your burnout story. That was really nice to hear. I consume a lot of information about burnout and I do a lot of teaching and a lot of people promote some unhelpful messages. So it was really nice to listen to your podcast where I was like, yes, she’s getting it and talking about real burnout, not some false notion that a lot of people have. That’s been, and I’m still in that work.

I actually just got back a few days ago from a soul-care retreat with Dawn Gabriel, who you probably know. She does the podcast, Faith Fringes, and had a amazing time there. That was a really, really wonderful experience. So I think she’s going to continue to do those retreats, but that’s, been another important piece in my burnout recovery journey is to do things like that. It was about six months in that I was starting to get to feel like, yes, I think we could do group practice and I would run the numbers. I mean, from a logistical perspective, from a money financial perspective is very clear. Like, oh, if I do this right, owning a group practice could be really a good gig, but I was in and out like, oh, will I get more burned out? Will I create some sort of nightmare that I don’t really want? Maybe it’s best just to stick with the two of us and just increase our rates. We could probably live pretty comfortably and retire well with just this.

But I was really starting to feel that, no, I should do it. I want to do it. A woman reached out to me wanting me to supervise her as she got licensure in Minnesota and as we interacted and talked, it just became more and more clear, like actually, if you were to work for our practice, and, of course you’d get that supervision and you’d get more hours. It just was one of those things that felt so right and so it was an easy thing. So we interviewed her, my spouse and in just our conversation right after we hung up, it was fascinating because the feeling was well, even if this is a horrible hire, if this person ends up not being good. You always hear about that and you say that everyone will make a bad hire at some point, but it was just so clear that even if that was the case, and it’s not, this is a wonderful person for our practice.

I think she’ll be with us for a long time, but it was just so clear in that moment, like this is what we need to do. Around that same time, because I knew that I wanted to do Group Practice Lunch but I didn’t know when it was opening up. I remember going to the website and it was, I think it was that day, or it was opening up in one or two days after that or something. So I went for it and it was a very good decision. We can explore that more, but the first day just opening up and all the paperwork that you had in the Teachable course with the employee handbook and the examples of the contract letters or the offers of employment.

It pretty much took two to three hours to set up most everything. We went to a lawyer and I’d used all the stuff that you had in there. The lawyer went through and said this looks good. I don’t have any suggestions or updates, which was a huge win. The employee handbook, I remember I just opened that up, what you had, and I copied and pasted it, and I changed the name and the logo, and then just went through line by line, what fits for us, what doesn’t fit. Probably 80, 90%, I just left it because I liked what you had. So day one, it was a, I think I got a good return of investment on the money I put in.
[WHITNEY]
Oh, I love hearing that. That’s something we commonly hear from people is it going to be worth the money and the time that I put into this? And it sounds like you quickly experienced that. Nate, something else I’m just hearing, because I’m also a very faith-based person, all these doors opened at this exact moment. The fact that you got on Group Practice Launch the day before we launched, we only launched twice a year, that this girl reaches out to you at this exact moment. It’s just like, all the pieces started coming together for you, it sounds like.
[NATE]
Yes. I’ve had a few moments in my life like that. One was graduate school and I went to a depression screening day and there were a number of professors there and a number of students, and it was a program I wanted to get into. I actually applied and got rejected two years in a row but there was something about that day. I was meeting some professors for the first time and I could just feel it in that day, like, oh, this is a turning point. I’ve had that a couple other times in life and it’s very similar with the Group Practice Launch. The stars are aligning and it feels right.
[WHITNEY]
I love that. I’m here to tell you, you’re going to feel that way many more times in your group practice experience. Just today I heard this crazy story and I can’t really share it because it’s clinically oriented, but it was like, wow, I can’t believe that happened when that client came in. Or every person I hire, usually at the annual Christmas party, it’s like the tradition, I go around and share the story of how these people came to the practice and we laugh, but they’re all so beautiful and perfect and came in these neat ways, like through crazy connections. I just attributed it back to the way things work out and the Lord Handle my practice and what He’s doing.
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[WHITNEY]
Well, all right, you joined Group Practice Launch, so can you talk a little bit about what is it like to be in Group Practice Launch? Like you attend regular meetings, you talked a little bit about Teachable. What’s the experience like?
[NATE]
So I think we’re four to five months into it. I mean, like I mentioned just day one, having access to all the materials was wonderful. And something I didn’t know but found out day one was, I also had access to all of the Next Level Practice coursework and paperwork and even the Facebook groups and the meetings and events and other things. That was a nice surprise. So you get a really good value in that way. But it’s, I think it was a fairly small cohort. I don’t know for sure there are 30 of us that signed up together or —
[WHITNEY]
That’s a pretty average number, actually.
[NATE]
Pretty average number, and so, yes, it’s a six month cohort experience. So there’s a Facebook group that’s private, that’s just for us. I think one of the first tasks we had was to record a Facebook video message to introduce ourselves to the group. I was a few days behind on even knowing I needed to do that but as I was going through the Facebook page, it was really nice to see five or six other clinicians that were posting and sharing their reasons for joining and their hopes and dreams and goals. So then I threw mine on there. And we have meetings most every Thursday except for when there are holidays or other things.

They’re structured with what a typical process would be for building a group practice. So we all go on a journey together and I mean, you can help me remember the phases more or less that you go through, but what is it like to hire a virtual assistant or to hire a clinician or what are the systems and structures that you want to set up with your electronic health record and your phone record? Right now further in we’re doing more of the meetings about, well, how do you help clinicians really be happy and really learn how to thrive in the practice? So my experience, I’d say probably the first three months or so is just absorbing everything. Every little thing that you Whitney would say, or Alison would say, or other people I’d be, oh, wow, that’s a new revelation.

So I’m very much in that learning stage. I think the last month or two I’ve been more and that, well, how do I want to make this my own? So in our practice we now have two clinicians that are hired and trying to build up to 20 clients each. Then we do have a virtual assistant. So yes, I’m more in that place and sometimes in the meetings now, I’m like, oh, that’s not for me, or, oh, I would want to do it differently. So it’s nice to be in that more growth phase in some ways of how do I make this my own?
[WHITNEY]
Wow. So since starting Group Practice Launch, we’re almost done with month four and you already have two clinicians and an assistant?
[NATE]
Right.
[WHITNEY]
Which is pretty good.
[WHITNEY]
I love that you talked a little bit about the phases. So we do take people through a structured program; it’s over six months and Alison and I have tailored this based on the many people we’ve helped start group practices on what we think are the most important things. It’s really walking through that process, like trying to encourage people, not to jump too far ahead, but also push them forward. Being in that cohort really does help people push forward when you’re wanting to slow down. The very first part is just the foundation of your practice. We want to make sure that everyone has everything they need to start a group. A lot of people come and say, oh, I got everything. It’s a shocker ow many things people don’t have, even their name being group practice oriented or their bank accounts aren’t set up right, getting payroll set up, all these types of things.

We help on that end. Then we really walk people through the other part of setting up your rates, W2 versus 1099, what’s going to be best for your practice. Then after that, we teach you how to write a job description, all the stuff that you said was in Teachable, all that paperwork and helping you figure out what clinician you want to have, what culture you want to have. Then hopefully by the end of the third month, most people have hired somebody by that point. Then after that, we walk you through hiring an assistant, because you’re going to need that. Then how do you market a group practice, because you have to do that differently. Then getting that culture of a place where people want to work, a place that you enjoy.

A lot of times people go through programs to start a group practice and they don’t get to that part. They just, here’s how you hire. Go do it. We want you to be really successful and you want you to really love what you do and not make a lot of mistakes. So by going through that process of, okay, you’ve hired someone, here’s what you do now and then here’s how you look back and make sure you’re actually making money. Are you running your numbers? Do you have the space you need? That’s why we have it as a six month program instead of a three month program. Then when everyone finishes, you have the option to join Group Practice Boss, which is our membership community for group practice owners. So we love that because we get to continue working with you after the six months is over and helping you because we all need continued help on our practice.
[NATE]
Yes. Well, and as you’re talking right now, Whitney, it’s helping me remember why I trusted you. I’ve known liked and trusted Joe for a while and then I’ve listened to your podcast and Alison’s for a while. And in being in the group, the cohort, the Group Practice Launch. When you talk, well, I’ve been through things enough that I do trust you. There’s a nice, surety that I think comes with this program, that this is really the best way to do it. Maybe 2% of the time I’m like, oh, I’m going to try it a different way but 98% of the time, I’m like, oh yes, that feels very solid and true what you’re saying, Whitney and what Alison is saying.
[WHITNEY]
Thank you. Well, we love it. I mean, we love it. You were talking earlier about jobs and pay and stuff. When I was in college, actually one of my professors said, find something you love so much you do it for free, but be so good at it people pay you. I mean, we feel that way as therapists. I also feel that way as a consultant. I think Alison would say the same, like we love it. In fact, I talked to someone today who I helped start a group practice. This was before we had Group Practice Launch; helped her hire her first people and just hearing her talk about the success she had last year and the money she made. I was like, wow, that is so cool. We just did this a year ago? And just the progress you can have in a very quick amount of time, if you really put the right pieces in place. One of them is a consultant because you don’t want to go down that road and make those mistakes without setting it up.
[NATE]
I can’t even picture what things would be like if I would’ve tried to do this on my own. I have no idea, but it clearly would not be where I’m at right now.
[WHITNEY]
Oh, well we appreciate having you and you’ve made a lot of success. You’ve worked super hard and also have just loved seeing you interact with the group and the relationships you’ve made through that.
[NATE]
Well, I’ll quickly say too spending time at Dawn Gabriel’s soul-care retreat, there were a lot of group practice owners there that, or a few years further along than I am. That was really great to rub shoulders. I’ve listened to people on podcasts and I was at Killin’It Camp, for those of your audience members that know about that conference every October. So that’s one thing that’s helped me increase the trust too, is just seeing where people are at, after they’ve done this program. Being able to spend time with people, I was like, wow, I’ll probably be there in a year or two having eight or nine clinicians and maybe doing a podcast myself or who knows exactly what the next steps will be.
[WHITNEY]
Awesome. Hopefully we’ll keep connecting through that and I can be on your show.
[NATE]
There we go.
[WHITNEY]
Awesome. All right. Well as we wrap up here, I want to ask you what I ask every person that comes on the show. What do you believe every counselor needs to know?
[NATE]
So the direction I’ll go is I guess maybe to promote myself. I run online groups for therapists and I’m a big fan of Irvin Yala. He talks about, you are too, it looks like you —
[WHITNEY]
Oh my gosh, if I could meet anyone in the clinical world —
[NATE]
Well, he does consultations. He’s been referring people to the groups that I do and so he does one time consultations. I run three online groups, four therapists, and they’re process oriented, Yala style groups that meet for 90 minutes twice a month. We do that real here and now interpersonal dynamic work; what are our relationships, where are we at with that? So we’re curious about your life outside of group, what might have happened throughout your week or in your relationship with your parents growing up, but we’re always curious to how is that playing out in the room or the virtual room, in our relationships and the ways that you get stuck in your life outside of group. How do you get stuck in your relationships with us? So I’ve met, there’s been four people this week that have done consultations Yala and he refers to them saying go find a group for therapist.

So you can go to my website and I have, I think there’s 18 or 19 now of my colleagues that do online groups for therapists that are process oriented. So that’s what I’ve seen echo what Irvin Yala says when usually he’s on podcasts or giving presentations. He says, every therapist could use a group. So we focus more on that clinical, emotional therapist as a tool, how you can get better at doing that. So to be a better clinician for your clients, to be a better spouse, better a parent and of course probably the most important, be better in your relationship with yourself and learning how to get your emotional needs met more. That’s what I would tell every therapist. If you have any interest in group work, find a group. You can go to Group Therapy Central and look through a lot of people that do these kinds of groups.
[WHITNEY]
Awesome. I appreciate you sharing that with us today and thank you so much for taking the time to come and share with everyone about your experience with Group Practice Launch. If you’re listening and you’re thinking, gosh, I can empathize with Nate, or I feel like him sometimes, or maybe I just stumbled into my first hire and don’t know what I’m doing, please join Group Practice Launch. That will be happening March, 2022 here at the beginning of the month of March. If you listen to this episode, after that, you can still jump in our next cohort. Or if it’s before that, you can join the way so that you get early bird access. So just go to the website, practiceofthepractice.com/grouppracticelaunch to get all that information. All right, Nate, thank you so much for being on the show.
[NATE]
Thank you. Catch you next time.
[JOE]
Well, go take some action and just think different. In grad school, we weren’t taught all this. We weren’t taught about marketing or business or ROI or profit and loss statements. Be surrounded by the people that you want to become. Find that community of folks that can just surround you and you can learn from and grow from. Maybe you can even contribute your ideas to. So whether that’s Group Practice Launch, Group Practice Boss, or finding your own community, find that community so that you can level up in 2022.

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Thank you so much for letting me into your ears and into your brain. Have an amazing day. I’ll talk to you soon.

Special thanks to the band Silence is Sexy for that intro music. This podcast is designed to provide accurate and authoritative information in regard to the subject matter covered. It is given with the understanding that neither the host, the producers, the publishers, or guests are render legal accounting, clinical, or other professional information. If you want a professional, you should find one.