Live Consulting with Stephanie Stockham-Ronollo on Decreasing Burnout while Growing a Group Practice | PoP 556

Are you overworking yourself without realizing it? Do you want to change your work schedule so that you can pull back, spend time with your family, plan your future while still making money? What systems can you put in place to decrease burnout?

In this podcast takeover episode, Whitney Owens speaks with Stephanie Stockham-Ronollo about decreasing burnout while growing a group practice.

Podcast Sponsor

When you’re in private practice it can be tough to find the time to review your marketing efforts and make improvements where needed.

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By first understanding your practice and what makes it unique, Brighter Vision’s team of developers will create a custom website catered to your specific marketing goals. Better yet, they provide unlimited technical support to make sure it stays updated, and professional search engine optimization to make sure you rank high in online searches – all at no additional cost.

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Meet Stephanie Stockham-Ronollo

Stephanie Stockham-Ronollo, MA, LPC, NCC, is founder and director of Roots Renewal Counseling. Previously Stephanie has worked at Washington University and Happy Brain Counseling, both in St. Louis. She specializes in working with children, individuals, couples, and families throughout their lifespan.

She received her master’s degree in Counseling Psychology and Counselor Education from the University of Colorado Denver in 2011. Prior to her work in St. Louis, Stephanie was a Staff Counselor at Creighton University in Omaha, Nebraska. She has also counseled young adults at both Simon Fraser University in Vancouver, British Columbia, Canada and at the University of Colorado Denver. Stephanie is clinically a generalist and draws upon several different theoretical orientations that include as follows: cognitive behavioral therapy, mindfulness, interpersonal neurobiology, interpersonal process therapy, and EMDR. Stephanie also uses child centered play therapy and Theraplay with her younger clients.

Her professional areas of interest include self-esteem, relationship concerns, anxiety, depression, grief, body image and eating disorders, identity development (including multicultural and LGBTQIA identity), and trauma. Stephanie is highly interested in relationship dynamics and enjoys facilitating couples counseling.

Visit her website and connect on Facebook.

In This Podcast

  • How often do you actually want to work?
  • Dream bigger

How often do you actually want to work?

It is possible for you to create the work lifestyle that you want to live. It is possible to structure your work so that you work less hours but still bring in enough revenue for you to thrive on ad build your business with.

What if you:

  • Worked 3 days a week,
  • Saw 5 clients a day,
  • Spent 2 hours a day on administration.

Then you can reduce and minimize burn-out, still see 15 clients a week and get enough admin out of the way.

Dream bigger

We can get stuck in the daily routines we have now instead of making intentional space to plan the future and the life we want to lead.

Sit with your current work schedule and figure out how you would want it to look, in your most successful, wildest dreams, and then take meaningful actions in the forms of small steps and changes to slowly bring that reality to fruition.

You can consider:

  • Hiring assistants,
  • Increase your hourly rate,
  • Write to insurance companies to increase your rate,

Useful Links:

Meet Whitney Owens

Whitney Owens is a Licensed Professional Counselor and Private Practice Consultant. She lives in Savannah, Georgia, where she owns a group private practice, Water’s Edge Counseling.

In addition to running her practice, she offers individual and group consulting through Practice of the Practice. Whitney places a special emphasis on helping clinicians start and grow faith-based practices. She hosts a podcast to help faith-based practice owners called the Faith in Practice Podcast.

Whitney has spoken at the Licensed Professional Counselors Association of Georgia’s annual convention as well as Maryland. She has spoken the past two years at Practice of the Practice’s Killin’ It Camp Conference. She has also been interviewed about mental health issues on several media outlets including WSAV in Savannah and in the Atlanta Journal-Constitution. Whitney is a wife and mother of two beautiful girls.

Thanks For Listening!

Feel free to leave a comment below or share this podcast on social media by clicking on one of the social media links below! Alternatively, leave a review on iTunes and subscribe!

 

Podcast Transcription

[JOE SANOK] When you’re in private practice, it can be tough to find the time to review your marketing efforts and make improvements where needed. Whether you are a seasoned clinician whose current website needs to be revamped or a new therapist building a website for the first time, Brighter Vision is here to help. By first understanding your practice and what makes it unique, Brighter Visions’ team of developers will create you a custom website catered to your specific marketing goals. Better yet, they provide unlimited technical support to make sure it stays updated and professional search engine optimization to make sure you rank high in online searches, all at no additional cost. To get started for $100 off head over to www.brightervision.com/Joe. Again, that’s www.brightervision.com/Joe.
[WHITNEY OWENS] This is the Practice of the Practice podcast, episode 556.

Welcome to the Practice of the Practice podcast. This is Whitney Owens doing a podcast takeover on how to level up in your practice. We are interviewing Group Practice Boss members doing live consulting here on the podcast. So today I’ve got Stephanie Stockham Ronollo. She’s an MA, LPC and founder and director of Roots Renewal Counseling. Previously, Stephanie has worked at the Washington University and Happy Brain Counseling, both in St. Louis. She specializes in working with children, individuals, couples, and families throughout their lifespan. Thanks for coming on the show today, Stephanie.
[STEPHANIE STOCKHAM-RONOLLO] Thank you so much, Whitney. I’m really excited for our conversation today.
[WHITNEY] Fantastic. Well, why don’t you first start out telling people a little bit about your practice, kind of the logistics of your practice, how it’s set up as far as how many people are working there, where you’re located, and then we can kind of get into your live consulting question for today.
[STEPHANIE] Yes. And this will all tie in together nicely. So Roots Renewal Counseling was started in 2018 in St. Louis, Missouri. It’s a nonprofit practice. We are really there to service the community and we’ve just been around for a couple of years, but just saw such a need in the community to serve people throughout their lifespan, especially children. I feel like there’s a shortage of people working with children, although it can be really challenging work. So basically right now it’s me and then I have one other person that I’m working with, who’s working with getting her LPC right now. We are looking at expanding, but similar to many people, the many clinicians in the country, I feel like there’s such a need for mental health services and yet at the same time there’s a shortage, I feel like of clinicians right now. So we’re really working at attracting one or two staff members.
[WHITNEY] Yes, that’s great. And this LPC, is she a 1099 or a W2?
[STEPHANIE] I, because of your wonderful advice, I’m just changing her from a 1099 to a W2 as we speak.
[WHITNEY] Oh, awesome. And how’s that going for you?
[STEPHANIE] It’s going well, I think it’s really appropriate for where she is. She’s in training right now. So I just think it’s the right classification for her.
[WHITNEY] Okay, fantastic. All right. So what question do you have for today?
[STEPHANIE] Okay. This is a big one. You will hopefully help me be able to narrow some things down. So I think you might’ve seen, I had COVID recently and my whole family got it. My mom got it, and I just, I realized it was the first time I had had downtime in years. I mean, especially also since the pandemic started, as mental health workers, we’ve been, I mean, everyone was saying how bored they were. I don’t know about you, but I have not been bored. I’ve been exhausted, fatigued, doing so much. Anyways, COVID has been this great teacher for me. I was very lucky that it was a mild case. I mean, I’m still exhausted. It was still really challenging, but I had some time to sit back and reflect. In that reflection, I noticed I love doing online therapy. I love it so much because I’m able to pop in between sessions and see my kiddo, say hi to my husband.

And I just realized these days of being away from my family for like 12 hours a day, I don’t love that. It doesn’t feel right to me. In addition, I really want to expand Roots Renewal to not just be in Missouri. I’d like to, I’ve lived in Colorado and Oregon, and I’m interested in relocating to Oregon. I’m actually in Oregon as we speak right now and I’d really like to have a practice that’s flexible and able to do online work with others. I just think that it’s a really cool modality for the right fit of a person.
[WHITNEY] Getting a lot of good information. Tell me what question do we want to hit on with this?
[STEPHANIE] Okay. There’s two different ways we can go and I want to hear how you think we should narrow it down. One is the idea of just talking through, going all online, what that looks like. And then the other piece, I am part of an online therapist group, which people love it. They’re traveling all over the place. But every, a lot of people have been encouraging me to move towards private pay for doing online work, just because the insurance companies, well, we’re not sure what they’re going to do with all of us online people moving forward. So, but then that would require me even probably changing my business model from being a nonprofit to a different type of entity. So from what you’re hearing me say, maybe you can say, “Oh, let’s work on this piece.” I’m happy with any of those.
[WHITNEY] Great. I bet we can hit a couple of things here. So I’ll be honest with you. I love talking about cash pay practices. I don’t know if you know this about me, but my practice here in Savannah, we have eight clinicians and we’re all cash pay. And I’m actually in the process of interviewing another person. As you just said, like the need is so high right now. So I think when it boils down to the difference between insurance and cash pay practices, more of your model of how you want to do your practice more so than anything else. So a cash pay practice, you have to focus on a lot of different things that insurance-based practice clients come in different ways to your practice. Your marketing has to be different. You can meet the different kinds of needs of clients. So that is the first thing I’d say, consider that first.
[WHITNEY] Now, if for you, that means doing telehealth and insurance isn’t covering it, well, then that tells you what you need to do. Now we don’t know that for sure about insurance yet. It can be shared decision if it really comes to that. Who knows what it’s really going to come to. There’s so much going on in our world, like even with the counselors are trying to get across state lines stuff certified in. Georgia has got that going in the Senate and it’s a lot going on. So a lot of things could change. So I would make your decision on cash pay insurance work based on that model of how you want to run your business more so than what you think you can and can’t do.
[STEPHANIE] Got it.
[WHITNEY] Now I want to take you back a step on this idea of the telehealth. You like telehealth because it offers you, what I heard you say was it offers you time to be with your family. Is there any other reason why you felt like you’re valuing telehealth over in-person other than just the time with your family?
[STEPHANIE] Yes. There are other factors now, and I will give this caveat. I think with kiddos, I am trained in digital play therapy but I have not found it as great with the kiddos. Like I really do love that in-person interaction with them, but with adults I focus on EMDR and I’m very somatic and I literally see no difference in results with in-person versus online. Now I do not work, I don’t have anyone right now who has DID or like extreme, extreme disassociation, because I feel like that would be like a different story, but I just feel like the results are really good. And I think something I’ve been well, there’s a couple more things. One is, obviously I rent a practice space. So I’m basically paying, with utilities, everything probably $15,000 a year for that space, when I’m really happy working out of my home. My employee right now, she’s very happy with that situation. So there’s that, and there was something else. Okay, that’s what I have for right now, but there are other reasons as well that I, oh, one other thing. I think, because we’ve been working with trauma work for so many years, I think my energy level is a bit higher when I’m not in that space of being right next to the trauma sometimes.
[WHITNEY] That’s a really good point. Yes, you really have to contain that trauma for people.
[STEPHANIE] Mmh. And so I just know it’s been giving me a little bit more space for that, which looks good to me.
[WHITNEY] Sure. Okay, here’s my thoughts. You are a business owner. You’re tired, not only clinically, but administratively thinking about your practice and running it. It’s a lot. And you’ll find that as your practice grows as a business owner, you have to take down your client load to be able to meet the growing needs. How many clients do you see a week?
[STEPHANIE] You don’t even want to know?
[WHITNEY] I know this is probably what the problem actually is. So how many?
[STEPHANIE] Okay, you’ll be proud of one thing I’ve done. So I see probably about 27, 28 a week now, with some cancellation, it kind of varies week by week, but that’s usually what I have scheduled. And it’s like, I’m busting at the seams and there’s a wait list. But one thing you might be proud that I recently did is I changed my hours from 9:00 AM to 5:00 PM because I was just working so many nights. I have a young child. So that’s a step in the right direction. Okay, I see you giving me a look right now. What are you thinking?
[WHITNEY] I love video podcasting. All right, Stephanie, I’m going to go ahead and stop you here. First of all, you’re acting like you’re not a group practice owner, like you’re a solo practice owner. Because you’re seeing so many clients, there’s no way you can work on your business. No wonder you’re so tired. And if you’re coming off of COVID, more reason why you shouldn’t be seeing so many clients. And then you’ve got to think about the types of clients you see. Even for a solo practice owner who’s not working on the business as a whole, to be seeing 25 clients a week that have trauma, that’s tough. EMDR work and kids play therapy, tough, tough, tough. So I encourage you, unless we’re at a point where you’re not going to eat your next meal, which hopefully we’re not at that point
[STEPHANIE] We’re not at that point. We’re actually doing, I mean —
[WHITNEY] You’re doing fine.
[STEPHANIE] Yes, yes.
[WHITNEY] Then you need to decrease your client load. Pants down. So what makes you scared about decreasing your client load because you’re kind of laughing. You seem uncertain about that.
[STEPHANIE] Thanks for calling me out Whitney. Well, I’m like close to being complete with several of the clients and we’ve been working together for years. Like I just want to help them get to that place they want to be. There’s that. I think it’s that I get, I have like attachment and care for my clients. now, do I think I’m the only person that can help them? No, but these are relationships that have been developed for a while. So I think there’s that, feeling like I’m letting others down or not being there for them in the way they need me to be, but I recognize that’s putting others before my own health as well.
[WHITNEY] Hm. And you know, you’re bringing up a lot of things that many therapists tell me. So you’re not alone in this.
[STEPHANIE] Yes. Yes.
[WHITNEY] Many of us see way too many clients because of our compassion and care. But ultimately you just said it, you’re hurting yourself. And if you’re hurting yourself, you’re hurting everyone you love, including your clients. So I encourage you, what do you think would be a healthy number of clients for you to see where you’d feel comfortable with the amount of money you make and also running your business and enjoying your life more?
[STEPHANIE] Probably about 20 would be really easy for me. Like what —
[WHITNEY] You seeing 20 would be easy?
[STEPHANIE] It would be easy because then, I’m seeing 27 or 28 a week, but that doesn’t mean that’s money. How many clients I have summer, twice a month, once, you know? So I have way more clients than that. So yes, I think 20 would honestly feel like a vacation.
[WHITNEY] I want to expand your idea of how good your life can be for a second. So Stephanie, how often do you actually want to work? How old is your child?
[STEPHANIE] Six. I mean, if I want to be honest, I just like, yes. I want to work very little right now because I’m savoring like all these moments or I want to be savoring on with my son and I have a wonderful husband. It feels like I won the lottery. I don’t know how it happened. So I love being with them and I want to work more in creating a more community of friends, which I haven’t been able to do as much lately.
[WHITNEY] Great. How many days a week, what’s your ideal schedule?
[STEPHANIE] That’s a good question. Well, right now I have one admin day and then four days where I see everyone. I would love to keep that admin day. I need that admin day. And then I’m happy seeing people four days a week, but if I saw like four or five clients on those days, that would be literally like, almost not feel like working to me.
[WHITNEY] Exactly. That’s what we’re trying to do. I mean the whole point of the consulting, the idea of what Practice of the Practice is all about. It’s about finding that life that you want, working less and making more and then really loving the work you do. Yes. So I’m going to give you, just a one more question. Do you have an assistant?
[STEPHANIE] Actually, that is something I do have. She’s amazing. And she’s really okay working up to 20 hours. So sometimes I need her help a lot and then sometimes I don’t need it as much and she’s just like cool with however much I can give to her, like under 20 hours a week.
[WHITNEY] Okay, great. So I would suggest what if you worked three days a week and you saw —
[STEPHANIE] What?
[WHITNEY] Let’s say you saw five clients a day and then you gave yourself two hours a day for administrative time and you wouldn’t be so burned out with your clients. You saw 15 clients a week.
[STEPHANIE] I mean that would feel amazing. I’d be concerned. I would definitely have to hire more people before I did that because I am a primary breadwinner. My husband also works, but I bring in more and that’s like really helpful for us.
[WHITNEY] Yes. And so I would also take some time to look at your contracts with insurance companies to see what they’re paying you out. I mean, I consult with people who will tell me, yes, I’m making 60 from one and a hundred from another. Well get off the panels that are paying you so low. You already have so many clients knocking on your door. Why are you? You’re basically losing money every time you take a lower paying client and you hate to think of them like that, but ultimately you have to take care of yourself.
[STEPHANIE] Right. Right. And that’s where you also bring up a good point that I think should be addressed in this conversation. So I do have a huge social justice. Part of myself, it comes from my grandfather, my mother. And I, I just think it’s real. I want people to have access to healthcare and mental health care so much. And so that’s kind of one of the propelling reasons I started the nonprofit. So I just have these two competing values coming up. It’s like, I’m getting so done with insurance. I’m getting so done with all the rules and regulations around that. And yet I know that’s a lot of the ways in which people can receive services.
[WHITNEY] I’m going to dream big here with you for just a second.
[STEPHANIE] Okay. Okay.
[WHITNEY] Like what if, let’s say six months from now, your nonprofit is running, you have three to four therapists there and you were a cash pay practice. So you could offer lower rates to people who don’t have insurance and you hire people who are not licensed, like they have a master’s degree. And so they can offer those lower rates and maybe you or someone else offers the supervision to them. So that way you’re kind of hitting multiple birds with one stone there in meeting the needs of your community. You’re helping students get their hours towards licensure and all that.
[STEPHANIE] I would love that. And that’s, I do have someone who’s in training right now and she’s fabulous. She’s also a naturopathic doctor. So she’s like so mature and just amazing. And I do love working with clinicians that are in training. I think that’s a great idea. I’m just having, I think, because I’m working so many hours, I can’t put as much time into the hiring, or even when I am putting time into the hiring, it’s just, I haven’t found people who are a great fit and it’s just like my name, my business, I feel is really important to me, but they’ll be a good fit.
[WHITNEY] Sure. Well, that’s important to all of us and that’s definitely something we talk about, especially in Group Practice Boss, is that hiring the right fit, the process of the interviews, how to really narrow it down. And I will also tell you, I’ve been pleasantly surprised by some of my hires, people that I kind of wasn’t certain about, but I felt like they kind of met a need. So I went on ahead and went with my gut. And I honestly, the references really helped me a lot when I hear what their experience is like working at other places. And they have surprised me.
[STEPHANIE] Okay. Yes.
[WHITNEY] So what do you feel like maybe you’re kind of taking from this conversation?
[STEPHANIE] That I should probably focus on getting more people hired as a priority so that I can take some of this off of my plate and in some way lowering my caseload, whether I need to refer some people out or just like people are graduating and then they’re none. That’s kind of what I’m taking away. Like getting more work-life balance, which is something I truly do want, and I’m heading towards. Definitely it’s so important.
[WHITNEY] Good. I would set a plan for yourself even when we get off of this console, you know it’s easy to move on and start working, but set a plan like, “Okay, well here’s when I’m going to decrease my load by three by two weeks from now,” or whatever the case may be. Just to throw some ideas of how to do that is kind of what you just say in the graduating, trying to move people to every other week instead of every week or those every other week or once a month. And then yes, the ones that you feel like maybe could benefit from something else, try to refer them to a therapist that works with that specialization, or if you can hire somebody and then refer those people.

Another way to do it, which is a little bit more difficult with an insurance-based practice, but you can raise your rates, if you do have a few cash pay payers, sometimes that will encourage them to come every other week, instead of every week, when the rate goes up. You can also write those letters to insurance companies, request an increase in your rate, see how that goes and start coming off those panels that aren’t paying you as much. Because you’re wearing yourself out.
[STEPHANIE] Yes, it’s so true. Another thing about the insurances, they dictate the amount of time you see people. I’m doing EMDR sessions and I feel like I’m about to get audited. I’m like I can’t safely do shorter sessions and I just hate that I have to prove that to someone.
[WHITNEY] I hear that from a lot of, I hear that often from people who do EMDR and couples work. It becomes very difficult. And that’s another thing, with the insurance-based versus cash based is what type of therapy are you offering and where can you comfortably code and those types of things for sure.
[STEPHANIE] Okay. Yep. That’s really helpful.
[WHITNEY] Well, good. Well, Stephanie, can you talk for a few minutes about Group Practice Boss and kind of what that is and your involvement in that?
[STEPHANIE] Sure. Yes. So I actually found out about Group Practice Boss from a colleague who works at St. Louis. She has a really successful business and I was actually working on hiring someone and I called her out of the blue. I was like, ”Hey, I am so confused. Should this person be a W2 or 1099? What should I do?” And she was like, “You need to look up Joe and you need to find out more about this.” So I started listening to the podcast and then I heard you and Alison speak on one of the podcasts about this organization. And I was like, “Oh my gosh, I think this is exactly what I need”. And so somehow by the gift of the universe, personally I normally see him at the time of your meetings every Tuesday has, is doing really well and doesn’t need to be seen as much as I’m able to attend the meetings. It’s so great to be with like-minded therapists who are looking at kind of living the life of their dreams and managing things well, and it kind of, it’s like a visionary process, which I think I really need right now.
[WHITNEY] I’m so glad to hear it. Yes, girl, you can get there. I mean, I remember feeling a lot of the things you feel in the beginning times of my practice and you just kind of have to work through it, but like I have such an amazing team now. I work three days a week and I do consulting on the days that I work.
[STEPHANIE] Amazing.
[WHITNEY] You’re going to fall over when I tell you, I probably see about five clients a week.
[STEPHANIE] That, I mean, and the care you can probably give to those people, that’s just really incredible.
[WHITNEY] And I’m able to really see people that bring me a lot of life and joy as opposed to some of the issues that really drained me. Well, awesome, I’m so glad you are part of Group Practice Boss, and I love it because I get to stay in community with you and others. And so I’m going to get to hear in a few weeks about all the changes that you make in your practice because of our time together today. So I’m excited.
[STEPHANIE] Okay. Thank you, Whitney. I really appreciate your time today.
[WHITNEY] If you’ve been listening to this podcast for a while, you know one of the big foundational components of Practice of the Practice is helping practice owners have the lifestyle that they want, decreasing burnout, making more money and being passionate about the work they do. And that was what we talked about in our live consulting today. And so if you’re a practice owner and you want to make this a part of your life, if you want to make more money, work less, have more time with your family, scale your practice, then I want you to head on over to practiceofthepractice.com\grouppracticeboss. We will help you do all of that more.
[JOE] If you don’t absolutely love your website, you’ve got to do an update. And doing an update can be complex. It can be frustrating, but Brighter Vision makes it so easy. Head on over to brightervision.com/Joe and they’ve got a deal that is going to help you be able to maximize the image that you have for yourself, connect with your ideal clients and be able to really make a difference in your community. If you don’t love your website, there’s no reason to keep it. So switch over to a brighter vision website today over brightervision.com/Joe.

Special thanks to the band Silence is Sexy for your intro music. We really like it. And 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, the publisher, or the guests are rendering legal, accounting, clinical, or other professional information. If you want a professional, you should find one.

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