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Hi, I’m Alison Pidgeon your host. This is the Grow a Group Practice podcast. I’m so happy you’re with me today. I have a group practice owner with me today. Her name is Maria Spada. She is the founder and lead psychotherapist at Awakened Path Counseling & Psychotherapy in Monmouth Junction, New Jersey. She has a very particular philosophy when it comes to mental health treatment that is very holistic. We talk a lot more about that in the interview where she talks about how they do a lot of integrative treatment and she’s trying to move away from the traditional disease centered model where diagnoses and medication are the cornerstones of treatment. So she talks about how her philosophy is really infused in everything in the practice, from how she hires staff to how she does her marketing. So if you’ve ever thought about starting a holistic mental health type practice, this is definitely a great interview to listen to you.
[ALISON]: Hi Maria. Welcome to the podcast. I’m so glad you’re here.
[MARIA SPADA]: Hi, Alison. Thank you so much for having me.
[ALISON]: I’m excited to talk with you today. So I thought a good starting point would just be for you to kind of give a short introduction and tell us about your group practice and kind of where it stands now.
[MARIA]: Sure. My practice is in New Jersey and we currently have two, actually one fully licensed professional counselor, LPC, one intern, who is an LEC and an office manager at this time.
[ALISON]: Great. And you have a very specific specialty for the group practice. I think you try to focus on kind of more holistic wellness. Can you talk about that a little bit?
[MARIA]: Sure. We’re a bit atypical in that. Our focus isn’t diagnoses. While we are bound to use diagnoses when it comes to insurance, and of course that’s the way we’ve all been trained, it’s not the cornerstone of treatment. Medication is not the cornerstone of treatment while we, obviously there’s a time and place for medication. There are times where we believe that it can help in addition to other components like diet, exercise, what are you exposing yourself to socially? And it’s an all encompassing view.
However, we really aim to help the client claim their power in healing and healing themselves. And so what that looks like is not being so focused on the symptoms, but instead being focused on what do I have control over? What are some small changes I can make with support and comfort that will lead to feeling relief? That will lead to healing? We have a belief that the more you focus on your symptoms, there can also be a tendency to exacerbate those symptom if that’s all we’re thinking and talking about sorry.
[ALISON]: Well, [crosstalk].
[MARIA]: Sorry, go ahead.
[ALISON]: No, I was just going to say, I think that’s great. I think, you know, it’s cool to see that shift happening in healthcare where there’s this recognition of like, yeah, there’s not just like all these separate things related to health that don’t all interact with each other. You know, we treat the brain and the body as like separate things, but it is really all interconnected and having a health practitioner, that’s going to recognize how all those things are intertwined is obviously going to be much more effective. So I think what you’re talking about is definitely the way things are going. And I’m curious too, if you find that people are seeking you out because they also believe that healthcare is more holistic or do you think that they find you for a different reason?
[MARIA]: So I think what we provide is, or at least our objective is to kind of bridge that gap. So you have, you know, in my experience, there’s kind of a camp of people who are very comfortable with our medical model and the way that it is and then there’s the other side of that spectrum where people are very holistically focused and don’t want to take any medication at all. And what we’ve set out to do is kind of invite everyone in between those two camps to find where they’re comfortable. So, we’ve had the mix to be honest with you, people come in, who are already on medication and have a desire to maybe go in a different direction, but they’re not really sure how to start or clients who are very much already in that world, but not to the extent that they wouldn’t even consider taking medication. So it really is a mix and we just take every case really individually. And it’s all within the client’s comfort.
[ALISON]: So does that become challenging from a marketing perspective, is knowing how to market the practice given that people might be on different areas of the spectrum of how much they know about holistic wellness or not?
[MARIA]: I think marketing is kind of this living breathing thing, and you’re in a constant state of kind of adapting and niching. A lot of it is education. So, our marketing, when we say marketing for us, it’s SEO, it’s the website, how does our website represent us? There’s a lot of education on our website that kind of explains to people, well, what does holistic mean? What does holistic mean in the mental health treatment standpoint? And so there’s that, and the other is we build relationships with like-minded professionals for referral sources. So, I haven’t really had a difficult time in terms of marketing, other than let’s stick with the holistic, let’s stick with the empowerment based work and kind of that perspective and the angle that, you know, have you been to other therapists? Has it not worked out for you? We want to help you figure out how you can tap into that ability that’s already within you. And that’s kind of the angle that we’ve taken and continue to use and it’s been working for us.
[ALISON]: Yeah, that’s great. So I just have a couple follow-up questions to that. And the one is so obviously very smart for you to reach out to other professionals who do similar types of work, who could become referral sources. So for your practice, what types of professionals are those? Are there like naturopathic doctors or who’s like a natural referral source for you?
[MARIA]: Sure. What I found, the method that I used first is who is local to us? So that is who are the local massage therapists who are, there are quite a few integrative medicine practices in our area. So we’re very lucky to have been able to establish those relationships, but even physical therapists, chiropractors, I’m trying to, I’m kind of going through my mind to know who we’ve connected to. There’s a local EFT practitioner that we have a wonderful relationship with. Even certain stores. Like, you know, your new age shops that provide essential oils or things that are going to attract both sides, but we don’t limit ourselves at the same time. Because networking, at least in my view is really about establishing a genuine relationship and also not discounting that any person that you connect with genuinely from a business standpoint could lead to a referral.
So, we will meet with family law attorneys and neurologists, and we don’t limit it because there are people who are going to be in their office and maybe they’re not really comfortable with what they’re receiving at the current time. Then that opens us up to a referral as well. So, from a networking standpoint, I found that it’s more about, are you establishing genuine relationships with people that are also business owners and are you nurturing those relationships? And I think for me, it’s been less about where do they work? What field are they in as much as it has been about the relationship?
[ALISON]: I’m glad that you brought that up because I think that is so important. I know that I found some unlikely referral sources in various places that you wouldn’t think necessarily go together. But if it’s just somebody who sort of like gets what you’re doing and obviously trusts you. It could be your kid’s piano teacher. It’s a new clients, but it’s just about, like you said, just being yourself and just letting them know who you are and you know, how you help clients and that kind of thing. Referral sources can come from all different places.
So I want to kind of hear the story about how you got the group practice started because I feel like for a lot of people, that’s always like a big stumbling block. They’re like, “Okay, I know I want to start a group practice, but I don’t know how to start.” So how did that all come about for you?
[MARIA]: Sure. Well, I had been doing work on my own, so I was already a kind of a solo practitioner, but I was doing in-home services through a grant funded program through the state of New Jersey. And so essentially I hadn’t been working for anyone for a while outside of some part-time work in private practice. So part of me was kind of comfortable being on my own and then I also had the experience in private practice working for another group where I had such a wonderful experience. Really great people ran the practice very professionally, but also had a supportive, very family like feel and things were organized. What was expected of you was very clear. And I grew as a professional in that setting more than I have in any other setting. So that was really inspiring for me that it was just the energy of being trusted as a professional, supported when I needed to be supported, and I flourished.
I flourished in terms of like expanding my scope of practice, my level of perceived confidence in terms of even certain business practices. You know, kind of getting an understanding of how does insurance work? How does the billing work? How does it work to manage staff? One of the things that I kind of kept running into in treatment was I felt like I was a bit limited, like really wanting to step outside of that world of diagnoses. And I think diagnoses has a place. It really helps us understand what someone is going through. I think it’s a great tool. The DSM is a great tool to kind of take a look at and say, “Okay, here’s what this person’s experience has been.” But what I also found is that outside of the stigma that I think all of us have spoken about so many times, it’s also inhibiting from the client where it’s, “I ascribed to this, therefore I am this.”
And I kept finding that to be a stumbling block for a lot of clients to kind of move past a certain level of healing. So I started incorporating things like guided meditation and other holistic practices that were atypical. And it came to a point where I said, “I want to be able to do more without limitation.” So I on a personal level reached this place where it really wasn’t an option. I don’t know if you’ve ever experienced kind of this like stagnant kind of “Okay, well, I’m doing well and I’m comfortable, but —
[ALISON]: Yeah, you felt like you are through it. It sounds like, yeah…
[MARIA]: It just, it was time. It was time, and I was initially on my own. I was on my own for six months and the initial opening I think was probably the more overwhelming component and I knew I needed help. So I actually hired a coach. I hired a coach and it was the best thing I did because she helped me push past my own fears. It was amazing to see how much, you know, even if you’re a driven, confident, successful person, how much you can still get in your own way.
[ALISON]: Absolutely.
[MARIA]: And it was very humbling, and she had a personality where, how do I describe it? She just, it was kind of like, “Well, is that true or are you just kind of like making that story up in your head?” And so she really challenged me and I needed it. I needed it and although there were moments where I felt a little resentful here and there, because while my life was going just fine and I did great as long as I had. And so after, I worked with her for about six months, got the idea and understanding of what it is to build systems and then very quickly decided because, I’m lucky enough in terms of how I set the practice up that referrals really have never been an issue. Knock on wood.
[ALISON]: Yes, that’s great.
[MARIA]: We had a waiting list pretty quickly. And so the opportunity to bring on an additional person was a need at that time. And so that’s kind of where it started and things went really well with the first hire and I learned a lot about the need for systems and how important it is to streamline things. And now we are at, since then one clinician has transitioned actually into opening her own practice. So we’re at two additional clinicians outside of myself, plus an office manager. And there’s so much to say about having the right support in place. And I think that, you know, Shannon is my office manager. She’s actually has a little bio on the website and I couldn’t do this without her. She was with me pretty much from the very beginning and she wears a lot of hats. That’s like from bookkeeping to, I mean, many, many other things. She handles the phone, she handles the billing, she deals with insurance. And so, that component allows me to be free to focus on the expansion part of the business as well.
[ALISON]: I think that’s such an important piece. I know when you have a good assistant or a good office manager, it feels like they’re the whole backbone of the practice. And I think that when you have somebody who is a really good fit and you know you can rely on them, it does, you’re not worried about it. You’re not like, “Oh my gosh, did I call this person back?” You’re just like, “Okay, they got it. I don’t worry about it. I can think about expanding the business.”
[MARIA]: Right.
[MARIA]: Yes, that’s great. So what has it been like finding clinicians who kind of share your same values or your same philosophy around the holistic counseling? Has it been hard to find clinicians who fit in with that model or not part, or what’s been your experience with hiring?
[MARIA]: So it takes time. I’ll put it that way. It takes time and you know, the process that I’ve come up with and actually we’re going to be hiring again this quarter because we need to at this point, but, so what I’ll do is I’ll put a post up. So far what we’ve been using is Indeed, or sometimes we’ll get inquiries directly through our website. And I’m very clear about the philosophy and the need to be comfortable with at least an integrative approach and having experience with meditation and breath work, you know, some of those baseline things that would really be a requirement for us. And also being very transparent about a clinician being comfortable with medication, not being the first go-to, or one of the first things in the treatment plan.
And you know, what I’ve found is, when you put an inquiry on a platform like that is, is even when you are very clear about what your business philosophy is, I think most people are really just looking for work. So they’re just applying. But then if a resume looks good, I then follow up with kind of like a, it’s a bunch of questions that I send out in addition to provide further screening and kind of based on those questions and the responses that I receive, and also you know how much time someone has taken to respond to those questions, which I think is apparent in the writing. Then that helps me decide, “Okay, will I meet with this person in person? Do we have a phone interview?”
So what I found is that it really does require several steps, and then also being clear even in the interview, you know, of what your expectations are as well. And I found that a lot of people are interested in this world or this side of things, but may not necessarily have the background in it. And so that becomes tough because you can have a great candidate in front of you, but at that point, it’s about making a decision, you know, “Do I have the time to really train this person to fit the brand or not?” And that’s something that, and you know, Alison it’s only been two years. So, we haven’t done a ton of interviewing and bringing people on, but we are looking forward to doing that again this quarter.
[ALISON]: I’m really glad that you talked about the hiring process that you go through, because I feel like having that sort of multi-step process is so important to figure out who is going to be a good fit and who is really committed to wanting to work for you and not like you said, just applying to anything and everything they can find on indeed.com.
[MARIA]: Yeah.
[ALISON]: So it sounds like you figured that out how to make sure you’re like, sort of screening people out. I liked what you said too about seeing how quickly people respond to answering the questions, because I find that there’s just these different little pieces that can happen in the hiring process that can be like a red flag. That person is showing you their true colors, even in the hiring process and so, if it takes them two weeks to finish a simple questionnaire, like to me, that’s probably a red flag. They’re going to be slow to get their paperwork done, or they’re going to be, maybe they’re just disorganized or whatever. So I think that’s great that you have like multiple steps they have to go through, because that can tell you so much about a person.
[MARIA]: Right. And you’re right in those behavioral manifestations in that process, because our interview process is lengthy. And so also, how long are those responses? Like, are they well thought out and honest or are they like quick two sentence responses to just kind of finish it up, which to me, as a business owner is also a reflection of character.
[ALISON]: Right, exactly. So tell me about if you had to give some advice to somebody who is just maybe in the very beginning stages of a group practice. What advice would you have for them, or maybe what were some mistakes you made that you can share, so other people avoid making the same mistakes?
[MARIA]: Sure. I have lots of advice. So I think, the first and most important component and, you know, I started sharing a little bit about this, earlier when I said I hired a coach to work with is mindset. It’s one of the first components. And it’s scary to do something now and I think it’s about really being aware of whether your decision-making is being led by fear or excitement or whatever the case may be is maintaining an awareness, but understanding and investing your energy in the fear and the fear of lack. So, “Oh, well, what if it doesn’t work out?” Or, you know, for example, when I got my first suite for rent, my first office suite, it was a really great deal. And even then I was fearful about the cost and, “Oh gosh, am I going to be able to cover the cost? Am I going to have enough clients to cover the cost of this?” And so I think being really cognizant of how much are you putting into, how much energy are you putting into those things versus your strengths and your abilities, and also your willingness to strengthen the areas that maybe you’re not as strong. And so for example, bookkeeping, not my thing. Never has been.
It was one of the first things that I put in place. I was like, “You know what? That numbers thing that people like to do, I need help.” And so, that was one of the things that I put into place. So knowing where your limitations are and not being shy about reaching out for help. So, you know, what does that look like? That looks like, you know, maybe investing in yourself and hiring a coach and putting that on a credit card with good faith that you’re going to cover that cost and more with the success of your practice. Or listening to those audio books. I think, the first year I started business, I had an audio book running every spare moment. I mean, in the shower, in the car, making dinner. I was feeding my brain as much as I could in any spare moment that I had and I wasn’t seeing clients a, basically at that time managing staff as well.
So one component. The other component, I would say if you have plans to become a group practice owner, I would say it’s going to be really important to understand that there is an entirely different skill set involved in managing humans.
[ALISON]: Yes, yes. There is.
[MARIA]: First thing is, versus, I mean, and we think we’re human experts because we are in a sense, because we’re all therapists. However, there is something to be learned about what kind of leader do you want to be and taking the time to cultivate that and what type of experience do you want your staff to have working for you? So for me, in terms of my value system, it’s really important for the people who work for the practice to feel valued, to feel heard, to feel supported, to feel that they can express hardship or a need. And in fact, every year, actually we just did our, I did my one-on-ones with my staff last week. We talk about those exact things. “What do you feel like your accomplishments were this year? If you were me, what would you do differently?” I love that question specifically, because it gives them the opportunity to hopefully in a safe way, say, “Hey, you know, if I were you, I would do this differently.”
And it gives you feedback with regard to how you’re doing as a leader. And I think it’s important to be humble enough to open yourself in that way and just understand that it is an undertaking because you will be developing an entirely different skillset within yourself as a leader, which is, I think in my experience, an additional component to learning how to manage a business and obviously different than being a therapist as well
[ALISON]: Yes, I wanted to pause right there because I think that’s such a great point and I feel very much the same in terms of the leadership component. Because I think so many practice owners just think when they’re starting out like, “Oh, I’m hiring this person and they seem great and we’re getting along.” And they don’t realize they have to be really intentional about how you’re going to be as the boss, and also you have to create a culture in which they’re going to want to stay because, you know, turnover is one of the most expensive parts about running a business. And so if you just assume, “Oh, everyone’s going to get along and stay forever.” Well, that’s pretty naive and you have to be really intentional about making that happen.
[MARIA]: Yeah, I agree, and with that intentionality understand that it’s a relationship. You want to have a relationship obviously with the important boundaries that need to exist, but you know, I think fostering loyalty and all of those things are really important and that’s all about the experience that they’re having. And you get to create that for them.
[ALISON]: Yeah, and it sounds like you had a really good experience in the previous group practice that you worked at. So was that kind of where you took some of that philosophy or kind of how you are as a boss?
[MARIA]: I took some things from the practice that I was at for sure. And I would say it was mainly the contrast. That I experienced working at a nonprofit agency for several years where, unfortunately there’s limitations due to funding and so many different reasons that unfortunately wasn’t the most supportive experience. Now when you transition and you have this contrast where it’s like, “Wow, these people are really nice to me.” And it’s this unconditional positive regard and this very simple concept of if you complete your responsibilities, you will be treated well and that there’s always someone available to you to support you. And I think that the contrast for me was huge, and then helping me understand that like, “Wow, things can be different.” And then I expanded upon that and, you know, there are a lot of like resources that you can read and like I said, audio books were a huge component of that. I think one of, there were several books and now I can’t remember the title of one of the books that really influenced me. It was written by one of the big VPs of Google. I can get back to you on the actual name of the book. I could probably check my Audible and pull it up, but
[ALISON]: it will be great. And then we can put that in the show notes when you figure out what the title is.
[MARIA]: Okay, perfect. And the components of what were in that book were applicable to small business. I mean, Google is a gigantic empire and they’re also known for how they treat their employees. So there were a lot of components that I pulled from there and just kind of making that commitment to yourself too. Like really understanding what that vision is for you as a practice owner and how do you want to be seen, when your staff is out and about and having a conversation at a party? Well, maybe once, you know, COVID comes down and people go to parties again, how do you want to be seen? How do you want them to talk about you? Do you want them to be grateful for their position and feel very supported by you or are you comfortable just being that kind of like status quo job?
And what I’ve found is that how they feel is also very much connected to how effective they are. And that’s the other piece of all of this. Is the ethics behind it all. We want to help people heal, but we actually really want to do that. It’s not just about getting clients in. It’s more. It’s the intention of, we want people to leave feeling better, significantly better. And that’s correlated to us because we are our instrument. So in my view is kind of this whole trickle down effect.
[ALISON]: Absolutely. Yeah, and I think that just to kind of expand on what you just mentioned about how would your staff talk about you if they were at a social event and you weren’t around.
[MARIA]: Right.
[ALISON]: I find that since, you know, I’ve been in business now for a little over five years and my current employees are actually my best kind of advertisement for future employees because mental health, obviously can be a small world. And so word gets around that your practice is a good place to work and then people are just sending you unsolicited resumes. So that has worked out really well for me, and it just kind of builds on itself.
[MARIA]: And I guess I would add, for someone just starting out, I think there’s always this, “Do I take insurance? Do I not take insurance?” And I would say, enroll yourself with just at least one insurance company where you are in network and it allows you kind of a baseline foundation of referrals just to kind of get things started. And if you’re with them for a year and you find that you’re getting enough referrals on your own, you can always discontinue that contract. But I think it helps when you’re first starting out. I think it really helps alleviate some of that fear that, “How am I going to get referrals or how am I going to build up to the point where I’m getting referrals or doing enough networking?” So, I think that’s always something that is worth looking into as well.
[ALISON]: I think that is really good advice, especially if you’re transitioning totally away from a full-time job and trying to get your practice up and going. It can definitely help to get it started quicker.
[MARIA]: Yeah.
[ALISON]: Well, Maria, it sounds like you’re running an amazing group practice and I’m so glad that you are in our membership community, Group Practice Boss. It’s so cool to see people kind of supporting each other and answering each other’s questions. So I’m really glad you’re with us. If there is email or your website that you want to share with the audience in case they want to get ahold of you, that’d be great.
[MARIA]: Sure. Feel free to check us out at www.awakenedpathcounseling.com. I know it’s a little long and you can actually email us, there’s a contact page on the website itself. So you can always submit inquiries directly through the website or our email is [email protected]. You can feel free to reach us any way that works for you.
[ALISON]: Awesome. Well, thank you so much, Maria, for taking the time to talk with me today.
[MARIA]: Thank you for having me, Alison and I look forward to seeing you in our next meeting.
[ALISON]: Yeah. Well, thank you so much for tuning in today. If you are an established group practice owner like Maria, who is in our Group Practice Boss membership community, and you want some ongoing support sign up for our email list so that you can be notified when we open the doors again to Group Practice Boss. The website is www.practiceofthepractice.com/gpbdoor. And I will 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.