B (3:25)

Yeah.

A (3:26)

And then I was actually prepping to go out on maternity leave when I got pregnant with my first kiddo and I just kind of fell into a group. It just started off really small. Of course. Let me just get one or two people to cover my patients while I'm on leave and then maybe that'll give me some flexibility to be more part time in regards to carrying a clinical caseload with my. When my little guy is little. And then it just kind of snowballed into now I have four clinicians, you know, working under me and it's just kind of continued since then.

B (4:00)

Yeah, yeah. And do you do much clinical work anymore?

A (4:04)

I actually do. I love the clinical work. I'm like really not ready to step out of it. So I do have a pretty strong clinical caseload. Yeah. Which is like maybe I see maybe like 15 to 20 clients a week which is. Yeah. Maybe on the higher side compared to other group practice owners.

B (4:21)

Yeah, yeah, yeah. Especially I mean, I think that a distinguishing factor of group practice owners who are. It's a private pay practice is that often like referrals are harder to come by than if you're an insurance based practice. So like what do you do for marketing that is working to get folks in?

A (4:39)

For me, I am really all in to like direct marketing with people right in front of me. So like a lot of networking meetings. Right. With other psychiatrists, pediatricians, therapists. I try to meet with therapists that work with a population that is adjacent to my population. So I. We really specialize in kids and teens. So the therapists that I meet with tend to be couple specific therapists or adult specific therapists or maybe child therapists, but child therapists that don't work with kiddos under the age of 10. So therapists that have kind of an adjacent population to mine. I feel like I get the Those are the most effective networking opportunities. And then recently, if I can go on, of course, I've really branched into like hosting these networking events, which have been awesome and really fun. And like, I kid you not, Allison, I have found a way to host 30 person networking events for under $30.

B (5:42)

Which is like, okay, wow. And it's not. You're using words like fun, which is not how most people think of networking events. So can you kind of just lay it all out for us? How are you doing these? Networking event.

A (5:52)

Yeah. So, I mean, I kind of lucked out that I found a really good venue. Basically, it's like a conference room of an office building that you can use for free. So I've got a venue which is free, which is awesome. And then I just get pastries from Costco, which is like $30 for a million. Pastries, Right? If you're going to Costco.

B (6:15)

Yeah.

A (6:15)

You put them on, you know, like nice. You bring plates from home, put them out on nice plates so they don't look like Costco pastries. Although I'm a huge Costco. Costco is kind of like a cult thing. If you're into Costco, you're really into Costco. We are really into Costco now, so you better believe I'm telling everyone. Can you believe I got these at Costco? So I don't hide the fact, but so it's affordable. Pastries, a free venue. And then I think you actually always say this in your podcast when you're networking. It should really feel like you're making friends.

B (6:45)

Yeah.

A (6:45)

So all the people that I network with that have stayed in my community are people that I genuinely really get along with. And everyone's really friendly, really easy to talk to. We end up talking about, oh, how did that move in process go? You just bought a new house. How's your kiddo adjusting to the new school? Like, it ends up almost feeling more personal and work.

B (7:06)

Yeah.

A (7:07)

And I don't know, people. People keep coming, so I love it. It's. It's really. It's really been fun for me. All it takes really is a little bit of my time, and I'm happy to give that.

B (7:17)

That's awesome. And do you invite people that are like, outside of the folks you've done one on one networking with? Like, are you putting it in a therapist Facebook group that's local or anything like that?

A (7:26)

I haven't done that. It tends to just be people that I know, people that I've networked with in a one on one or we have some kind of other professional relationship with maybe people I used to work with, you know, prior at some of my other placements before I did my private practice.

B (7:42)

Yeah, I love that. And so I'm thinking for people right now who are building their practice and they get invited to a networking event, I think it's so different when it's like you're invited by a therapist that you've talked to versus it's posted on meetup, and it's like young professionals of your city kind of a networking event. It's almost like the people who are coming are probably vetted to be cool and friendly if it's through somebody you've already talked to. Yeah. And while, you know, I say, like, if the idea of a networking event makes you want to crawl under the covers and die, then you don't have to go for one. This one might be the kind that is a lot less scary. It's more beneficial for your practice, probably, than if you're like, talking to the, you know, guy that owns the plumbing company, that kind of thing. So, yeah, very cool. I love that.

A (8:35)

I think it tends to. It tends to be kind of like six degrees of separation or even less the people at the event, because everyone knows me and then I know someone else. So it's like they end up being somewhat connected to each other already, even if they've never met. So, yeah, it kind of. There's more of a common denominator, and I feel like it makes it easier. Yeah.

B (8:55)

Yeah, I love that. That's awesome. Okay, so I'm hearing networking, I'm hearing networking events. I'm hearing niching. So something that we didn't talk about is the fact that your group practice is niched by population.

A (9:08)

Yes.

B (9:09)

Which I have seen make a big difference in private pay practices. Yes. It's easier, as we know with solo practices, when you're niched to get clients. And so if your group practice is also niched, it's just easier to fill for private pay than if it's like, we treat everybody for everything.

A (9:29)

Yeah, totally. And the. The narrative out there, the dialogue around whether you niche a group practice or not, is I think there's. There's differences of opinion. And you will definitely hear some people say, ah, you don't really need to niche if you're a group. And obviously there's a lot of groups that aren't niched that are doing freaking amazing. And I say yay them. You know, I'm just very passionate about working with kids, and that's very Much my niche. And so it just kind of made sense. I've only hired people that are really into working with kids. And I've told everyone that I've interviewed, you know, to bring on you have to be really into kids. That's like, that's a non negotiable because those are really the majority of the referrals that we're getting.

B (10:12)

Yeah.

A (10:12)

So I feel like that's actually worked really well for us having that kid niche. And it's not just a kid niche, it's kids with anxieties and ocd. And we specifically use CBT and erp. So that would really be our niche. CBT and ERP for kids with anxiety or ocd.

B (10:27)

Love it. Amazing. Yeah. And that specificity and being like, like the ERP being research. So research backed. Like any parent who does research into like how do I help my kid with OCD is gonna come across ERP and they're searching and to find some people who are actually trained and specializing kids. Because that is a hard thing to find. Like one of our best friends has a kid with OCD and like trying to find somebody to help her kid was. It was like so hard. I'm like in there trying to help and there's just not care everywhere.

A (11:01)

Yeah.

B (11:01)

So yeah. Amazing. And do you guys do virtual work as well or is it all in person?

A (11:08)

You know, we have the office I'm seeing, we're located in San Diego. And just I'm sure maybe it region by region, maybe the demand varies. But what I'm seeing here in San Diego is almost everyone's asking for in office work for kids and teens. Have you seen that shift? Like on the whole?

B (11:26)

Yeah, I mean I see a lot more. I'm thinking about it from like all my students perspectives and there does seem to be for kids and teens, definitely more of a pull towards in person. For adults, a slight pull towards in person, but not as strong.

A (11:42)

Okay.

B (11:42)

But yeah, there does seem to be a real benefit if you have an office.

A (11:46)

So we have the office and. But of course we offer video too. And some people do ask for video, but probably majority are wanting in person. Wanting in person with the option to do video if there's maybe an off week where they're the soccer practice clashes or whatever it is.

B (12:02)

Yeah. So I also want to talk about mindset because as we know, mindset is vital. I mean that's the thing like with limitless practice, which you were in, the thing everybody says at the end is like I thought what I needed were all these tips and strategies and tasks, and I realized that I needed some of those things. The majority of what I needed was some mindset work. So, you know, I love some mindset work. Can you talk to us about, like, being a group practice owner? What mindset is necessary for that? How do you get there?

A (12:37)

Oh, my gosh. And that mindset is so interesting because it's one of those things that you don't know you need or I didn't know that I needed it. Like, it's not something. It's an intangible. Right. So when you're setting up your group, you're really thinking about the logistics, the nitty gritty, am I an S corp or this or that? Like the who's going to meet be my accountant. How am I going to handle it? Like all the background number stuff. And you don't think about the mindset until it hits you in the face and you're like, oh, shoot, I should probably look at this. Yeah, that was really helpful for me with Limitless, the emphasis on the mindset piece for me with the. And so I guess there's two pieces here. One is the mindset. When you're private pay and having that feeling of my time or my therapist time is worth X amount of money. And it's even worth X amount of money if the client doesn't show. And having confidence in that. And I know you have done such amazing work helping your students and me in particular, with feeling that sense of I'm allowed to charge blank. Whatever blank is, whatever the number is doesn't matter. The number could even be like 50. Right. And it can be hard even to grapple with someone's going to spend that much to see me.

B (13:48)

Yeah.

A (13:49)

So I think, I guess that would be part one and then part two of being then a group owner. The mindset piece I had to work through is my time not in the therapy room, but my time just doing everything behind the scenes to orchestrate. All of this is worth X amount of whatever I'm taking from the therapists, whatever the therapists earn. Right. But I also deserve to draw some sort of revenue. Not for sitting in front of a client and being a therapist, because I tackled that hurdle, but just for doing all the behind the scenes, the coordinating, the orchestrating, the generating referrals, the whole behemoth. That is all of that. And that time is worth something. And I'm allowed to pull something from that. And that's okay.

B (14:32)

Yeah, absolutely. And it's interesting too, because I work with practices everywhere and seeing group practices that take insurance that doesn't pay well, but they want to pay their people well.

A (14:46)

Yes.

B (14:47)

So they're doing their best. They're really stretching the limits of what they can truly afford to pay their people.

A (14:54)

Yeah.

B (14:54)

And the margins are so much slimmer in group practice than anyone who's ever been like an associate or group practice thinks. I remember being like, well, you're getting 40% of what I bring home or what I make. But like, so much of that goes to the office, the tissues, the software, the marketing.

A (15:15)

Yeah.

B (15:16)

Plus the time it takes out of your schedule. Like, the margins are very slim. Most people in other businesses would consider a 40% or like the 40% we take. And when you actually look at the profit margin, like, not worth it.

A (15:31)

Yeah.

B (15:32)

So like, a lot of my business friends are like, yeah, don't do that.

A (15:35)

Yeah.

B (15:36)

Because the profit margins are just too slim.

A (15:38)

Yeah.

B (15:38)

I know so many of these folks who have. Who take insurance that. The insurance that pays to keep their businesses open. Oh my gosh, it is so stressful and it's so sad because everybody's doing really good work. And I mean, I think we all have stories of knowing group practices that went under and many of them didn't pay that last paycheck to people. Many of them, you know, did some shady stuff. But it's. I want people out there who have worked in group practices. As a group practice owner myself, I want you to understand, like, the group practice owners aren't rolling in it unless they have like 100 people working for them or 50 people working for them. Really large group practices. Yes. But the usual, the typical kind of smaller group practice. Yeah. There's some additional kind of passive ish income, but in order for you to have that income, you're putting in a lot of work.

A (16:31)

You just, oh my gosh. Sparked so many different ideas in me with all of that. 1. Is this the false narrative of passive income?

B (16:39)

Oh, I hate it.

A (16:40)

Does it ever exist anywhere? Like, it certainly doesn't exist in group practice. Like, there's nothing passive about it because, I mean, your brain is always, always, always, always on thinking about everything. So, no, not passive, but like anywhere. Is it. Is it such a thing?

B (17:01)

I think it's a get rich quick theme. Like, I think that people use it, use the idea of passive income to try to get people to buy their programs about passive income where they then have to do a shit ton of work. It's not passive in order to make an income. So, like, I think it's. I Think passive income is as real as get rich quick schemes are?

A (17:24)

Basically, yes. And yeah. Just remembering that there's so many expenses if you are in a group practice and you. I think probably vast majority of group practice owners are really trying to do the best by everyone, including their employees. Might there be a small percentage that are in it for the money? I mean, I haven't met a group practice owner that's in it for the money, truly. But I'm not saying there aren't maybe some bad apples out there. I guess there could be, but my guess would be that's really a very small minority. And every single group practice practice owner I've met is really busting their butt to try to give their employees the best gig that they can and give their. While giving their clients the best gig that the best treatment and care that they can too.

B (18:08)

Absolutely. Yeah.

A (18:10)

And the margins are much more thin than you would realize. And in California, let me tell you, if you're a W2, you would not believe what I pay just in payroll tax. It's like 20, 30% just goes to like processing payroll taxes. And that's not even the taxes that I have to pay on top of that for my own income. It's. Yeah. It's pricey.

B (18:31)

Yeah. Yeah. So if you think you get 40%, 20 or 30% more goes to taxes.

A (18:37)

Yes.

B (18:37)

And you've got overhead, like, it just gets very slim. It's gotta be. I really wish that all group practice owners, before they get into it, they have some sense of mission, you know, that it is more of a mission in their life driven kind of a thing, rather than. Because I think a lot of people are like, I have all these extra referrals that I can't take. I could make a little extra money on the side and support someone with a job. Girl, you're gonna get run over.

A (19:06)

Yes.

B (19:07)

Yeah, I think.

A (19:08)

I think it was you that I heard this from. Don't do a group practice unless you really have a passion to lead.

B (19:16)

Yes. You have to want to manage people well. You have to want to be a boss.

A (19:20)

Yes. And that's also part of the mindset for me. Like, I've had to step into. What does it mean that I'm a quote unquote boss now? I can't even use that word without putting quotes around it. Right. I'm still kind of leaning into that. Like that's a new Persona. And how. What kind of boss do I want to be? And how do I balance being supportive, unconditional positive regard for My employees, while also being direct with feedback. If and when that happens, which it does for any group practice owner, there are times where you have to give feedback. Yeah. It's a whole other world. Get ready. It's a whole other world. And awesome. And I can truly say I really love what I do. And I feel so fortunate to have been able to build this and to have my family support, which, you know, gave me the confidence to take this risk. It is a really big risk, but.

B (20:12)

I really love it.

A (20:13)

I really do. It's really fun. To build something is really cool. It's like. It's like Legos, but real life Legos, you know? Yeah.

B (20:21)

Yeah. Smoking like a child therapist.

A (20:23)

Yeah. There you go. Yeah.

B (20:25)

And I mean, I think about when people start a solo practice and they're like, oh, wow, this is really pushing me. This is, like, expanding parts of me. This is uncomfortable. Like, I'm. It just forces personal development. Any sort of leadership, when done correctly, will do the same. Like, if you are a boss and you're not having to have, like, corrective conversations with your staff, you're not actually doing your job.

A (20:50)

Yeah. Oh, my gosh, they've got to happen.

B (20:52)

And most of us as therapists, we might be able to call somebody that we're seeing in therapists on their stuff, but that's really different from being like, hey, we discussed that you would get your notes in on time, and that hasn't been done. So we need to figure out what needs to happen in order for you to remain in my employ. You know, that's a.

A (21:13)

Yes.

B (21:15)

That's not how any of us really want to show up, but also it's how we need to show up. That's part of being a boss, is being accountable and holding people accountable.

A (21:23)

I think if we're in this field, we tend to come. The unconditional positive regard comes pretty easy for us.

B (21:30)

Yeah, yeah.

A (21:31)

But that can be problematic when managing employees if you only lean in that direction.

B (21:38)

Right. And like, we preach boundaries with our clients all day long, and then we don't want to set and maintain them as bosses because it doesn't feel. It's just like a different way of setting boundaries and a good, healthy, beautiful way. Because any employee, anybody who's ever been employed by somebody who doesn't have boundaries or doesn't have clear expectations that are upheld, know that that is never comfortable as an employee. It feels like the shoe can drop any minute. You know, you're not necessarily doing your best job because you're not exactly sure what you're supposed to do be doing. We need to have fewer of those people in charge of therapists. We've already got agencies full of them. We've got tons of group practices full of them. That's why I've been successful in abundance, is because of poor leadership across the board. Like, be a good boss. If you choose to be a boss, really look into leadership. And you can't figure leadership out yourself. I don't think you've got to have other friends who are leaders or a mentor of some sort of.

A (22:38)

That's one other step that I've taken is I've really made an effort to network with other group practice owners. Not for the purpose of generating referrals, although if that happens, great. But also to create just a community, a support system. Because it is really lonely being a group practice owner, especially if you're a sole owner, which I am. Because no one relates to you, it's inappropriate for you to try to get your employees to relate to you. Right. That's not their job to validate you and your experience. And that would be putting way too large of an emotional burden on them if you were to even ask that your spouse, as much as they're there to listen at the end of the night, they don't understand what it's like. Your other therapist friends that are in solo work, they have this, again, false narrative. You're rolling in it. And so they don't understand, like, the trials and tribulations. So I've tried to create kind of an informal community of other group practice that we meet with. Yeah. Maybe once a month, once every two months, just to touch base and to hear like, oh, my gosh, that you struggled with that. That was hard for you. Yes. That has been so hard for me, too. And that is just so powerful. Oh, my gosh, that is priceless.

B (23:50)

Yeah.

A (23:50)

That shared experience. Yeah.

B (23:53)

Yeah. And people who've, like, figured it out, who can guide you, because, I mean, that's the thing. And, you know, solo practice owners get this too. You come across things that you don't know how to deal with. You just don't. You have a gut feeling of how to deal with it. That's not always right. But being able to talk to somebody who's been through it really matters. I love. I love how much you, like, you're like, you know what we need? We need community.

A (24:17)

Boom.

B (24:17)

Here's a community, here's another community. I love it. I love it.

A (24:22)

Well, it's funny you mentioned there's so much personal development in becoming a therapist and becoming a business owner, becoming a group practice owner. Right. Those different levels and I was reflecting myself. I used to be so socially anxious and, like, talking to strangers was so hard for me. And now I feel like I can just talk to anyone. And I do all day long. Talk to random people all the time. Get coffee with random people, Email a random person, call a random person.

B (24:51)

Yeah.

A (24:51)

And it's like, wow, that's really. This work has changed me in that way. And that's pretty cool.

B (24:57)

Yeah, absolutely. What a great way to be able to just, like, up level without even meaning to. Like, that probably wasn't even something you were, like, actively working on. It just happened because of exposure therapy, essentially.

A (25:10)

There you go. It speaks to the power of exposure. So if networking events do make you want to crawl and, like, just like, you know, crawl under your skin and die, I would say try it.

B (25:20)

Yeah.

A (25:21)

Try it once, try it twice, try it three times. And I don't know, it'll get easier with time. I really, truly believe that. Mm.

B (25:29)

I briefly wanna touch on workforce retention.

A (25:33)

Yes.

B (25:33)

How do you retain your therapists? They've got the option of private practice out there.

A (25:39)

Yes.

B (25:40)

How do you keep them interested in staying with you?

A (25:43)

So that's a great question, and that's one that's really been at the forefront of my mind. So my vision for my practice has always been to be very small, intentionally small. Amen. Have never wanted to do this, what I call, like the revolving door group practice, where you have a therapist comes in and comes out. Comes in, comes out. That, to me, is like my biggest nightmare. I would rather not have a group practice than have that. So I really try to focus on quality of life, obviously. Right. For my therapist. And actually a patient of mine who's a teacher, she told me this teacher working conditions are student learning conditions. And so I think of that for therapists, therapist working conditions are client healing conditions, but also therapist retention conditions. Right. So I asked myself, what am I offering them that makes it worth it? And I need to make sure that that get for them is big enough. So, you know, what do I offer them? I try to offer them a community. Right. We have these events they're always invited to. They can meet with members of their team, they can meet with other members, like therapists in the. Obviously, they get supervision. But then in addition to that, I started a consultation group, which I'm so fortunate. A child psychiatrist that I know in the community offered to lead it with me. So they get to consult with the child Psychiatrist, you know, twice a month on cases and just that, learning by absorption, hearing other people talk about their cases. You know, obviously, compensation, that package is one. And then someone gave me, you know, group practice. Owner gave me really great mentorship when I was starting off. She said, you want to make sure there's levels to compensation. It's better to start someone off lower with a plan of how they can go up, then start them at the highest number. Because people are wanting to see, how can I grow? How can I advance? What's next? And that's great. You want to hire therapists that are ambitious because you want. You want to hire people that are proactive and really dedicated and wanting to grow and learn. So, like, what's your evolution for an associate that you hire? How can their compensation raise. How can their duties raise their responsibilities raise? So I'm getting ready right now. One of the therapists I first hired when she was an associate, she's now gotten licensed with me. She's now been licensed for two years, and now she's gonna get ready to become one of my supervisors.

B (28:10)

Love it. That's amazing.

A (28:12)

Oh, my gosh. So freaking cool. And the therapist that supervised her to get licensed is now gonna be the therapist that supervises her to be a supervisor.

B (28:21)

Amazing.

A (28:21)

So there's, like, there's that growth and that forward movement. We all want that.

B (28:28)

Yes.

A (28:28)

And you want the therapists that want that if you're hiring.

B (28:31)

Yes. You don't want the person who just wants to, like, clock in and clock out and, like, their job is over here. They don't really care.

A (28:39)

Yeah.

B (28:40)

Amazing. Well, thank you, Kelly. I really appreciate getting to talk with you about this. And for those of you who are considering group practice, I hope you really do think through what Kelly shared. And if you've got a kid to refer with OCD or anxiety in San Diego or California virtually, then how do they find you, Kelly?

A (28:58)

Our website is best www.lajollatherapycenter.com. that's L, A, J, O, L, L, A. If you're in San Diego, you know La Jolla. But if you're not, you're like, what the heck is that? Yeah.

B (29:12)

Amazing. Well, thank you, Kelly. I will talk with you later.

A (29:15)

Thank you so much. Have a great day. Bye.

B (29:17)

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