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Private Practice Startup Podcast
Episode 155: How to CYA Your Private Practice with a Court Policy
00:29:38
Nicol Stolar-Peterson, LCSW, BCD
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- [00:02]
A
Welcome to the Private Practice Startup podcast where we help ambitious private practitioners across the globe to brand themselves and grow their dream practices. We chat with successful private practitioners, business coaches and marketing experts, bringing you tons of practice building Ninja tips. Visit privatepracticestartup.com for awesome resources, attorney approved private practice paperwork and our signature marketing E course. Here are your co hosts, Dr. Kate Campbell and Katie Lemieux.
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B
Hey there startup nation. Welcome back to another episode of the Private Practice Startup podcast. What is going on everybody today? So I am flying solo again. I know I didn't announce that on the last podcast, but I am flying solo again for this recording because unfortunately Kate is down and out with a really nasty cold and we actually botch, not botch, we batch our podcast. So we actually do four back to back on one day of the month and that's kind of our, you know, our systems. But let's jump into today's podcast. So we are going to be talking with Nicole Stoller Peterson on how to CYA your private practice with a court policy. And because you guys were so interested in her topics, we're actually doing another one right after this one and I'll tell you a little bit about that after. But before we do get started, I hope you joined us last week for Michael Knowles podcast on how to start a private practice on a shoestring budget. And I have to say that slow because I think if I tongue twisted I might slip something else out. So I had to say it really slow. He offered a ton of tips and resources which are all on the show notes page and he started his private practice for I think he said under $400. So if you're just starting out, it is possible and you always grow, evolve and change. So you just want to check that out. If you are one of our loyal listeners, we wanted to say thank you for listening and joining us again. And if you were brand new here, we want to welcome you with open arms and give you a big virtual hu. And we're so glad you're here, Kate and I also want to offer you a gift because you are our VIP and that is our A to Z cheat sheet. The essentials for building and growing a dream practice. Perfect for the previous podcast because it's a freebie and it is A to Z with chock full of so much resources, ninja tips and things like that. So you want to get that and you can get that@privatepracticestartup.com head over to the resources tab and there you'll see it and not only do you get the cheat sheet, but it does come with five days of practice practice building email. So we are here to support you in your private practice journey. So a little bit about Nicole. Nicole's an expert witness, child custody evaluator, and court performance coach.
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C
Excuse me.
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B
She helps therapists cya. She loves court and accepts that that makes her a little odd in the community of healers. A fun fact about Nicole is when she testified the first time, she tanked, which was really the motivation that helped her go back and learn everything she could about court. And now she's recruited by top law firms to work as their expert. As their expert and educate their attorneys and the court about therapy and child abuse. So please join me in welcoming Nicole.
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C
Thank you. I'm so excited to be here.
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B
We are excited to have you. And we actually got to meet Nicole, just like Michael, at the not so typical psychotherapist summit, which is another tongue twister. If I say it fast, it totally is. So I'm really excited about your topic because I really do love talking about legal stuff. And this is one of the areas. Sometimes I think it's like one of those denial areas. It's like, I don't really want to know, so let's not go there. But it is so important and so important that Startup Nation actually wanted you to talk about two topics. So we are actually doing two podcasts today, but why don't we dive in? So how did you. I know that you bombed the first time at court, but how did you get started in this area?
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C
So after bombing and realizing I had a few choices at that point in my career that I could just crawl away and cry in a corner somewhere, or I could go back and learn. And so I actually spoke to my supervisor at that time, and I said, you know, I feel like I really need to figure this out because I felt horrible. And it really does make a huge difference in people's lives, how we perform in court. And not necessarily because we're there to advocate, but we're just there to present information. And because it's such a different environment, we really have to learn the rules and the environment and what the expectations are. And so it's just like anything else, learning the environment and then how to get our information across. And so I went back and I learned and I swallowed my pride, which is probably one of the biggest issues. I think, for a lot of us, it's going to be our ego. Like, what would it mean to not do an amazing job at something and A lot of therapists really hide from this area. And so when I left my 11.7 year job at CPS alive, thank God, one of the things that I got into was child custody evaluations. But what became extremely clear in the community was that therapists really struggled with court, the concept of it, and just would ignore it and just would say, I'm just not going to think about it, or I'm just going to ignore if a subpoena comes in, or I'm just going to not worry about it. I have malpractice. And I'm thinking this is a not the way that we. That we teach our clients to get ready for things. And it's the complete opposite. So it's this strange phenomenon. So I just sort of fell into it. And then Kelly and Miranda Zinnieme had a talk with me about how needed this was, and I was like, oh, people need this. You know, I should probably, like, do something to help to help my community. And then the court policy was born. And so it just kind of culminated from a horrible day in court to now hopefully helping some therapists avoid ever having to experience something like that.
- [05:41]
B
And often some of our biggest struggles are really sometimes become our life mission.
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C
Oh, interestingly enough. Right. And I was sued back in 2005, I think, at that point in my career, and we won. And that law firm, now that I have left the agency, hires me from time to time as their expert. And so that's come full circle.
- [06:04]
B
That is. I got chills for that. That's really so exciting. You know, I know when we're going through certain things, it feels like our life could be over. It's the death of us, and we're embarrassed and going through all of that. And I love how you really turn that around. So back in 2005, were you in private practice or were you working for Child Protective Investigation?
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C
I was working for CPS at that time. And it, like a lot of cases, it was very intricate, it took years, it was scary. It really taught me what gets looked for in regards to a court case. And so now actually when I, if I'm writing notes or anything that I do, I think, how would this show up in court? If it was read out loud in court, how would it sound? And it really helps me, I think, stay within, I think, the guidelines of what the expectations are that we're supposed to do. And so that's been helpful. Back then, it sure didn't feel that way. It felt horrible and scary. And I'm sure I Probably lost some. Lost some weight during that time because the stress was so high. But now I think taking what I learned from that and being able to help others just avoid situations and also just knowing what to look for, just being prepared. It's like anything else. We have car insurance, we have malpractice insurance. So why wouldn't we have something in place during our intake that helps send some protection forward? It's a boundary. It's really just a boundary. Lisa Fraley actually said that it's like setting a healthy boundary with our clients. And I was like, yes, what you said exactly it. And so I was like, that is what we're doing. And again, burying our heads in the sand is just not going to work anymore. It's a very litigious time and the work that we do matters and we should protect it. And that's what having a court policy is about. It's about having some protection in place and really valuing the work that we do and saying it out loud and saying it out loud enough that we do it in an intake and then there's no surprises and later. And so that's really helpful.
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B
I love that you say that. And I'm sure Startup Nation is wondering, like, how did you bomb that first?
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C
Oh, I'm. Because my boss said to me, just read your notes and go tell the truth. And that's what I did. And I read my notes, I studied them, and I went in and I went and I told the truth. I didn't know, though, how to wait. I didn't know how to respond to certain types of questions. I didn't know how to look over and wait for the attorney to object. I didn't know what I could and couldn't take with me. I didn't know how to create a timeline, which is like my go to for every single case that I do now is I come in with a binder and I actually have a timeline that looks a lot like a genogram for you therapists out there. And it's like sometimes four pages long and it's all color coded. And I'll have the judge look over my shoulder and be like, wow, look at that. Did you bring me one? I'm like, yes, Ron, I have a color copy for you and the attorneys. You can have black and white.
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B
You're like, color cost too much.
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C
It's a way to it. But just it's being prepared. It's just this completely different preparation. And I don't blame my boss. He told the truth, but he Told what he knew. And so now that I know more, I'm happy to say no, that's not the way we prepare. We can do so much more. We can really walk in and feel good about the information. And also it tells the court we're ready. You're not just going to push me around. You're not going to think I'm some, you know, therapist that you're just going to, you're going to get me to cry. It's not going to happen because look at me, I'm in a situation. I got my binder. Like, what do you have?
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B
You know, I got my color coded genogram timeline.
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C
Thank you so much. I do. And I sure I've got my tabs. Oh my gosh, I am. And I'm happy to show them what I bring with me because again, I think it's just a way to let them know and it lets me know. And then I'm not standing up there fumbling, looking for something and some crazy looking file. I'm just, you know, using my tabs. And then it tends to set back that attorney and they kind of calm down a little bit and they're like, oh, I might have to deal with this person a little differently. I thought I was just gonna go, go in for the kill. And then that's not the case. So preparation, preparation, preparation. Yeah.
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B
Well, one of the things that I really love that you said and Kate and I view, you know, we have our attorney approved private practice paperwork and we really believe that paperwork creates a conversation and it creates a conversation around a relationship that we're about to have. And it helps set the boundaries, the guidelines and the expectations. And, you know, it's so easier when your client calls and says, cancels three hours before your session and says, I know, you have to charge me, no problem, I understand. Because we already talked about that. Right. Or it's easier when maybe they forgot and you have to enforce the rule because not only did you read it, you sign on it, but we talked about it, right? And they're like, oh, that's right, I understand. No problem. It just makes things. And I also feel like clients feel cared for more because they're very, well, it's transparent. It's kind of like, you know, if you have a doctor's appointment and, I don't know, you go to the doctor and they're speaking in their doctor mumbo jumbo, they don't really talk to you. You know, that's really uncomfortable. So share a little bit about, you know, Kind of the court policy and what's in that? How do you talk with clients about that?
- [10:58]
C
I think the biggest piece to remember is to do it at the beginning, to do it at intake. And I really think it's a form of our informed consent. I think it's important to let our clients know what we can and can't do in regards to court, because oftentimes they're coming to us hoping that they're going to get a court letter. They're coming to us with hopes of, you know, at some point I might need you to testify and say that I'm a good mom or I'm a good dad or I'm a good person. And so we need to let them know ahead of time whether or not we even write those letters, right? We need him to let them know ahead of time whether or not we like to go to court. And then if we don't like to go to court, then we would actually add in the caveat that says, however, should you subpoena me, this is the fee, right? This is, I only charge a flat rate per day because then I have to be away from my practice. And you're just really clear about what you can and can't do. And I think when you set that up at the very beginning, it helps. I think clients also respect the relationship as well, because three months later or even five months later, when they have a request, it's not, well, wait, you didn't tell me that you didn't write letters. I thought this whole time we were working together. And so it's that surprise. And so again, when we talk about informed consent, what do we do? What don't we do? What can we offer? What can we not? And then one of the biggest pieces of the court policy is clearly states that we cannot make recommendations regarding custody. And I think that's probably the biggest issue that comes up from all over the United States. When I get phone calls of, oh, gosh, I think I might have made a recommendation in a letter to court. I'm like, okay, let's slow down. Let's read it to me. What does it say? Because that's the risk is when we go out of scope. And so what this court policy does is it provides our scope of practice. Here's what we can and can't do, and here's why. And it's so clear. And it's all of a page and a half, right? So this page and a half offers the ability to convey what we can and can't do. From a legal standpoint. And then also preferences and fees all in one place. And then should they subpoena us later, I'm more than happy to send them a copy of that to remind them this is what you signed. I didn't want you to forget about this. Because they forget and they think, oh, she'll come to court and I'll just pay my copay. Or she'll come to court and I'll just pay for an hour of therapy. No, because we're preparing. We're clearing our day, and no one can promise us what time court's gonna happen. Calendars are nuts, so you don't know. So I just clear out the day, and that's what I'm gonna bill for. And then. And then we can talk about billing, too, if you want. Cause that always comes up. People like, I'm gonna charge $20,000. I'm like, no, you're not.
- [13:27]
B
No, I like that. It's interesting. So I love talking, like law and legal. I don't know if I was an attorney in my past life. I just like to pretend I'm one, even though I do make the disclaimer that I'm not. What's interesting is, you know, I'm like, I'm excited about what we're talking about today. And also at the same time, I feel very validated, right? Because I actually used to run a program where all of our referrals came from child protective investigations. So there was a lot of, like, law stuff. And you're right. And I think, you know, my training and agency work, and the agency did a great job in training and also my love of compliance and auditing, who likes that stuff and law is ridiculous, but really helped me. And, you know, I would, you know, train my. My. My staff this way, but it was very important, is that's the first thing we would say. Like, we're not making any recommendations. Like, here you have, like, maybe, you know, no contact orders with the kids or the other partner or whatever. And that was our first thing. We're here for therapy. All we can do is report what we've observed, what we have seen, and treatment recommendations, period. So, no, we're not going to say you're the fantastic mom and the kids with you, or that's. That's child custody evaluations. Like, that's not us. So it's amusing to my ears when I think about what you shared in regards to having those conversations beforehand, writing it down, making it really clear, because it is always so nice to refer back to it, and especially that they've signed it. They can't say no. But before we go further, Nicole, let's just take a quick break for our sponsor.
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C
Sounds good.
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D
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B
So what are some other do's and don'ts? We were talking a little bit, you were going with fees, so let's talk about that.
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C
So I hear all the time, what if I'm just going to charge $10,000 and then nobody's going to have me go to court? And I would think that. Here's the issue with that. Let me see how to phrase this in a way that I won't get sued. Okay, so if, let's say that's what's on your policy is that it's $10,000 for the day and you get a subpoena. Let's say you ignore it and then the judge puts out an order and says you will be at court, right? So now there's a court order for you to appear and you show up and you haven't been paid and the judge says to you, how did you come up with this number? Because I've heard this before. How did you come up with this number? Well, I just didn't want to come to court. You're going to have a very irritated judge because you're under oath. You have to tell the truth.
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B
Do people say that?
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C
Well, yeah, because they're under oath.
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B
No. Do people say, like, I put this really high number because I didn't want to come to court?
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C
Yeah. Oh, yeah. Oh, oh, yeah. Oh, yeah. And so.
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B
So.
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C
And I know a few judges, and they're always. They always prepare emotionally and mentally before they have a therapist come in, because you never know what's going to happen. And one of the things that's come up is, yeah, you know, she was charging some crazy number, and I asked her, like, how did she get to that number? And she just said, I just, you know, I. Honestly, you, Honor, I just didn't want to come to court. And I was hoping that would keep me from having to be here. And now there's an order, nobody's paid, and the judge is like, well, I'm not going to make an order that they have to pay you this ridiculous amount because this isn't consistent with your fees. And I. And so when I've had this conversation, I look at fees, and the way that I've come up with mine is I go by my highest hourly cash rate. So if you have a day at eight hours at, let's say 100 bucks is your rate, then you're looking at 800 to $1,000. I go with 1,000 because of drive time and lunch, and you're really stacking your day. Then you might want to add in some preparation time to be able to really get ready for your case. You might add in 100, 400, but something, again, that's comparable, reasonable, and you should be able to answer in court how you spent that money, because fees are such a huge piece of court, they come up so often. And if they feel like you're taking advantage of your client because you're charging some enormous amount and the judge is saying, well, I want the answers from you, regardless of you being paid or not, it can turn into something that's really ugly and you can end up in front of the board. And so I think it's safer to either choose half day or full day. I choose full day because I really do give the whole day to focus on just that case. And then also, if you're focusing on that, the way that you're looking at your fees too, is, you know, is it comparable to what I do? I always think of like comparables, like real estate, you know, is it. You can't sell your house at the end of the corner for $5 million when next door neighbor just sold theirs for 200 bucks. It's not going to work. And they're like, your house will never sell. It's same concept. So what is comparable to what you charge? And all of us charge completely different fees. But again, what would it cost for you to miss a full day of clients? And then I also put in there to not be on call. Being on call is probably the most disruptive as I'm experiencing it right now. But it's different. Close your ears. It's so disruptive to your practice right now. The trial that I happen to be on call for right now, it has to do with a lot of different components and I am the expert witness on it. So that is quite different than when I'm the therapist role. The therapist role. You are the fact witness, you are the percipient witness. And it makes no sense to be on call. I don't ever agree to it. I say, let's agree on a date and time. And I actually put that into my court policy because I don't need a surprise. I don't want some creepy person waiting outside my door to hand me a subpoena. You, you know, I want to know what's coming, when it's coming. Because I want to show up to court. I don't want a bench warrant. I've had one of those too. We could talk about that. Show up when you have a subpoena. And that was from my agency days. Somebody gave me bad advice. But you don't just not go. It's so crazy to me to hear that, oh, I just won't go. And I'm like, someday you're going to get pulled over and find out, surprise. You have a bench for it. And maybe you're going to be in a city or county that actually cares. And then they're going to hook you. You're going to get a new set of bracelets and you're, you're going to go have a little time out, right? A little break from everything.
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B
Some people might yearn for that. I don't know.
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C
I know, right? I joke about it all the time. 72 hours away sounds amazing, but again, it's just looking forward. What could happen in five seconds, five minutes, five hours, five days. And I always, I've got the five Second rule down, because what could happen really helps me make good choices. And when we talk about fees, I think you really have to be able to answer to it. And there's so many discussions in our community about fees, fees and, you know, and people who really look down on therapists who only take, you know, who don't take insurance. And then there's others who say you should only do this or that. And I think what's really important is we all know that we're offering amazing service, and we honor that in whatever way that looks like for each of us and that we not judge each other. But at the same time, we have to be able to answer for it. So if you're charging, you know, $400 an hour, you should be amazing, you know, and if you're charging 100, you should still be amazing, but you should be able to stand in that. Right? And that's part of, I think the court policy is standing in it and saying, look, this is completely different than my normal day. And I'm really. Because we lose money from being away from our practices, so we should get paid. But again, I think you have to be able to answer to how you came up with that number because you would hate to have to answer in front of a judge. I just didn't want to be here, your honor.
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B
And one of the things that I wanted to highlight, you know, you referenced this, but as a private practitioner, is you absolutely cannot put in your documentation that you don't go to court. You can't do that.
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C
You could say you don't like it, so, sure, but you can't.
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B
And we get asked that question all the time. It's like, well, I'll just put in my documentation that I don't go to court. Right.
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C
I see it all the time. And it's funny because my court policy, I actually have two choices. First is may court, and I think the second is yea court. And so for the nay court, it says, you know, I don't write court letters. I don't really want to go to court. You know, you just kind of clarify, like, if you're looking for somebody that does that, that that's not me. And then the other option is, I love court. You know, I write court letters, whatever. But then it up with, however, regardless, should you subpoena me, this is what it's going to cost. This is what I can and can't do. This is, you know, these are the things that are going to come up. And so either way, you're just Giving them a heads up that you're either kind of on board or not with that. Because a lot of therapists really are not. And I think you need to give people the heads up. Like, that's not what we're here for. I'm here to really just work with you and treat you. And, you know, that's just not the environment that I think we should be spending our time in.
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B
And so how do you protect client confidentiality in court?
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C
So the trick about confidentiality is always going to be it's always easier when you're dealing with one client versus a minor or a couples, right? So when it's an individual, if. Here's the trick, you did not get a subpoena out of thin air. Somebody gave you up, and guess what? It was your client. Your client gave you up. So if they're not willing to sign consent, you have much bigger issues, right? Because then you have to deal with, you know, invoking privilege on their behalf. And you still have to go to court. You're just going to invoke privilege. And I've never had a judge forcefully say, oh, no, you still need to share whatever in the records. So 90% of times they're going to give you consent because they gave you up as a witness. The rest of the time, it gets stickier. We're talking about minors. What's the age of consent? You know, what state are you in? And then also couples, if it's done in a couple setting and only one person signs consent, you can't release because you have, you know, you have this dual consent issue. And so I think that's really the trick about court is where your consent forms, and anytime I get that request for court, I not only send them the court policy, I just automatically send them a consent form to release of information. And I really leave it wide open because I'm not going to be on the phone with their attorney. We're not going to be in cahoots having these conversations. I will just go to court and, you know, we'll do what we do. But I think that's really important is that we clarify what that is for everybody.
- [24:37]
B
And. And so you guys are probably wondering like, well, what about if you write letters and stuff like that? And that's what we're going to be talking about in the second part of the podcast, but before we move over to that one or next week. So you had mentioned you were talking about fees and you talk about your bench warrant. So I'm sure I don't want to leave people in suspense about the bench warrant. Or maybe we should start the next podcast off with that so they go that way. But I'm wondering, like, how do you. So you talked about laying out your fees, but how do you kind of request payment? Do you request 50% up front? Do you request the full fee?
- [25:08]
C
How do you do that? I'm the full fee seven days prior to the court hearing. Okay. And typically, I'm going to request it in a cashier's check because my fee is significant, and I don't really want to have to deal with the credit card. And they say I really can't afford that, and I have to pay my credit card or I'll do the credit card, but my preference is going to be cashier's check.
- [25:29]
B
Nice. Yeah, that's pretty badass, Nicole. I am going to actually make people wait for the bench. One conversation and the next part.
- [25:40]
C
This podcast was done from her jail cell. It's not. I'm out. I'm out. I'm good.
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B
Is there anything left that we need to know about your court policy?
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C
It's just something that I created. It's. It's available at Therapist Court Prep. It's. You can write your own. And I always tell people that, like, you can buy mine for the whopping 37 bucks and copy and paste it, make it into your own. But I do believe that everybody can write their own. They just don't want to, because, again, it's that, oh, it's scary. And so that's where I got to the point where I was like, okay, I'm just gonna make this a product that people can buy. But I really do believe it's probably not great for me in sales to say, I honestly believe all of you can write your own. I do. Absolutely do. It's just something that therapists don't like very much. And so it's there for you if you want it, or write your own. But whatever you do, Last thought is you have to have one. You cannot, cannot not have one. It sets boundaries. It's healthy. It's good for your practice, it's good for your clients. It improves the relationship, and it really just clarifies from the beginning. It shouldn't be a surprise later. We should be upfront, and it's part of our informed consent, and there's no surprises later. So I just believe in it. Regardless, write your own, buy one, whatever, but just have one, no matter what.
- [26:51]
B
You're a woman after my own heart. I love the systems and legal talk and protective talk, and it just makes.
- [26:58]
C
Life easier, you know, it does make it easier. I mean, if you get into a car accident, you want to know, you have car insurance, you know, something happens, you have malpractice. It's just something that we can put in place that nobody told us about in grad school. Nobody told us. Right? There's so much they didn't tell us. They didn't tell us how to start a practice. You know, they taught us how to go work for somebody else. You know, they didn't tell us these things. And so now we're all helping each other. And thank goodness that you have this podcast that actually gives information and helps people go, oh, this is possible. This can be done. There are more of us out there. And so this is just one of those tips of the trade that nobody gave us before, but you have it now. So just whatever you do, put a court policy in place.
- [27:37]
B
Awesome. So thank you for this part one of talking about court stuff and court documents. And we're gonna have you guys join us on the next episode where we talk about court letters, the do's and the don'ts. So join us over there. But before we go, we want to give our Startup Nation superhero shout out to Noreen Van Der Heven, who actually, Noreen was on our podcast talking. We're talking about suicidality and things like that and things that you want to put in your consent and those really important things, how to talk about suicide with their clients. So that was good. So I don't know off the top of my head what episode that was, but I will put that in the show notes as well. But Noreen says Kate and Katie are beyond amazing. I purchased their paperwork packet over the summer, and when I transitioned from group into private practice, it made my life so simple. And how funny that this Start Nation superhero shout out is on this podcast. She also says, I know, right? I knew all the forms were complete and all I had to do was enter them into my system. Their podcasts are fantastic. They are filled with so much great information. A definite must for all the clinicians. And now you're going to go purchase Nicole's core policy and add that actually to your paperwork as well, folks. So thank you, Noreen, for that. And Startup Nation, thank you so much for joining us on this episode of the Private Practice Startup, we always love inspiring you from startup to mastery. And we'll see you on the next episode as we talk about Nicole's bench warrant. So join us over there. Take care, everybody.
- [29:01]
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Thanks for joining us on the Private practice startup. Visit theprivatepracticestartup.com for awesome resources, free trainings, attorney approved private practice paperwork, and so much more.