Did you know that group practices do not need to be a forever commitment? How do you want your group practice to look? How can you combine 1099 employees with training?
In this podcast episode, Whitney Owens does a live consulting call with Alyssa Johnson about whether she should grow a group practice.
Meet Alyssa Johnson
Alyssa (pronounced: UH-LEE-SUH) Johnson is a Licensed Clinical Social Worker and the owner of Vibrantly Live (pronounced: Live – as in I LIVE in the US), a faith-based practice located near Indianapolis, Indiana. Vibrantly Live specializes in providing counseling and coaching services to stressed out, exhausted, and over-committed women.
She’s been in practice for over 20 years. In addition to her work at Vibrantly Live, Alyssa is a Leadership Consultant and Coach with an executive coaching firm called Kairos.
In This Podcast
- It is not a permanent commitment
- Bringing on new therapists
- Working with 1099s
It is not a permanent commitment
If you are nervous about starting a group practice because you may be concerned that it would be a long-term project, this is not the case. Owning and maintaining a group practice is not for forever.
You can decide to reshape your practice after a period of time again, so the changes that you make to your practice can always be reversed or changed again in the future.
Bringing on new therapists
One thing I always recommend to people is to not bring on another therapist unless they are willing to see at least 10 clients a week, and the reason I say that is because it’s a lot of work to bring on somebody and if they don’t see at least 10 [then] you really don’t see much profit or gain from it. (Whitney Owens)
A reason why many group practice owners – or group practice owners-to-be – feel burnt out is because they hire new clinicians but the owners are still seeing clients while doing the onboarding, and that is a lot of work.
Set the rules so that new clinicians know what is expected of them so that they can begin right away seeing clients until their schedules are full.
Working with 1099s
If you are wanting to take time off your hands, working with 1099 clinicians can help you, because they essentially run their own businesses under your roof.
You are hands off with it. Once you have onboarded them and given them their contract, you don’t have to have regular staff meetings … you can choose to do those things if you want to, but it’s really the model you want. (Whitney Owens)
You can also do a collective option, where contractors will pay you a certain amount per hour or per month to rent the space from you.
In this way, you are not involved in the training piece but more involved in the later spaces. With private practice and with group private practice, there are so many models, so you can create the space in the way that best suits you and your needs.
- Katie Read on How to Create a Coaching Business | FP 83
- Email Whitney at firstname.lastname@example.org
Meet Whitney Owens
Whitney is a licensed professional counselor and owns a growing group practice in Savannah, Georgia. Along with a wealth of experience managing a practice, she also has an extensive history working in a variety of clinical and religious settings, allowing her to specialize in consulting for faith-based practices and those wanting to connect with religious organizations.
Knowing the pains and difficulties surrounding building a private practice, she started this podcast to help clinicians start, grow, and scale a faith-based practice. She has learned how to start and grow a successful practice that adheres to her own faith and values. And as a private practice consultant, she has helped many clinicians do the same.
Thanks For Listening!
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Welcome to the Faith in Practice podcast. I’m your host Whitney Owens, and today I’m interviewing Alyssa Johnson. She’s a licensed clinical social worker and the owner of Vibrantly Live, a faith-based practice located in Indianapolis, Indiana. Vibrantly Live specializes in providing counseling and coaching sessions to stressed out, exhausted, over committed women. She’s been in practice for over 20 years. In addition to her work with Vibrantly Live, Alicia is a leadership consultant and a coach with an executive coaching firm called Kairos.
[WHITNEY] Hey, welcome to the show.
[ALYSSA JOHNSON] Thanks Whitney.
[WHITNEY] How are you doing today?
[ALYSSA] I’m doing good.
[WHITNEY] Awesome. Well, great. Well, why don’t you first share a little bit about your practice as far as kind of where it’s at, number of clients you see, cash pay, insurance based, those types of things, and then we can kind of jump into your consulting question for today.
[ALYSSA] Yes, sounds great. So I have been in practice for about 20 years at this point. It has always been a nice job to have as I was raising my kids. And it’s morphed over the years, obviously with the types of clients that I work with, but in the last 10 years or so, I’ve really been focused on working with women. We are cash pay only. And I work in the practice probably about 20 hours a week. I typically try to keep the number of clients that I always see anywhere between nine and 12 a week. Due to the pandemic things got a little crazy, and that was the first time that I ever really considered expanding beyond just myself and I hired an additional therapist in the practice in July of last year. So that’s new.
[WHITNEY] And is that therapist a 1099 or a W2?
[ALYSSA] She’s a 1099 and actually it was a very easy transition as she’s also my best friend.
[WHITNEY] That’s awesome. And tell me a little bit about her specialty or how many clients is she seeing?
[ALYSSA] She’s only seeing about five clients per week because she homeschools her children. Her specialty area is in working with children adolescents. So she originally came on to pick up overflow of women that I see and then we started marketing more and more for child and adolescent. So she’s about 50/50 on her caseload now of women and child and adolescent work.
[WHITNEY] Perfect. And then tell me a little bit about the coaching that you do on the side with Kairos. Is that what you mean?
[ALYSSA] Yes. So I’ve been working with them for nearly seven years and it was, I found it in my counseling and coaching practice with Vibrantly Live. I was working with a lot of entrepreneurial women and they were interested in me doing some work with their teams. I really liked that work and so I pursued trying to work in more of a corporate setting with teams and that ended up with me getting connected with the owner of Kairos and joining their team. I really liked that work a lot.
[WHITNEY] Yes, that’s really great. Just so needed. I mean, being able to bring that mental health component into an organization with women is fantastic. So what is your consulting question that you have for today?
[ALYSSA] So my question is this. Chris is the name of the other therapist that I brought on. We’re now in 2021 and we are still flooded with referrals. she is full and what the plan was is as I got full I’d keep passing them onto her and then when she got full, I would have more room and we thought we could do this balancing act. Well, we’re both full and I’m trying to figure out what to do at this point. I had never really considered a group practice previously. I love counseling. I’ve loved doing the one-on-one work and I also love the work that I do with Kairos and I’m not willing to give up Kairos in order to just focus on Vibrantly Live. So I have some parameters on my time and so I’m trying to figure out what to do and do, it doesn’t make sense to bring on other therapists. Do I really want to do that and all of the additional business kind of pieces that are going to be involved with that?
[WHITNEY] Hmm, good question. And I love that you’ve been in practice for 20 years. I mean, you have enough time under your belt to know if you’re going to be burned out on clients and kind of how to manage that piece of that. And so you’re said you see in nine to 12 clients a week. Is that where you want to stick for the long haul, you think, or you said you love the clinical work, so I’m guessing that’s not something you want to take away. I would prefer to stay more in the nine max. That’s a good place for me. 12 is starting to push it and it gets a little frantic balancing between Vibrantly Live and Kairos at that point.
[WHITNEY] Yes. Okay. And let’s talk about your ideal schedule for your life. How many hours of work do you want to, how many hours a week do you want to work?
[ALYSSA] I’m good with working 40. I enjoy working a lot. And at this point my kids are adults and it’s, and so I’ve got margin and I enjoy it.
[WHITNEY] Okay. And how many hours a week do you do with coaching?
[ALYSSA] Right now I do between 20 to 25.
[WHITNEY] Okay, and do you want to change that number at all?
[ALYSSA] I think I would like, the minimum that I would want to work with Kairos is 20.
[WHITNEY] Okay. So if you were to do 20 hours of coaching and basically 10 hours of clients, because that’s an easier number, that leaves 10 hours to play with for anything else that you want to do. Now, I’m guessing obviously you probably spend what, two or three hours a week, just doing administrative tasks with your practice, bills, notes, things like that.
[ALYSSA] I have a VA and we have a lot of really good systems in place because I’m a systems girl.
[ALYSSA] So she does a lot of that stuff. So I typically mark out about, I spend about three to five hours a week working on the business itself, marketing, promoting supervising Chris, that kind of thing.
[WHITNEY] Okay, great. So there’s a lot to consider here and no answer is a perfect answer. And I, she could have gone on a podcast and someone told me what to do, but I can give you some thoughts and advice and then kind of get some feedback from you as to what you think would be the best for you. The good news is if you start a group practice, you don’t have to do it forever. And I just feel like a lot of people, when they think about starting a group practice, they put a lot of pressure on themselves to have to know everything and to know they’re going to do it for the long haul. And the truth is this is this don’t always survive, and that’s just what it is. So you don’t have to do it forever.
Or some people find that they start running a group practice and they hate it. They hate all the admin work, the business work, they miss the clinical work, and so they go back to solo practice. And that’s okay too. So know that you’ve got some options and you can pivot, however you see fit as you grow. Now my question is how do you like having a 1099 and how’s that been since July?
[ALYSSA] The initial startup piece was frustrating because I was so frantic with my schedule. I was drowning and I just naively wanted somebody just to come in and rescue and just like start seeing people and not require all of the business kind of stuff. And so trying to manage the clients, trying to balance Kairos and then trying to do everything that was necessary to bring her up to speed was very, very stressful. And I don’t think I did it well. I know, and that’s part of my hesitation is if I bring on a new, another person, I’m going to have to do it the right way this time. Like she and I don’t have any contract in writing. We don’t have anything like that because I just, I trusted her. And it’s been fine, but I don’t have anybody else like that, that I can bring on. So there’s going to be like, Alyssa needs to be a business owner at this point now, not this therapist.
[WHITNEY] So why did you choose to bring her on? Just for the relief of clients, because you could refer clients to other therapists?
[ALYSSA] I could. I really wanted to be able to meet needs in a way that I felt like were going to be done well. And while I have relationships with other therapists that are local, I don’t know the quality of care that they provide. And the way that we sort of do things in our practice is rather unique. The faith element is huge for us. And I do know other faith-based therapists, but I just wanted to provide us just a safe place for these people instead of just turning them away, turning them away.
[WHITNEY] That’s great. Yes. And you can have bigger impact. I mean, if you can grow a group practice and you invest in your clinicians and they all love Jesus and they’re doing good work in the community, bigger impact than you do in it by yourself. And that’s beauty, there’s something beautiful to say about that. Not that you have to do it, but I just think it’s a glorious thing. Okay. One thing I always recommend to people is to not bring on another therapist, unless they’re willing to see at least 10 clients a week.
[WHITNEY] And the reason I say that is it’s a lot of work to bring on somebody. And if they don’t see at least 10, you really don’t see much profit or gain from it.
[ALYSSA] And that’s true.
[WHITNEY] That could be part of the reason you’re feeling burned out. And a lot of practice owners, especially people in your situation where you have kind of a side gig that you just love doing and brings in income and it’s going really well, people start a group practice, but they put systems in place for other people to manage it so that they don’t have to do all that work. Now it does take some time to get to that place. You would have to really hustle for probably a year or two to get a group practice really up and going. And I would definitely say, get consulting as you do it, to make sure that you’re doing it as fast and as well as you can with your systems. But some people will get like someone to manage the practice. So that way they can just see the clients and do the work they want to do and someone else takes on all the crisis.
So that’s something you could consider doing if you wanted to. I would do that if it was the fact of, this is my mission in my community, and I do want to make money in the process so I can go on more vacations or have more flexibility or whatever the case may be. Now, the other option that you could consider is continuing with the 1099 model and really work hard for two or three months, get good contracts created and then just hire the people and let them do the work. And you kind of become hands-off in your approach because technically 1099’s should have their own business, their own LLC, their own liability, so they can come in and do their own work. I mean, and all practices do this a little differently, but in a true 1099 model, they would have their own phone line. You would refer clients to call them to schedule, or the VA gets them in touch with them and puts them on the schedule but you’re really, hands-off in it. Once you’ve onboarded them and given them their contract, you don’t have to have regular staff meetings. You won’t have to do all those things.
You can choose to do those things if you want to, but it’s really the kind of model, whatever model you want. And then some people do like a collective where they just offer the space and people pay a certain amount per hour to rent the space where they pay a certain amount per month to rent the space. So that would be another option. But in all those options, you really are not very involved in the training piece, which sounds like that might be part of what you like.
[ALYSSA] One of the things that I’ve been considering, and it almost sounds like just that 1099 kind of piece is I am very passionate about helping early in their career therapists develop their own practice and be able to make a living out of it. I’m very passionate about therapists getting compensated the way that they should. And a lot of therapists don’t see the value that they provide and they just burn themselves out, and so I have, I enjoy providing supervision for early therapists. I’ve rented space in my office previously to early therapists at a pretty discounted rate, just to help support them in getting up and moving in their practice. And I like the idea of almost like of an incubator kind of model where they have space, but there’s also opportunities for mindset development on being a business, like seeing your practice as a business and learning how to take care of your clients from a business standpoint, in a healthy, really solid customer experience kind of way. Because that’s something that’s really important to me.
[WHITNEY] I love that model. So this is what I love about private practice. All of our models can be different and everyone brings something unique in their passion and their desire to the table. And so as we’re kind of talking about this, like we’re kind of like creating something beautiful and that’s so neat. So what if you had three or four 109’s that were young therapists and you created somewhat like a school where they would come and you would do their supervision, clinically, it sounds like you’re a clinical supervisor, is that right?
[WHITNEY] And then you also could provide some coaching as a bonus if they want it. So maybe you would put that in your contract. You’d have to talk to an attorney about how to word all that, but maybe a different percentage amount comes out or they pay a flat fee extra to get the extra coaching, however you decided to make that fee and that you offer that to them as well. And so you kind of have a two-pronged approach. That’s just an option.
[ALYSSA] Yes. And I think that’s, to be honest, as I think about it though, I’m much more like, I’m more excited about the idea of providing the coaching piece than I am the actual clinical supervision piece. I’ve done that and I enjoy doing that, but that takes up a whole lot more time and a whole lot more energy. I’m much more interested in helping them think about what kind of, like I’m doing this 40 hour a week job and I really want to create a private practice on the side. How can I do this in a way that feels safe for me? How can I do this in a way that feels sustainable for me? I enjoy doing that work because it fits in line with a lot of the similar kinds of things that I do with Kairos as well.
[WHITNEY] Yes. It sounds like it. So you could bring on 1099’s and ask them to get supervision elsewhere if they need supervision or maybe some of them are actually already licensed and you just provide some coaching to them on how to build a business, they see how you’ve built your business, and you just create an understanding that when they build their business and they’re ready to kind of go out on their own, they go on their own. You know, I mean, you can create things in the contract of, I need you to stay at least this amount of time because, you know, a problem you could run into is they only stay for four months as soon as you build their caseload and then they leave and you’ve put a lot of money and time into them.
[WHITNEY] But I love that you kind of mentioned that clinical supervision part, because even as I was saying, and I was thinking, you definitely want to check with your state about requirements if a clinical supervisor can still do a coaching. And that does seem kind of milky, not milky, murky.
[WHITNEY] I’m like all over the place right now, but anyway, it feels like making things messy. And so maybe you want to separate those two.
[ALYSSA] Yes. As I was thinking about it, I was considering, I think probably an ideal person here is somebody who is licensed and is working like full-time at a school or full-time in a community mental health center and they’re really desperately wanting to start up private practice, but don’t know how to go about doing that. And so giving them an opportunity to be able to rent space at my office, to be able to start building that up, that frees me up to be able to make referrals to people that I am establishing a relationship with and helping them create a business that then yes, go get your own space and you flourish. And now we have a relationship. Like I now have people when I’m too full I know do a good job and I can make referrals to, rather than blindly making referrals to somebody I had one coffee with. And I’m like, “Okay, well you seem like a nice person. I guess I’ll send referrals to you.”
[WHITNEY] Yes. That is tough. And the other thing, you’re a cash pay practice. And I would say a lot of therapists, even in the consulting I do come to me wanting to know how to market a cash pay practice. That’s something you can really offer a lot of value to people about.
[WHITNEY] So how are you feeling about this decision?
[ALYSSA] I feel good about it where I guess, where I struggle is like all of the house. Like how do I go about doing that? And I’m trying not to go there right now. I just want to allow myself to dream a little bit about what that might look like and then start breaking down specific steps.
[WHITNEY] Yes. Well, that’s great and I love that you’re talking about dreaming because too many of us step right into do this, do this, do this, and that dreaming phase is so fun and special that you need to like enjoy that moment. Well this has been really great and as you move forward and you think through these things, at some point, I would say your next step is to kind of talk to an attorney about your options. Like find someone who specializes in employment law and small business so that way y’all can kind of explore together, “Okay, well, here’s the laws in my state and here’s some things that could and couldn’t work because all day long, I can tell you some ideas, but we want to make sure that they fit what the laws are in your area.”
[ALYSSA] Yes. Good.
[WHITNEY] Wonderful. Well, thank you so much. And I’m going to ask you what I ask everyone that comes on the show. What do you believe every Christian counselor needs to know?
[ALYSSA] It’s a great question, Whitney. I think all of them need to know that it’s really important to recognize the value of the work that you provide to people. The space that we create is a very sacred space and not to discount that, but to really, truly own that.
[WHITNEY] It’s so good to like go back and remember that because we can get really caught up in all the details and all the business to remember how special that spaces is.
[WHITNEY] Well, thank you again for taking the time to come on the show and being vulnerable and doing some consulting and I’ve really enjoyed talking with you.
[ALYSSA] Yes. Thank you so much, Whitney. I really appreciate your time perspective.
[WHITNEY] Thank you for listening to the Faith in Practice podcast. If you love this podcast, please rate and review on iTunes or your favorite podcast player. If you liked this episode and want to know more, check out the Practice of the Practice website. Also there, you can learn more about me, options for working together, such as individual and group consulting, or just shoot me an email, email@example.com. Would love to hear from you.
This podcast is designed to provide accurate and authoritative information in regard 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.